U.S. VS THEM

Source Of Ecstasy Experiencing 'Fatigue' With It

AMSTERDAM, Netherlands -- When Dutch Prime Minister Wim Kok visited
President Clinton last fall, talks quickly turned to a sore point in
U.S.-Dutch relations: the "club" drug ecstasy.

The United States has seen a jump in ecstasy use, especially among
teenagers, and a surge in violence involving dealers. As far as U.S.
authorities are concerned, a root cause of the problem is the Netherlands,
which produces up to 80 percent of the ecstasy tablets coming into the
United States.

It is not known exactly what was discussed at the White House. But soon
after Kok returned home, the Dutch government announced a major crackdown
on ecstasy production and trafficking.

While the United States hailed the move, some Dutch critics saw it as yet
another example of the world's biggest consumer of illicit drugs trying to
blame other countries for its problems.

"You attack us ever more fiercely about producing ecstasy -- as if the drug
trade can be blamed exclusively on the country where production takes
place," Fredrick Polak, a psychiatrist with the Amsterdam health
department, said in an open letter to the United States. "The truth is
really very simple. As long as there is a strong demand for drugs, there
will be production, and criminalization will only make the trade more
lucrative."

The Netherlands is well-suited to the manufacture and distribution of
ecstasy and other illicit synthetic drugs. It has a large chemical
industry, which provides ready access to the required precursor chemicals.
It boasts the world's biggest seaport and one of Europe's busiest airports,
both major drug smuggling points.

Ecstasy, chemically known as MDMA, is related to amphetamines, which act as
stimulants. Discovered in 1912, it was not until the 1980s that MDMA became
popular in the United States and Europe with young people attending all
night "rave" dance parties.

Within 20 minutes of taking ecstasy, most users feel a "rush" and a
fluttery sensation in the stomach. That is followed by a warm, euphoric
glow that lasts four to six hours.

After the glow wears off, users can become depressed, forgetful and
extremely tired. Animal studies have suggested there may be long-term brain
and memory damage. But the major short-term risk is that ecstasy's
stimulant effects can lead to dehydration, seizures and kidney and heart
failure.

In Florida, ecstasy has been blamed for at least 27 deaths since 1997,
including two teenage boys in the Tampa Bay area. (By comparison, in 1998,
1,128 people in Florida died of cocaine overdoses and 206 from heroin
overdoses.)

Nationwide, 8.2 percent of U.S. high school seniors said they had used
ecstasy in the past year, nearly double the level in 1996.

In the Netherlands, use of the drug rose from 1993 to 1997 but has since
leveled off, reflecting a "mild ecstasy fatigue," as one writer put it.
Even at its peak, only about 3 percent of Amsterdam residents 12 and older
reported taking ecstasy in the past year.

"We don't have a problem with ecstasy in the Netherlands," says Peter
Cohen, a University of Amsterdam professor and expert on drug issues.
"There are few overdoses, the big fashion has passed, the ecstasy market
was always quite calm. You (in the United States) shouldn't have an ecstasy
problem but you are constructing one."

Unlike the United States, where ecstasy use is treated as criminal, the
Dutch have taken more of a public health approach.

Jellinek, a Dutch organization that runs drug prevention and counseling
programs, has five centers in Amsterdam where users can bring ecstasy
tablets for testing to see if they contain dangerous adulterants such as
heroin.

Through pamphlets, a Web site and a hotline, Jellinek provides information
on ecstasy's effects, pleasurable and negative. It also works with clubs to
make sure plenty of water is available.

These "harm reduction" measures have been criticized by the International
Narcotics Board, a U.N. agency that closely reflects the views of the
United States.

"Such actions, though well-intended, lead to ambiguous messages and
confusion," the board says in its 2000 report on global drug trends. "Thus
many drug abusers are not aware that there is no safe use of such drugs."

Although crackdowns on ecstasy production might limit supplies, they can
have harmful consequences, says Janhuib Blans, head of Jellinek's
prevention programs.

In 1996, Dutch authorities seized enough precursor chemicals that
ecstasymakers turned to more dangerous substances with which to manufacture
the pills.

"The effect was that the market quality of pills was going up and down,"
Blans says. "People were so unsure of what they were buying that they moved
to the next (drug), cocaine. In terms of health and prevention, the move
from ecstasy to cocaine is not a happy one."

The most recent crackdown targets equipment used in making ecstasy pills.
That could result in ecstasy being distributed in powder form, causing
confusion between it and cocaine.

"People might try to shoot up or smoke it," Blans says. "It looks a lot
like cocaine, so how do we tell the difference?"

Coming Tuesday Switzerland puts drug traffickers in prison -- then gives
some of them heroin as part of a controversial program to treat opiate
addictions.