Pubdate: Sat, 20 Nov 1999
Source: Toronto Star (CN ON)
Copyright: 1999, The Toronto Star
Contact:  http://www.thestar.com/
Author: Mitch Potter and Betsy Powell, Toronto Star Entertainment Reporters

AGONIZING OVER ECSTASY

Jagged Little Pills: Long-term Effects Are Unknown.

The Rave Drug Is Now Mainstream, But At What Cost?

Adam is happy tonight. Very happy.

In fact, the world has never felt better for this 42-year-old architectural
designer, who describes himself as health-conscious and "not a bar person."

A non-smoker and self-professed "light drinker," Adam is enjoying a
euphoria that comes courtesy of a tiny pill called Ecstasy.

It's illegal.

It's his second time.

And nobody knows, in the long term, what the possible damage to his brain
and body might be.

Adam is not alone.

Police and health care workers confirm what a legion of users already know:
Ecstasy in Ontario is moving from the rave scene to the mainstream, into
the realm of 30- and 40-something circles populated by lawyers and
schoolteachers.

Ecstasy's growing number of converts now consume as many as 100,000 hits a
week in Ontario, according to new police estimates.

At $30 a pop -- the average street price for Ecstasy -- that's a retail
industry worth $150 million a year, and it's growing steadily.

Bob Runciman, Ontario's minister of consumer affairs, said this month that
there have been three deaths since July related to drugs and rave parties.

Yesterday, the Ontario Chief Coroner's Office confirmed two deaths are
believed to be related to Ecstasy, and a third is suspected.

And Deputy Chief Coroner Dr. Jim Cairns added fuel to the already heated
debate over the drug's potential dangers, with a promise to conduct an
inquest into one of those deaths.

"We're looking at which (Ecstasy-related death) would be best suited to get
the message across to the public, the perfect case that demonstrates our
concern," Cairns told The Star.

An Ontario student drug-use survey, released this week by the Centre for
Addiction and Mental Health, revealed an eightfold increase in Ecstasy use
among high-schoolers since 1993.  It found that the drug has been used by
4.8 per cent of Ontario students from grades 7 to 13. No apparatus exists
to track adult drug use in Ontario.

What is it that draws people to E, or MDMA (methylenedioxymethamphetamine),
as the amphetamine derivative is formally known?  It's the promise of four
to six hours of inhibition-melting, love-your-neighbour euphoria, according
to medical experts and recreational users.

Is Ecstasy too good to be true?  Maybe.  Some medical researchers say the
short-term risks appear moderate when its dosage is low, and its use
occasional, provided users don't dance themselves into a dehydrated state.
Those with pre-existing conditions such as diabetes and heart disease are
also advised to steer clear.

The scary part is that the most current medical research simply isn't
certain about the long-term effects of MDMA.  Questions of potential
low-level depression, liver damage and brain damage remain questions, not
answers.

"A lot of people who lived next door to Chernobyl didn't feel any effects
the day after the meltdown," says Const. Rob Cullen, a York Region police
officer specializing in drug and vice enforcement.

Try telling that to Adam, who was too busy enjoying his recent Ecstasy
experience to think about tomorrow.

"The effect was so pleasurable that you almost want it to last forever," he
says, admitting to being acutely shy in public places.

"We started dancing, the bar was very crowded.  I just felt really happy as
I was looking at everybody.  I had this big grin and I seemed to really
like people.  It was pretty crowded -- just the closeness felt nice."

Toronto police say the allure of Ecstasy has resulted in a 500 per cent
increase in MDMA seizures in the past year.

"It's definitely moving away from the actual rave subculture and into the
neighbourhood bars," says Det. Rick Chase, a veteran drug cop widely
regarded as an expert on Ecstasy.

"I don't know about Bay Street yet, but it's going to an older group,
people in their 30s and early 40s, that are using it on the weekend."

Sold in both tablets and gelatin capsules, E comes in a range of colours,
almost always stamped with a cheeky corporate icon that makes the pill seem
as benign as a Flintstone vitamin.

"It's excellent marketing by whoever's trafficking," says Chase. "Even the
name, Ecstasy -- everybody likes a nice warm, fuzzy, huggy-type name. It's
on the opposite end of the drug spectrum from the scary names like speed,
acid, heroin."

