Second Discussion Session
Public Symposium on Psychedelic Drugs,
Wesleyan University, March
1967.
From LSD, Man & Society, DeBold and Leaf, editors. ©Wesleyan University, 1967.
The following discussion between the participants and audience
attending the Wesleyan University symposium is illustrative of
the mood of the times: On the one side we see authoritarians
agitating for maximal control of the psychedelic drugs with criminal
penalties for those who would contravene the regulations; on the
other the more rational voices which, as so often happens, are
little heard and less considered in times when a rush to judgment,
inspired by panic, rules the day. Of particular note are the figures showing
the radically diminishing funding and licensing provided by the government:
If rational decisions and legislation were to be effected, one would think that
greatly expanded research would have been in the general interest. A List of participants follows the discussion.
The moderator: The psychedelic drugs have often been referred
to as an instrument for conversion, with use centered on the college
campuses. Many articles about LSD seem to stress the college campuses.
Of course, Greenwich Village is essentially in the watershed of
New York University and other universities there, and the Berkeley
scene is close to the Berkeley campus. On the other hand, it has
been suggested that the spread of LSD is an autonomous phenomenon,
not related to the college community. I would like to ask the
members of the panel to speak to this. Is the LSD phenomenon in
our culture today a college-bound phenomenon or is it, in fact,
independent and autonomous?
Dr. Pahnke: I would say that Dr. Louria's figures from
this afternoon would dispute that, because he showed that it was
used by people with all kinds of occupations, not only by students.
I think that 15% were students. I'm not sure that use was ever
confined to colleges.
Dr. Louria: The Blum studies show us the same thing exactly,
but far more precisely than the few data from our hospital.
A member of the audience: I have a suggestion to make,
and I'd like to ask both Mr. Joffe and Dr. Pahnke whether it's
feasible. Everybody is agreed that more research is needed. The
problem seems to be that today and tomorrow and the next few weeks
a lot of kids and others are going to be turning on, and a small,
yet unknown proportion of these are going to be harmed. I would
like to suggest that perhaps the people from Spring Grove could
get together with the people from the government to the extent
that they have techniques worked out, to the extent that any bit
of information that could be provided to the community at large
to help people use whatever research there has been and to prevent
people from harming themselves. I think that this might be useful.
So that the proportion, whether it is one in a thousand or one
in ten thousand, goes down. And that something be done relatively
soon to try to alleviate the problem as it exists.
Mr. Joffe: Dr. Louria has already given you the answer
this afternoon. He said don't use it; it's a dangerous drug.
Same member of the audience: But people are not listening,
though it is a dangerous drug, because of the kinds of evidence
referred to today. People think that they can use it, taking the
proper precautions themselves; and these people are trying to
decide for themselves whether they can handle it.
Mr. Joffe: Do you suggest that each individual who would
like to try the drug furnish a complete medical history, including
electroencephalograms and psychiatric interview, which is the
only way I know of to be reasonably sure that the individual will
not have a bad reaction?
Same member of the audience: I think that there appears
a general principle for dealing with the LSD experience that seems
to be implied in what Dr. Pahnke said, and I am asking whether
such things couldn't be made available to the public, because
some segment of the public is going to experiment regardless of
what anyone says.
The moderator: I'm not clear on just what you're proposing.
It sounds to me as though you're proposing something that we thought
we were getting at when we set up this symposium, that is, providing
definitive information on which people can base their decisions.
This is one thing, but I think that there is inherent in what
you are saying a second suggestion, which is that there be set
up essentially some instrument for providing a mechanism of screening.
I don't know what that would be.
Same member of the audience: I am talking about procedures
for guiding people on trips. To the extent that such procedures—
and Dr. Pahnke stressed the importance of this—seem to be the
prime determinant as to whether a person has or has not a favorable
experience.
Dr. Pahnke: Let me comment. Such procedures have been worked
out at Spring Grove and are continuing to be. They will be published
in the scientific literature, but that will take time, at least
a couple of years. If what you want actually happened, if you
did have the information now, and it was disseminated, I don't
think it would help too much because other researchers couldn't,
perhaps, get the permission to use the drug anyway. You want it
for the lay people. In a handbook?
Same member of the audience: For the people whom Dr. Louria
is worried about.
Dr. Pahnke: But you see, they wouldn't be using it under
medical guidance, which is the essential point.
