Sex, Drugs & Techno Music: Why the rap against Ecstasy has a familiar ring to it

Reason, Jan, 2002 by Jacob Sullum

Another hazard is a product of the black market created by prohibition: Tablets or capsules sold as Ecstasy may in fact contain other, possibly more dangerous drugs. In tests by private U.S. laboratories, more than one-third of "Ecstasy" pills turned out to be bogus. (The samples were not necessarily representative, and the results may be on the high side, since the drugs were submitted voluntarily for testing, perhaps by buyers who had reason to be suspicious.) Most of the MDMA substitutes, which included caffeine, ephedrine, and aspirin, were relatively harmless, but one of them, the cough suppressant dextromethorphan (DXM), has disturbing psychoactive effects in high doses, impedes the metabolism of MDMA, and blocks perspiration, raising the risk of overheating. Another drug that has been passed off as MDMA is paramethoxyamphetamine (PMA), which is potentially lethal in doses over 50 milligrams, especially when combined with other drugs. In 2000 the DEA reported 10 deaths tied to PMA. Wary Ecstasy users ca n buy test kits or have pills analyzed by organizations such as DanceSafe, which sets up booths at raves and nightclubs.

Nervous Breakdown

Generally speaking, a careful user can avoid the short-term dangers of MDMA. Of more concern is the possibility of long-term brain damage. In animal studies, high or repeated doses of MDMA cause degeneration of serotonin nerve receptors, and some of the changes appear to be permanent. The relevance of these studies to human use of MDMA is unclear because we don't know whether the same changes occur in people or, if they do, at what doses and with what practical consequences. Studies of human users, which often have serious methodological shortcomings, so far have been inconclusive.

Still, the possibility of lasting damage to memory should not be lightly dismissed. There's enough reason for concern that MDMA should no longer be treated as casually as "a low-calorie martini." If the fears of neurotoxicity prove to be well founded and a safe dose cannot be estimated with any confidence, a prudent person would need a good reason--probably better than a fun night out--to take the risk. On the other hand, the animal research suggests that it may be possible to avoid neural damage by preventing hyperthermia or by taking certain drugs (for example, Prozac) in conjunction with MDMA. In that case, such precautions would be a requirement of responsible use.

However the debate about MDMA'S long-term effects turns out, we should be wary of claims that it (or any drug) makes people "engage in random sex acts." Like the idea that certain intoxicants make people lazy, crazy, or violent, it vastly oversimplifies a complex interaction between the drug, the user, and the context. As MDMA's versatility demonstrates, the same drug can be different things to different people. Michael Buchanan, a retired professor in his early 70s, has used MDMA several times with one or two other people. "It's just wonderful," he says, "to bring closeness, intimacy--not erotic intimacy at all, but a kind of spiritual intimacy, a loving relationship, an openness to dialogue that nothing else can quite match." When I mention MDMA use at raves, he says, "I don't understand how the kids can use it that way."