Yet for all the health concerns, police acknowledge that complaints about
Ecstasy are few and far between.

As a recreational drug used in a social setting on the weekend, Ecstasy
simply isn't spawning a wave of addiction-relation crimes associated with
cocaine and heroin.

"It's hard to raise alarms when I get no complaints . . . as opposed to
crack.  I get 50 (crack complaints) a week," says Chase.

No Ecstasy fatalities were reported in Ontario until this year. Preliminary
statistics also show that, in 1997, there were 62 deaths related directly
to ingesting cocaine, and 70 related to using heroin, according to deputy
chief coroner Cairns.

The people who may have died because of using Ecstasy, who Cairns wouldn't
identify, citing the Freedom of Information Act, were "otherwise perfectly
healthy" individuals in their 20s.

Autopsy results on another eight deaths in the province revealed traces of
MDMA among other substances, he added.

Other medical researchers, meanwhile, suggest some deaths attributed to
Ecstasy may in fact be linked to another so-called designer drug -- GHB
(gamma hydroxy butyrate) -- which, though chemically unrelated, has caused
confusion due to its nickname, "Liquid Ecstasy."

None of which lets Ecstasy itself off the hook.  Researchers still warn
that reactions to the drug, particularly when used in a dance party session
involving hours upon hours of vigorous physical activity, can vary wildly.
Though rare, there are documented instances in the U.K. of users being
hospitalized for seizures, intravascular coagulation, renal failure and
suspected allergic reactions.

"Ecstasy can cause death.  It's a small risk, but it exists," says Dr.
Stephen Kish, a Toronto research scientist specializing in the neurotoxic
effects of Ecstasy and other amphetamine derivatives.

"In my opinion, the risk of death from Ecstasy is much, much lower than the
risk of dying from alcohol."

Alcoholic poisoning in Ontario, according to the coroner's preliminary
figures, killed 44 people in 1997.

Kish, along with the vast majority of researchers, says it's Ecstasy's
long-term unknowns that are most worrisome.

"Most scientists agree that, in studies on monkeys and rodents, high doses
of Ecstasy are known to damage serotonin nerve endings in the brain.

"Does this happen in the human?  It's too early to say.  But the
preliminary suggestion is there could be cognitive damage with prolonged,
chronic use."

As for heavy users of Ecstasy, the preliminary findings are bleak, at best.
 Last March, Johns Hopkins University researchers unveiled a study in which
24 chronic Ecstasy users -- those who took an average of 440 milligrams of
the drug per month for five years -- were shown to have suffered damage to
their visual and verbal memory.

According to the Hopkins study, MDMA appears to damage brain cells that
make serotonin, an important neurotransmitter involved in the regulation of
memory, mood, pain, sleep, appetite and sex.

Males are more susceptible to Ecstasy's damaging effects than females, the
study said.

Yet many health-care professionals and police warn there's no way of
ensuring what you're popping in your mouth is, in fact, Ecstasy.

"We know for a fact that some of the Ecstasy samples we analyze for the
police are blends of other drugs, including methamphetamine and PCP," a
Health Canada official told The Star this week.

"We found the same thing coming back in some of our samples," confirms
Const. Cullen of York Regional Police Service.

"The buyers were looking for six hours of happy.  They got six hours of hell."

Initially, Ecstasy found its way to Toronto streets as an import, and
Amsterdam has always been a major source.  Two weeks ago, 100,000 Ecstasy
tablets were seized at Vancouver airport, with two men arrested on an
incoming flight from the Dutch city renowned for its runaway hedonism.

But more and more, Ecstasy is being made in Ontario.  In the past year,
police have taken down several "bathtub chemists" in cities throughout the
province.

The highest-profile bust involved Robert Drake, a 25-year-old University of
Windsor honours student, whose extra-curricular activities included cooking
up thousands of hits of Ecstasy at a school lab.

Among the faculty unaware of his hobby was his own father, a chemistry
professor.

Acting on a tip, police seized enough equipment and raw chemicals to turn
the lab into a $13.5 million operation, court was told later. Drake was
convicted of nine charges and sentenced to 23 months in a provincial
reformatory.

He got off lightly, according to police, who say they're urging Crown
prosecutors to punish Ecstasy offenders with the five-year sentences doled
out to other amphetamine makers and traffickers.