Dr. Louria: I think we're in a real dilemma. You see, the
whole thing is that there are several levels involved. On the
one hand, there's the research problem, and during the evening
I was just figuring out from the Congressional hearings what the
research situation is. And here is what it is, if my figures are
at all accurate. In 1964 there were about seventy licensed investigators;
in 1965, thirty-nine; in 1966, thirty-one; and currently, only
sixteen. As to N.I.M.H. funds, there was available in 1964 1.5
million dollars; in 1965, 1.49 million dollars; in 1966, 927,000
dollars, a decrease of over one-third in one year; and currently
there is still less available. It is abundantly clear that research
has been markedly reduced; and you can prove this fact with the
government's own figures. Now, that's one level, research that
we desperately want to increase. And I don't think that there
is any excuse for the N.I.M.H. not to increase it.
Then, there's the second level, which is the kind of research
that you are doing, Dr. Kurland, absolutely well controlled and
under medical aegis. We all want that increased. That has to be
increased. That's very important research. And there's the third
level, research in a broader context, in a community that may
be in your semi-utopian future under some control. And there's
the fourth level, the level that you're talking about, namely,
having people take the drug, young people, unprepared, on their
own. That level is the one that bothers me. I am not bothered
by the other three levels. There is no way of disseminating information
now to that fourth group and to prevent their having adverse reactions.
That group, young, unprepared, under uncontrolled conditions,
that group is the one that we are desperately trying to educate
not to take the drug in any circumstances, because it is not one
in a thousand or one in ten thousand. At the very minimum it is
several per cent. Now, the derivative problem is that of that
several per cent who do get into trouble, certain ones are going
to do very dramatic things. They are going to jump out windows
or walk in front of cars, enough to get front-page headlines.
In New York City 1 % of heroin addicts die every year of an overdose.
This fact almost never gets headlines, because it isn't very dramatic.
They shoot the stuff into their veins, and they drop dead. They
are taken to the coroner's office. We whisk them off to the grave,
and nobody cares. But let somebody jump out a window under LSD,
the way the newspapers are now, and that's front-page across the
country.
In doing that, what you do is to arouse not the people who are
interested in LSD, a very small segment of the population, but
what Leary has called the middle-class, middle-aged monolith that
runs our country. I'm not derogating that, for I'm rather for
their running the country. This relatively stable group then transmits
its fears and angers and anxieties to legislatures, which are
dependent on this middle-aged monolith for their maintenance in
office, and you know what happens. So the only way by which you
can avoid more restrictive laws, which make the whole situation
worse, is by getting the fourth group off its LSD kick. I think
that we have to have some laws, both federal and state, to help
us in that endeavor; because if you don't, then you will destroy
the other three levels— from animal research to human research
to community research, all of which could be of enormous value
to all of us in the future.
The moderator: Are there any questions from the floor?
A member of the audience: It seems to me that a lot of
people have forgotten the fact that the reason people are dropping
out is because their society wants them to drop out. Dr. Pahnke,
what do you think that the possibilities are that at some time
in the future, people won't drop out, but will work to change
the aspects of society that tend to drive them out?
Dr. Pahnke: I think that would be fine. I am a little concerned
as to what happens to these people who do drop out. Who is really
helping them? I know what happens to some of the people who drop
out, because we get them as patients in our out-patient clinic.
These are people who before they took LSD had, perhaps, some problems
and were told that they needed psychotherapy, but they would have
none of it. They felt that they were quite healthy and that their
advisers were just talking through their hats. They took LSD,
got very shaken up and perhaps dropped out of school. But then
they come to the clinic seeking therapy, and, paradoxically enough,
these people are then quite eager to work in therapy. This is
a danger that has a paradoxical, perhaps good, effect, but I certainly
would not recommend it as a way of getting into therapy.
A member of the audience: There was an earlier question
concerning black-market impurities and the dangers of them. Would
Mr. Joffe discuss this?
Mr. Joffe: I'm afraid I can't tell you what the impurities
might be. There is some black-market material that is of exceedingly
good quality. I don't mean to say that everything that is not
legitimate is of poor quality. We do know, however, that a simple
analysis of a cube will show perhaps 30% of LSD; it will also
show on an ultraviolet spectrum many peaks that you know are not
LSD and do not occur in the pure product. Therefore they are impurities
of one sort or another. It has not seemed too important to our
activities to find out what is wrong with this product or that
product, because they are all illegal. I don't see what good it
will do us to run the analyses of the home-made products so that
someone will know that there is bad in his product.
Dr. Pahnke: Unless he were getting heroin or something
else. That should be publicized, I think. It might deter some
people from taking it. I've heard of that happening. Amphetamines,
barbiturates and heroin do get mixed in with LSD. I think this
could have very bad effects in terms of persons' becoming addicted.
Mr. Joffe: These are recognizable peaks on an ultraviolet
absorption spectrum.
Dr. Pahnke: Yes, but if you're not making an analysis,
how would you know that?
