THE POISONING OF SUBURBIA

An 18-year-old girl died after taking a pill she thought was ecstasy. Is
her death a sign of more tragedies to come?

By Ted Oehmke

July 06, 2000 | Sara Aeschlimann called her mom, Janice, in typical fashion
at 12:30 one Saturday night. "I just wanted to let you know that I'm OK and
that I'll be staying at Garrett's house," she said. Though Garrett Harth
was three years older than 18-year-old Sara, they had known each other a
long time, and he lived with his parents only five minutes away in the
Chicago suburb of Naperville, Ill.

Like other teens, Sara had experimented with drugs, and had recently
confided to her mom that she liked to smoke pot every once in a while. That
worried her mother. But Sara had a job and a wide circle of friends, and
was just a few weeks from high school graduation. All in all, she seemed
OK. Aeschlimann thanked her daughter for calling and hung up.

A short time after the call, as Sara was watching TV and playing pool in
Harth's basement, he reportedly offered the striking blond, brown-eyed girl
a potent brand of ecstasy known as "double stack white Mitsubishi." She had
apparently taken ecstasy for the first time a couple of months earlier, and
the round white pills were supposed to be the hottest version of ecstasy
around. She washed down a few and waited for the drug's effects to kick in.

Indeed, they did. Within hours, she was in convulsions and had to be rushed
to the hospital. There, she lapsed into a coma and her body temperature
rose quickly, not stopping until it reached 108 degrees. "She was bleeding
everywhere," says her mother. "Her blood cells were just erupting. Her
intestines were bleeding; her stomach was bleeding. She was bleeding from
the mouth. She bit her lip when she had a seizure, and it wouldn't stop
bleeding, but she was not moving at all."

By 3 the next afternoon, Mother's Day, she was dead. Instead of taking
methylenedioxymethamphetamine (MDMA), the only chemical contained in
unadulterated ecstasy, she had unknowingly swallowed
paramethoxymethamphetamine, a much more dangerous chemical known as PMA.
The DuPage County coroner's office determined that Sara died from an
accidental overdose of PMA, a substance also believed to be responsible for
at least two other recent deaths in the Chicago area.

Contaminated illegal drugs have never been a big issue in the United
States. But if the demand for ecstasy continues to rise, as some
researchers speculate it will, more and more dealers may start substituting
deadly substances like PMA for less harmful drugs like MDMA.

"The ingredients for MDMA are highly controlled, and you have any number of
people willing to make substitutes that are much more dangerous," says Dr.
David Nichols, professor of medicinal chemistry and molecular pharmacology
at Purdue University and one of the few to ever study the effects of PMA.
"If you make one drug illegal, it will be replaced by a more dangerous
drug. No matter how much you try to control it, people will come up with
substitutes."

With the skyrocketing demand for ecstasy and its low production outlay --
it costs only 10 to 50 cents to make a pill that sells on the street for
$20 to $45 -- there is a compelling economic incentive to sell the drug
even if it's entirely made of another substance. "The rave scene is a huge
market of people willing to pay $20 or $30 per pill to get high, and a lot
of people are taking advantage of it," Nichols says.

The tablets and capsules sold as ecstasy might contain any number of
adulterants. A quick look at the pill-testing results of DanceSafe, a harm
reduction organization that analyzes such pills in a forensic laboratory,
shows a cookbook's worth of ingredients that the drug is often cut with or
downright replaced by: caffeine, DXM (dextromethorphan, an ingredient in
cough suppressants), the psychedelic PCP, Valium and ketamine (an
anesthetic). Ingestion of DXM, for example, has led to hospitalizion of
ravers in cities like Oakland, Calif., and London. Included on DanceSafe's
list of tested pills is a picture of white Mitsubishi, the variety of
ecstasy that killed Sara.

But the problem of drug contamination and substance swapping by drug
dealers is not widely recognized. An epidemiologist who attended a recent
drug trends seminar in Washington, but who wishes to remain anonymous, says
that a Drug Enforcement Administration representative at the conference
commented that ecstasy is "a pretty pure drug." And a slide show presented
at the seminar revealed that the DEA had analyzed more than 3 million
ecstasy pills in 1999 and found that "all tablets contained some MDMA."

The Customs Service uses dogs to detect ecstasy being smuggled into the
United States, but the canines can only detect MDMA, not adulterants.
During the first four months of this year alone, around 5 million ecstasy
pills were seized by customs, and in all probability the confiscated pills
had some level of purity to them. The result is that the better-quality
drugs are being taken off the market, increasing the ratio of contaminated
pills to clean ones.

While there have always been risks involved in taking any illegal drugs --
which are produced with no oversight by any agency monitoring safety
concerns -- drug contamination has traditionally been limited to substances
like heroin.

