FLYING BLIND

The jury's out on whether users of ecstasy face health problems down the line

Unlike booze or beer, which only make Emily more angry or more sad, the
little blue-green pills she's been popping most weekends, take her far away
from the dark and perilous places she wants to escape.

Like most chemical highs, though, a long, steep crash soon follows.

For ecstasy users, the drug is all about squeezing a better experience out
of life. The irony is that when you squeeze too hard, you may end up worse
down the line.

The long-term effects of ecstasy, a drug considered benign by those looking
for a quick trip to euphoria, is what researchers are trying to determine
- -- whether it can really lead to the type of memory loss, brain damage or
chronic depression that a number of inconclusive international studies have
suggested.

But it's hard to convince those like 18-year-old Emily (not her real name),
who consider ecstasy their drug of choice, of long-term dangers.

Talking about the immediate side effects, the Grade 12 student, who's
sitting in an Internet cafe near Scarborough's western edge, says most
experienced ecstasy users know how to ward off the "terrible Tuesdays"
often associated with the drug.

"My mom's generation had acid (LSD) and we have E," she says. "That girl
who died last week either didn't know what she was doing or took something
that wasn't even E. There's no difference between E, pure E, and most drugs
people get from their doctors if they're depressed. You just have to make
sure you watch how much you take, what you take it with. Down lots of
vitamins and water when you take it and you'll be fine."

Will you?

When ecstasy was suspected as the possible cause of 17-year-old Nicole
Malik's death a week and a half ago, the immediate concern was about the
short-term effects of the drug, such as a dangerous elevation in the heart
rate, respiratory problems and an inability to regulate body temperature.

But, while experienced users talk of ways to avoid short-term side effects
(contrary to media portrayals of ecstasy as a drug exclusive to the youth
rave scene, many chronic users are their 30s, 40s and 50s), it's the
long-term effect that researchers are trying to study.

"Right now, the scientific literature on the risks of using ecstasy, in
regard to brain damage is so conflicting that, in my opinion, no conclusion
can be drawn," says Dr. Stephen Kish, head of a neuro-pathology lab at
Toronto's Centre for Addictions and Mental Health. Kish is conducting
research to determine exactly what the long-term effects of ecstasy are.

A controversy over long-term effects arose after a number of European and
North American studies, published since the mid-'90s, reported vastly
different findings about permanent damage to serotonin, a chemical that
regulated mood, producing neurons in the brain.

Various forms of depression are associated with a lack of serotonin being
released, while upbeat, happy moods are associated with an increased level
of the chemical released in the brain.

Antidepressants, which regulate the amount of serotonin, are prescribed for
a variety of anxiety and depression disorders and do not destroy neurons
that help produce the chemical.

The "terrible Tuesdays" commonly mentioned by ecstasy users refers to a
depressed feeling when coming down from a high, a result of depleted
serotonin levels after the initial increase, which rises for up to two
hours after the drug is ingested. The amount of serotonin then plateaus for
up to three hours, before the level starts to decrease.

It can take up to a week before the brain is able to produce regular levels
of the chemical, resulting in a prolonged depression after taking ecstasy.

"What we're trying to find out is whether chronic ecstasy use can
permanently damage the brain's ability to produce serotonin," says Dr.
Clare Roscoe, a psychiatrist at the Centre for Addiction and Mental Health
who has focused her research on the effects of ecstasy. "One heavy user who
was 17 at the time of his death, had serotonin levels about 50 to 80 per
cent below normal control levels."

Those reduced levels, says Roscoe, are similar to the findings of a Dutch
study, which reported ecstasy users who had taken the drug regularly (at
least one pill a week) for over a year, had between 55 and 80 per cent
less serotonin than the control group. "We have to determine, conclusively,
what the effects of ecstasy are," says Roscoe. "But I would worry that this
generation is at risk of a much higher rate of depression and other effects
such as memory loss."

"How do you believe any study?" asks 35-year-old Daryn, after hearing about
some of the research. "They all say something different." She's sitting
with six friends in a King St. apartment, sipping wine on a Friday night,
talking about the drug which all but one of them have used since the late
'90s. They've replaced their real names with "club" names for the interview.

"If you're doing pure MDMA (the chemical name for ecstasy) it's completely
different than doing whatever is in most of the pills being passed off as
E," says Princess, 24, who only gets the drug from one of two dealers she
trusts.

"I've done a pill that wasn't E at all once. I vomited for eight hours.
I've done pure MDMA and you do not get sick from it, it's a gentle
euphoria, there's nothing mashy or nauseating about it."

"I've chosen not to do E any more," says 24-year-old Jan. "It taught me a
lot. I was a very introverted person and E brought me out of that, but now
I don't need it to be open. And I don't need to be on E to be happy or to
feel the rush that it gives you. It's like I can remember that feeling when
I was on E, but I can get it back without taking any now."

Ecstasy users often mention one of two primary motives for taking the drug:
to relieve depression or to gain a heightened sensation from routine
experiences that, without ecstasy, would seem mundane -- a dozen scents
drawn from every breath, vivid colours, shapes and details carved from
every sight. Sounds resonate and reverberate deep within the body and an
intoxicating flood of emotion accompanies even the most subtle human
contact. In short, euphoria.

Taken for either reason, ecstasy seems like the perfect drug for the times.
During the last decade and a half of seemingly limitless consumption, as
people developed a desire for what they don't have, and a dissatisfaction
with what they do, ecstasy represents the potential for a much more vibrant
experience of life. So it's difficult to convince users that the drug might
not be so benign.

The belief that ecstasy is both "safe" and intoxicating, suits those who
seek escape from the routine, while never thinking there's any real risk of
loosing their footing.

"It's not like speed or cocaine that are addictive," says Princess. "I took
pills in Amsterdam that had speed in them and I'll never do that again."

Whatever the drug's long-term effects are proven to be, for now at least,
its users seem unfazed.

"Everyone I know who's done E for years is fine," says 30-year-old Scooter,
who, like his friends in the apartment, is skeptical about theories linking
ecstasy and brain damage.

"If they want to criminalize the drug because what you get on the streets
might not be real E, it might be dangerous, that's fine," he says. "But
don't criminalize it and try to scare people by talking about things that
can't even be proved. All the crackdowns on E, raiding the clubs and stuff,
is going to do is push it farther underground.

"That's when it gets dangerous, because you don't know what you're getting
then."