A BITTER PILL

This week it was revealed that 37 per cent of drivers stopped by gardai
last year on suspicion of drink driving tested positive for drugs,
including 16 per cent using amphetamines such as ecstasy. Is ecstasy still
the drug of choice? Research from the US and Britain suggests it can cause
permanent brain damage. Is E stunting the minds of a generation? Sarah
Boseley investigates.

ECSTASY RESEARCH: There was a time, while the dance music was pumping and
before free raves were closed down, when it seemed as if one young
generation had finally found the perfect pill. It got them high, it was
cheap, it did not send them to hell and back on bad trips and it was not
addictive. They had found ecstasy.

Hundreds of thousands of kids were dropping Es, dancing all night without
so much as a mouthful of expensive alcohol and heading for school or work
on Monday morning pretty much intact. They still are.

Ecstasy is the way of the weekend for large numbers of young people. The
latest figures in Britain show that 12 per cent of 16- to 24-year-olds have
taken it at some time. Only 2 per cent effectively admit to regular use,
but not everybody is going to confess to the crime survey; there's no doubt
the real figures are higher. Look at the temptation: a pill that will give
you euphoria and energy all night long for under a tenner.

But it's starting to look as though it's all going sour. One study after
another is suggesting ecstasy can cause brain damage. No, it isn't likely
to leave you a vegetable in the near future, but evidence seems to be
steadily accumulating that it is doing something to your brain, and it may
be irreversible.

The research is still in its early stages, there's still time for most of
it to be overturned, but it's all pointing the same way. The latest study
in Britain is a pilot, involving 30 people aged 18-25 who took
psychological tests to establish whether ecstasy had affected their working
memory - the part that enables us to carry out routine everyday tasks such
as cooking a meal. It also tested their ability to take in and use information.

The scientists, from Edge Hill college of higher education in Ormskirk,
Lancashire, found that ecstasy users performed significantly worse than the
others. "We don't want to start any scares or panics," says Dr Philip
Murphy, one of the authors of the study published in the British Journal of
Psychology. "It's a pilot study with a relatively small sample. We have to
balance that with our responsibility as scientists to point out potential
dangers that we discover.

"The problems that we found in working memory emerged when people worked
under pressure and, most notably, under time pressure. For normal working
circumstances there was no problem." So could ecstasy cause problems for
people in high pressure jobs, late in their lives? "That is perfectly
conceivable," he says.

In December came the really scary news, published in the highly reputable
Lancet medical journal, that a group of scientists in the US had scanned
human brains and found damage to serotonin neurons caused, they believe, by
ecstasy. Serotonin is the chemical in the brain partly responsible for mood
changes; neuroscientists are beginning to believe people who drop Es may be
at greater risk of mood and sleep disturbance, aggressive tendencies and
anxiety.

All drugs cause mood swings. If you go high, you must come down low. But
the most alarming part of the research is the suggestion that some of the
changes caused in the brain could be permanent. Prof Una McCann of the US
National Institute of Mental Health in Bethesda, Maryland, described a
series of experiments on monkeys carried out in laboratories around the
globe. Each was given a four-day course of ecstasy. Every single animal
showed signs of brain damage seven years later.

These are early days. Monkeys are not humans. Much more research needs to
be done. The scientists cannot be sure how much ecstasy their human
volunteers have taken and what other drugs they may have mixed it with. So
it is too early to say whether we are heading for a generation of the
neurologically impaired - and some think that there is a danger of making
the wrong risk assessment.

Children are already confused because of the spin that has been put on
information about ecstasy, say some campaigners. After the huge publicity
given to the death of British teenager Leah Betts after she took ecstasy,
and the campaign against the drug launched by her father, research showed
that school children thought ecstasy was more dangerous than cocaine and
heroin.

Yet among healthy young people there have been only about 80 recorded
deaths while taking ecstasy, and nearly all collapsed with severe
heatstroke at raves. "A lot depends on what sort of criteria you are using
to measure risk," says Harry Shapiro of the drugs information charity
Drugscope.

"If you are talking about addiction, drugs like heroin, cocaine, tobacco
and alcohol are going to come fairly high up the list, but you don't drop
dead from smoking a packet of cigarettes. There have been a number of
people who have died after taking one pill. It's the same as with
glue-sniffing. It could be the first time."

