On Tuesday 13th of March 2011, the Students for Sensible Drug Policy invited me to a meeting with Professor David Nutt. For those not in the know Professor David Nutt was the chair of Advisory Council for the Misuse of drugs under the Labour government. Prof David Nutt oversaw the classification of ketamine under the misuse of drugs act in 2005. Previously ketamine was only covered by the medicines act, which made it legal to possess, the penalty for supply was tiny.   He was sacked from his voluntary position in 2008 after it came to the media’s attention that he ranked ecstasy as lesser harmful drug than alcohol – even though he concluded this through interpretation of data provided by the home office.

Dylan Kerr Addictic recovery thailand1187

Is ecstasy safer than riding a horse?

If you remember back in 2009 this featured in the headlines of some newspapers, it wasn’t the main bulk of what Professor David Nutt was trying to say but he did cite that statistically you’re more likely to harm or kill yourself riding a horse than taking ecstasy.  It was not to condone ecstasy usage, but it was to merely present to the public the likelihood of encountering harm from using the drug. He argued against the classification system, that he felt did not bare total relevance to dependence and harm.

Below was how he ranked the drugs, measuring harm against dependence:

dylan kerr addiction harm

 

Please note that the information was based statistical data pre-2007.  Some things have changed since, one notable changed is the use of GHB (most commonly GBL now). This is increasingly showing signs of dependence and physical harm. In 2005 GBL/GHB accounted for 3.2% of cases for drug problems the in Chelsea and Westminster area, which has risen to 27% in 2010.  This can be attributed to a number of issues; one thing that has certainly changed is the availability of drugs over the internet.  It has been shown repeatedly throughout time that any increase in supply leads to an increase of usage.

Perhaps one of the main reasons Ecstasy (MDMA) is listed so low in harm is because of the way it is measured against dependence and physical harm.   Ecstasy is not a drug of dependence, often users report that the appeal of ecstasy fades after being consumed a number of times. It is thought that the brain assimilates the ecstasy experience and becomes accustomed to the surge of the chemistry. Ecstasy causes an explosion of 5-HTP within the brain which is a neurotransmitter (brain chemistry) associated with feelings of euphoria, happiness, empathy and joy.  This is also why after ingesting the drug users are likely to feel drawn out, tired, depressed, frustrated, angry and easily upset – because they are now experiencing a deficit of 5-HTP in their brain. As ecstasy relies on stimulating the body’s natural chemistry, repeating the same dosage does not achieve the same effects. Clinical tests have shown that the tolerance to MDMA builds up, after the fifth day of taking MDMA a user will feel no effects from the drug at all and requires a break of up to six days to feel the effects again (Shulgin 2010). This is why it is not addictive. If you compare MDMA with drugs of addiction like, alcohol and cocaine, tolerance builds up but the user will still feel intoxicated or high.

There are reports of some people becoming addicted to taking ecstasy, these case are exceptionally rare and are statistically an anomaly.  There is more chance of becoming addicted to the adulterants used in combination with MDMA or a replacement for MDMA.

MDMA is a “phen-ethyl-amine”. Phenethylamine is the name given to all chemicals that have the phenethylamine skeleton in their makeup (this refers purely to the molecular structure).  MDMA requires precursors to manufacture which can only be obtained by chemical manufacturing companies, organised criminals and hobby chemists (surprisingly there is an increase of the latter- possibly due to the internet and free exchange of ideas on forums, websites..etc).  It is a criminal offence to gather up precursors for the production of MDMA; groups like the Serious Organised Crime Association (SOCA) monitor for people trying to collect equipment to produce these drugs. It is punishable under the Misuse of Drugs Act and carries a maximum sentence of 25 years in prison plus an unlimited fine.  Because of this being difficult to produce many criminal gangs who produce ecstasy, add a lot of adulterants for the following reasons:

 

  • increase potency of weak batches
  • because they lack the ingredients to make ecstasy properly
  • they simply don’t care about what they put in
  • are interested in purely making money (MDMA can be made from Safrole-rich oil which can only be found in several places in the world, one of which is Cambodia, this can be expensive and difficult to obtain)
  • don’t have the skill or lab-kit to make MDMA (other compounds like amphetamines are easier to make)
  • something has gone wrong in the production of the chemistry and there are no quality controls(due to being illicit)
  • the authorities destroy/seize lab equipment and precursors

 

As an Example in February 2009 National Drug Law Enforcement Agencies (Indonesia) led by the Australian Federal Police seized and destroyed 15 tonnes of Safrole-rich oils (SRO) in Cambodia. This led to a global shortage in the precursor to make MDMA which in turn lead to a lot more adulterants in ecstasy tablets and MDMA became scarce. Taking an ecstasy tablet became more of a gamble as to what the pills contained. In the same year, Mephedrone (a new designer drug) became the new drug on the scene and peaked in its usage. By the summertime, it was the number one choice for drug taking-festivalgoers, ravers and hedonistic partiers.

