If addiction is judged by how long a dumb animal will sit pressing a lever to get a "fix" of something, to its own detriment,
then I would conclude that Netnews is far more addictive than cocaine.

- Rob Stampfli
 

Throughout history man has used plants to become intoxicated.  Today, advances in science allow man to custom design intoxicating drugs.  Illicit drug chemists manipulate the basic molecular structure of intoxicating compounds to create new drug analogs.  The motivation for custom designing drugs are:

	Avoid police detection and prosecution.  It often takes years for government to detect, classify and pass legislation against a dangerous designer drug.  GHB (see below) is currently an example of this circumstance.  Abused since the early 1990's, many states have still not enacted laws against it's use.  In some states, drivers arrested for drug impaired driving can not be prosecuted for GHB as it is not officially listed as a "controlled substance."
	Improve an existing drug.  Chemists have found re-arranging the chemical structure of an existing drug can yield dramatic improvements in the intoxicating effect.  The designer drug THREE is a good example of this effect.  An illegal analog of the basic synthetic narcotic drug Fentanyl, 3 Methyl Fentanyl is 500 time more potent than pure natural heroin.
	Remove unwanted side-effects from an existing drug.  Many popular intoxicating illicit drugs also produce unwanted side effects.  Methamphetamines produce a hyperactive "wired" condition many users do not like.  By altering the chemical structure illicit chemists produced the designer drug Ecstasy which gives the pleasurable stimulating effects of methamphetamines without the unwanted "speedy" side effects.

