Pubdate: Sat, 25 Feb 2012
Source: Ottawa Citizen (CN ON)
Copyright: 2012 The Ottawa Citizen
Contact: http://www.canada.com/ottawacitizen/letters.html
Website: http://www.canada.com/ottawacitizen/
Details: http://www.mapinc.org/media/326
Author: Sarah Boesveld

HARM REDUCTION VERSUS 'JUST DON'T TOUCH THE STUFF'

Experts agree ecstasy use is a problem, but they are less unified
about how to fix it, Sarah Boesveld reports.

Cheryl McCormack, 17, of Abbotsford, B.C., died after popping ecstasy
with her high school friends during a sleepover. They thought it would
help them lose weight.

Leonard Timothy's heart stopped beating after coming home from the bar
one night. The 38-year-old Red Deer father of two had taken an ecstasy
pill.

The mother of 18-year-old Calgarian Daniel Dahl remembers watching her
son's brains bleed out his nose in the emergency room after he
overdosed on ecstasy, his body temperature rising so rapidly that he
was cooked from the inside.

These are just some in a spate of ecstasy-related deaths that have
marched a morbid path through southern Alberta and British Columbia in
the past few months, spurring public awareness campaigns and scaring
parents and partiers. Over the past year and until now, there have
been 19 deaths in B.C. and 12 in Alberta related to ecstasy overdoses
- - at least five in the past few weeks alone.

Thirteen of those deaths, which all occurred late last year and last
month, have been linked to paramethoxymethamphetamine (PMMA), a
chemical turning up inside Canadian ecstasy. It was once the street
name for MDMA, or methylenedioxymethamphetamine, but has come to mean
any pill passing itself off as MDMA, even if it's been so adulterated
as to hardly be like the original drug. PMMA, known on the street as
"Doctor Death," is considered five times more toxic than
run-of-themill street ecstasy. It was in the pill that Timothy took.

As police try to trace the path of this especially lethal brand of
ecstasy, they are once again spreading the message that law
enforcement, schools and other government bodies have been spreading
for decades: Don't touch the stuff. Just say no.

At the same time, a growing chorus of harm reduction advocates say
that message isn't working. The use of illegal drugs has not declined
in recent years and there is a slice of the population that is simply
determined to engage in risky behaviour like taking drugs. The way to
prevent these deaths, these advocates say, may actually be to accept
that people will still take ecstasy despite the warnings and give them
a safer means of doing so. If we ignore users and hope they stop, they
say, the deaths will continue.

Since early January, B.C.'s medical officer Dr. Perry Kendall has
woven advice to drug users into his public comments on the
ecstasy-related deaths in his province. Users should just take one
pill instead of several at a time (as some of the overdosers have
done), they should keep hydrated, and they should make sure there's a
sober person there to help if something goes wrong. They should also
know their dealers so they have a better idea where the drugs came
from.

Of course, he's taken flak for that from those who are
anti-drug.

"I understand the concerns. If nobody was doing drugs, I wouldn't go
out with a message saying 'Here's how to do drugs safely,' " says
Kendall. "But given we have a substantial portion of vulnerable
populations doing drugs, and given that police don't seem to be able
to stop the importation or the manufacturing of drugs, the issue is
how do you best deal with the situation you have? How do you mitigate
risk?"

After cannabis and cocaine, ecstasy is one of the most popular drugs
in Canada. About one per cent of Canadians said they used it in 2009,
the government-funded Canadian Alcohol and Drug Use Monitoring Survey
reports.

"That might seem small, but when we put it into context it's certainly
an epidemic," says Tyler Pirie, a research and policy analyst for the
Canadian Centre on Substance Abuse.

The broader public health community has backed the harm reduction
approach, Kendall says, but it has run up against some political
ambivalence, including from a federal government pushing a
toughon-crime mandate. Prime Minister Stephen Harper kept harm
reduction out of his $63.8-million national anti-drug strategy.

When it was unveiled in 2007, Harper said harm-reduction efforts such
as Vancouver's Insite needle exchange clinic were a "second-best
strategy at best."

Ecstasy is so consistently adulterated that when pure MDMA turns up on
the street, it's likely be to sold under the name MDMA, or, sometimes,
"Molly." Cpl. Luc Chicoine, the national co-ordinator for the RCMP's
pharmaceutical and synthetic drug operations, has worked on the street
in drug operations for 18 years and says he can't remember ever seeing
pure MDMA, which is being considered in other countries for potential
treatment of post-traumatic stress disorder.

