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“Net-zero trauma by 2070”: 5 Questions for MAPS founder Rick Doblin
Doblin discusses his vision for a world with "net-zero trauma."
When Rick Doblin founded the Multidisciplinary Association for Psychedelic Studies, or MAPS, in 1986, the psychedelics world looked quite different. The U.S. Drug Enforcement Administration had just added MDMA to its list of Schedule I drugs, making the substance illegal. Doblin’s mission was to create an organization that would pioneer studies demonstrating the therapeutic uses of MDMA. Over the last thirty-odd years, MAPS has sponsored clinical trials investigating the use of MDMA to treat post-traumatic stress disorder, and supported trials with ketamine, psilocybin, marijuana, and LSD. The organization began as a non-profit, but in 2014, it spun out a public benefit corporation (MAPS PBC) to focus on commercializing psychedelics. Over the last year, MAPS, and Doblin, have announced that they expect the U.S. Food and Drug Administration to approve MDMA for therapeutic use in 2024.
In January, Doblin went on the podcast The Joe Rogan Experience to discuss MAPS’ clinical trial results and public benefit corporation’s plans. During that appearance, Doblin said that he believed that “fully globalized access to MDMA-assisted therapy can lead to a world of net-zero trauma by 2070.” The idea of “net-zero” trauma came up again in June at MAPS’s Psychedelic Science conference; in Doblin’s keynote speech opening the conference, he presented the idea again, saying that the FDA’s approval of MDMA would lay the groundwork for “net-zero trauma” by 2070, a claim The Associated Press called “grandiose.” The Microdose spoke with Doblin about the idea and what he means by it.
Where did this idea of “net-zero trauma” come from?
It came from this idea that we needed a new, bigger vision now that we are getting closer to making MDMA into a medicine. I’ve been working on this since 1972; I thought we needed a more challenging vision for the next 50 years. The term came from conversations with Kris Lotlikar, our executive director. He worked for a renewable energy company, and mentioned the idea of net zero carbon. That struck me as a really good way to phrase things.
We see that humans are really good at procrastinating; look at what's happening now with extreme weather. There are now no longer any credible voices that are holding onto the idea that there is no such thing as global warming. But we've delayed action; it was clear back in the 1970s that we needed to move to renewables. So what is it that keeps people from doing the things that they need to be doing? A lot of it is trauma. We’re motivated more by fear, anxiety. By one estimate, there could be over a billion climate refugees by 2050. That suggests that the stresses on humans as a collective are going to increase as the weather changes, as we see more droughts, as it impacts farming. So the idea of net zero trauma is: How do we make it so that people can process the fear, the anxiety, the trauma of seeing what's happening to the world? How do we make it so people are able to make more rational decisions about the challenges?
So you know the story of Passover where the Jews leave the pyramids? One of the questions that people ask is, why did it take 40 years for the Israelites to wander in the desert before they entered the promised land? The rabbis say that the reason is that they needed to have the generation that was born into slavery die out, and then they could start the new promised land with the generation born into freedom. It's going to be multiple generations, I think, before we can reach a place where there's enough openness to psychedelic clinics, where there's tens of thousands of therapists, where we've figured out group therapy. The goal I'd like to achieve is not something that can be achieved in one generation.
We also have all of this about the epigenetics of trauma — trauma is passed from one generation to the next. Right now, it looks like when you help heal somebody from PTSD, that the epigenetic markers can disappear. Not all of that is perfectly clear yet, but it felt to me like this vision was going to require multiple generations.
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To even begin to engage with the idea of “net-zero trauma” one would need metrics measuring trauma at a global scale. How would you go about measuring or operationalizing something like trauma?
This will be really, really critical; we need a way to measure our progress. What is the way? Otherwise it's just an airy statement. There's just so much of this that is not really fully quantified: How many people have had sexual trauma? Domestic violence? These are only going to be rough estimates. Some countries will have more data than other countries; some countries might have more trauma. It's going to be kind of an imprecise measure, but we will do our best to try to not only develop the metric, but then get the data on a country by country basis. We'd want to work with the W.H.O. or perhaps the U.N.
We've looked at other measures like gross national happiness and gross national product, and we've actually done some outreach for bids from different groups that can develop a metric for gross national trauma. It's really going to be a several million dollar project just to create the metric, and it'll take a couple of years to do that. Then trying to get the data for each individual country will be another big project.
If the FDA approves MDMA to treat PTSD, MAPS PBC will have data exclusivity for at least five years, meaning MAPS will have a monopoly on the sale of MDMA for PTSD. It sounds like part of the vision for “net-zero trauma” is widespread access to the drug, including in marginalized communities and countries. In your mind, are exclusivity and equitable access compatible?
There will be a period where MAPS PBC has a monopoly and there will be income opportunities. What we've learned in our phase two clinical trial, and what we reported in our first phase three study, was that the results were durable. But it's labor intensive at the very beginning; it's a lot of therapy, so it's more expensive than just giving somebody a prescription for drugs. That, in combination with data exclusivity, suggests that there is this opportunity to have a profitable business that takes money mostly from insurance companies, and leaves people just paying the co-pays. The hope is that wherever we set the price, it’s not going to significantly reduce demand.
At the same time — and this is the big challenge — we're stuck in America where many don't have insurance or are underinsured. We'll make resources available for patient assistance programs. That’ll be different from what pharmaceutical companies can do, because they just give you the drug. This program will provide not only the drug, but the therapy. We would need to have a very large amount of money going towards this because the therapy is going to be a couple of hundred times more expensive than the drug. So with data exclusivity, we can make money and we can use some of that for patient assistance programs.
Imagine it's 2071 and a war has broken out. This is a new source of trauma: people are seeing each other die; there are bombings, rape. Say we live in your net zero trauma world; what’s your vision for what happens next? Would people be actively neutralizing that new trauma, or is the “net zero” idea more abstract than that?
No matter how many therapies we have, there's going to be massive new sources of trauma that we need to account for. So let's say that in 2071, a war breaks out, but on the other hand, let's say that we've got a hundred thousand trained psychedelic therapists all over the world. It's kind of just a math question: how many more people are traumatized, and how many did we help get over their traumas?
Hermann Hesse wrote the book The Glass Bead Game during World War II, and it helped him get the Nobel Prize. It was about a post apocalyptic world where people had learned to channel the competitive, aggressive nature of humans into a non destructive form. The glass bead game was a form of philosophy, mathematics, music, poetry. I won’t ruin it for you, but the idea behind it is: how do we take our competitive nature and channel it in productive ways that involve less killing, less inequitable distribution of resources. Can humanity cooperate more than compete, and compete in healthy ways and recognize the sort of pain that we're inflicting on others? Getting over racism and sexism, and all of that, is part of getting to net zero trauma. It's an enormously broad term that sort of just points towards the way we need to uplevel mental health for humanity.
Psychedelics are not the only tools that we have for this. So, even though we at MAPS willl be focused on the psychedelic distribution of therapies and treatments, people can do this through meditation, they can do this through education. I don't want to say psychedelics are the only solution to get to this point. But they're going to be, I think, an integral part of the solution.
This interview has been edited and condensed for clarity and length.