On February 23, 2004, the DEA granted Dr. Michael Mithoefer a Schedule I license to use MDMA, the recreational drug commonly known as ecstasy, in a series of studies aimed at treating the symptoms of Post-Traumatic Stress Disorder (PTSD). Two years prior, the FDA had given Dr. Mithoefer the go-ahead, making his the first ever MDMA-assisted psychotherapy study approved by the federal government.

The potential therapeutic uses of psychedelic and other types of recreational drugs is a long-running, if mostly one-sided, debate in medical circles. Since Timothy Leary's reckless LSD experimentation in the 60s, the general public has viewed illegal drugs with a mix of wariness, skepticism and ridicule, with serious discussion of their medical properties generally limited to hazy dorm room conversations. What minimal steps have been taken to legalize certain substances (marijuana most especially) have been counteracted with an overwhelmingly restrictive legal system that has successfully stifled all but the most determined of scientific studies.

Such has long been the case with Dr. Mithoefer and his attempts at breaching the legitimacy of the therapeutic properties of MDMA. Since 1986, Dr. Mithoefer's organization, the Multidisciplinary Association for Psychedelic Studies (MAPS), has fought to bring the ecstasy debate to the forefront of the medical community. It is his belief that ecstasy, when administered at the hands of a trained therapist, can have a powerful impact on overcoming the symptoms of PTSD. Dr. Mithoefer began his study in early 2007 in the U.S. with coordinated studies in Switzerland, Israel and Spain, and the results may prove to revolutionize treatment of PTSD worldwide.

It is estimated that 8% of Americans will experience PTSD at some point in their lifetime, with about 5 million suffering from it annually. The most common causes are sexual and physical assault, childhood trauma and exposure to extreme violence or death.

The military estimates than anywhere between 6 and 20 percent of soldiers returning from the Iraq and Afghanistan battlegrounds will develop PTSD, a figure that stands to place a hefty emotional toll on our soldiers and a hefty financial toll on the taxpayer.  Harvard public policy expert Linda Bilmes estimated that the treatment of soldiers returning from Iraq for PTSD would cost $100 billion over the next 50 years.  Indeed, two of Dr. Mithoefer's 21 test subjects are Iraq war veterans.

Unlike many recreational drugs, MDMA was born in the lab, synthesized in 1912 by the Merck pharmaceutical company. It wasn't an instant hit, and it didn't gain popularity as a street drug until the mid-80s, at which point the Drug Enforcement Agency (DEA)outlawed it. Previously, beginning in the mid-70s with its experimentation among various chemists and psychotherapists and continuing up to and following its ban, the drug's euphoric properties had been suggested as a possible means of one's coming to terms with serious trauma. Dr. Mithoefer's theory is that a controlled dosage of ecstasy, in conjunction with the supervision and counsel of a professional therapist, will have a lasting positive impact on the crippling symptoms of PTSD.

As one might imagine, getting the MAPS ecstasy trials off the ground was an expensive and time-consuming process, lorded over every step of the way by organizations like the DEA and FDA that were apprehensive about the drug's potential dangers. Despite announcing his intentions to conduct the study in 1986, Dr. Mithoefer was unable to proceed with his experiments until 2004, when the DEA gave him final approval.

The MAPS study, which involves either a two or three-time administration of either ecstasy or placebo to PTSD sufferers under Mithoefer's personal supervision, will conclude June 2008. Though results of the study have yet to be published, it is evidently Mithoefer's belief that the feelings of empathy and insightfulness that accompany the ecstasy "trip" can be invaluable in enabling a PTSD sufferer to understand and take control of the emotional  damages wreaked by past trauma.

Opposition to Mithoefer's study comes from nearly every corner of the country. Many in the federal government, which spends about $13 billion annually on drug control, do not wish to see legal ecstasy, even if its use was confined to PTSD patients under a licensed therapist's control. Similarly, given its strong associations with the bacchanalia of the dance club or "raver" community, the general public is unlikely to take MDMA seriously, regardless of what the science demonstrates. And then there's the prescription drug manufacturers who stand to lose billions if MDMA, with its infrequent dosage, gains FDA approval.

A larger issue, and one that remains unresolved within the medical community, is over MDMA's health effects. Although Mithoefer and his supporters claim that use of ecstasy in a controlled environment (i.e. a therapist's office instead of Studio 54) has no long-term effects on the brain, opponents of ecstasy claim that massive brain damage and memory loss are par for experimentation with the drug.

An infamous paper published by Dr. George Ricaurte in 2002 claimed that ecstasy was a sure-fire means of ruining one's brain, but the finding was later refuted. Numerous other studies have found that ecstasy is harmful to the neurological health of primates, but have yet to unearth similar trends among humans. With no definitive study to support either side of the argument, Mithoefer's potential success could set off a storm of debate within the medical community.

But is medical ecstasy the answer? Antidepressants like Zoloft and Paxil have for years been viable, if not wholly effective, means of combating PTSD. Is there any reason to expect that MDMA, or any other kind of medication, can truly erase the horrors of war, rape or other psychological trauma?

Perhaps a victory over PTSD is one that sadly cannot be achieved. But Mithoefer and his colleagues soldier on, convinced that ecstasy might be that magic pill. When the results of their first test are published, it will be interesting to see just how effective the drug's use has proven to be and, if successful, just how reluctant the public is to accept it.