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Ecstasy in the mainstream

More people have died after being struck by lightning than from taking
Ecstasy. Yet the drug of choice for many of today's users is criminalised,
demonised and marginalised by law makers and politicians, argues Brian Boyd
about the drug that is no longer part of the counterculture

If alcohol and nicotine were discovered today, they would be classified as
illegal and possession or intent to supply of either would lead to fines
and/or imprisonment. There are valid public health reasons why this would
be so: figures just released by the British Home Office show that over the
last 10 years in Britain, over one million people have died as a direct
result of nicotine use and between 200,000 and 400,000 have died from
alcohol use.

There are no such figures available for Ireland but experts in the field
suggest that broadly speaking the figures are equally applicable here.

Scroll through the figures and you find that the most popular drug on the
street today, the one that has created a mini moral panic in the media, the
drug which is invariably prefaced by the word "killer", namely Ecstasy,
has, over the same 10 year period, been responsible for 59 deaths. In the
same period more people have died after being struck by lightning than from
Ecstasy

If you infer from the above that Ecstasy is a "safer" drug than alcohol and
nicotine, you'd be dangerously deluded. There are far more users of alcohol
and nicotine than there are of Ecstasy, and the usage takes place in small
doses over a lifetime. There is also the significant fact that the two
former drugs are socially acceptable (to a point) and instant death (as can
happen with Ecstasy) due to usage is a rarity. However, when you crunch the
numbers further and factor in the percentage of deaths in relation to the
estimated total population of users of each drug, they still found that
tobacco deaths ran at 0.9% of all users, drink deaths at 0.5% of all users
and Ecstasy deaths at 0.0002% of all users. While it is understood that all
drugs, regardless of provenance, are dangerous, it is getting to the
situation in Ireland now where the same sort of informed medical and
scientific opinion that has raised awareness of the dangers of drink and
cigarettes should now be equally applied to illegal drugs.

Ecstasy is a popular drug, and while it doesn't recognise handy
socioeconomic boundaries, it is mainly used by the 15 to 40 age group.
Because of its illegal status it is always difficult to estimate its level
of usage but when you combine Garda figures with those of the Drugs
Awareness Programme (run by the Catholic church's Social Services
Conference) you're looking at about 10,000 Ecstasy tabs been taken in
Dublin alone every weekend spread those figures over the country and the
total figure is conservatively estimated at 25,000. In Britain, official
sources report over 500,000 tabs being taken every weekend, a figure that
is reflected all over Europe in ratio to head of population. The recently
published survey by the independent drug agency Relate among European
clubgoers found that taking Ecstasy was deemed more important than meeting
prospective sexual partners.

What's the attraction, and furthermore, what's the risk?

In his bestselling book, E Is For Ecstasy, Nicholas Saunders reports from
an international drugs conference where the broadcaster and TV presenter
Nick Ross spoke (controversially) about the appeal of the drug for young
people and how, he believed, it was misrepresented in the media.

"I suppose if I were to tell the truth, I would point out that many drugs
are fun," he said. "They give you an extraordinary sensation of
exhilaration, of excitement, of energy, escape, relief and pleasure
that's why so many people take them." Realising that was not a message the
judiciary, the police force, the politicians and the media want to hear, he
added: "I'm not sure that being honest is really what society asks of the
media. I think that what we are being asked, under a rather fraudulent
umbrella of being candid, is to carry a PR message. Society likes the
simple message: `Drugs are there, they are bad, they are criminal and you
shouldn't go near them.' And the media put across that message pretty
effectively."

No amount of "Killer Drug Evil Junkies" headlines contribute much to what
is becoming a pressing debate. Regardless of its legal status E is viewed
as a Class A drug, alongside heroin and cocaine, and personal possession or
intent to supply will result in large fines and/or a prison sentence
people take the drug in significant numbers it is quite simply today's
drug of choice.

Seven years on from the drug being widely available and widely used,
attitudes appear to have become polarised the losers been being the
people who continue to take Ecstasy without the sort of cool and clear
advice that could save their lives.

Known chemically as MDMA, Ecstasy is an amphetamine (or "upper") usually
taken in 100 mg doses. In chemical structure it is closely related to the
popular 1960s drug LSD, although it would take a strong dose of Ecstasy to
provide an hallucinogenic experience.

It was first synthesised by German chemists in 1910 but largely forgotten
about until the 1940s when a US pharmaceutical company planned to market
the drug as an appetite suppressant (weight loss usually resulting from
amphetamine use) but the plans were dropped because of potential side
effects. Strangely enough, the drug was used for a while by marital
therapists in the US who found that it encouraged empathy and decreased
hostility and anger between warring spouses; however, once it hit the
streets as a recreational drug it ended up on the statute books as a banned
drug, as late as 1985 in the US.

On this side of the Atlantic, Ecstasy was originally associated with clubs
that played "House" music (or "rave music" as it is usually inaccurately
referred to). The resultant dance scene, which saw many live music venues
give way to dance clubs, involved energetic dancing for hours on end in
packed clubs and Ecstasy, as a stimulantbased drug which promotes empathy
between users, seemed tailormade for these surroundings.