	GHB - (also called Grievous Bodily Harm, Liquid Ecstasy, Georgia Home Boy, Scoop, Liquid X, Somatomax, G, Easy Lay, Liquid G) - Gamma Hydroxy-Butyrate was originally thought to be a human growth hormone and was abuse by body builders until banned in 1991 by the FDA.  It is a clear odorless liquid with a slight salty taste which produces a alcohol-like drunken condition when mixed with water.  Mixed with alcoholic liquor GHB produces a stupor, vomiting and coma.  It is frequently abused at Rave dances and teen dance clubs and has been used as a date-rape drug.  Federal law now makes it a crime for possession of GHB due to drug rapes.
	Blue Nitro, GBL - Furanone di-hydro, gamma-butyrolactone, and 1,4 BD are being sold over the internet and in health food stores and body building gyms to avoid the growing number of laws against GHB.  The human body quickly converts Blue Nitro into GHB producing the same intoxicating effects but avoiding prosecution, one of the key factors driving designer drugs.
	Rohynol - (also called Rohypnol Roofies, Ruffies, Ropies, Roche, R-2, Mexican Valium, Rib, Rope) produced overseas by Hoffman-LaRoche company it is a designer analog of valium (a benzodiazepine) but ten times more powerful. When mixed with alcohol it is frequently used as a "date rape" drug. The US Drug Enforcement Administration calls "Rohphies" the "Quaalude of the '90's." Very popular with young people in the south.
	Ecstasy - (also called XTC, E, X, clarity, essence, Adam, decadence, M & M) - or MDMA a designer analog of the old 1970's drug, MDA which itself is an analog of methamphetamine.  It gives a cocaine like high, (but without the speedy side-effects), with very mild hallucinations and a pronounced feeling of emotional closeness to other people.  Users feel they can talk all night about their deepest secrets and want to be physically close and affectionate with everyone.  Some users have said it makes you "feel like everyone is your soulmate".  Abused at Rave dance parties, long term use leads to brain damage as the cells that produce seratonin begin to die after as few of ten uses.  The most sought after Club Drug.
	EVE - or MDE - a closely related analog of MDMA - Ecstasy, but it is not as popular a Club Drug because it does NOT produce the feeling of emotional closeness of Ecstasy.  The EVE experience is one of being "drugged-out" or "stoned" making it a poor choice for Raves.  Police labs report 20% of Ecstasy are really knock-off drugs like EVE or PMA, or DXM.
	Double Stack - or PMA Paramethoxyamphetamine is a designer analog of methamphetamine first used illicitly in Australia in 1994.  It is often sold as “Ecstasy” but is much more dangerous because it doesn't produce the pleasurable MDMA effects and users take more of the drug seeking the high they crave.  Overdose causes a dramatic rise in body temperature in excess of 109 degrees and death occurs from hyperthermia.  Pills can be any colour and often have the same head stamp as Ecstasy.  Recently seen in Chicago in pill form with three diamond design, but also found widely all over the US as evidenced by recent news accounts in Boston and Florida.
	DXM - Dextromethorphan is very often passed off as Ecstasy at clubs and Raves, it can also be found in Robitussin cough syrup.  DXM produces hallucinations and a heavy "stoned" feeling in users but none of the desirable Ecstasy effects.  DXM is wide-spread over the United States how ever it is usually misidentified as MDMA by users and police alike.
	Nexus - or 2C-B is a phenylethylamine analog of the powerful hallucinatory drug "DOB."  It has much stronger Ecstasy-like feelings of closeness and is highly sought after for its strong sexual enhancement properties however it produces much less powerful hallucinations then DOB.  Most pills sold as Nexus do not contain any 2C-B but rather the cheaper DXM.  True 2C-B is much more rare than MDMA at this time.
	Ketamine - (also called Special K, Ket, Vitamin K, K) is a designer analog of PCP, (Angle Dust), and is used as a powerful veterinary tranquilizer which causes hallucinations and stupor.  It is abused at Rave parties and dance clubs and has often been used as a date rape drug.  It can be smoked, snorted, injected, and mixed with other drugs such as heroin.  It is not active taken orally unless in very high doses.  This drug is highly addictive even though the hallucinatory effect lasts only one hour.  It is especially dangerous when mixed with alcohol or other depressants.
	Methcathanone - (also called Cat) is a designer analog of methamphetamine which has been brought into the country from Russia.  Easy to make without the tell-tail fumes of methamphetamine production, cat produces a cocaine like high with hallucinations similar to mescaline.  This drug seems to be limited to the Midwest at this time.
	Ice - another designer analog of methamphetamine which has been chemically converted to all it to be smoked like crack cocaine.  However unlike the crack high which lasts only 10 - 15 minutes, the ice high lasts 10 hours.
	China White - street name for Beta Hydroxide Methal Fentanyl, it is 6,000 times the potency of pure natural heroin.  There are many designer analogs of the basic narcotic fentanyl and because of their potency they have been responsible for over 2,000 narcotic overdose deaths.

Ecstasy is the Preferred Club Drug - The National Household Survey of drug use fund that 1.4 million young people between the ages of 18 - 25 had tried the most popular of the Designer Drugs, Ecstasy, up from 960,000 in 1995.  Use of Ecstasy is moving into the younger age groups.  In 1999, 8% of 12 grade students had tried Ecstasy, up from 3.6% in 1998.  14% of males in the 12th grade reported using Ecstasy.  59% of Ecstasy users take five pills per 12 hour drug session.  72% of users prefer to use Ecstasy at Rave dance parties.  Last year police seized 3 million Ecstasy pills and European police seized 5.7 million Ecstasy pills.

Source: members.aol.com/brucertalbot/designerdrugs.html

Highs and Lows

A History of Intoxication

Source: newscientist.com 4 September 2006

The Best Night of Your Life

Ecstasy makes shirtless, disgusting men, a club with broken bathrooms, a deejay that plays crap and vomiting into a trash can the best night of your life.  It has done two things in my life.  I had always been aloof or insecure or snobby, however you want to put it.  And I took it and realised, You know what?  We're like all here; we're like all dancing; we're like not so different.  I allowed myself to like get closer to people.  Everything was like more positive.  But my life also became, quickly, like all about the next time I would do it...  You feel like at ease with yourself and like right with the world, and that's like a feeling you want to duplicate - like every single week.

Adrienne
frequent Raver from the Midwest

Source: "The Lure of Ecstasy" Time Magazine 5 June 2000

You know how it makes me feel?  Like she needs like an editor...

