Pubdate: Sat, 26 Oct 2002 Source: National Post (Canada) Copyright: 2002 Southam Inc. Contact: http://www.nationalpost.com/ Details: http://www.mapinc.org/media/286 Author: Margaret Munro, National Post Bookmark: http://www.mapinc.org/mdma.htm (Ecstasy) PRESCRIPTION DRUGS, ECSTASY A RISKY MIXTURE Viagra, Amphetamines: 'It Is Rare to Find a Young Person Who Uses Only Ecstasy' VANCOUVER - The pills with the happy faces, shamrocks and dolphins are designed to keep users partying for hours. The pink ones, with the Calvin Klein logo, are supposed to be pure Ecstasy. The small vials of clear liquid contain gamma hydroxy butyric acid or GHB, also known as the date-rape drug, which affects the central nervous system like alcohol. And the tiny plastic pouches are filled with methamphetamine or speed, which revs up the mind and body. RCMP Corporal Scott Rintoul digs through this cache of drugs confiscated at clubs, music festivals and raves and says, increasingly, prescription drugs are being added to the mind-altering mix. Paxil, Zoloft and Effexor, prescribed by doctors to treat depression, are being sold illicitly to Ecstasy users in a bid to "save the brain," Cpl. Rintoul says. The idea is that the antidepressants, if taken within six hours of swallowing Ecstasy, will help repair neurotransmitters damaged by the drug. Then there is Viagra, which can deliver what is being billed as a "sextasy" experience. "Ecstasy increases libido and increases the desire for sex, but they [users] can't maintain the erection," Cpl. Rintoul says. "Hence, Viagra comes into play." Sedatives, such as Valium, which have been used and abused for years, are also being reborn. This time as "sleep and chill" remedies to help Ecstasy and amphetamine users rest before returning to the reality of work or school. All of which adds up to what authorities warn is an alarming trend towards poly-drug use by young, often well-heeled, Canadian adults and teenagers. "Unfortunately, there's been no research on the additive effect of these drugs," says Keith McErlane at the University of British Columbia, who has been analyzing the chemical contents of the drugs for the RCMP. Efforts to understand what the compounds do individually are stymied by the way users -- either inadvertently or willingly -- take so many different drugs. "It is extremely rare to find a young person [who uses drugs and] who uses only Ecstasy," says Stephen Kish at the University of Toronto. He says he and his colleagues had to interview hundreds of multi-drug users before finding 20 dedicated Ecstasy users for an ongoing study on the effect of that drug. "It makes it terribly difficult for scientists such as myself to try and sort out what the effects of ecstasy alone [are] on the human brain," he says. Dr. Kish, who heads the human neurochemical pathology laboratory at the Centre for Addiction and Mental Health, has an interesting perspective on club and party drugs. His freezer contains samples from the brains of drug users who pushed their luck too far. Like the police, Dr. Kish is particularly worried about the growing use of amphetamine and methamphetamine. Cpl. Rintoul and his colleagues are so concerned with the chemicals' growing use on the West Coast that they have organized a summit in November to come up with plans to curb their production and use. The chemicals, which are easy to make in clandestine laboratories using inexpensive materials available at hardware stores, are addictive and deadly. "Based simply on the number of bodies coming into the morgue, they are much more dangerous than Ecstasy," says Dr. Kish, who has brain samples of two Ecstasy users and 30 amphetamine users in his freezer. "They typically die from heart attack or a cardiac arrhythmia, or by a burst vessel in the gut or the brain," he says. Amphetamines also have what he describes as a striking effect on the serotonin system, which helps regulate mood, emotion, appetite and body temperature. In one user he examined after death, Dr. Kish found serotonin levels in the brain to be more than 50% lower than normal. The case against Ecstasy is not quite as clear-cut. While Ecstasy is often implicated in deaths in Canada and the United States, coroners typically find multiple drugs in a body and amphetamines are often part of the lethal mix. A New York study has shown that of 20 ecstasy-related deaths, no more than three were caused by Ecstasy alone, says Dr. Kish. In suspectible individuals, Ecstasy has been known to cause death. "The risk of death is very, very low, but it is present," says Dr. Kish , noting that it is impossible to tell in advance who will be susceptible to the over-heating and increased heart rate associated with death by Ecstasy. There is also concern about what Ecstasy does to the brain. A U.S. study on monkeys and baboons, published in the journal Science, showed Ecstasy is toxic to neurons in the dopamine system that helps control movement. Neurologist George Ricaurte at Johns Hopkins University, who led the study, says similar damage is probably also occurring in human users. He warned one night's use of Ecstasy might be enough to lead to premature onset of neurodegenerative diseases, such as Parkinson's Disease. Dr. Kish says the evidence does not support such dire warnings. Autopsies on Ecstasy users show no evidence of damage to the dopamine system, he says. "In my opinion, if there is brain damage in Ecstasy users, it is more likely to involve the serotonin system," says Dr. Kish, noting that such damage might explain the transient hangovers and sleep disorders that Ecstasy users experience. But this cannot be said with certainty. "We should have a good answer within a year or two," Dr. Kish says. His team has been recruiting Ecstasy users in Ontario to undergo brain scans to help come to a conclusion. Dr. Kish warns against compounding the risks by adding prescription drugs to the mix. Taking Viagra with Ecstasy is "on pharmacological grounds, a horribly bad combination," he says, because both drugs raise blood pressure. And Ecstasy users taking antidepressants in a bid to "save the brain" are likely wasting their money. It typically takes four to six weeks for antidepressants to work, Dr. Kish says, "not a day or two." - --- MAP posted-by: Terry Liittschwager