FOR PARTYGOERS WHO CAN'T SAY NO, EXPERTS TRY TO REDUCE THE RISKS

Despite frequent admonitions to "just say no," some people -- from
their teens to well past middle age -- will use drugs anyway.

Acknowledging that reality, some experts on drug abuse are advocating
an approach called harm reduction, which says, in essence, that while
drug use should be discouraged, people who do take drugs should be
taught to do so in the least dangerous way possible.

Harm reduction is controversial. Proponents say it can save lives, but
critics say it means giving up on the drug problem, and may condone
drug use and lull people into thinking drugs are safe.

Dr. Alan I. Leshner, director of the National Institute on Drug Abuse,
said, "I'm against anything that sends a message that if you do it
well it is O.K., because it is not O.K."

Harm reduction gained prominence with the AIDS epidemic. The spread of
H.I.V. among drug users who shared needles prompted the establishment
of programs to distribute needles and exchange used ones for clean
ones -- essentially helping drug users shoot up more safely.

Patterns of drug use evolve, and harm reduction advocates have moved
to dance clubs and raves, all-night dance parties fueled by loud music
and, often, drugs.

"Harm reduction is about meeting the drug users where they are," said
Amu Ptah, the director of policy at the Harm Reduction Coalition a
nationwide nonprofit group based in Manhattan.

One of the most popular drugs among clubgoers is Ecstasy (also known
as MDMA, for 3,4-methylenedioxymethamphetamine). It appeals to users
because it seems to melt away their defenses and inhibitions and often
gives them warm and loving feelings toward those around them.

Last year, 11 percent of high school students surveyed reported that
they had used Ecstasy at least once, according to a survey of 50,000
students around the country conducted by University of Michigan
researchers. The Drug Enforcement Administration seized three million
Ecstasy tablets in 2000, about three times as many as were confiscated
the previous year.

Ecstasy can cause a range of adverse effects, including nausea,
chills, sweating, muscle cramps and blurred vision. Dr. Leshner called
it dangerous and "clearly neurotoxic."

Ecstasy users at clubs and raves dance energetically in stuffy
quarters, increasing the risk of heat exhaustion, which can result in
dangerous dehydration leading to convulsions and, on occasion, death.
Last month, the federal Drug Abuse Warning Network, a survey covering
21 metropolitan areas, reported more than 4,500 Ecstasy-related
emergency room visits in 2000, up 58 percent from 1999.

Several organizations have been formed to combat the risks by applying
harm reduction principles to club drugs. One is DanceSafe, a nonprofit
national network of volunteers in two dozen local chapters, which
promotes guidelines for "safe settings" for Ecstasy use.

The guidelines encourage club owners and rave promoters to provide
"free and accessible cold drinking water," "adequate ventilation" and
"a separate chill-out room."

Because Ecstasy is illegal and not made by any legitimate
manufacturer, users risk taking pills contaminated with other drugs,
like PMA, a powerful stimulant easier to make than Ecstasy but far
more dangerous.

Concerns about poison pills drive DanceSafe's most controversial harm
reduction program -- "adulterant screening" by volunteers who test
illicit pills for content and purity.

The volunteers douse a tiny scraping from a partygoer's pill with a
few drops of a reagent. A color change instantly reveals whether MDMA
is present, but not how much or whether any other ingredients
contaminate the pill. Volunteers maintain a nonjudgmental approach,
never telling a person whether or not to take a particular pill. But a
spokesman for the group said teenagers almost always threw the pills
away if they were shown to contain no MDMA.

DanceSafe also negotiates with the local police to give volunteer
testers and Ecstasy users amnesty from arrest. "If the police started
arresting users who sought out these health services, they would no
longer be utilized, and people would die," the group says on its Web
site.

"We see a lot of bad pills out there," said DanceSafe's executive
director, Tim Santamour, who has been involved in harm reduction since
the early days of the H.I.V. epidemic. He maintains that merely
threatening to test deters purveyors of bogus or adulterated pills.

DanceSafe volunteers record the popular name, size, color and shape of
pills, along with any distinguishing logos. The testing helps monitor
waves of pills flowing through the illicit market. A pill from a
certain distributor may become popular, only to be followed by a
copycat pill that looks the same but contains different
ingredients.

Marcie Chambers of Louisville, Colo., thinks parents need to know more
about the risks of club drugs, which are spreading beyond the dance
and rave scene. Ms. Chambers's 16-year-old daughter, Brittney, died
earlier this year from brain damage after taking Ecstasy in her own
home. The drug was a birthday gift from a girlfriend.

Ms. Chambers praised DanceSafe for its educational efforts, but
expressed reservations about the drug-testing program. "I struggle
with that one," she said. "They are giving kids a false sense of
safety by handing them back a pill and saying it's MDMA. I can tell
you from personal experience that MDMA by itself is not safe."

DanceSafe also offers more sophisticated testing. A gas chromatography
analysis is available (with results posted to the Internet in a few
weeks) to those who mail a sample pill to a laboratory in Sacramento.
No questions are asked. The test identifies the presence and amounts
of virtually all known illicit or pharmaceutical drugs in the pill.

Senator Bob Graham, Democrat of Florida, thinks there needs to be more
awareness of Ecstasy's dangers.

"We need to get the word out -- and fast -- before one more teenager
'raves' himself to death," says his Web site, promoting the Ecstasy
Prevention Act of 2001, which was introduced July 19 to increase
financing for research into long-term effects of Ecstasy and education
about its risks and harms.

"Arguably, organizations such as DanceSafe promote Ecstasy use," said
Tandy Barrett, a legislative aide to Senator Graham. "These
organizations are giving a mixed message, a very dangerous message to
people who use this drug."

Ms. Barrett said if teenagers heard the real dangers of Ecstasy, "they
wouldn't need to go to an organization like DanceSafe because they
wouldn't be wanting to use this drug."

Last year Congress voted to enhance penalties under federal sentencing
guidelines for large-scale Ecstasy sales. Senator Graham's pending
bill would provide federal financing for local initiatives to combat
Ecstasy use, giving priority to communities "passing ordinances
restricting rave clubs" and "seizing lands under nuisance abatement
laws to make new restrictions on an establishment's use."

Proponents of harm reduction say banning rave clubs will simply drive
drug users underground, beyond the reach of public health programs.

Graham Boyd, who is with the New Haven office of the American Civil
Liberties Union and directs the group's drug policy litigation
project, is one of the lawyers representing the owners and promoters
of a New Orleans electronic music club, the State Palace. A young
woman died at the club a few years ago.

Last year, three men who operated the club were indicted under the
federal Crack House Statute, enacted in 1986 during the crack cocaine
epidemic. It was the first application of the statute to defendants
not charged with selling or trafficking in drugs.

Mr. Boyd said, "Worst of all, law enforcement officials decided to
identify some of the safety precautions that promoters take, like
making water and chill rooms and ambulances available, as actually
being evidence of criminality -- running a crack house."

But ultimately, a plea bargain resulted in no prison time for the
defendants.