Going Mad on Ecstasy

The average adult has about two pints of blood for every 25 pounds of body weight.
 

A rave on the resort island of Ibiza, one of the first places where Ecstasy dance parties were held

Jo, one of my best friends, with whom I used to go clubbing, has called me up to tell me that she thinks she is going mad.  She can't stop crying, she feels as if she is "slipping out of the back of her head" and she is terrified.  It was these exact symptoms which made me stop taking Ecstasy.

I sold Jo an E about six years ago in a club when I was 17.  She was one of the few people I knew who had been taking Ecstasy for a while, but without any negative repercussions.  But what she has described to me is strikingly similar to what I went through.  She has obviously joined the majority of ex-clubbers for whom drug-induced panic attacks and anxiety are commonplace.

I took my first Class A drug when I was 16 and at a leading London day school.  Knowing virtually nothing about Ecstasy, my best friend Helen and I bought a pill from a friend of a friend and shared it, as it seemed like an amusing idea.  The reality was amazing.  It was as if you were in love with someone and you suddenly found out that they loved you back, that you were the most brilliant, beautiful person in the world.  Aside from the chemical after-effects, this very feeling, the reason why people take E, illustrates how dangerous the drug is.  How can one induce this artificially and then come back to real life without feeling more than a little depressed?

I felt my life had changed forever and I was right, but not in the way I anticipated.  For the next 4 years my life revolved around clubbing, and selling and taking drugs.  It was the most exciting time I've ever had.  Life for Helen and me became divided between two completely different worlds: the flat grey reality of school during the week, and at the weekend the intensely colourful, insane London underworld.  There was a whole network of squats and free parties and festivals in which we became inextricably involved.  Very soon we cared about nothing else.

My parents lived abroad so I forged a letter in order to get the keys for their flat copied.  That became our base and we were then totally free.  Early on we realised that we could not afford what was turning out to be an expensive habit.  We constructed a business plan - I had met someone who sold larger amounts of Ecstasy at a cheaper price.  As we both had a bit of money we thought it would be a good investment, and it seemed so easy: the more we went out the more people we met, the better our contacts became, and the more ambitious our plans.  It was nerve-wracking, but the thrill and satisfaction of coming back from a night out with your pockets full of money made it irresistible.

However, after a while I realised that there were things going on in my head that weren't normal.  Fear and unease crept over me at random times of the day and night.  This got progressively worse and I tried to stop drugs several times.  But as soon as I felt better I simply could not resist and started again - despite the fact that I had had countless bad experiences: pills which made me vomit and unable to move so that I would sit in a corner all night with my eyes rolled back in my head, thinking I was going to die and not really caring.

Eventually it got to a point where I thought I was going mad and I knew I had to stop.  But I was already trapped in the terrible circle of not knowing what to do with myself when I wasn't on drugs, sorting them out, or looking forward to taking them.  I only knew that nothing compared to the feeling of chemicals rushing around my brain, that there was nothing else to look forward to, and that the things in life that normally make people happy were stupid and mundane.

All my friends, in fact, were like this and we had such a world of our own, I felt I could not just abandon it.  Having always thought that people who hadn't taken E were clueless and didn't understand.  I couldn't just suddenly become a straight person.  My whole identity was being an "E-head."  At this point I had lost my university place at Oxford.  I had not done well in my A levels and I was having serious problems with my family.  My parents had long since realised something was very wrong, partly from my appearance - I had lost a lot of weight - and partly from my behaviour.

From my point of view, whenever they came back they were interfering with what had been a perfectly good setup and I could not tolerate it.  I would not and could not stop, so our relationship became a series of threats and pleadings and massive rows.  For several years it seemed impossible even to sit down for a meal together.&nbp; When they were in England I hardly ever went home as I knew that it could only be one screaming, unresolved argument after another.  At the time I was convinced it was their fault, but looking back it was obviously mine.

