Blurry Ecstasy

As a part of its “harm reduction” activities, last year the Los Angeles County Department of Public Health produced flyers informing youth of the dangers associated with use of ecstasy. The campaign, addressed to young ravers, was designed to inform and guide potential users of how to behave, react and what to except once the drug has been consumed. Despite the apparent relevancy of the project, the content of the flyers has been criticised last week by substance abuse professionals including the Long Island Council on Alcoholism and Drug Dependence, claiming that this form of information sends a wrong message to the youth, encouraging them to use the substance. Jeffrey Reynolds, executive director of the institution, went a step further, claiming that “the reality is they're illegal drugs and come with significant health risks."

Although the argument given by Reynolds cannot be considered as wrong, it produces an assumption that everything that is illegal is harmful. In opposite, everything that is legal should does not damage our health. In case of drugs and particularly ecstasy however, this argument seems to bea bit vague. 

The aim of making some drugs illegal was to eliminate its production and consumption due to its effects on health. International agreements like the Single Convention on Narcotic Drugs (1961) or the Convention on Psychotropic Substances (1971) and their equivalents in national systems like the British Misuse of Drugs Act are based on the assumption that particular substances pose a threat to public health and accordingly they need to be banned. In this line of reasoning, ecstasy is currently ranked as a class A drug (Misuse of Drugs Act), along with the likes of cocaine and heroin.

On the other hand, some of the recent studies and opinions tend to describe ecstasy as a substance which use (although still having inferior effects on health) is not more dangerous then the use of widely available products. The extreme version of this claim was produced by former chief constable of North Wales, Richard Brunstrom who stated that “ecstasy is a remarkably safe substance, far safer than aspirin”. What is the true face of ecstasy then? What do we know about it? Is it so harmful as heroine and cocaine that it has to be classified as class A drug?
 
The exact number of deaths brought about by ecstasy use is hard to pin down, as it depends on how the figure is measured. According to the National Programme on Substance Abuse Deaths, there were 42 deaths related to ecstasy in 2006. Most of them however resulted as due to mixing ecstasy with other drugs. Only 16 deaths came after the use of an ecstasy-type drug alone. And even within that figure, very few deaths have ever been caused by direct poisoning from the drug. Most come from other related effects, most commonly overheating and dehydrating in a hot club. The Independent in its article on ecstasy (3 January 2008) points out that even the “high-profile death of Leah Betts in 1995 involved consuming fatal quantities of fluid after taking ecstasy” rather then was a case of overdosing.

Technically, ecstasy is not considered a physically addictive drug. The body will not crave more, or become dependent with repeated use. There is a psychological danger, however, that users can start to like it too much and crave the emotional contentment that it provides. WHO report on ecstasy (2001) highlights that more severe psychiatric consequences may occur however only in those individuals made vulnerable by personal or family history of psychiatric disturbance, by stress or by concurrent use of other drugs.

Ecstasy in comparison to other popular drugs is also regarded as a safer. Paper by Professor David Nutt et al., publish in the famous Lancet journal classifies ecstasy on the 18th position in reference to drug’s harmfulness. The same work places legal substances like alcohol and tobacco much higher on the scale (5th and 9th respectively). 

Where does the popular image of ecstasy as prime danger for youth and clubber come from? As observed by the 2001 WHO report on ecstasy, the present state of scientific knowledge and reports is considerably biased towards analyisng the severe examples of ecstasy use, and therefore the general image of ecstasy as a dangerous substance is clearly misleading. The bias is further pushed by popular media, according to Alasdair J.M. Forsyth, Senior Research Fellow, Violence, Risk & Public Health Network of the Glasgow Caledonian University shows that, the ration between the ecstasy-related deaths and newspapers reports on them in 1990s in Scotland is 1:1 (each case has its own report). On the other hand ratio of the paracetamol related deaths to the newspaper reports was only 265:1 (only one of 265 cases was covered in press).

Criticism submitted by the Long Island Council on Alcoholism and Drug Dependence, is clearly understood from the political point of view. Prohibition as the only possible option in dealing with drugs, has been officially facilitated by every nation around the globe. However the same prohibition has also been totally inefficient and unsuccessful to produce positive results. It is commonly known that legal penalties do not pose enough threat for the users to prevent them from occasional consumption. Unfortunately, alternative of educating rather then punishing and prohibiting for many seems still needless despite of clear evidence for its effectiveness.