January 13, 2012
The Ecstasy and the Agony
By: Colby Cosh
A well-written article in Macleans explains how the illegal status of MDMA creates a dangerous black market in adulterated Ecstasy pills. The gulf between the relative safety and healing potential of MDMA in therapeutic contexts and the uncertainty of recreational Ecstasy use is widened by current harm-maximization drug policies.
Originally appearing here.
In recent weeks, it seems, adulterated ecstasy (MDMA) has left Alberta and B.C. with a sizable heap of young corpses. A tragedy has thus come home to roost in the West: namely, the tragedy of policy that incentivizes adulteration of drugs that, if manufactured in the open and checked for purity, would kill hardly anybody. Pure MDMA has a larger “therapeutic index”—a wider safety margin for overdose—than alcohol. It would probably make a pretty reasonable substitute for alcohol in many settings if we were to sit down and rebuild a drug culture from scratch. But over the past ten years or so, both Liberal and Conservative governments have worked to increase penalties for and monitoring of the flow of “precursor chemicals” used in the manufacture of MDMA.
It has been their goal to make pure MDMA more difficult to manufacture; when precursors are seized it is hailed as a triumph. But illicit drug factories never do put out the follow-up press release announcing that they’re putting less MDMA in their “ecstasy” and replacing it with other party drugs that have much smaller safety margins, or with drugs that interact dangerously with MDMA. And when rave kids die as a result, the RCMP chooses not to pose imperiously alongside the body bags giving a big thumbs-up. They are eager to take credit only for the immediately visible results of their work.
The medical examiner in Alberta said she was surprised to find methamphetamine and other meth analogues in the remains of some of the victims she saw. As this monograph on the history of ecstasy explains, however, adulteration of ecstasy with precisely this class of substances is a known result of intensified legal pressure on ecstasy markets—and that, in turn, has made it harder for researchers to measure the harm from chronic use of MDMA, as such, in the wild. It’s the circle of drug-war life: hysteria begets ignorance, and vice versa.
The debate over “harm reduction” in Canada has, for the past year or so, revolved around the Insite clinic in East Vancouver. That debate has been fraught with as much confusion and misinformation as drug moralizers could possibly create, but the core message, I think, has gotten through to Canadians, and certainly to the gatekeepers of their media. The message is this: we have only meagre power to stop people from abusing heroin if they are determined to do that. We do have, however, significant ability to protect people from the problems of a poorly-titrated or actively adulterated supply of heroin. The morbidity and mortality burden from the actual addiction itself, compared to the burden resulting from the drug’s illegality, is both modest and intractable. Insite is basically designed to yield the benefits that allowing heroin to be issued by prescription would bring.
Canada is apparently too under-equipped with libertarians to see that the logic extends to ecstasy, which about a million adult Canadians have used at least once. Yet rave-scene users have already been implementing “harm reduction” philosophy on the dance floor for decades. They react as best they can to adulteration risks by sharing information about dealer reliability, and they mitigate the most important medical peril of MDMA—the possibility of hyperthermia, i.e., internal overheating—by making sure ravers have access to cool rooms and plenty of fluids.
Drug prohibition makes all of this more difficult, though in practice the cops look the other way. They’re interested, they’ll tell you, in the synthesizers and traffickers. That approach sets off a cascade of adulteration that lands on the heads of young people outside the bounds of an established consumer-safety culture—the ones who will buy “ecstasy” out of a truck because it’s cheaper than booze. (Which, by the way, the Alberta government wants to make more expensive.)
Ecstasy is synonymous with raves, but none of the five Calgarian youths who have died seem to have taken it in that setting. A couple were reported to have taken alarmingly large numbers of pills, prompting the Calgary Herald to accuse them posthumously of “extreme drug use” before it became clear that they were not victims of MDMA at all. The Herald was given a pretty strong clue by the death of Daniel Dahl, a young graffiti artist whose death the paper attributed to “toxic” MDMA—even though he had been thrown out of a bar for fighting the evening he got sick. That’s not the behaviour of someone who’s taken ecstasy. It’s the behaviour of somebody who thinks he’s taken ecstasy and has ended up with a liver full of meth and other junk.
Maybe Dahl (who had gulped seven tablets) and the others weren’t drug-crazy idiots who overdid it; maybe they had just adapted to a supply of “ecstasy” tablets largely consisting of caffeine and cough medicine, and were taken by surprise when they flooded their organs with paramethoxymethamphetamine instead. It’s prohibition that makes that possible—indeed, makes it virtually certain to happen on occasion. When Daniel Dahl’s mother says “I feel like they’ve murdered my son,” there are an awful lot of people who could be included in that “they”.
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