Widely Hyped Ecstasy Study Full of Holes, Critics Say 10/4/02

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special to DRCNet by John Calvin Jones

(Jones is a PhD candidate writing his dissertation on US and Dutch drug policy at Panamerican University in Edinburg, TX.)

In 1974, a Tulane University researcher, Dr. Robert Heath, declared that marijuana was dangerous, caused brain damage and even death -- when taken in standard doses. Heath's evidence was from autopsies of monkeys that he "exposed" to marijuana. Heath had placed gas masks on the creatures and pumped the equivalent of 63 joints into their lungs in five minutes. Of course the monkeys had brain damage -- it was due to oxygen deprivation and carbon monoxide poisoning.

Thirty years later "science" is at it again. The September 27 issue of Science presented an ecstasy study headed by John's Hopkins' neurologist Dr. George Ricaurte, in which the authors claim that ecstasy causes brain damage, leads to Parkinson's and can kill -- when taken in standard doses. Again the evidence was found in 10 dead primates, two that died from the ecstasy alone.

While the study is earning well-deserved criticism on methodological grounds (see below), it also smells of politics. The National Institutes of Health funded Ricaurte's study -- a proposal that sought to explain why ecstasy is a bad drug. Alan Leshner, the former chief at NIDA, now heads the American Association of the Advancement of Science, which publishes Science. So what looks like a scholarly study, published by a group of disinterested scientists, turns out to be a PR piece written and promoted by politically astute PhDs with a financial interest in touting pro-drug war messages.

Ricaurte's team planned to inject five squirrel monkeys and five baboons with three doses of ecstasy, 2mg/kg body weight, at three-hour intervals, for a total of 6mg/kg in six hours. The dose, 6mg/kg, is supposedly typical. "Partygoers... consume multiple doses [of MDMA] during the night," said Ricaurte and company, citing Erica Weir for this fact. In truth, the cited article made no mention of how much MDMA ravers consume in one night. Dr. Weir's only reference to ecstasy use was that European data (n=69) found that up to 57% of the pills sold as ecstasy contained no MDMA, and pills with MDMA had anywhere from 2-150mg.

Ricaurte and colleagues could have used American data to make dosage estimates. In three million pills seized by the DEA in 1999, the ecstasy content was about 90mg per pill. Although, as groups like the club scene hard reduction outfit DanceSafe (http://www.dancesafe.org) and Australian pharmacologist Rod Irvine have shown, there is no way to know how much MDMA people take in one night, using the DEA sample one might assume that average ecstasy dose about 1-1.5mg/kg. Regardless Ricaurte chose three doses at 2mg/kg for the "typical dose." To justify the 6mg/kg further, Ricaurte et al. added that such was less than the amount typically taken by humans. Of course the authors had no way to know that.

So the animals were injected. What were the results of the heavy and repeated doses? The first set of five monkeys were all given the first two injections, then four got a third. One of the four died and the fifth "became less mobile and had an unstable tentative gait after the second dose," and was not given a third injection. For the five baboons, it was worse as one "baboon appeared unstable after the second dose," and one died after only two injections.

Of the initial survivors, the four monkeys and four baboons were killed two and eight weeks later for autopsy. Ricaurte's team found that MDMA-exposed animals had "lasting reductions" in serotonin levels and damaged dopamine synapses. They concluded that MDMA caused motor dysfunction, could lead to Parkinson's or kill.

A number of neurologists and researchers took issue with the Science piece. Critics challenged the MDMA-Parkinson's link, and claims that typical human self-administration of ecstasy causes permanent brain damage or death.

The nonprofit research and advocacy group Multidisciplinary Association for Psychedelic Studies" (http://www.maps.org) obtained reaction to the Science article from neurologists in the US and abroad. Robert Meadowcroft of the UK's Parkinson's Disease Society told New Scientist that despite the significant rise in MDMA use, "there is no evidence early-onset Parkinson's disease is on the increase or that MDMA users [show] Parkinson's symptoms." "If [ecstasy], used in large quantities, were responsible for the young-onset of Parkinson's disease, we might have expected to see some early evidence of this," Adrian Williams, a neurologist at the University of Birmingham, UK, told MAPS.

MAPS added that the scientific integrity of the paper was so bad that Ricaurte failed to cite his own previous studies that found long-term MDMA users showed no sign of lower dopamine production. As well, when interviewed by Time magazine in 2000, Ricaurte said that "the vast majority of people who have experimented with MDMA appear normal, and there's no obvious indication that something is amiss."

By far the study was condemned most strongly because of the high death rate, 20%, in the test subjects. Death rates this high tell us that ravers and others commonly take much lower doses. Research from England, Australia and the US shows that MDMA fatalities are exceptionally rare. Many supposed ecstasy deaths are, as Time reported, from kids taking mega-doses of dextromethorphan (DXM) or paramethoxyamphetamine (PMA).

We all know that no drug is "perfectly safe." You can wreck your liver on Tylenol. Too much aspirin causes gastrointestinal bleeding. Too much lithium damages the thyroid. Marijuana aside, too much of any substance, be it water, gasoline, alcohol or uranium, will damage tissues and cause death. It matters how much you take - the difference between a poison and a cure is the dose. And thanks to prohibition, no one from the raver to the scientist to the parent can know what is in a dose of ecstasy.

Like he used to do at NIDA, once again Leshner has failed to condemn more problematic and destructive recreational substances, tobacco and alcohol. To Leshner, Ricaurte and other agents of the drug war, we should recite the words of President Bush, "fool me once, shame... shame on you. And you're not gonna fool me again."

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