http://www.drcnet.org/wol/149.html#emanuelsferios

As the ecstasy situation continues to heat up, Emanuel Sferios of
DanceSafe is in a unique position to comment. DanceSafe is a
harm reduction-based organization best known for providing access
to pill-testing for purity or adulteration at raves or through
its several offices. DanceSafe can be found on the world wide
web at <http://www.dancesafe.org>.

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.

================

ReconsiDer Tidbits