EXAMINING THE USE AND ABUSE OF ECSTASY

WE HEAR a lot about the drug Ecstasy of late.

MDMA (its chemical name) has been around since 1914. But it was not
actually used until the 1970s, when a small group of psychiatrists
discovered the drug's ability to melt away patients' fears and defenses. It
became useful in psychotherapy.

By the early 1980s, entrepreneurs coined the name "Ecstasy." MDMA crossed
over from therapy to recreation. The open presence of "X" among young
professionals -- coupled with disturbing (though preliminary) research
findings about possible brain changes -- caused the Federal Drug
Enforcement Administration in 1985 to ban MDMA for both medical and
recreational use.

But Ecstasy never disappeared from the drug scene.

Its reputation as a "feel good," "love/hug" drug, and its continued use
among affluent young people has caused much concern and controversy.

Millions have tried MDMA, and government studies indicate that use among
teenagers is growing faster than any other drug, nearly doubling in the
past five years.

Use of Ecstasy in the gay community has grown. A culture of users who
attend large dance parties known as "raves" has developed worldwide.

An adulterated market has emerged, making it impossible for users to know
exactly what they are actually getting. Other drugs (such as PMA and DXM)
look just like Ecstasy but have caused severe reactions in naive users.

The hot, stuffy environment at some raves has overheated and dehydrated
dancers, bringing about seizures or fainting.

Meanwhile, researchers remain concerned that even small amounts of MDMA can
have long-term consequences for brain chemistry. As a response, the
government launched a "Club Drugs" initiative to warn users about Ecstasy's
dangers; politicians are calling for stricter penalties for manufacture,
distribution and use, and raves are being closely scrutinized, or even shut
down.

Resolution is far from imminent. Claims about risks and benefits of MDMA
diverge widely, with proponents going so far as to call the drug "a
penicillin for the soul" and detractors labeling it "the worst new drug to
hit the streets since heroin."

Somewhere in between the extreme views are (1) scientists and physicians
who believe MDMA to be less harmful than government officials have claimed;
(2) those who wish to conduct research on both therapeutic and recreational
use; (3) those who wish to simply reduce the harms associated with use, and
(4) the millions of people who do not know what to believe.

In a first-of-its-kind "only in San Francisco" gathering, scientific
researchers, clinical and public health professionals, government
officials, patients, psychotherapists and "ravers" are meeting in the city
today to discuss the history, medical uses, potential problems and culture
of Ecstasy, with an eye toward proposing sound approaches and
"harm-reduction" policies.

"The State of Ecstasy: Science, Medicine and Culture" conference is
sponsored by the San Francisco Medical Society, the Lindesmith Center-Drug
Policy Foundation, the University of California in San Francisco, the San
Francisco Department of Public Health and the California Society of
Addiction Medicine.