Yet the lucrative dynamic of huge profits and a growing market is likely to
spawn a new wave of made-in-Ontario Ecstasy.

"It costs pennies a pill to make, and retails at $30 to $40," says Chase.

"When you consider that the Internet offers several recipes as simple as
Betty Crocker, and most of the ingredients are available at Canadian Tire,
you can forecast more home-cooking."

Though Ecstasy's proliferation in North America was spawned by the London
rave scene and its attendant electronic music boom, the history of MDMA
actually stretches back to 1912, when it was first synthesized by the
German pharmaceutical film Merck.

MDMA was shelved at the outbreak of World War I, and remained there until
its rediscovery in the 1960s.  Though some U.S. medical researchers
maintain Ecstasy can work wonders in a variety of medical and
psychotherapeutic applications, the drug's late-1980s adoption by the rave
movement secured its status as modern pop culture's most demonized pastime.

Though Ecstasy is clearly spilling into Toronto's suburbs, investigators in
York Region say they're especially concerned about users taking more than
one drug at a time.

"Some people are taking GHB on top of Ecstasy, because the latter provides
what they call `a softer roll.'  They might be soaring a little too much on
Ecstasy, so they level it off with GHB," says Cullen, of York Region's
police service.

"But the danger is GHB has a really sharp dosage curve.  The difference
between a dose that gets you high and a dose that will put you in hospital
is minuscule."

Cullen suggests that cavalier attitudes toward Ecstasy stem from a
widespread understanding that the drug is virtually hangover-free.

"You wake up the next day and you maybe have a sore jaw from grinding your
teeth, but otherwise you feel pretty good.  So you think, `This can't be
bad for me.'"

As worldwide research into MDMA intensifies, researchers expect conclusive
answers to Ecstasy's long-term questions may come within three to five years.

In the meantime, Toronto health officials are beginning to take a closer
look at MDMA, along with other problem children in the designer drug
family.  Among new initiatives is an upcoming three-month health department
study involving drug-related admissions to three downtown emergency rooms.

"The intent is to get a better handle on club-drug related problems at the
hospitals," says Dr. Joyce Bernstein, an epidemiologist with the health
department.

"This study will be looking at Ecstasy, but also GHB and Ketamine (Special
K)," she says.

"The other designer drug we're looking at is Rohypnol, the original
date-rape drug.  There've been all sorts of rumours about it over the past
couple of years.  It's time to take a closer look."

If Ecstasy's long view remains unknown, Toronto users appear content to
assume that what they don't know won't hurt them.

"It puts me in an extremely good mood," says Tom, a high-level provincial
civil servant in his late 30s.  He started taking E a couple of years ago
with a bunch of his friends, also 30-something professionals.

"It doesn't seem to have any side effects, and there's no negative
consequences that I'm aware of, and it makes me feel better than anything
else that I've ingested."

Raoul, 33, works behind the scenes in television news.  He does it once
every four to six weeks, usually taking it before hitting a number of
downtown gay dance clubs.

"It makes you really want it, mentally.  Physically, that's something else.
 But that's okay.  A lot of people take it around midnight, dance for four
or five hours, (and when the E wears off) then have sex.

"It is getting more acceptance.  Some still don't approve of it, but it's
no longer taboo."

Community workers in Toronto also wonder about the drug's sociological impact.

"I'm of the opinion that there's more rhetoric than reason stoking the
public fears over Ecstasy," says John Collins, a member of the Toronto Harm
Reduction Task Force and an outreach worker based at All Saints Church.

"There are health risks associated with Ecstasy, but not the type that are
killing kids instantly."

But Collins makes the point that Ecstasy makes its users max-out their
emotional credit card -- accruing a bill that will have to be paid eventually.

"Ecstasy is an artificial high, so the rest of your natural highs start
losing their taste, somewhat," he says.

"It shifts the paradigm of what happiness is.  So there's a lot of really
jaded 18-year-olds out there who have experienced the mountaintop --
they've been to Everest on Ecstasy -- so what the hell is a new boyfriend
or girlfriend or an A on that English paper?  Like they care.

"That's the sad part.  There's a sense that this stuff can really pervert
happiness.  I think over time that really jades people, or insulates them
from natural happiness."

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