"From what we've seen in last three years, if there's MDMA there's
almost always meth" in the same tablet or powder, Chicoine says,
referring to methamphetamine, the highly addictive stimulant. He has
also seen MDMA cut with metallic glitter and car paint to give it an
exciting look (it sells better that way, he says). Because of the
clandestine nature of the way the drugs are made, it's almost
impossible to ensure their safety, he says, adding that one can't even
trust a dealer since drugs can change hands and end up modified dozens
of times before they're ingested.

But there are ways for drug users to test for chemicals lurking in
their drugs. U.S.-based organization DanceSafe.org has been selling
test kits - made from a solution of selenious acid in sulphuric acid -
that identify certain chemicals so one knows the makeup of the pill or
powder they're ingesting. DanceSafe sets up booths at parties and
raves to test drugs for partiers, just as government workers in the
Netherlands, Norway, Austria and Switzerland have been known to do.

The Trip! Project, a harm-reduction peer initiative run by a public
health clinic in Toronto, has obtained test kits carried
surreptitiously over the border (they've been seized in the past), and
handed them out to volunteers who help people test their own drugs at
house parties.

The volunteer can't test the drugs for the user because that would be
considered trafficking under Canadian law, says Lisa Campbell Salazar,
a former co-ordinator of Trip! and current co-ordinator of the Queen
West Harm Reduction Program at the Central Toronto Community Health
Centre. Trip! will still go to parties, many of them underground since
the rave scene fizzled out, hand out information and ensure people
stay hydrated to keep their body temperatures down.

They also counsel users if they need someone to talk to, since MD-MA
has been known to open up people's emotions.

Campbell Salazar, 28, is herself a recreational user of MDMA, which
she differentiates from ecstasy. She always tests her drugs with home
testing kits - something older, more dedicated users are more likely
to do than the kids are - but thinks the government can save lives by
making information about lethal drug concoctions known.

"If Health Canada were to release drug information, not just for
judicial purposes but for public health, it definitely would save
lives," she says.

Health Canada has sophisticated drug testing that can determine
chemical compounds found in drugs seized by the RCMP, says Chicoine.
It does not share the results of any of these tests with the public,
says Gary Holub, a Health Canada spokesman, adding that home test kits
are unreliable.

"The best way to avoid harm from illicit drugs, including ecstasy, is
to avoid using them," he wrote in an email to the National Post. In
the meantime, education is the best tool both harm-reduction advocates
and those advising abstinence have at hand.

Online social networks have helped party drug users, especially
teenagers and post-secondary students, seek out safer drugs and party
in a safer way, says Nick Boyce, a former volunteer with Trip! and
current provincial director of the Ontario HIV and substance use
training program. Sites like ecstasydata. org also identify different
drug concoctions by their street names and tell users what's in them.

Of course, that would never be definitive, Boyce says, just as the
test kits can only identify the presence of additives that the user is
specifically testing for; a test for meth, for instance, might not
tell you if the pill contains PMMA.

Police in Abbotsford, where two ecstasy-related overdoses besides
McCormack's occurred in the past few months, are preparing to go
allout with a new campaign to warn students off ecstasy. The campaign
will acknowledge the recent deaths in B.C. and Alberta and tell
students about what happens to the body when these drugs are ingested.

"I guess there might be people on the harm-reduction side who take
issue with what I'm saying, but I'm concerned about keeping people
safe and keeping them on the planet," says Abbotsford Police spokesman
Const. Ian MacDonald.

And while harm reduction advocates insist there are ways to keep drug
users safe (one of the big ideas being legalization), people like
Chicoine say it's impossible.

"At the end of the day, you have to remember that the only reason why
those drugs are being produced is because somebody, somewhere is
making a ton of cash on your $5 or $10 on your one or two tablets you
purchased," he says. "If there is money involved and with no
regulation and control, someone's going to make a lot of money and
they don't care what they put in. They don't care about the user."

Legalization would only increase the ranks of people taking ecstasy,
Chicoine says. "We have enough legal junkies on the street," he says,
referring to people who guzzle mouthwash and hand sanitizer or sniff
gas and glue, all items you can buy in a shop. "Do we really need more?"

And from where Kendall sits, the only thing he can do is keep
spreading the word about harm reduction, hoping those who do choose to
take drugs can be a little smarter about it.

"I'd like to see the deaths come down, clearly, but I think we're
limited in our ability to get the messages out."
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MAP posted-by: Matt