I tried to escape by going elsewhere to university, but the students there were just discovering the scene, and I had dropped it.  I felt excluded.  I knew what people who took Es thought of those who didn't.  I couldn't tell everyone the history of my excessive drug-taking and my paranoia, so I just tried to stay away and was consequently miserable.

My boyfriend at the time helped enormously: he made me interested in life again.  I became totally obsessed with chess and played it with him all day, every day.  But I couldn't stay away from drugs forever and, after a massive binge, my paranoia returned with a vengeance.  I couldn't go out or see anyone; I was too scared to do anything.  Life became unbearable.

It is the worst feeling in the world, knowing that there is something wrong with your own brain, that which constitutes you.  Weird thoughts would terrify me.  For a while I was convinced that I had a worm in my brain, or that my head was somehow just going to fly off into space - I knew it was ridiculous but that used to scare me even more, that I was capable of even contemplating these things.  I went to a doctor, but he was unsympathetic.  He told me it could be the start of psychosis but only time would tell, so could I come back in a couple of months?  That frightened me so much that I didn't dare go to another just in case he said something worse.  They did not seem to be able to help anyway.

The only person who could calm me down was my boyfriend and even he began to tire of my bizarre and annoying behaviour.  When we split up I could not cope on my own.  I felt as if I was on the edge of an abyss.  I lay on my bed crying, for about five months, wanting to die.  Now I feel as if my personality has changed forever, I will probably never be free of panic attacks and paranoia, and that interferes with a lot of my life.  At times I've thought that it was all down to my individual inability to cope, but when Jo described her symptoms to me, it was the final proof that this is what Ecstasy does to everyone.  I feel lucky in comparison with some others.

Among the people I knew in 1992, two have committed suicide, three have moved on to heroin, two have been diagnosed schizophrenic, about six have had to take serious medication or have had complete breakdowns (but are getting better).  Only three or four of them no longer take drugs and remain unaffected by mental or social problems.  Is it normal for a group of friends to have so many casualties?  Normal for a group of friends in the nineties perhaps. - Daily Telegraph

The Effects and Risks of E

What is Ecstasy?

The drug is MDMA, or 3,4 Methylene-dioxy-methamphetamine, a mildly hallucinogenic amphetamine.  It was first synthesised in Germany in 1912 and used as an appetite suppressant.  In the 1970s it was used in psychotherapy.  Later people began to take it recreationally, and with the birth of rave culture in the Spanish resort of Ibiza in the mid 1980s it became inextricably linked to dance music.

	It releases a flood of serotonin and dopamine in the brain.  These send messages between brain cells, and are involved in temperature - and appetite - control.
	The drug takes effect within half an hour and in an average dose will continue for between 4 and 6 hours.  The effects include euphoria ("getting loved-up") and feelings of calmness, benevolence and confidence.

Most Ecstasy-related deaths are caused by overheating.  Serotonin raises the body temperature, which is exacerbated by dancing in a hot nightclub.  Failure to replace the salt and water lost through sweating causes dehydration, which can lead to convulsions, coma and death.  Users should drink a pint of fluid (fruit juice, sport drinks) an hour.  Too much pure water is dangerous because it does not replace the salt and dilutes the blood.  This causes cells to swell up, which can be lethal in the brain.  The kidneys can be damaged trying to get rid of the excess water.  Psychiatric effects include depression, paranoia and psychosis.  Long-term effects may include brain and liver damage.

Source: The Dominion Thursday 25 February 1999

I don't mean to push this drug, which I think impairs brain function - something other chemicals such as those found in gingko apparently enhance.  However, to take a stance against the use of ALL chemicals, some of which have dual roles as food and vitamins, herbs (anti-bacterial, anti-microbial and/or preservative taste-enhancers), mood enhancers, medicines of all sorts, industrial products (hemp) and beauty (poppies) is to put your money into a non-interest bearing account - it's to fail to maximise your assets.  On the other hand, if all drugs were freely available, the human race would be instantly morphed, possibly out of existence.  I've included the above anecdotal article mainly to illustrate what it's like when drugs are freely available and inadequate parenting fails to prepare young adults to handle their new social freedoms responsibly.

