News Analysis:

IS ECSTASY HARMFUL? SCIENTISTS STRUGGLE TO PROVIDE AN ANSWER

Despite high-profile cases such as the death of Leah Betts, one
million people a week still take Britain's favourite dance drug

Exactly what does ecstasy do to the brain? And are those effects good,
bad, or indifferent? To the estimated one million people who take the
drug each weekend, one could guess that the answers are: it gives you
energy to dance; you feel "loved up"; it's good.

But a growing body of scientific evidence suggests that it's bad in
the long term and almost always bad in the short term. But many of the
people who take "E" - which has enjoyed a dancefloor revival in the
past year or so - do not heed those warnings.

They may have even taken heart from the reports about an article
published in The Psychologist, the official journal of the British
Psychological Society. The article suggests that it's hard to say
whether MDMA - standing for 3,4-methylanedioxymethamphetamine, the
amphetamine constituent of ecstasy - is really harmful, and that the
people who show most of the milder effects ascribed to the drug -
panic attacks, depression or anxiety - might simply be showing the
symptoms of problems that they would have anyway. That's because they
are young adults, reaching the age when any psychological illness
could be expected to show through stress.

The researchers insisted yesterday that they were not saying ecstasy
was safe or without harmful effects. "The newspaper reports about our
article were inaccurate," insisted a co-author, Dr Harry Sumnall, a
postdoctoral researcher at the University of Liverpool. "We did not
say that ecstasy is harmless. We explicitly say that it is dangerous."
He pointed out that the article was not based on fresh research; it
was a review of other research, and quotes scientific papers published
since 1990. And the article itself was hardly freshly minted; it had
been written 18 months ago, Dr Sumnall said. That meant it could not
include some more recent research - such as that which appeared
earlier this year, investigating a study published in 1998.

That 1998 study included pictures of brain scans which apparently
demonstrated that ecstasy destroys nerve cells involved in the
production and transport of serotonin, a vital brain chemical involved
in a wide range of functions including memory, sleep, sex, appetite,
and primarily, mood. On PET brain scans, which make it possible to
view a brain at work, those for non-users showed large "bright"
regions, but those of ecstasy users showed fewer such regions -
suggesting nerve damage. The pictures were adopted in anti-drugs
advertising, and the research findings used to underpin stiffer
penalties for ecstasy use.

But in April the doubts emerged: it turned out that brains vary
enormously when studied in that way. Stephen Kish, a neuropathologist
at the Centre for Addiction and Health in Toronto, told New Scientist
magazine: "There are no holes in the brains of ecstasy users. And if
anyone wants a straightforward answer to whether ecstasy causes any
brain damage, it's impossible to get one from these papers.

"So, should we reconsider our attitude to ecstasy? In May, the Home
Secretary David Blunkett was blunt. "Reclassification of ecstasy is
not on the Government's agenda. Ecstasy can, and does, kill
unpredictably and there is no such thing as a safe dose."

Scientists are reluctant to be as didactic. Science, unlike politics,
allows for uncertainty, and constantly re-evaluates its ideas.

But at the same time, the scientific community that is studying
ecstasy is "converging" on a set of theories about the drug which are
consistent and which keep coming through study after study, said John
Henry, professor of accident and emergency medicine at St Mary's
Medical School, London, who is one of Britain's foremost experts on
the subject. It is not good. It is not even neutral. Ecstasy does harm
you, in subtle ways.

"The short-term effects are very clear, because they're more
measurable than long-term ones," he said. "The Government's pitch is
about the deaths due to ecstasy, which are actually very small in
number - though very serious, because these are all young people who
were doing something recreational that's not regarded as dangerous in
itself."

The Psychologist article, he believes, is being "picky" from among the
vast body of research that has been conducted into ecstasy over the
past 20 years. People have wanted to believe it is harmless, and that
the Government was wrong to ban it in 1977. And for some time in the
1980s when usage took off, it seemed like ecstasy could do no wrong,
or at least little harm.

Dr Sumnall points out that the drug does not cause dependency in the
way it is usually defined. "You don't see [physical] dependency in
ecstasy users," he said. "Although people might start to rely on it to
have a good time." At that stage it could pass over to a different
sort of reliance. But no scientist would ever claim that it could be
harder to give up ecstasy than, for example, heroin, cocaine or crack
cocaine, which generate a physical craving.

While that may be true, the suggestion that the case against ecstasy
is unproven raised the ire of other scientists in The Psychologist.
"The article tends to ignore the overwhelming evidence that regular
ecstasy users suffer from impulsive behaviour and deficits in verbal
memory performance," said Michael Morgan, senior lecturer in
experimental psychology at the University of Sussex. And Rodney Croft,
a research fellow at the Centre for Neuropsychopharmacology at
Swinburne University of Technology, Australia, said: "There is strong
converging evidence that ecstasy does cause some [neuron]
impairment."

Professor Henry said that to attempt to ameliorate the potential
effects of ecstasy based on a selective reading of research was wrong.
"To suggest that its effects are all in the mind, that if you read
about things like panic attacks and depression and memory loss then
you're more likely to get them - well, there's plenty of evidence
that adverse effects do occur." He pointed particularly to a study in
Canada which followed a large number of users and non-users, and
subjected them to regular memory tests. That found that the regular
ecstasy users suffered from memory loss.

"Even if they weren't aware of it, it was there," he said. "Your
ability to function as a normal member of society is being nibbled
away. I'm not saying it's some sort of premature Alzheimer's; but
their ability to organise themselves and do things is being impaired,
long term. And if that's happening nationwide, over a large proportion
of the population - that's very bad news."