Ecstasy, Science and Politics 

Ecstasy, Science and Politics 
Posted by FoM on August 14, 2001 at 10:44:22 PT
By Marsha Rosenbaum
Source: San Francisco Chronicle 
"Ecstasy" Seems to be on the minds of everyone these days. This month, the Drug Abuse Warning Network reported more than 4,500 Ecstasy-related emergency room visits in 2000 -- up 58 percent from 1999. To boot, MDMA (Ecstasy's chemical name) topped this year's list of substances "increasing sharply" on the government's annual survey of high school students. More than 1 in 10 12th-graders have tried the euphoric drug. 
Law enforcement is concerned, and in what was reported to be "the largest seizure in history," police in New York confiscated 1 million Ecstasy pills last month. Raves, the large dance parties in which Ecstasy is used by some, have been deemed venues for drug use and sales, and a movement is under way to shut them down. Politicians are again sounding tough on drugs by proposing ever-increasing penalties for sales as well as possession of Ecstasy. On July 19, U.S. Sen. Bob Graham, D-Fla., introduced the "Ecstasy Prevention Act of 2001," and just this month, Illinois Gov. George H. Ryan signed into law one of the nation's harshest laws. A person convicted of possessing 15 Ecstasy pills in Illinois will receive a mandatory minimum sentence of four years in prison. Scientists are concerned about Ecstasy, too. Recently, the National Institute on Drug Abuse (NIDA) hosted a conference presenting the latest research on Ecstasy's physiological and psychological effects. As a parent, I wonder whether all the expression of concern by law enforcement, politicians and even scientists is really helping. If history is any guide, increased drug seizures will make little dent in the supply of Ecstasy. It is cheap to make and relatively easy to import. The motive for profit will ensure that manufacturers will find ways to outsmart Customs and the Drug Enforcement Administration, as was illustrated so brilliantly in the Hollywood movie, "Traffic." The attempt to close raves will not curtail young people's desire to get together and dance. Instead, parties will be driven underground and efforts to ensure safety (like having health professionals on hand) will be compromised. Increased penalties for possession and sales will do little to deter the use of Ecstasy. Instead, we will see an affirmative action of sorts, with a larger proportion of white men and women adding to the expansion of our burgeoning black and brown prison population. I attended last month's National Institute on Drug Abuse conference, hoping to get answers to troubling questions about the effects of Ecstasy. Claims of brain damage that fuel the government's "Just Say No" message dominated, but the bulk of evidence at the conference produced far more questions than answers. The single most consistent message coming out of the research was that we need much more research. We surely need more research about Ecstasy's long-term effects on the brain, but evidence presented at the conference also revealed that experts know plenty about MDMA's immediate effects. I heard researchers talk about the negative consequences of overheating, dehydration, combining drugs and "fake" Ecstasy. Scientists know how Ecstasy users can lessen these risks: -- They can "chill out" periodically, -- Drink water, -- Test pills to be sure they do not contain dangerous adulterants, -- Avoid combining MDMA with other drugs, -- And use moderation in dose level and frequency of use. No such recommendations were made at NIDA's conference. Scientists have instead been silent about harm reduction. It's "Just Say No" or nothing at all. Facing ostracism and loss of research funding, scientists are, in practical terms, prevented from making safety-oriented recommendations. Instead, political interests that mandate abstinence determine which "findings" are to be disseminated. As a parent, I take issue with researchers' refusal to reveal everything that is known about MDMA. If our government is truly concerned about young people, it will dispense with rhetoric and give them the information they need to stay safe. Marsha Rosenbaum directs the San Francisco office of the Lindesmith Center-Drug Policy Foundationhttp://www.drugpolicy.orgShe co-authored "Pursuit of Ecstasy: The MDMA Experience," in 1994 and wrote "Safety First: A Reality-Based Approach to Teens, Drugs, and Drug Education" San Francisco Chronicle (CA)Author: Marsha RosenbaumPublished: Tuesday, August 14, 2001 Copyright: 2001 San Francisco Chronicle  Page A - 17 Contact: letters sfchronicle.comWebsite: Articles:Source of Ecstasy Experiencing 'Fatigue' With It Ecstasy in Five Years?
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Comment #11 posted by Doug on August 15, 2001 at 09:29:48 PT
Remember Dan B., Ph.D.
Wasn't there a problem a while ago when Dan B got his Ph.D. (love that rhyme!) and he couldn't register it. I suspect the problem is the comma in the name; commas are used as a delimiter in some ASCII databases, and perhaps somewhere in the system this screws things up, so it doesn't come out red. Easy to test, just don't put in the comma.