R. Terry Furst, an associate professor of anthropology at John Jay College
of Criminal Justice in New York, has studied the demographics of drug
users. He believes the ecstasy-taking crowd, whose numbers have increased
by more than 50 percent among high school seniors in the past two years, is
a whole different demographic group than users of drugs like heroin, who
are mostly from lower economic strata. Furst notes that "income is higher
for ecstasy users because you have to be able to afford to go to a club,
and you have to pay for the ecstasy, too."

Users of ecstasy are generally associated more with ravers -- who are
likely to be found bunny-hopping on the dance floor while sucking on
pacifiers -- than with the traditional type of drug users who will do
anything for a fix. In other words, many of these users aren't aware of the
inherent dangers of taking street drugs -- especially since ecstasy isn't
often linked to fatal overdoses and its dangers are still being debated
among scientists.

"After Sara died," says her mother, "her friends came to see me. They talk
about taking drugs as if they were taking milk and cookies."

The adulterant PMA is not known to be useful for much of anything. Like
MDMA, PMA raises body temperature, but much more severely. Unlike MDMA, PMA
is not known to have very pleasant effects. Chemist Alexander Shulgin,
known for his outspokenness on the positive effects of MDMA, synthesized
PMA and tested it on himself several years ago. In an e-mail interview,
Shulgin says he tried it half a dozen times and found that "it was not too
enjoyable." He said that the chemical "compound is about twice as potent as
MDMA."

According to representatives of the DEA's Chicago office, the PMA
contamination found there was not a novice chemist's mistake -- it was
deliberate. The process required to synthesize PMA is similar to the
process of making MDMA, but the chemical precursors are totally different.
As Mike Hillebran, a DEA spokesman says, it's "like making angel food cake
and coming up with chocolate chip cookies."

The recent overdoses in the Chicago area are the first known instances of
PMA in the illicit-drug market in the United States. However, it has shown
up before. Between 1995 and 1996, at least six Australians were killed
after ingesting PMA they thought was ecstasy, prompting scientists in that
country to warn, in the American Journal of Forensic Medical Pathology,
that "PMA has been associated with a much higher rate of lethal
complications than other designer drugs, and that no guarantee can be made
that tablets sold as Ecstasy are not PMA."

The known incidence of contaminated or substituted drugs in the United
States is relatively small. One of the more publicized cases occurred in
the 1970s, when the U.S. government, under President Jimmy Carter,
supported a Mexican program of spraying crops with the pesticide paraquat
in an attempt to stem the flow of opium and marijuana from Mexico to the
U.S. Keith Stroup, then president of the National Organization for the
Reform of Marijuana Laws, was so infuriated that then-drug czar Peter
Bourne had tolerated the spraying, which many believed could be harmful to
pot smokers, that he leaked a report that Bourne had snorted some coke at a
NORML party. Bourne was subsequently forced to resign.

And in the early '80s, several people showed up at a neurology clinic in
California, exhibiting signs of Parkinson's disease. It turned out they had
tried a form of synthetic heroin called MTPT, which caused damage to the
nervous system in much the same way Parkinson's does.

Drug overdoses are always hard to treat -- doctors don't know how much of
the substance the user took, over how long a period it was taken, if there
was any interaction with another drug already ingested -- but physicians
say the problem skyrockets when someone comes in after having ingested a
drug of unknown origin. In Sara's case lab technicians were unable to
identify what she took until after she died.

"We don't have tests for most of these drugs," says Dr. Alan Kaplan, head
of emergency services at Edward Hospital in McHenry, Ill., where Sara was
taken. "We have to treat symptoms ... We would treat someone with
hyperthermia caused by a [PMA] overdose the same way we would treat a
roofer with hyperthermia. But these drugs," he adds, referring to so-called
club drugs like PMA, "reset the body's thermostat so that it's very hard to
control. Sometimes we just can't get ahead of it."

Six weeks after their only child's death, Sara's parents remain dazed.
Robert, Sara's father, has been "fixing things around the house that don't
need to be fixed," says Janice, who just returned to work as a receptionist
at an animal hospital, and the days without Sara "seem very empty and long."

When she's not having nightmares of Sara's vacant eyes and her bleeding
body lying on a hospital bed, what Janice Aeschlimann remembers is a
daughter who "liked long walks in the woods" and had a pet parakeet who
followed her around the house. "It's very hard to not see her in my mind,"
she says. "She is what I was. Now, I'm not that anymore. It's hard to be,
and not be empty."

Sitting by Sara's bedside at the hospital, the Aeschlimanns told their
daughter they loved her, and Janice vowed that her death would not be for
nothing. "We just hope she heard us," she says. "We hope that she knows we
were there."