CLUB DRUGS MORE AGONY THAN ECSTASY FOR YOUNG PATIENTS

Physicians Are Urged To Offer Guidance, Information About The Dangers Of
The Illegal Drug Ecstasy

Washington -- Physicians should be aware that ever-increasing numbers of
their young patients are using illegal "club drugs" such as Ecstasy, a
synthetic, psychoactive drug that many users consider to be relatively
harmless.

But the drug is far from harmless. "It's a dangerous drug," said Michael
Miller, MD, secretary of the American Society of Addiction Medicine, "with
both stimulant and hallucinogenic properties."

Patients tend to place Ecstasy in a different category from other illicit
drugs, said Stuart Gitlow, MD, medical director of Nantucket (Mass.)
Behavioral Services. "When we question people about using drugs they say
no, but when we ask them if they are using Ecstasy they say yes," he said.

Ask young patients how they spend their leisure time, suggests Dr. Miller.
Ask them if they attend concerts or all-night dance parties and what
experiences they've had with people using club drugs. Such conversations
could lead to discussion about the patient's own drug use.

Physicians in New England have seen a huge increase in Ecstasy's use over
the past two years, said Dr. Gitlow. And the same is true in Wisconsin,
where Dr. Miller practices.

"Now that the marketing of the drug is being revved up," said Dr. Miller,
"we can expect to see Ecstasy in every corner of the nation and in every
size community."

Young people 12 to 27 years old are the primary users of Ecstasy, which has
been around for at least 30 years. The drug also bears the ponderous name,
methylenedioxymethamphetamine, or MDMA.

While the use of Ecstasy has not yet reached epidemic levels, it is rising,
National Institute on Drug Abuse Director Alan Leshner, PhD, told
scientists, drug counselors and policymakers who gathered last month in
Washington, D.C., for a conference,"MDMA/Ecstasy Research: Advances,
Challenges, Future Directions."

"In the short term, Ecstasy can cause dramatic changes in heart rate and
blood pressure, dehydration and a potentially life-threatening increase in
body temperature," said Dr. Leshner.

"In the longer term, research shows that Ecstasy can cause lasting changes
in the brain's chemical systems that control mood and memory," he noted.

Ecstasy and several other drugs have gained notoriety because of their use
at popular, all-night dance parties, or "raves," that are attended by young
people.

The burgeoning use of the drug has also inspired a wave of violence across
the nation as drug dealers entered the picture.

Ecstasy is distributed in pill form that is inexpensive to manufacture and
can reap a large profit for those trafficking the substance.

Complicating the picture is a claim by some that Ecstasy holds therapeutic
powers for treating mental ills and is a safe, nonaddictive drug. Those
claims, said Dr. Miller, "are tragically comical notions." The claims are
reminiscent of those made for the drug LSD (lysergic acid diethylamide) in
the 1960s, he noted.

Conference Findings

The fact that many users of Ecstasy also use several other drugs at the
same time makes it difficult to tease out the effects of Ecstasy, noted
researchers at the NIDA conference.

Among some other findings presented at the conference:

* Patricia Case, ScD, director of Harvard Medical School's Program in Urban
Health, reported that preliminary findings of studies in Boston and New
York indicate that Ecstasy use has increased among men who have sex with
men. Participants in Dr. Case's study reported having unprotected oral and
anal sex when using Ecstasy, particularly in conjunction with the use of
the drugs ketamine hydrochloride and methamphetamine.

* Robert G. Carlson, PhD, a professor at Wright State University School of
Medicine in Dayton, Ohio, reported that research in central Ohio revealed
that the use of Ecstasy is no longer limited to the rave scene or dance
clubs but has moved to concerts, parks and house parties and is
increasingly popular among high school and college students as well as
among young people not in school.

* Jean J. Schensul, PhD, executive director of the Institute for Community
Research in Hartford, Conn., found that Ecstasy use is not limited to
suburban youth but is being widely used among teens in Hartford. Dr. Miller
compared the rising use of Ecstasy with past epidemics of drug use in the
nation. "What has happened with Ecstasy is exactly what happened with
cocaine in the 1980s and will happen again with an unnamed agent 10 or 20
years from now," he said. "It's part of a cycle, and people need to be wary
about these trends and how seductive they are."