THE WAR ON (SOME) DRUGS

Joshua Shenk makes some excellent points about our arbitrary distinction
between licit and illicit drugs, but he is way off-base in comparing the
hallucinogen MDMA with antidepressants such as Prozac. MDMA, commonly known
as ecstasy, is dangerous.

The changes found in both human and animal brains after MDMA use are not
like those found after the use of selective serotonin reuptake inhibitors
(SSRIs), of which Prozac is an example.

The changes are quite like those seen as a result of the diet drug
dexfenfluramine, which was recently pulled from the market because it caused
heart problems.

Anyone taking MDMA as an antidepressant would wind up worse off: the drug
decreases in efficacy with continued use, and even casual users report
short-term depression following their "trips." In someone already
predisposed, this exacerbated depression can be quite serious.

And because of a liver-enzyme deficit and an unpredictable overdose/allergic
reaction syndrome, someone could take MDMA safely one day and the next day
die on the same dose. Avoiding heat and drinking water do not prevent the
problem, and in fact can, as in one notorious death in England, make it
worse. Unless the drug were found to be a cure for cancer or AIDS, it could
never be approved; the risk-benefit ratio is simply unacceptable.

If we are to make changes to our drug policy, they must be based on fact,
and those who push for such changes must be as forthcoming about the harms
related to the drugs they like as they are about harms related to the drugs
they don't like.

Maia Szalavitz New York City