Agonies of Ecstasy

By Prof Dzulkifli Abdul Razak

As the year draws to a close and people, especially the young, head for the dance floors, new worrying developments on Ecstasy have made media headlines. The Times (NST, Nov 21), for example, reported the great risk Ecstasy poses for young women, criting a recent study published by researchers at King's College, London.

At about the same time, reportedly in the United States, "one in 10 teens has experimented" with the drug.

Time magazine (Nov 13) wrote a cover story about Ecstasy as "Asia's hippest designer drug".

Meanwhile, in Malaysia, little is now reported about the campaign against Ecstasy, in comparison with a few months ago. The latest statement from the National Dadah Agency director-general which says more Malays are using Ecstasy (NST, Dec 1) does not give the impression that the Ecstasy war is being won.

So a review of recent findings may kick-start the campaign once again in a more sustained fashion, cutting across all ethnoreligious boundaries.

The study from King's College presented at the annual meeting of Society of Endocrinology in London has some grim news. It says young women taking the synthetic drug reportedly are more likely to die than any other group. It reasons that the drug is more dangerous for women or reproductive age because of the the high levels of estrogen (a predominantly female hormone) found in their bodies.

The hormone is said to prevent their bodies from coping with water retention as Ecstasy is being absorbed in the body. The use of the drug and the eventual so-called "rave" behaviour invariably results in overheating, and thus thirst. The body temperature can climb from the normal 37 degrees Celsius to anything above 40.

The user will then consume an "unusually" large amount of water in the attempt to offset this potentially deadly effect. Too much water in a short time can lead to imbalances in the body's mineral and electrolyte composition, damaging brain and nerve tissue which is sensitive to such imbalance. 

For young women there seems to be an added risk since they are already known to lack minerals, especially sodium (salt). Estrogen makes the nerve system more vulnerable to this effect. 

Also, at such high temperature blood starts to coagulate, one of the causes  of Ecstasy-related deaths over the past two decades, notes Times.

In the long-term, brain cells could be chemically resculptured by the drug (see http://prn.usm,my/bulletin/sun/1996/sun23.html for detailed explanation), causing irreparable damage.

As Ecstasy breaks down, it produces acronymned HMMA (4-hydroxy-3-methoxymethamphetamine) which causes the release of a hormone (vasopressin) boosting water retention.

Despite such new finding, driving home the message to teenagers is a challenge. A survey by the Partnership for a Drug-Free America finds Ecstasy use has doubled among teens since 1995. The number of teens who have tried the drug at least once had increased from seven per cent to 10 per cent over the past year (full report at http://www.drugfreeamerica.org/research/pats20002.asp).

The appeal is so strong that the survey finds more teens being turned off by marijuana than Ecstasy. This change is interesting because marijuana seems to be gaining mileage as a potential therapeutic agent.

Part of Ecstasy's appeal has to do with misconceptions. Even senior citizens, as reported by the National Dadah Agency, are vulnerable.

Even more mind-boggling is the notion senior citizens seem to have that it will make them more active! But nothing can be farther from the truth.  Sexually too, it has a downside. The drug lowers sexual drive. Men generally cannot get erections when high on it, through the reverse may happen when its effects begin to fade.

Here lies another danger. It was found that men in New York City who use the drug are about three times more likely to have unprotected sex. It is worth recalling that just 10 days ago we celebrated the World AIDS Day with the theme "Men make the difference"!

It seems certain that the problems, associated with Ecstasy in this country are getting more complicated. The drug is beginning to move out of discos and dance clubs into the mainstream of illicit drug users. And it is no longer confined to any clear ethnic identity. We need to configure our new strategy fast.