E-users may be moved by the threat of brain damage - but they may not.
Young people's risk perception is different from that of older people.
"Everyone thinks they are immortal," says Shapiro. Faced with the
possibility of something happening to them 20 to 30 years down the line
they may decide, as they frequently do with cigarettes, to say: "I'm not
going to bother with that."

John McKevitt, a graphic designer, has no intention of worrying about scare
stories, and he is a relatively long-term user of the drug. "You feel
absolutely brilliant," he says. "That first rush is fantastic. Plus it's
incredibly social and it's good to dance to - all the stuff you normally
hear about it. I am 31 now and I started taking E when I was 21, though
only using it heavily - around once a week - for about a year of that. The
rest of the time might be once a month or so. But when I say using it, that
would be two pills, or occasionally three.

"I've never had any negative side-effects or negative experiences, and I
have never seen anyone have a negative experience. I have got a bit bored
with the dance scene, so now when I take it it would be round with some
friends. But I have good friends who still use it regularly at raves.

"I have never been one for the scare stories. I do think there should be
more testing on it, but it wouldn't put me off taking it."

There are others who worry more. "When I was at university I used to take
ecstasy quite a lot," says Anna Thornton (25), an administrator. "I was
really into the club scene and I knew lots of people who went mad on it. I
did really enjoy it and then I managed to stop in the last year. I do feel
now that it's made me a bit paranoid and panicky. It's hard to tell, but
discussing it with my friends who have been through similar times, they
feel the same way as well.

"One of my friends definitely thinks that it's made her have panic attacks
and is convinced it has had a really bad effect on her. I think it does
affect your memory. I don't know whether it's a paranoia of mine that I
have a bad memory, but I do feel it's slowed me down in that way."

While everybody agrees ecstasy is not physically addictive, Dr Murphy is
one of those who thinks it may cause psychological dependence - in that
anything that makes you feel good makes you want it again and again. Scott
Ferguson, a 23-year-old student, says the highs are so good that the lows,
to him, feel really bad.

"I haven't taken any for a year or so. I must have taken E for the first
time when I was 17. All my mates were doing it. It was amazing - a real
rush, like nothing I had ever done before. I had done acid and smoked
cannabis, but it was like nothing else, a total, euphoric feeling. I have
taken it a few times, about a year ago, but now I don't want to get that
spaced out, because the come-downs are a nightmare.

"The come-downs get worse over time. It's like drinking: as you get older
the hangovers get worse. I think your body gets a bit weak. The next day
you are feeling completely washed out. The highs are really happy and loved
up and everything's great, and the lows are the complete opposite of that.
I hope I haven't suffered any long-term effects but I imagine that heavy
use would affect you. It's mental damage, isn't it?"

Ecstasy - formally known as MDMA - was first synthesised in 1912. It is
part of a group of drugs known as MDA, some of which (including MDMA) are
derived from the oils of natural products such as nutmeg and sassafras.

But from a very early stage, ecstasy was considered benign. It was used by
marital therapists in the US because it diffused the hostility of angry
couples, allowing them to talk civilly to each other. It has only been
available in Ireland and the UK since the mid-1980s, most of it initially
produced in underground labs in Holland and Belgium.

In March, the British Police Foundation made a pragmatic risk assessment,
saying that ecstasy should not be bracketed with heroin and cocaine, which
kill and destroy lives. "Although deaths from ecstasy are highly
publicised, it probably kills fewer than 10 people each year which, though
deeply distressing for the surviving relatives and friends, is a small
percentage of the many thousands of people who use it each week," said its
report.

Nor is it clear what killed those victims. Was it E and the cocktail of
drugs in a pill, or hyperthermia, dehydration, or excessive rehydration
because of acute thirst (the verdict at the inquiry into Leah Betts's death).

The foundation recommended that the definition of ecstasy be moved from
class A to class B - not least so that those who drop Es will not be
emboldened to try heroin, which is currently in the same class.

If there is such a thing as a fashion in drugs, then E could be on the way
out. Harsh publicity about its dangers may well persuade some young people
not to take it. The trouble is, say campaigners, they may look elsewhere
for a high. And there are some drugs that do not go out of fashion -
because those who use them become terminally addicted to them.

Additional reporting by Esther Addley. Names of ecstasy users have been changed.