This girl was still in secondary school when her parents moved out of the country leaving her alone.  They moved away and left an empty flat to which she was not offered free access.  Her parents didn't seem to pick up clues left around in plain sight that she was in dire need of help (see No Smoking in the section on Lifestyles for an only-partly-satirical example).

It is this sort of youth (nurtured like this), plus a certain novelty-seeking element in the personality (natured like that), who are more likely to experiment with chemical pleasures.  It is the more emotionally destitute of these who are drawn back again because the pleasure is SO MUCH more than anything they experience regularly.

I've had acquaintances who have confessed to taking ecstasy frequently.  I see no obvious ill effects in them.  Perhaps for them this is a safe drug.  But it may also mean than evidence of detrimental effect appears at different rates - and they, too are affected. (CJD doesn't show up until 10 - 15 years after eating nerve tissue from an animal infected with BSE.  For 9 - 14 years those people could've been telling their neighbours: "See, I did it and it didn't hurt me.")

To deny people all chemical pleasures is to condemn them to a rather grey existence.  (The chemical straightjackets will still be applied when necessary.)  To acknowledge that there is nothing inherently wrong with the judicious application of chemicals to enhance mood is a step forward.  I always thought Huxley was warning the reader against soma in his seminal novel Brave New World.  Perhaps he was just softening us up.  Qualifications already are encouraged by all governments and (coincidentally?) they also take the best and brightest and specialise them into one small area so that they are more easily contained, controlled, conscripted, what-have-you.  Why not use chemicals to make them happy with their lot if their lot is something they cannot change?

Stanislav Lem wrote an odd novel called (translated from Polish) The Futurological Congress.  In it, an unliveable world was made not just tolerant but beautiful through the use of drugs.  But if everyone is happy on drugs, no changes are made to the causes of problems - only the effects get prettied up.  Somehow I feel that misses the point of existence - the biological reasons we evolved to feel unhappy in the first place.

Ecstasy Damages Users' Ability to Remember

London - The dance drug Ecstasy, thought to be taken by half a million people a week in Britain, has been found for the first time to damage a part of the brain that allows people to remember what they have to do next.  A study shows that heavy users become unreliable and liable to forget things such as brushing their hair in the morning, locking the door, zipping their trousers or making a necessary telephone call.  In some ways their behaviour mimics the forgetfulness of old age or early dementia.  The research into the drug and "prospective memory" found that users suffer impairments in three types of memory to do with things in the future.

Researchers told the British Psychological Society conference in Glasgow that their work provided more evidence that Ecstasy was dangerous and should not be made legal.  Between 200,000 and 5 million Ecstasy tablets were taken in Britain each week and there was growing concern that the drug might damage frontal and pre-frontal lobes of the brain, they said.

A team of psychologists tested 40 adults who took Ecstasy regularly - at least 10 times a month - and compared their memories with 39 adults who did not use the drug.  Though all the participants were familiar with some memory lapses, the drug users were much more forgetful. - Daily Telegraph

Source: The Dominion 30 March 2001

Potent Form of Ecstasy in NZ

A potentially fatal variant of the party drug Ecstasy, 20 times more powerful than amIphetamines, has hit the New Zealand drug scene.  The drug contains PMA (paramethoxyamphetamine), which has been linked to deaths overseas.  PMA, a stimulant, is said to be 20 times more powerful than amphetamines and causes hallucinations.

The National Drug Intelligence Bureau has confirmed that the drug appeared to have reached New Zealand streets in small quantities.  Detective Sergeant Tony Quayle said the drug, known on the street as Double Stacked, was difficult to distinguish from Ecstasy and was probably being sold as the same thing.  "People may have had experience with Ecstasy in the past and think this is the same but each time they take an Ecstasy tablet they are taking an unknown drug," he said.

