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Press the Panic Button

New Scientist

January 25, 1997

PANIC reigns. Fear overwhelms logical thought. Pointless activity replaces reason, and sensible advice is no longer heard. Sometimes whole nations are affected. A threat appears---a religious cult, a rare disease, aliens who take you up into their saucers--- and rationality flies out of the window. Parents lock up their children lest they be abducted. No one eats beef, or eggs, or whatever is causing the latest panic. Previously sensible people see flashbacks of the aliens' green eyes.

In the middle of a panic, what's needed is for everyone to calm down. And that's just the treatment Britain requires for the current panic over the drug ecstasy. Following the heart-rending deaths of several teenagers who were apparently trying ecstasy for the first time, it has become impossible to express any sensible opinion on the drug. Either you condemn ecstasy use out of hand, or you risk being seen as in favour of killing children. Amid the hysteria, confused new legislation is being hurried through Parliament. The idea is to allow clubs to be closed down immediately if there is a suspicion that ecstasy is being sold in them. As the drug is easily concealed, the law can do no more than punish clubs for failing to achieve the impossible. Unjust and ineffective legislation is a classic symptom of national panic.

The real problem in dealing with ecstasy is the huge gap in the perception of the drug between those who take it and those who do not. And the real scandal is our lack of understanding of its long-term risks.

Ecstasy (or MDMA, as it is known chemically) inhibits the uptake of the brain transmitter serotonin, and so amplifies the signals it transmits between nerve cells. The result is raised heartbeat, an emotional "high" and increased energy levels. In Britain, it is estimated that at least half a million people have taken ecstasy and that around a million tablets are consumed each week. The benefits are seen by users as a state of euphoria, closeness to fellow humans, and the ability to dance all night. Users consider the short-term risks to be small, a perception that available statistics tend to bear out.

Over the past ten years, six people a year are thought to have died as a result of taking ecstasy in Britain. This number appears small compared to the hundreds of thousands who die each year from long- term alcohol and tobacco abuse. It is dwarfed by the 1000 people who die each year in traffic accidents caused by drivers under 21 years of age, and the 600 or so who are killed each year in Britain by drunk drivers. Even pursuits such as mountain climbing, skiing and horse riding kill more people.

Six deaths a year from ecstasy are six too many, but it seems pretty clear that the short-term dangers are not as great as media and many public figures portray them. Ecstasy takers know this, and become understandable cynical about warnings issued by those in authority. Trust disappears---another victim of panic. It would be far better to present an honest assessment of the risks and benefits of illegal drugs and maintain the trust without which any influence over young people is impossible.

The search for truth is also at risk in times of panic. Little has been done to investigate the long-term dangers of ecstasy use, not least because in Europe it has been more difficult that it should be to get funding to carry out research.

The information is badly needed so that a full and honest picture of the effects and dangers can be presented to users and would- be users. The evidence so far suggests that, at very high doses, ecstasy can damage the brain cells that produce serotonin, and they never fully recover (New Scientist, Science, 2 September 1995, p 14). Unfortunately, we don't know if the same is true at the doses taken by ordinary users, and we don't know what the effect of such damage might be. Alcohol also damages brain cells. The worst prognosis is that irreversible injury will show up as today's ecstasy users get older.

These are questions that need to be settled. Recreational drug taking is an emotional issue, but we have to accept that ecstasy use is widespread and deal with it rationally. Attempts to curtail the supply of the drug have failed. So we must learn as much as we can about its effects, and present that information honestly.