Mr. Joffe: You run the curve, and you see that here is
the peak that we know is LSD...
Dr. Pahnke: Yes, that's fine, if you're doing them, but
you said that you're not doing them.
Mr. Joffe: No, I said we're not running the peak down to
find out what the impurity is.
Dr. Pahnke: Well, say the impurity was heroin? Somebody
had added...
Mr. Joffe: Heroin has a recognizable peak.
Dr. Pahnke: One that is easily recognized?
Mr. Joffe: Yes.
Dr. Pahnke: Do you find that?
Mr. Joffe: I don't know. I have not myself heard of it.
The moderator: I'm afraid that some of you couldn't hear
the discussion that went on at the table. Let me try to paraphrase
it quickly for you. Dr. Pahnke asked the question if it wasn't
a social responsibility of the F.D.A. to check out the actual
nature of impurities to forestall possibly the use of drugs such
as heroin as additives to sugar cubes and therefore make this
public knowledge in order to warn people who might use them.
A member of the audience: I am not satisfied with a previous
answer. LSD appeals to young people, and what's to prevent their
using it? You agree that something should be done to stop free
usage by young people. You refuse to recognize any valid reason
for using LSD regardless of whether the user be a young student
or a middle-aged person. I think there is a responsibility among
all groups, doctors, psychiatrists and legal people, to recognize
that there is going to be a lot of illegal LSD usage. In light
of the circumstances, what can be done to keep the number of bad
trips down? This is a problem. The refusal to offer any kind of
guidance to users is bad.
The moderator: As I understand the question, it says, as
a banner did over the Sather Gate at the University of California
recently, "Never trust anybody over thirty." We are
being accused, I guess, of evading the issue that has been brought
before us, which is that there is a large population of people
who fall into category four, as defined earlier by Dr. Louria,
those who use LSD on their own in situations in which there is
no guidance. The panel is asked to comment on possible ways of
minimizing bad trips, psychotic episodes and hospital admissions
for this category.
Mr. Chayet: I think that this is one of the basic defenses
for the existing laws. As I understand these gentlemen who are
certainly the professionals in dealing with LSD, there is no way
to give out information on a mass scale to tell you how to take
LSD on your own. Even Mr. Leary has suggested that there be licensing
of individuals. He wants, of course, to reduce the criteria for
getting a license to work with LSD; and he certainly doesn't believe
in the medical profession's having exclusive control. But even
Mr. Leary says that there should be some control and some guidance;
and as I understand it, there is just no way of preparing a brochure
so that you can do it yourself and be successful at it, though
I would be interested to hear if this is a possibility.
Mr. Joffe: I think that the question ultimately boils down
to the fact that the gentleman says that there will be the use
of this drug whether we authorize it or not. There will also be
bank robberies, murders and other crimes whether we have laws
or not. What you are asking us to do is to show you the best way
to evade the law. You want the government to furnish the safecracker
with tools to make his job easier. We can't do this. It is not
a province of a regulatory agency to show people how to evade
the law. Aside from the fact that there is no cookbook sort of
thing for this.
Dr. Pahnke: Well, actually, there are some manuals.
Mr. Joffe: But not for the ordinary individual.
Dr. Pahnke: Well, yes.
Mr. Joffe: One off the street?
Dr. Pahnke: Yes. Actually, this is what Leary proposed
when he founded IF-IF. He was going to write a number of manuals.
He wrote two, and The Psychedelic Experience has nearly a chapter
describing how to run a session. The trouble is that you cannot
learn this from a book. What you need is specialized training,
in which you work under someone or watch someone run sessions,
as it is possible at Spring Grove, where there is a closed-circuit
television system. But this is not yet set up to train a lot of
people, though it might be possible sometime in the future. This
is what I suggested, having training centers, but we're a long
way from that. So for the present time I can't offer you any advice.
These manuals may be somewhat helpful, but I certainly don't think
that that's the way to learn how to use LSD.
Same member of the audience: My question asked for the
recognition that there is going to be a lot of usage by the layman.
Instead of saying merely that this is something to be outlawed,
leaving it at that and limiting research to laboratory settings,
you are asked to shift from your concern with developing a definite
set of rules and direct your attention toward existing problems.
Perhaps there's something that should be outlawed. But users of
LSD have a right to be considered themselves.
The moderator: I will say that I believe many people in
our culture, in our nation and in the western nations whom I know
and have talked to are very concerned about this. As I understand
the question, we are being asked to increase at least the amount
of attention that we are paying to that group, group four, people
who are taking LSD on their own, and to share our attention with
them, the same attention that animal research receives. I think
that's what you are asking us to do.