It was often sold as a thick white tablet and was also known as Chicken Yellow or Chicken Fever.  Some tablets were known as Mitsubishi Turbos, because they were embossed with the carmaker's logo.  The same logo was quite common on Ecstasy tablets, Mr Quayle said.  The United States Drug Enforcement Agency said that though "Ecstasy is bad, PMA is death."  It has killed at least 6 people in Florida since July.  Police there said the drug raised victims' temperatures so high that the central nervous system burned out. - NZPA

Source: The Dominion Friday 26 January 2001

The People's Prozac

by Carla Spartos

Dissident scientists question the ban on Ecstasy

Consider the two dosing lines for America's young people - the one outside the club and the one in the school nurse's office.  At the door to raves, kids stand with Ecstasy pills on their tongues, waiting for the weekly surge of empathy and good feeling that comes from the combination of hallucinogen and amphetamine.  For this rush, which was legal before 1985, they risk jail terms and the loss of student aid.

But every day outside the nurse's office, roughly 2 million kids line up for their daily dose of stimulant, very likely Adderall, a prescription amphetamine that is quickly replacing Ritalin as the drug of choice for attention deficit hyperactivity disorder.  For this high, which is said to help learning, teachers and parents lend encouragement.

The double standard, says neurotoxicologist Dr James O'Callaghan, points to the nation's blind spot when it comes to Ecstasy, also known as MDMA.  O'Callaghan says that chemical cousins Adderall and Ecstasy carry similar risks, but while one is considered safe for America's youth, the other is its scourge.  Maybe the government's line - that MDMA causes brain damage - isn't so clear-cut after all.  "You can buy d-amphetamine on the street, and that's bad, but you can give the same compound to a kid chronically - twice a day, every day for the rest of their lives," says O'Callaghan.  "If you truly believe MDMA is bad, then why would you give [Adderall] to your kids?"

In an America that has declared war on Ecstasy, O'Callaghan's is a lonely voice of dissent.  This summer, Florida senator Bob Graham introduced the "Ecstasy Prevention Act of 2001," which would provide more than $22 million for stepped-up law enforcement, a "national youth antidrug media campaign," and the creation of a new test to suss out MDMA users.  New York senators Hillary Clinton and Chuck Schumer are co-sponsors of the bill, which came on the heels of a two-day conference at the National Institutes of Health in Bethesda, Maryland, that presented some of the latest research findings.

So why all the fuss about a little pill?  Ecstasy, like a host of legal drugs on the market, affects the chemical serotonin, which regulates critical brain functions like mood, aggression, sexual desire, sleep, and sensitivity to pain.  By decreasing serotonin, scientists can send you spiraling into despair; alternately, by increasing it, they can lift you out.  Yet for all their tinkering, surprisingly little is known about the brain chemical - we still don't know, for instance, WHY serotonin affects mood; it just DOES.

As part of its campaign against club drugs, the National Institute on Drug Abuse is running ads that picture "your brain on Ecstasy" as a lump with dark blotches and holes.  And the pitch goes, "Chronic use of MDMA can produce long-lasting, perhaps permanent, damage to the neurons that release serotonin."

Not necessarily true, says O'Callaghan, who works for the federal Centers for Disease Control and Prevention.  He says these ads are misleading because they leap beyond what we already know - that administering the popular club drug, also known as MDMA, carries the aftereffect of temporarily decreasing serotonin.  "It looks like a blank slate, but it comes back," says O'Callaghan.  "I'm not saying that MDMA isn't bad.  I'm just saying that there's no evidence that it destroys serotonin neurons."

While clinical trials treating mental disorders with MDMA have never been conducted, proponents say anecdotal evidence from before 1985, when the drug was still legal, looked promising.  It appeared to help people open up during psychotherapy, and some doctors suggested it could aid trauma victims or people suffering from terminal illness.  Now researchers are gearing up to try again.  In late September, scientists at the Medical University of South Carolina will submit a draft protocol to the FDA for a study examining Ecstasy-assisted psychotherapy for the treatment of post-traumatic stress disorder.

