Ecstasy in the mainstream

If alcohol and nicotine were discovered today, they would be classified as illegal and possession or intent to supply of either…

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.

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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

??????andy socio-economic 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 best-selling 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.

What are they putting into their bodies?

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 stimulant-based 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 socio-economic boundaries although age-wise 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 mood-enhancing effects. After 90 minutes: you feel extremely relaxed and have warm and loving feelings for everyone around you. After two-six 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 over-heating 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 longterms effects of usage are unclear (scientists still don't fully understand the long-terms 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 short-lived. Ecstasy is not believed to be physically addictive in that there are no heroin-like withdrawal symptoms, but the notion of "psychological addiction" remains an individual response, depending on the person's personality make-up.

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 genito-urinary 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 harder-drug 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.

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?