Dr. Pahnke: I would just like to say in addition that it
takes three to six months to train adequately an LSD therapist,
to have him learn how to deal with all possible contingencies,
so that he can really guide people with safety. It's no thing
that you can learn easily just from a few rules. Some people have
gone ahead on their own and had experiences, and there have been
a lot of bad experiences. These people of the lay public have
learned by experience, and some have had some very bad trips.
But I don't think that's the ideal way to do it. And you're right,
it is a problem. Some people feel that we just suppress the problem
by passing a law against it and assuming that this law will take
care of it. I don't feel that it will, and I think that it will
take time to work this out. If LSD does continue to spread, and
more and more people do continue to take it, there will eventually
be pressure to change the laws or to make some provision for this,
but that also will take time. I know that this solution probably
won't satisfy you. You want something right now. The reality is
that it probably is not practical.
A member of the audience: Well, I see some sense of understanding
among certain members of the panel who have spoken today, and
I wonder whether the more legalistically oriented members of the
panel are sitting with points of view that might be expressed
by the statement "Well, we'll let the sympathetic people
speak, but we've got the say, because we make the laws, we enforce
them, we regulate them." Or whether, in fact, there is a
sense of cooperation and understanding among the people who are
gathered here to speak to us on the issue?
The moderator: But that precisely is the reason why we're
doing it.
Same member of the audience: Yes, I know. I understand.
My question, though, is whether in the process there are formulations
going on?
Mr. Joffe: I am working for the Bureau of Drug Abuse Control,
which you may call legalistically oriented, if you wish, but I
am not a lawyer. I am not an enforcement agent. I am a pharmacologist.
The reason that I am working for this agency is because it offers
me a chance to get some scientific work done, and I am interested
in the scientific aspects of this problem. But that the support
happens to be in a bureau that has as well the responsibility
for enforcement does not deter me. I am not going to try to change
the rules of enforcement. This is something else. But I have joined
them, because they give me an opportunity to do the scientific
work that I want to see done. This is my personal approach to
it. I can't speak for anyone else. We have the authority not only
to do in-house research but also to have contract research done.
When I say support for research, I don't mean that someone has
to build me a ten-million-dollar laboratory. I have the authority
to solicit or to receive unsolicited proposals from those individuals
who would like to do work on drug abuse of a scientific nature
that I am capable of supporting.
The moderator: I think that we have slipped away from the
question, and rather than see this thread followed, I'd like the
question to get the attention that I think it really deserves.
I wasn't kidding when I said that one of the shocking signs of
my life was the sign over the Sather Gate, which appeared in all
the papers, saying "Never trust anybody over thirty."
You know, that really gets at me. I don't know why. I need a lot
of love, I guess, and I want people who are under thirty to believe
somehow that even if I am not a part of their culture and don't
understand them, I do want to understand them, and I think that
this feeling is shared by many people who are my age and older.
We are trying very hard to understand, and in addition to trying
to understand we are trying to act in good faith. Now, in your
question, as you phrased it, there was an implication that I hear
very frequently—"Yes, you pay lip service to understanding,
but actually you want to pass regulations and hold us down. You're
afraid of us. We are coming up. We're new and we're different,
and we threaten you." In a sense, that's true. It is the
business of the young to displace the old. That's the story of
life, but I would defend the people here today, all of us, the
people who have been most militant in their expressions and those
who seem most permissive, from the charge of insincerity. I don't
think that these people are, and I certainly know that I am not,
insincere.
Mr. Chayet: I would like to comment. I am under thirty,
so I don't know where that really puts me. I'm also probably not
a very good representative of the law-enforcement profession,
because I don't like these laws. I think, however, that they are
an absolute necessity. For example, the law regarding marijuana.
I have grave doubt that anybody who is carrying around marijuana seed ought
to get thirty years in prison. That bothers me very much, because
it doesn't seem to me that the danger is there. I've heard from
so many that alcohol is much more dangerous than marijuana, but
this may be subject to rebuttal by those who know more about marijuana.
It seems to me that when you talk about psilocybin and LSD, the
danger is very great, and therefore we do need laws to protect
people from themselves. I think that if the danger weren't there,
that the laws would be bad and unnecessary. It's the danger that
really necessitates the legislation. As soon as we have some control
and some training centers, or anything else, I would be the first
to want to see the laws go.
Dr. Louria: Well, I think that you really said what I was
going to say, Mr. Chayet. I'm not sympathetic with the questioner's
point of view. I think that we have shown you beyond peradventure
that this drug, taken under those conditions that you want to
take it under, is a dangerous drug. There's no question about
that. You can't show me evidence that taken under your circumstances
this gives you anything other than a kick. You can't show me that
it gives you any lasting benefit, though it may. But that will
come from the kind of research that Dr. Kurland is doing and Dr.