In appearance, Ecstasy varies considerably depending on the actual content
of the drug, but ranges from brown or white tablets to pink and yellow. In
the vernacular it goes under many names but among the most popular are
"Disco biscuits" and "Love Doves" although you'd be hard pressed to keep up
with the changes in nomenclature.

The drug knows no socioeconomic boundaries although agewise users are
typically between 15 and 40 years of age. On the streets of Dublin,
including the more fashionable enclaves of the southside, you can buy an
Ecstasy tab for anywhere between £7.50 and £15.

Given the proper circumstances (correct dosage, purity of active ingredient
and being in a supportive environment among friends), users typically find
the following when they use Ecstasy. After 30 minutes: having swallowed the
pill, it dissolves and the MDMA slowly enters you brain through the
bloodstream. After 45 minutes: your body temperature rises by about one per
cent, your blood pressure increases and you begin to perspire mildly. After
one hour: The MDMA causes serotonin to be released in your brain which
brings about moodenhancing effects. After 90 minutes: you feel extremely
relaxed and have warm and loving feelings for everyone around you. After
twosix hours: you may begin to act in a repetitive way, e.g. dancing.
After 12 hours: the last traces of MDMA will have been broken down by your
liver and eliminated from your body as urine.

In short, the appeal of the drug lies in the mild euphoric "rush" it
provides followed by feelings of serenity and calmness and the reduction of
angry and hostile feelings. Not surprisingly, Ecstasy is also known as the
"horny" drug.

The other side of the story is (a) you might die, and in quite considerable
pain. This could result from an allergic reaction (however statistically
rare, it still happens) or (b) from the Ecstasy tab overheating your body
from the inside out if this doesn't kill you it might result in mere heat
stroke or heat exhaustion, neither of which are pleasurable experiences,
but generally this side effect can be countered by drinking regular and
copious amounts of fluid to cool your body temperature down. You could also
be seriously damaged by (c) the rogue "Ecstasy" tab.

Because the drug is illegal and only available on the black market, you and
your body are at the mercy of whatever is contained in the tab going under
the name "Ecstasy". Some tabs have been known to be laced with cheaper and
dangerous substitutes (dog worming tablets being an example to hand) and
ironically enough, the very lack of MDMA might end up killing you,
seriously injuring you or making you very ill indeed. All the above
scenarios are potentialities that may or may not be realised under
differing sets of circumstances.

Because it is relatively a new drug, the longterm effects of usage are
unclear (scientists still don't fully understand the longterms effects, if
any, of cannabis either). In the short term, there is a "crash" sensation
after the drug wears off (about 12 hours after ingestion) where the user
can report feelings of muscle pain, fatigue and general listlessness which
generally speaking are shortlived. Ecstasy is not believed to be
physically addictive in that there are no heroinlike withdrawal symptoms,
but the notion of "psychological addiction" remains an individual response,
depending on the person's personality makeup.

The only symptoms reported (so far) by long term, habitual users are an
increased likelihood of minor ailments like colds, 'flu and sore throats
while a small percentage of women report an increased frequency of
genitourinary tract disorders. Tolerance to the drug does develop over
time, meaning that larger doses may be required to acquire the same initial
sensation. It is considered extremely unwise for people with poor mental
health to take the drug.

There is little evidence that Ecstasy use leads on to harderdrug use (e.g.
heroin) primarily because it is seen as a "lifestyle" drug and is usually
taken recreationally (at weekends) and is not used, like harder drugs, as a
desperate "escape" from reality.

Given the fact that there is little tapering off in the popularity of
Ecstasy, there remains the need to inform, educate and indeed agitate about
Ecstasy's effects and consequences. In much the same way as knowledge about
alcohol and nicotine has filtered into the culture and raised awareness
about their effects and consequences, there is a dire need for more medical
and scientific input into the Ecstasy debate. What appears to be preventing
this, on a general societal level, is the drug's illegal status. The view
seems to be that "drugs are illegal so you shouldn't be taking them anyway"
the Irish "solution" to the Irish "problem".

The reality of Ecstasy use in this country renders this kind of argument
redundant and while, as seems likely, the drug will remain banned for the
foreseeable future, the question remains: how best to serve the many people
using it?

On a very basic level, there should be a plentiful supply of free water at
events that are normally associated with Ecstasy use constant hydration
of the body being a paramount concern for Ecstasy users (this reporter has
seen people drink water from toilet bowls after promoters have shut off
water supplies in toilets so people will have to pay exorbitant prices for
bottled mineral water) Similarly, it would beneficial to have experienced
medical staff present at these events. Ecstasy

On another level, there needs to be a change in the social representation
of Ecstasy users. The image of ignorant youngsters being exploited by
dealers is inaccurate. Ecstasy users are, as likely as not, intelligent and
clued in about what they are taking and what it will do to them they
understand both the advantages and risks of taking the drug. This is not a
marginalised group of "addicts", it is now the mainstream. Decades of law
enforcement have clearly not worked, illegal drug use is now higher than it
was in the heyday of the "Swinging Sixties" and the issue of
decriminalisation needs to be put on the table and debated in an informed
and educated manner. Look at how far we've travelled with information about
nicotine and alcohol and how little we've travelled with Ecstasy.

There will be another 25,000 Ecstasy tablets taken in Ireland this weekend
is this a risk we can keep affording to take?