WHAT SHOULD THE PUBLIC BE TOLD ABOUT THE RISKS OF ECSTASY?

To the Editor:

Judging from the content of Mr Vastag's Medical News & Perspectives
article, it appears that he missed the big-picture message from the 60
researchers who presented the latest science findings on MDMA
(methylenedioxymethamphetamine; "ecstasy") at the National Institutes of
Health (NIH). The overarching message from this international conference
with over 500 attendees was that MDMA is quite dangerous both in the short
term and in the long term.

There is substantial scientific and clinical evidence to show that MDMA
damages brain cells, which may account for the long-lasting behavioral
effects that users report, such as memory loss and mood changes.
Admittedly, there is still much that is not known about the consequences of
using this drug; however, the conclusion from this NIH conference is that
ecstasy is clearly anything but benign. Because of its stimulant properties
MDMA can dangerously increase heart rate, blood pressure, and body
temperature. Scientific experts at the conference have confirmed that it
damages brain cells, even in occasional users. This is a message that the
public needs to hear.

There is no disputing that MDMA use is increasing and that effective
prevention messages must be matched with the appropriate population. The
NIH will continue to support and disseminate research on this important
topic as the science continues to unravel the consequences of this drug.

Alan I. Leshner, PhD National Institutes of Health Washington, DC

1. Vastag B. Ecstasy experts want realistic messages. JAMA. 2001;286:777.
FULL TEXT | PDF | MEDLINE

Dr Leshner is now affiliated with the American Association for the
Advancement of Science.ED.

To the Editor:

In Mr Vastag's Medical News & Perspectives story,1 I applaud those ecstasy
researchers who are bravely challenging the effectiveness of the
anti-ecstasy scare campaign promoted by the National Institute on Drug
Abuse (NIDA). As pointed out by the researchers quoted in the article,
ecstasy is a complex drug, and the reasons various people use it are
equally complex.

Portraying ecstasy as nothing but a brain deadener is not only inaccurate,
it is ineffective and dangerous social policy. With million of young adults
saying "yes" to ecstasy it is NIDA's duty to provide them with complete and
accurate information about the drug. The fact that NIDA still does not do
so is an artifact of the larger "war" policy with respect to illegal drugs.

Richard Glen Boire,

JD Center for Cognitive Liberty and Ethics Davis, Calif

1. Vastag B. Ecstasy experts want realistic messages. JAMA. 2001;286:777.

In Reply: Dr Leshner argues that my article missed the big picture from the
meeting that MDMA is dangerous. That message, promoted heavily by NIDA, has
received plenty of press. Instead of rehashing it, I decided to present
another viewpoint, one held by several of the conference's presenters. As I
reported, these social scientists emphasize the need for more realistic
prevention messages. The weight, originality, and underexposure of their
research made it newsworthy.

Brian Vastag JAMA Medical News & Perspectives