| WOL: We have Customs
figures that show a dramatic increase in ecstasy imports and we certainly
have increased law enforcement attention, but the measures for ecstasy
use, such as the DAWN emergency-room reporting system and the "Monitoring
the Future" surveys of high school students are both tenuous and behind
the curve. Is ecstasy use really increasing?
Sferios: I think it
is the hot drug now. Aside from my work, those are the only indicators
I have. I think the "Monitoring the Future" project is a good indicator,
but the number is probably higher because of self-reporting, the tendency
for people to understate their involvement in illegal acts. We should
note, however, that in England the figure is 17% of high school students
having used ecstasy as opposed to the 2.5% here. The only reason
is that England is closer to the source. The US is lagging behind
a couple of years because of the time it takes for criminal syndicates
to develop effective import strategies.
There is no reason to assume
that ecstasy will not be as popular in the US as in rest of the Western
world. The drug produces a very pleasant experience that is highly
appreciated by a great many people. It's appreciated by middle class
professionals who would otherwise not use an illicit drug, such as speed
or heroin, because ecstasy simply doesn't have the side effects, doesn't
destroy peoples' lives like addictive substances. It produces an
almost therapeutic experience; many users report ecstasy use helped them.
The bad news is frequent
use can cause depression in many people. It's very common.
Heavy users will often report depression in midweek. My professional
opinion is that those people may have preexisting depression that ecstasy
exacerbates through depletion of serotonin. This is all happening
without there necessarily being any neurotoxic effect.
WOL: But Gen. McCaffrey
is telling us that it causes brain damage.
Sferios: This has become
the leading justification for the crackdown and the heavy enforcement emphasis
being taken by the police and the DEA; they're claiming to be saving the
children from this drug that produces brain damage. But there is
currently no evidence that there is any permanent cognitive impairment
from ecstasy use. In the 11 studies comparing heavy ecstasy users
with a control group on which this argument is based, only about half of
them found slight but statistically significant differences in short-term
memory, and only short-term memory. Even here, those differences
were subclinical; no one's memory was considered to be a problem.
We know there's probably neurotoxic damage going on in heavy users, but
we don't see any evidence for permanent cognitive impairment.
I can say that there is no
one on the planet today who has put more effort into explaining the risks
of ecstasy neurotoxicity than myself. And I can say that neurotoxic
effects should have no bearing whatsoever on crafting drug policy.
Take alcohol, for example. Alcohol is also neurotoxic and damages
the brain so significantly that it doesn't take any sophisticated controlled
studies to see its effects on the brains of alcoholics. Yet we have
decriminalized and regulated alcohol in such a way as to reduce the harm
it has upon young people in our society. If ecstasy is extremely
dangerous, the most appropriate response would be harm reduction.
If ecstasy is a relatively benign, the most appropriate response is harm
reduction. The most appropriate response is harm reduction.
WOL: What about these
reports of deaths, overdoses and emergency room visits?
Sferios: The vast majority
are heatstroke. Heatstroke can happen whether or not a person has
taken a stimulant drug, although stimulants certainly increase the chances.
The emergency room visits and the vast majority of deaths have not resulted
from an overdose of ecstasy but rather from behaviors and an environment
which contributes to heatstroke. By calling these incidents ecstasy-related,
the media gives users the false impression that as long as they don't take
too much they'll be okay. But these are not overdoses; the adverse
reaction is not related to the amount of the drug consumed.
The good news is that adverse
reactions such as heatstroke are easily preventable. Harm reduction
methods which educate users to drink water and stay cool have greatly reduced
the number of medical emergencies and deaths in the rave scene in England.
Regulation of the rave industry would help. DanceSafe is going to
launch a national "safe settings" campaign to encourage club owners to
adopt harm reduction measures.
WOL: Much of the ecstasy
furor seems to be infused with fear or disdain toward the rave culture.
Any comment?
Sferios: I think we
live in a prohibition-industrial complex and it's easier to demonize a
drug if it can be associated with a subculture that's perceived as countercultural.
What's ironic about the rave culture, compared, say, to the hippie culture
in the 1960s, is that young people in the rave scene don't see themselves
as countercultural. The rave culture doesn't exist in an overtly
political context, there is no anti-war movement, nothing like that.
Remember, the music they listen to is mainstream; the same DJ's and the
same drugs exist in nightclubs in major cities across the country.
Ecstasy is also popular with
middle class professionals, but the police don't seem to know how to deal
with that. The DEA just had an ecstasy conference in Washington,
and perhaps they're trying to figure out how to disrupt its distribution
and are looking at the rave scene. In their minds, this is where
the drug is being sold the most. Ecstasy is not a street drug, it's
not being pushed by inner city youth on street corners or in crack houses
where drug selling becomes a nuisance. Ecstasy sales are more hidden
and non-problematic; there is no violence. It's clear that the drug
is being used by many people outside of the rave culture, but the only
locations that are publicly known are the raves.
WOL: Can I tell my
mother you said it's okay to take ecstasy?
Sferios: No.
Any risk-taking activity is a personal decision and should be carefully
thought out. If you are using ecstasy, take lower doses less often
and not more than once every couple of months. Test your pills; fake
ecstasy is very common. And take precautions to avoid heatstroke.
Drink plenty of water. Stay cool. |