Pahnke is doing and others will do if we can get more research
on a broader level. Not from your going out with a do-it-yourself
kit and taking LSD. Our medical view is simple. If you take it
under those circumstances, you can't show anybody that it does
you any good; and a certain percentage of you are going to end
up in hospitals with acute or chronic psychoses; and some of you,
infrequently, but some of you, are going to end up dead. We know
that now. So what we're telling you is very simple. We do not
under any conditions condone the concept or understand the concept
or agree with any part of the concept that you ought to be able
to take drugs like LSD—not marijuana—under these conditions
and have us give to you a pamphlet that tells you how to do it
better. As far as I'm concerned, if you're going to do it, knowing
what the dangers are, you damn well take the risk; and if you
get into trouble, what we will do in the medical profession is
to publicize the adverse effects that you have in the hope that
other people won't get into that trouble until the time when we
do have the knowledge that it can be given to people, such as
you, on an outpatient basis, relatively safely.
Mr. Barron: Well, I don't think that Dr. Louria's response
answers the question, the intent of the question, as it was put.
Also, I wish that Dr. Louria would speak for himself and not say
"we." It seems you said, "We have shown you beyond
a peradventure of a doubt." There has been a lack of imaginative
or constructive attempts to find other means, other solutions,
new institutions to meet what has been an expressed need on the
part of a lot of people. I don't think that what one should do
is to give advice on how to break the law. I think it's just what
has to be built up as a body of opinion, reflecting pressure to
create forms that will meet new social needs. It is not a matter
just of restrictive laws.
Dr. Pahnke: At the end, Dr. Louria, you said if there was
enough evidence accumulated showing that it was safe to give LSD
on an out-patient basis, you would be for it. Now, what would
that evidence consist of for you? How much evidence would you
need? I think that there is some evidence already, but how much
more do you need?
Dr. Louria: Under whose aegis?
Dr. Pahnke: I think that what they are doing at Spring
Grove has shown that very sick patients can be given LSD without
serious consequences, so far anyway, with almost two hundred patients.
Dr. Kurland: I think that the safety question is in everybody's
mind, and the safety record established in research at Spring
Grove didn't happen by chance. There were years of pilot work
done by experts, by professionals in these drug studies; and before
we initiated these control studies, there were pilot studies that
went on a year or longer. The thing that I oppose is to let unsophisticated
people, who don't have the longitudinal experience, who don't
have all the things that one needs from the standpoint of physiological
and behavioral background, to plunge into these areas and carry
on research. The point is that without the necessary tools you
can't even document what you are doing. You can't put this down
in some kind of systematic way so that it can be replicated. The
way that our studies started, the history of prior research in
our area had to be studied in order to work out a plan. We didn't
just plunge into this. We gathered the reports that came from
the different investigators, and we formulated the usefulness
of treatment of alcoholics. These were very full reports. We started
out by attempting to replicate these things, and this is our point
for beginning to learn. For people who say that they can get something
accomplished in uncontrolled studies, who think that they are
going to get a lot of new information and insight, I would just
bring back to your attention the fact that we first had to learn
something about what goes on in group psychotherapy, where there
aren't many complicating conditions. So, with all due respect
to the younger people, it is very, very important to learn the
rules before you get involved; certainly they would refuse to
allow anybody to get into the field of radioactivity without having
a license indicating technical competency.
Mr. Barron: Let me make it quite clear that I am not, by
any means, advocating usage of any of these substances that are
illegal. What I was saying is that I think that the intent or
motive of the question was misinterpreted and that what is essentially
threatening is some kind of feeling that the present laws and
present social institutions are not adequate to a deeply felt
need on the part of some people. It's this, I think, that should
be taken seriously, as a feeling, and that if we use all of it,
we will work as best we can and create whatever kinds of institutions
are necessary, if indeed it's true that this is no passing fad
and represents something that is important to the general movement
of mind over the past fifty years.
The moderator: Let me say that it was my feeling that in
your paper, Mr. Barron, you tried to provide an historical analysis
for this anomie toward which the question was directed. I felt
that that was a matter of record today, and I was including you
among those of us who feel sincerely concerned about these problems.
A member of the audience: Well, I hope that the idea that
you don't trust anybody under thirty doesn't emerge.
The moderator: Let me just make that comment over the speaker,
for the people in the back, an important point, sometimes overlooked
in this controversy. One of the audience expressed the hope that
as the reaction to "You can't trust anyone over thirty,"
there wouldn't develop a backlash movement that would be expressed
"You can't trust anybody under thirty."