Some even foresee a future where a few doses of Ecstasy, taken in a therapist's office, replace a lifetime of couch sessions and serotonin manipulators like Prozac.  Those supporters include Rick Doblin, president of the Multidisciplinary Association for Psychedelic Studies.  Despite its flaky-sounding name, the group has actually funded much of the current research - pro and con - on Ecstasy.  Presently, it's backing a study in Spain that uses the drug to help rape victims recover.

"MDMA could be a tool to get you past drugs," says Doblin.  "Prozac is a tool to get the pharmaceutical industry rich."

Ecstasy, like Prozac, primarily targets serotonin-producing nerve cells.  It is inside the axons - the part of the cell that sends out signals - that the chemical is stored.  Under normal conditions, the brain works on electrical signals that cause the axon to release some of its serotonin into the synapse, or the gap between neurons.  Any excess is then either broken down or reabsorbed in a recycling process called re-uptake.  MDMA, however, can cause a neuron to dump its entire store of serotonin into the synapse, flooding the adjacent neuron's receptors.  This time, excess serotonin is not recycled: MDMA causes the transporters responsible for re-uptake to flow out instead of in.  It is this massive serotonin overload, combined with secondary effects on the brain's dopamine system, that produces Ecstasy's loved-up sensations.

What happens next is less clear.  According to Dr George Ricaurte, a neurotoxicologist at Johns Hopkins University School of Medicine, monkeys dosed with MDMA show evidence of "pruning" - a rewiring of the brain's serotonin system in which longer axons are lost, replaced by a dense growth of shorter ones.  This pruning phenomenon remained evident 8 years later, and although there's no proof of permanent changes, that's also, says Ricaurte, "a pretty long time, given monkeys live 25 years."

Since these changes are associated with decreased serotonin levels and lower numbers of serotonin transporters, Ricaurte believes they indicate damage from Ecstasy.  "It's a harmful drug, and it's harmful in doses used by humans," he says.

O'Callaghan thinks this view is too simplistic.  He says that just because the drug affects serotonin doesn't mean the damage takes place in those neurons.  The rewiring, he argues, stems from something other than injury.  "The [pruning phenomenon] is not necessarily reflective of damage," he says, "just profound and long-lasting changes."  He contends that if MDMA caused nerve-cell degeneration, star-shaped cells would form, leading to an increase of the glial fibrillary acidic protein, or GFAP.  "Any chemical known to damage the brain has caused an increase in GFAP," explains O'Callaghan.  "We don't see that response with MDMA."

While detractors agree that GFAP is a valid indicator of brain damage, they still take issue with O'Callaghan's measurements.  "MDMA is a potent brain neurotoxin.  The entire field reads the literature as such," says Ricaurte.  "Are all 100 nails in to shut the coffin?  No.  But are there 70, 85, 90?  At what point do you look at the data and say it's met a certain criteria?  That criteria's been met long ago."

O'Callaghan doesn't get invited to speak at many conferences anymore - even though he has been publishing extensively in this area for years.  So politicians end up listening less to dissidents like him than to mainstreamers like Ricaurte and Dr Alan Leshner, director of the National Institute on Drug Abuse.  In a hearing before the Senate Subcommittee on Governmental Affairs this past July, Leshner stated, "There is substantial evidence to show that MDMA damages brain cells.  Within the scientific community we cannot say with absolute certainty how and to what extent...but there is across-the-board agreement that brain damage does occur."

But O'Callaghan believes the whole idea of neurotoxicity - of brain damage - has been tossed around too freely. A single dose of reserpine, a prescription drug used to treat hypertension, markedly lowers serotonin levels for extended periods.  "It's just as neurotoxic as MDMA, if you equate neurotoxicity with serotonin decrease," he says.  "But if you look at damage as defined by loss of structure, you don't see it [with MDMA], even in whopping doses."

The long-term consequences of MDMA use are similarly ill-defined.  "The evidence up to date has been pretty crummy," Dr H Valerie Curran, a psychopharmacology professor at University College London, told the NIDA conference in July, noting that the most consistent findings relate to learning and memory.  "The effects are subtle, but have real implications."