 

Mephedrone, unlike MDMA is a recognised drug of addiction. It characterized by binge patterns of usage and those who have a problem with using it report similar addiction to that seen in crack and cocaine users.  Mephedrone however is thought to be less neuro-toxic through recent testing – perhaps the governments reasoning for mephedrone being classed as class B instead of class A like MDMA is.

 

Other scientists argue against the downgrading of ecstasy and highlight that is it is still very dangerous. Ecstasy is still potentially harmful and is thought to be the cause of at least 10 deaths a year (however this is difficult to attribute directly to ecstasy, unsafe practices around its use, adulterants or the combination of alcohol and other drugs).

Dying is not the only problem you may face with ecstasy. MDMA can weaken the immune system, cause an increase of cortisol (stress hormone), liver and kidney damage (in high concentration), alter moods over a long period, cause bouts of depression and decrease sperm production in males. If the drug is abused heavily users may find themselves experiencing severely low moods during the week. This can result in relationship breakdowns, heighted anxiety, depression, and poor performance at work.

If a young person experiences a bout of serious depression on the drug, this can mimic the effect of a mental breakdown. It can cause a massive amount of confusion for the young person. The young person having never experienced this extreme low feeling and loneliness has no idea when it will end – this phase will pass but to a person experiencing it, it feels very real. Although extremely rare, there have been some cases of people either attempting or committing suicide after heavy usage of MDMA.

David Raynes, semi-retired Customs and Excise Investigator (dealing with high-level organised crime) and national campaigner for drug prevention, heavily criticised David Nutt for suggesting ecstasy should be downgraded. He likened David’s views as a personal crusade and said they were not scientific and did not take into account aspects like organ damage and malignant-hyperthermia (when the brain loses control on the body’s natural ability to regular heat resulting in brain damage and death – commonly seen in nightclubs where heat build-up is an issue).

Before February 2009, there were around 500,000 ecstasy users in the UK and an estimated 3,000,000 ecstasy tablets were in circulation at any one point. Although ecstasy is potentially harmful to some, ecstasy admissions make up less than 1% of all drug treatment.

In 2001 Alasdair J.M Forsyth of the Department of Sociology, University of Glasgow, did a study into how the media reports drug deaths and how this may effect drug policy.  He looked at 10 years of newspaper reports of drug deaths. During this decade it was revealed that there were only 1:250 deaths occurred through use of paracetamol were reported, 1:50 deaths reported for diazepam, 1:3 for amphetamines but shockingly 1:1 of all ecstasy related deaths made it into the newspapers.  Does this influence have some effect on how we perceive harms around the drugs?

Ecstasy used to cost around £1-£4 a pill. Since MDMA has made a comeback in 2011, pills now regularly exceed over £10 a tablet.  Tablet quality is still highly variable and no matter the picture branding on the pill it is no real indication of the contents of the tablet.   If someone is taking ecstasy they can check for a rough guide on http://www.pillreport.com however this is not totally sound as sometimes pills containing a lot of adulterants can be re-branded as pills that are regarded as “good” for their MDMA content.   One important aspect to remember is Ecstasy pill production is with money in mind and is unregulated due to being an illicit trade.

The future of ecstasy?

MDMA as a drug of choice for young people and people experimenting drugs will probably always be around.  International forces to stop drug production are becoming more sophisticated but so are drug suppliers and manufacturers – and more importantly they are currently much better funded to supply the drugs than the agencies are to stop them.

MDMA has declined as the number one drug for clubbers, with mephedrone increasingly becoming more popular. Because mephedrone is less neurotoxic, compared to MDMA, the “come down” can be less lengthy for users.  MDMA supply is unreliable and mephedrone supply is still very consistent – despite being outlawed in most countries.

Legal highs with their ever-changing chemistry have also provided clubbers and recreational drug users with a service that outdoes most conventional drug dealing. Orders can be posted out within 24hrs and there are no penalties for possession or supply.

MDMA has been given a green light by the Food and Drug (FDA) administration in America to be tested therapeutically on sufferers of Post-Traumatic-Stress-Disorder (PTSD).  Currently in America more soldiers are dying due to suicide after their service than in combat situations (Nutt 2012). Military charities over in the UK are being asked to consider helping fund trials done by the Independent Scientific Committee on Drugs. Similar trials to help people in the UK could be introduced in the near future.  It is important to remember, however, that therapeutic use of drugs and recreational drug use are very different. Sufferers of PTSD won’t be handed out a few pills and taken to raves. MDMA will given by professionals under therapeutic supervision where practitioners will talk their patients through issues surrounding their mental illness.

 

 

 

 

 

 

 

 

 

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