THE AGONY AND THE ECSTASY PANIC

Warning: this column falls under the heading "Am I slowly going
insane or is there more than meets the eye here?" Canada's press has
been reporting this week on a heartbreaking incident that took place
at the Paul First Nation 60 kilo-metres west of Edmonton. Several
girls getting ready to attend a Sunday wedding reception took what
they thought was MDMA, the popular club amphetamine known as ecstasy.
Three or four of them fell ill, and two went into a coma and have
since died. This is a confusing event, but the reaction has been even
more confusing.

Many early news accounts uncritically described the sick girls as
having fallen prey to an "overdose" of ecstasy. Now, as it happens,
ecstasy "overdoses" are a lot less common than you might think.
Earlier this month, a top drug-safety adviser to the U.K. government,
David Nutt, caught hell for pointing out that if we redefined
horseback riding as a behavioural addiction called "equasy," any
rational harm scale would find it to be far more lethal than ecstasy.
Nutt pegged the number of acute harm events from ecstasy use, for the
purposes of contrived controversy, at no more than 1 per 10,000 exposures.

Yet even this is probably a massive exaggeration of the true amount
of harm from ecstasy as such. Exact figures are hard to derive
precisely because toxic reactions to ecstasy are so rare, and the
drug does not even seem to have an established LD-50 (median lethal
dosage) for humans. As pharmacologist Richard Green pointed out in a
2004 article, "In the U. K., there are around 12-15 deaths a year in
persons who have taken MDMA. Given the fact that around 500,000 young
persons ingest the drug in a very uncontrolled way every week in this
country, these figures do not indicate MDMA to be a particularly
toxic compound." (The media, he added, was responsible for "much
nonsense about MDMA being presented.")

And how many of those 12-15 deaths are actually the result of
legitimate, uncomplicated overdoses, or of adverse reactions to
ecstasy alone? Probably not many. A lot of "ecstasy deaths" turn out
to be the result of hyperthermia and dehydration on hot, crowded
dance floors. Others result from drug interactions. We might really
be talking about roughly five genuine ecstasy deaths a year, against
a U. K. background of about 25 million annual exposures to MDMA.

Those are long odds. Long enough to make it awfully suspicious that
two girls in Western Canada should essentially drop dead at the same
moment, without some common etiological element besides MDMA. Since
the ill-fated girls weren't at a dance or rave, the obvious
possibility that comes to mind is some impurity or adulteration in
the batch of pills they took. If so, killer drugs may be circulating
in the vicinity of Edmonton.

So far, there have been no other reports of adverse reactions to
ecstasy. The RCMP is on the case, but for unclear reasons, they seem
to find the "crazy coincidence" theory pretty satisfying. K Division
spokesman Cpl. Wayne Oakes said that Stollery Children's Hospital
staff found no evidence the girls had ingested anything but pure
ecstasy, and he went out of his way to dismiss "rumours" that they
had received a bad batch of pills. "It's not uncommon in a tragic
situation like this for rumours of that nature to arise," he told CTV
News, "because it's so devastating, it's so out of the norm, and
they're looking for some extreme cause to rationalize a tragedy like this."

Well, yes. There are two dead girls who were alive last week; it is
indeed natural to look for an "extreme cause." But it seems to me
that the people who wondered about rat poison were basically showing
good epidemiological instincts, and it's the RCMP's implicit
explanation for the incident that should be regarded as the weird one.

The police, in general, are not known for their scientific literacy
(or consistency or honesty) when it comes to illicit drugs. Like the
media, they have a known susceptibility to unfounded claims and moral
panics. And they are responsible for an abundant record of reported
"ecstasy overdoses" that weren't. I am concerned that in this case,
they may be accepting an account of events that fits the drug
warrior's animistic world-view -- evil party drug kills innocent
teenagers -- but that doesn't have much basis in fact.

It might be an idle question, were it not for the possible risk to
other ecstasy users who have essentially been reassured by Cpl. Oakes
that nobody's rave needs to be postponed just because of that downer
on the rez. I appeal to the Chief Medical Examiner of Alberta to
exercise diligence in protecting the welfare of this region's
hippies, burnouts, flakes and slackers.