Same member of the audience: I was prompted to say that
when you said that you can't prove to us that you're not taking
it just for kicks. This discussion is supposed to be about LSD
in society, and the legal justification for regulating the drugs
seems to be based on a pleasure-to-risk ratio, which was unfortunately
demonstrated today, what you call a high risk. But nobody has
talked about the other thing that you should substitute for pleasure—although
pleasure may be applicable in a majority of the cases—the utility-to-risk
ratio. Nobody has investigated the fantastic possibilities that
LSD brings out, so that the utility could be very, very high,
which would balance off, to some extent, the risks. And there's
one other orientation in this symposium that bothers me, which
I think bothered the writer of the recent letter in our college
paper, which is the very scientific cast of the symposium speakers.
And I would be the last one to go against science, because it's
proved to be very, very successful; but it is strange that there
are no artists involved in this, no philosophers, no theologians.
The moderator: Dr. Pahnke does have a degree in religion,
I am informed.
Same member of the audience: All right, but at least, say,
somebody artistic, who would use this in support of his art. This
hasn't really been brought out. Mr. Barron said that the response
to this explosion of knowledge and ideas prompts the response
—and McLuhan might be relevant here—to try other types of
integrating knowledge and intellect in these things. I think LSD
might be useful in exploring these areas. This has not been brought
out, though it goes right to the thing of the tremendous utility
of LSD. So I was wondering if the government and Dr. Louria had
considered the possible utility that might balance off some of
the risk? Maybe this isn't a very practical question either, as
we know that there are a lot of artists who are racked by opium
and other drugs who do produce very profound and good poetry.
You know, it's hard to tell whether it is worth it or not. But
there are laws restricting the use of LSD, and we could be losing
a lot. I don't think that this problem has been addressed.
The moderator: The member of the audience has asked if
we have paid enough attention to the possibility that LSD has
a high utility, which, if legislated against, would be lost to
the culture.
Mr. Chayet: On the question of utility and risk, I think
that this is a very realistic suggestion, and I would like to
say that the law of the country is based very much on utility
and risk. What the Supreme Court of the United States says in
its earth-shaking decisions, which are often five to four—five
jurists thinking one way and four equally learned jurists thinking
the other way—is based on a careful balancing of what they think
is useful and what they think is the social necessity. The example
was brought up today of the automobile—there's a terrific amount
of carnage, but we allow it; we don't outlaw it, because of its
utility. Now everybody who drives an automobile gets somewhere,
and if you could show me that everybody who takes LSD gets somewhere
that is useful in a constructive sense, then I would say let's
get rid of the laws. Let's allow it. But if you have one person
who takes it and really gets somewhere and many hundreds who get
nowhere and who go out windows, then I say there's a real question.
While I think that your suggestion is a good one, I just don't
think that we have reached the point where there is the utility-to-risk
ratio that would allow change in legislation.
Member of the audience: You were all here when Dr. Kurland
read his case studies, and you also heard Dr. Pahnke's case studies.
It seems to me that one thing that all these people had in common—and
they admitted it—was that they were all dead before they took
the drug, dead in some sense. These drugs were given to somebody—that
twenty-three-year-old girl with the illegitimate child, the Negro
who was a drinker—and gave them something very real. And this,
this introducing of pleasure, just because they and you are supposed
to wait for the other— what I really want to say is that it
would be a tragedy to wait until seventy years of age, wait fifty
years, until science comes up with some kind of result, then take
the drugs and find out, by God, I've been missing it all along.
The moderator: As I understand the member of the audience,
he has suggested that the protocols presented from the patients
indicated a gain in personal phenomenological experience, and
the member of the audience felt that if one waited until he was
a seventy-year-old person without having had those experiences,
it would be a great loss. I shall ask Dr. Kurland to speak to
this, if he will.
Dr. Kurland: The issue here is one of—one of the issues,
anyway, is, in plain English, impatience. Nobody will realize
the impatience and frustrations of the researchers who are actively
involved in something like this, who see all the possibilities,
yet are aware that society demands that they be responsible to
the public trust. Many times we have the very, very frustrating
business of going into our proposals and looking for advance research,
and then having our peers turn the proposals down, because they
say that there is something missing in the specifications, that
is, the plans are not well done. So we go back to the drawing
board again and again. We don't get everything we ask for. One
of the things that we have learned is that our peers sitting in
the committees that make judgments have not been wrong most of
the time. Most of the time we've been wrong if they haven't approved
of something. We have gone back and redesigned our plans so that
they can meet the objections, and we have been able to go ahead.