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Comment #10 posted by FoM on August 14, 2001 at 16:21:50 PT:
That's what I thought too but I talked to Ron a long time ago and it is something that needs fix. If it were serious I'm sure he would get it done. He did confirm or Matt confirmed Dr. Russo email was registered though. I'm use to seeing him in green. It would be odd now if he were red! LOL! Just kidding.
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Comment #9 posted by Dave in Florida on August 14, 2001 at 15:43:42 PT
Ethan this is why...
Ethan said: BTW, I tried life as red, but the system did not want me. I enjoy being green, but will convert if anyone can figure out the system.) You are green because you provided an email address, when you put the mouse pointer over your name it will show your email address that you may click on and send an email to you. When the name is red, it does not point to an email address. 
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Comment #8 posted by Dan B on August 14, 2001 at 14:33:06 PT:
One More Safety Tip
According to the DanceSafe site, one of the best things one can do to avoid brain damage after using ecstacy is take a Prozac within 6 hours after taking a dose of ecstacy. Here is why (Dr. Russo can likely do a much better job of describing this than me, but here goes . . .):The normal process of neuron functioning is that a "message" travels down an axon (transmitter), across a tiny space called a synapse, and into the next neuron's dendrite (receiver). The synapse is the transfer point for neurotransmitters, like seratonin and dopamine, from one neuron to another. These chemicals are stored in tiny vesicles in the axons, and their flow across the synapses to receptors in the dendrites is regulated in part by reuptake transporters (think of them as cogs on gears that "catch" some of the serotonin and put it back into the axons' vesicles for storage). The serotonin that makes it across the synapses attaches to specific sites on the dendrites, resulting in a transfer of the "message" from one neuron to the next. The dendrites have different receptors for different neurochemicals, and when enough of one kind of neurotransmitter is attached to enough receptor sites, the "message" is then transferred up the dendrite of the neuron and down that neuron's axon to the next synapse. This is how messages travel through the brain.An increase of serotonin is generally associated with an elevated mood, which is why drugs like Prozac (selective serotonin reuptake inhibitors, or SSRIs) are designed to essentially "clog" the reuptake transporters. These drugs do not cause more serotonin to be sent out of the vesicles; rather, they make it so that the serotonin that is sent out does not come back into the axons through the reuptake transporters. In this way, there is more serotonin in the synapses, and more of the serotonin receptors in the dendrites will absorb the serotonin that is there. Unlike Prozac, ecstacy does not clog the reuptake transporters. Instead, it makes more of the serotonin vesicles send their serotonin across synapses to the serotonin receptors in the dendrites. The result is euphoria--the brain is buzzing like mad with the "happy chemical" serotonin. Ecstacy causes more dopamine and norepinephrine to be released, as well. Remember, those reuptake transporters are also working to put some of that serotonin back into the axons. That is why eventually, when enough serotonin detaches from the dendrites and floats back into the synapses to be taken back into the axon through these reuptake transporters, you will come down from your ecstacy high. Another part of this equation is monoamine oxidase (MAO), which breaks down serotonin. Before there were SSRIs, there were MAO inhibitors (and they are still in use today, but not to the extent that SSRIs are being used). Instead of blocking the reuptake of serotonin (like SSRIs do), MAO inhibitors make it so that serotonin is no longer broken down, thus increasing serotonin levels in the synapse. Bear in mind that taking ecstacy and MAO inhibitors can be especially dangerous because the brain can no longer control the vast amounts of serotonin being pumped into the synapses, except through reuptake, which takes considerable time. The results of this serotonin overload can be fatal.Now, in about 4 hours into your ecstacy high (you should be coming down at this point, but not completely down for another couple of hours), the serotonin is basically all pumped out of your axons (serotonin takes a while to replenish, and you only have so much. Ecstacy does not cause the neurons to create more serotonin; instead, it causes more than the usual amount of the serotonin that is already there to be released, rather than kept in storage for future use), but remember that dopamine is also being pumped into the synapses and binding with its own receptors on the dendrites. Dopamine replenishes itself faster than serotonin, and the result is that your synapses gradually contain more dopamine than serotonin.One thing the serotonin overload can do (over time)is "downregulate" the receptor sites for serotonin on the dendrites, thus making serotonin less likely to have its desired effect in normal circumstances. I don't think they know yet whether this "downregulation" is permanent (I suspect that over time it will get back to normal if the person stops taking ecstacy, but it may take a long time. If the brain adjusts itself one way, it likely will also reverse its adjustments once it realizes it needs to).But that is not the main danger of ecstacy use. The main danger is the dopamine that MDMA has caused to be pumped out along with the serotonin. Remember those reuptake transporters? Well, the theory is that when there is little more serotonin to reuptake, they take up dopamine instead. This theory has been supported by several different studies. The problem with dopamine reuptake is that the serotonin neurons aren't equipped for dopamine--especially since these neurons contain MAO, which works fine for breaking down serotonin, but metabolizes dopamine into hydrogen peroxide. The dopamine and hydrogen peroxide can permanently damage the axon terminals (which store and release the serotonin).So, where does Prozac (or some other SSRI) come into the picture? Well, the same chemicals that block the reuptake transporters from taking up serotonin also block them from taking up dopamine. Studies have shown that, at least in animals, those animals that are given an SSRI within six hours after taking ecstacy suffer no neurotoxic damage. Those given SSRIs after six hours suffered neurotoxicity, and to greater degrees as the time extended from the 6 hour mark.The moral: if you take ecstacy, make sure you can get hold of some Prozac to take within six hours after taking the ecstacy. By the way, don't take Prozac before you take ecstacy, as it will diminish your high. I won't get into that here. If you want to know more, visit DanceSafe at http://www.dancesafe.orgDan B
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Comment #7 posted by aocp on August 14, 2001 at 14:27:53 PT
Sacre merde!!
