Pubdate: Mon, 13 Aug 2001
Source: American Medical News (US)
Copyright: 2001, American Medical Association
Contact: http://www.ama-assn.org/public/journals/amnews/edlet.htm
Website: http://www.amednews.com/
Details: http://www.mapinc.org/media/1235
Author: Susan J. Landers

CLUB DRUGS MORE AGONY THAN ECSTASY FOR YOUNG PATIENTS

Physicians are urged to offer guidance, information about the dangers of 
the illegal drug Ecstasy.

Washington -- Physicians should be aware that ever-increasing numbers of 
their young patients are using illegal "club drugs" such as Ecstasy, a 
synthetic, psychoactive drug that many users consider to be relatively 
harmless.

But the drug is far from harmless. "It's a dangerous drug," said Michael 
Miller, MD, secretary of the American Society of Addiction Medicine, "with 
both stimulant and hallucinogenic properties."

Patients tend to place Ecstasy in a different category from other illicit 
drugs, said Stuart Gitlow, MD, medical director of Nantucket (Mass.) 
Behavioral Services. "When we question people about using drugs they say 
no, but when we ask them if they are using Ecstasy they say yes," he said.

Ask young patients how they spend their leisure time, suggests Dr. Miller. 
Ask them if they attend concerts or all-night dance parties and what 
experiences they've had with people using club drugs. Such conversations 
could lead to discussion about the patient's own drug use.

Physicians in New England have seen a huge increase in Ecstasy's use over 
the past two years, said Dr. Gitlow. And the same is true in Wisconsin, 
where Dr. Miller practices.

"Now that the marketing of the drug is being revved up," said Dr. Miller, 
"we can expect to see Ecstasy in every corner of the nation and in every 
size community."

Young people 12 to 27 years old are the primary users of Ecstasy, which has 
been around for at least 30 years. The drug also bears the ponderous name, 
methylenedioxymethamphetamine, or MDMA.

While the use of Ecstasy has not yet reached epidemic levels, it is rising, 
National Institute on Drug Abuse Director Alan Leshner, PhD, told 
scientists, drug counselors and policymakers who gathered last month in 
Washington, D.C., for a conference,"MDMA/Ecstasy Research: Advances, 
Challenges, Future Directions."

"In the short term, Ecstasy can cause dramatic changes in heart rate and 
blood pressure, dehydration and a potentially life-threatening increase in 
body temperature," said Dr. Leshner.

"In the longer term, research shows that Ecstasy can cause lasting changes 
in the brain's chemical systems that control mood and memory," he noted.

Ecstasy and several other drugs have gained notoriety because of their use 
at popular, all-night dance parties, or "raves," that are attended by young 
people.

The burgeoning use of the drug has also inspired a wave of violence across 
the nation as drug dealers entered the picture.

Ecstasy is distributed in pill form that is inexpensive to manufacture and 
can reap a large profit for those trafficking the substance.

Complicating the picture is a claim by some that Ecstasy holds therapeutic 
powers for treating mental ills and is a safe, nonaddictive drug. Those 
claims, said Dr. Miller, "are tragically comical notions." The claims are 
reminiscent of those made for the drug LSD (lysergic acid diethylamide) in 
the 1960s, he noted.

Conference findings

The fact that many users of Ecstasy also use several other drugs at the 
same time makes it difficult to tease out the effects of Ecstasy, noted 
researchers at the NIDA conference.

Among some other findings presented at the conference:

Patricia Case, ScD, director of Harvard Medical School's Program in Urban 
Health, reported that preliminary findings of studies in Boston and New 
York indicate that Ecstasy use has increased among men who have sex with 
men. Participants in Dr. Case's study reported having unprotected oral and 
anal sex when using Ecstasy, particularly in conjunction with the use of 
the drugs ketamine hydrochloride and methamphetamine.

Robert G. Carlson, PhD, a professor at Wright State University School of 
Medicine in Dayton, Ohio, reported that research in central Ohio revealed 
that the use of Ecstasy is no longer limited to the rave scene or dance 
clubs but has moved to concerts, parks and house parties and is 
increasingly popular among high school and college students as well as 
among young people not in school.

Jean J. Schensul, PhD, executive director of the Institute for Community 
Research in Hartford, Conn., found that Ecstasy use is not limited to 
suburban youth but is being widely used among teens in Hartford.

Dr. Miller compared the rising use of Ecstasy with past epidemics of drug 
use in the nation.

"What has happened with Ecstasy is exactly what happened with cocaine in 
the 1980s and will happen again with an unnamed agent 10 or 20 years from 
now," he said. "It's part of a cycle, and people need to be wary about 
these trends and how seductive they are."

ADDITIONAL INFORMATION:

Weblink

ClubDrugs.org, a National Institute on Drug Abuse club drugs resource site 
(http://www.clubdrugs.org/)

DanceSafe, nonprofit organization that promotes health and safety for those 
attending raves (http://www.dancesafe.org/)

American Society of Addiction Medicine (http://www.asam.org/)
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MAP posted-by: Jay Bergstrom