For example, when you are dealing with human life and have the
responsibility of working in an unknown area, you have to take
every precaution to make sure that you are doing everything to
make things work out properly. We feel that it is the most important
rule in these areas to document what we are doing, so that the
way will be clear for the next men to follow through. If our research
can't be replicated in Russia or in Australia or in South America,
it means that we have not done the job right. We see things in
our work that we would like to measure. What we realize is that
it may take six months or a year to set up a program so it can
be done with safety and consideration for all the elements involved.
You can't rush good research. Good research takes a long time,
and that is why there are few places that we are able to get the
kind of balance needed. For example, with alcoholics, we started
in 1960, really 1958, and began following these people. So, we
had opportunities of comparing and maintaining balance. But in
a behavioral science, when one works with men, when one deals
with such complex issues, when one is taking psychotherapy and
adding research to it—and you heard how complex this job is—to
try to accomplish something, it is frustrating that some feel
that they can rush in and get the answers. Maybe we'll have perfected
techniques in ten, twenty, thirty years from now. We have computers
today, which we didn't have several years ago, and some of our
present experiments are not even possible without computers.
Dr. Pahnke: I detect in both the last two questions a feeling
that the panel here has not really taken seriously the possibilities
of the drugs, positive possibilities for enriching lives. Such
was not the intent of my remarks. I take these possibilities very
seriously. I think that there is promise in the experiments, but
I do not think that we know enough yet to make statements. We
need more research in these very areas, research to determine
the utility, but such research and planning for it will take time.
Member of the audience: Generally, I think, everyone here
would really have to agree with Dr. Louria's position that scientists
are trying to help in understanding these problems as well as
in control and prevention of abuse. But let me suggest two other
complications; and maybe Dr. Louria or someone on the panel will
comment on these. One is that people are obviously continuing
to use LSD, the so-called lay people, some of whom do know how
to use this drug and have knowledge of therapy. It seems to be
a fact. Why do people do this as often as they do? I think that
there must be some utility here, and it just can't be dismissed
out of hand if enough people are taking it. Too, I think that
Dr. Louria's position on the measures that need to be taken to
control this drug in the colleges could produce a number of problems
that might, in themselves, prove worse than the problem of cure.
Fortunately, there are times when the government gets itself into
a position of not being able to take a really utilitarian stand
and say that the law should stop this problem. We all know that
this law will create an environment in which these other probabilities
exist. And so we should not permit this law to stand, in order
to avoid creating this evil environment. The evidence of heroin
abuse suggests that there was a bad environment, which might serve
as an example, a situation where there is a black market, and
people in the underworld make a fortune on it by smuggling heroin
and starting people off on a terrible habit. So that has to be
considered. I mean, if you look at this and you look at the answers
that a lot of people are giving to these questions, you realize
that youth is a bit distrustful. I don't think that there is a
really considered opinion that exists in, let's say, the visional
people nowadays, which allows the use of LSD some respectability,
or in their criticism of existing statutes about the use of LSD.
The moderator: I think that your comments could be summed
up as a plea for more open-mindedness in enacting legislation
and in implementing programs. I'm not a member of the medical
profession, but I think I can say a word or two that will perhaps
help you in understanding the feeling of the medical profession
about things like this.
There was once a motion picture in which a man fought against
a dictator in one of the Latin American countries. He fought,
and he fought, and he did everything that he could to reject the
concept of help from the establishment, so to speak. Then, accidentally,
he became the dictator himself and immediately found himself in
political trouble. In what was probably the best punch-line in
the movie, he turns to the cabinet of men whom he has been rejecting
and says "Help me! Help me!"
I think that that is the feeling that the medical profession has,
for in its clinical work they regularly see people who are appealing
to them, and they constantly have a feeling of helplessness in
the face of certain of these problems. Therefore, their focus
tends toward avoidance of these terribly painful situations in
which they have to deal somehow with situations that they don't
understand, nor know what to do about. And I think that you see
strength of expression and a focusing on the negative side.
Dr. Kurland: Actually, there are several issues involved
here. One is that it isn't too difficult to do research in this
area if you submit a protocol. It's first a question of submitting
an experimental design that will be accepted; and the other issue
is that of financing. Many studies are accepted, but there just
aren't funds available to carry them out. For example, we had
the experience of this dying-patient study, which had earlier
been submitted on two occasions, and it had been rejected on two
occasions. If you have studies that you want to pursue, I'm pretty
sure that if they meet the judgment of your scientific peers,
they will be approved. Whether it will be funded is another matter,
because there are priorities in these matters. One must be aware
that there are only certain amounts of money available to go into
programs. We have heard that the funds for LSD research have been
decreasing for various reasons, which may not be relevant to the
research program itself, but to other factors that have no relationship
to these programs. If you're really interested in something and
go to the extent of submitting it to a scientific body for approval,
and if they reject it, there are most probably deficiencies in
that design that should be corrected. This has been our experience.