Scientists have instead been silent about harm reduction. It's "Just Say No" or nothing at all. Facing ostracism and loss of research funding, scientists are, in practical terms, prevented from making safety-oriented recommendations.Wow. That says a mouthful, yes? Read those last five words again, folks. What's a more blatant way to say that? How about, "encouraging non-safe use"? This is what the antis never want to say nor see ... the flipside of their own policies. When following a jihad, the blinders come out in force. Some days, i almost wish i could put mine back on. "Why, oh why, didn't i take the blue pill??"
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Comment #6 posted by Rambler on August 14, 2001 at 14:08:02 PT
Doc,I think the less said about that certain member of the mint family,the better.We got to be careful,or it will be the new media darling after exstacy,and meth have lost their prison filling dazzle.They are planning ahead,and looking for any excuse to keep their prisons chock full of living humans.It costs an average of about $26.000.00 dollars a year(*) to keep someone behind bars.For 26k a year,I'd swear never to do drugs again.Just like politicians swear to uphold the Constitution.(*)Not sure of the accuracy of my numbers.
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Comment #5 posted by Robbie on August 14, 2001 at 13:03:33 PT
Just Wait!
Instead, we will see an affirmative action of sorts, with a larger proportion of white men and women adding to the expansion of our burgeoning black and brown prison population.If the numbers of 15-17 yr old white kids arrested and given stiff prison sentences, then the CIA will start selling a super-strength derivative of Ecstasy in the inner cities and take the political heat off by putting more blacks and latinos in prison for Ecstasy use than whites. Can't endanger that gravy train!I've met Ms. Rosenbaum and have seen and heard her speak a few times. She is very intelligent, and a heck of a spokesman for drug-law reform.
Lindesmith Center - DPF
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Comment #4 posted by Ethan Russo, MD on August 14, 2001 at 13:01:03 PT:
Merry Go Round of Targets
Ecstasy is a current villain, and is getting a lot of attention due to the slipping War on Cannabis. Now there is a great deal of press about Salvia divinorum. This plant was a previously obscure item, that now due to the increased publicity (including the NY Times, where yours truly was quoted) will be tried by an increasing number of amateur psychonauts.When I discuss such items with reporters, I emphasize a few points:1) There are always risks attendant with drug usage, but efforts should be made to minimize them. Education is the answer, not repression.2) Current prohibition does not work, so it is absolutely pointless to add Salvia divinorum or other plants/chemicals to the list. Such approaches only exacerbate the problem.
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Comment #3 posted by dddd on August 14, 2001 at 11:43:34 PT
it's so obvious
..I think it is blatantly clear,that the drugpig,witchhuntershave got the drug villification media saturation for gravytrain fuel,,,,down to a science......This obsessed group ofextreme extremists will be almost impossibe to stop....The Extacy-Meth gravy train is hi-ballin through the trainyard,and is pickin' up steam......and the only thing it will slow downfor,,is to pick up some new passengers for a profitable trip onthe Cash Express.........All Aboard!!!....dddd
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Comment #2 posted by Patrick on August 14, 2001 at 11:12:51 PT
Safety First
"If our government is truly concerned about young people, it will dispense with rhetoric and give them the information they need to stay safe."Anything less is a malpractice of leadership.
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Comment #1 posted by Ethan Russo, MD on August 14, 2001 at 11:02:33 PT:
Marsha is My Hero
She has seen the war from both sides, and has managed to consistently say what is logical and right to do. The only reasonable approach to illegal drugs is one of harm reduction. Use the term, however, and the prohibitionists will instantly and irrevocably relegate you to the great unwashed of drug users or "legalizers." Such is the poor quality of the opposition's arguments. We actually have the moral high ground on this issue.(BTW, I tried life as red, but the system did not want me. I enjoy being green, but will convert if anyone can figure out the system.)
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