If MDMA does indeed cause brain damage by pruning the neuronal pathways, then a whole host of serotonin agents, including Prozac and Adderall, could be rewiring, and thus damaging, our brains.  The latter - often given to hyperactive children - is particularly worrisome, say critics, because it also affects dopamine, which helps the immature brain develop normally.

A paper co-authored by O'Callaghan in Brain Research last year concluded that all compounds acting on the brain's serotonin system can cause changes in serotonin neurons.  O'Callaghan says the creation of these abnormalities, including corkscrew-shaped neurons, could be part of Prozac's desired therapeutic effect.

While scientists like Ricaurte say Ecstasy is a much different drug from Prozac, it's not that different from the amphetamine Adderall.  They admit that the research on such pharmaceuticals is still lacking.  "I think we need more experimental studies addressing that question," says Ricaurte.  "We know amphetamines can damage dopamine cells.  What is not known is whether the amount of amphetamine used in kids is the amount required for toxicity."

This scares O'Callaghan.  "You can market a compound," he says, "unless it puts holes in your head."

What separates a good drug from a bad drug?  Why is it OK to prescribe amphetamines to children but bad when they ingest them for fun?  Drug-company ads pitch chemical remedies for everything from social anxiety to severe PMS.  Since 1970, their profits have more than quadrupled; roughly a quarter are from drugs that affect the central nervous system and sensory organs.  More people are taking more pills - whether Ecstasy or Prozac - to feel better.  Yet the war on drugs drags on.

For Ecstasy, it began in the early '80s, when rising use and a "designer drug" media scare forced the Drug Enforcement Agency to take notice.  Although a judge ruled during 1985 hearings that MDMA had therapeutic value and could be safely administered under medical supervision, the opinion was struck down by the DEA's director.  The drug became illegal, and the black market boomed.  Next came Ecstasy of questionable quality and potency.  DanceSafe, a nonprofit that tests the purity of pills at raves, reports that dangerous adulterants like the cough suppressant DXM and the hallucinogen PMA are on the increase, and says these compounds are the prime culprits for Ecstasy-related visits to emergency rooms.

For now, Ecstasy's medical potential is all anecdote and no hard fact.  Little data exists on its therapeutic value.  But that's not for lack of trying, say supporters of MDMA-assisted therapy.  Dr Charles Grob, director of Child and Adolescent Psychiatry at Harbor-UCLA Medical Center, was the first researcher to gain Food and Drug Administration approval for a study of MDMA, submitting a proposal in the early '90s to treat people with end-stage cancer.  The agency initially turned him down, saying a trial was first needed to determine the drug's dosage and safety.  After that was completed, Grob went back to the FDA with what he thought were promising results.  Again, the government turned down his bid to test Ecstasy among cancer patients.  "The bottom line was political, I felt," says Grob.  "This would have been the first treatment protocol.  This kind of schedule-one drug, with abuse liability, would have been very controversial."

Doblin is more optimistic.  "I think the FDA is the most immune of all agencies to outside pressure.  They're sympathetic to patients."  He also believes the FDA may take issue with the South Carolina study of Ecstasy and post-traumatic stress disorder on the grounds that it's too risky to decrease the serotonin levels of depressed subjects.

It may be this psychoactive element that most hinders the progress of Ecstasy as therapy.  With medical marijuana - which has gained acceptance and been doled out for decades to a handful of patients in a federal program - the high is almost a side effect, since the real good comes from increased appetite, decreased nausea, and a lessening of spasms and pain.  With Ecstasy, the benefit is the high.

In this way, Ecstasy is more like the roster of mood elevators prescribed every day.  Without the media scare, a company application to market this drug now, says O'Callaghan, would pass government muster.  "MDMA would have slipped through as an approved drug," says O'Callaghan.  "No one would think a priori that it was causing damage."

Source: villagevoice.com week of 5 - 11 September 2001

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