Not everything that we submit is approved. Some are rejected,
and we go back to try to work them out. And things that are called
to our attention are rejected. Sometimes we realize that we were
biased in a certain way and that this was a good decision. In
the LSD area, despite all the restrictions, you still can do research
if you are willing to undertake the effort to have your plan approved.
As you heard, the members of the panel are attempting now to work
this thing out. There's a very complex administrative procedure
because of the unique situation with this compound. When several
agencies are involved, it becomes a very complicated manoeuver.
Most of the time the rejected designs were rejected because there
was a lack of some kind in them.
Contributors to the 1967 Symposium
FRANK BARRON (B.A. LaSalle College, Ph.D. University of California)
is a research psychologist of the Institute of Personality Assessment
and Research of the University of California in Berkeley. A recognized
authority on the psychological aspects of human creativity, Mr.
Barron is the author of Creativity and Psychological Health (1963),
among other books, and has contributed numerous articles to professional
journals. He has lectured at several American colleges and universities
and has recently been awarded a Guggenheim Fellowship for cross-cultural
research in Italy.
NEIL L. CHAYET (B.A. Tufts University, LL.B. Harvard University)
is an assistant professor of legal medicine at the Law Medicine
Institute of Boston University as well as a practicing lawyer.
He is the author of a number of books and professional articles
on problems of medical jurisprudence and is currently a member
of the drafting committee for recodification of the Massachusetts
laws of mental health.
RICHARD C. DEBOLD (B.A. University of California, M.S. Yale University,
Ph.D. University of California) is Dean of Students and an associate
professor of psychology at Hobart College and a recognized expert
on the physiological basis of learned behavior. Mr. DeBold is
currently preparing both a manual of experiments and a college
textbook of psychology.
MURRAY E. JARVIK (B.S. City College of New York, M.A. University
of California at Los Angeles, M.D., Ph.D. University of California)
is an associate professor of pharmacology at the Albert Einstein
College of Medicine and the president of the Division of Psychopharmacology
of the American Psychological Association. Dr. Jarvik has studied
the effects of LSD on behavior intensively and is recognized as
one of the most knowledgeable researchers in this area. He has
written over seventy articles about his work for professional
journals and is himself the managing editor of Psychopharmacologia.
MILTON H. JOFFE (A.B., M.S. University of Rochester, Ph.D. Ohio
State University) has been associated for over twenty years with
various research projects of the federal government, such as the
Wright Field Aeromedical Laboratory and the Hanford AtomicEnergy
Installation. Mr. Joffe is now a member of the Division of Drug
Studies and Statistics of the Bureau of Drug Abuse Control of
the Food and Drug Administration.
ALBERT A. KURLAND (B.S., M.D. University of Maryland) has been
the Director of Research of the Maryland State Department of Mental
Hygiene since 1960, in which capacity he directs the largest currently
operating investigation of the therapeutic potential of LSD at
the Spring Grove State Hospital in Baltimore. Dr. Kurland and
his associates have published over one hundred articles on psychiatry
and psychopharmacology.
RUSSELL C. LEAF (A.B. University of Chicago, Sc.M. Brown University,
Ph.D. University of Pennsylvania) is an assistant professor of
psychology and biology at Wesleyan University and an active researcher
in psychopharmacology. Mr. Leaf was from 1963 until 1966 the senior
research psychopharmacologist of the Squibb Institute for Medical
Research.
DONALD B. LOURIA (B.S., M.D. Harvard University) is an associate
professor of medicine at the Cornell Medical College and the head
of the Infectious Disease Laboratory of Bellevue Hospital in New
York City. Dr. Louria has been very active in work on the social
problems of narcotics as the chairman both of the Subcommittee
on Narcotics and of the Public Health Committee of the New York
County Medical Society and as president and member of the New
York State Council on Drug Addiction. In 1966 he was MacArthur
Lecturer at the University of Edinburgh and is currently the Lowell
Lecturer at Harvard University.
WALTER N. PAHNKE (A.B. Carleton College, M.D., S.T.B., Ph.D. Harvard
University) is a teaching fellow of the Harvard Medical School
and a resident in psychiatry of the Massachusetts Mental Health
Center in Boston. Dr. Pahnke is currently on leave to carry out
research on the therapeutic use of LSD with alcoholics, neurotics
and terminal-cancer patients at the Spring Grove State Hospital
in Baltimore. He has done extensive psychopharmacological research
on LSD and similar psychotropic drugs both here and at the University
of Gottingen. He is probably best known for his carefully controlled
experiments concerning the effects of these drugs on mystical
and religious experiences.