<http://www.guardian.co.uk/drugs/Story/0,,1746407,00.html>
Police fail to quell Britain's appetite for dance drug 

The availability and use of ecstasy is increasing steadily
despite a fivefold increase in police seizures, according to new
research 

David McCandless
Tuesday April 4, 2006
The Guardian

The availability and use of ecstasy is increasing steadily
despite a fivefold increase in police seizures, according to new
research.

The study, published yesterday in the British Journal of
Psychopharmacology, is the largest survey of its kind, examining
official figures for consumption, availability, police seizures,
arrests and deaths between 1994 and 2003.

Young Britons are still by far the leading consumers of MDMA in
Europe and the second largest worldwide, after Australia. An
estimated 750,000 regular users consume about 26m tablets a
year, although the researchers concede that this is probably an
underestimate. In the EU, only the Czech Republic, Estonia and
Spain come close.

The last decade has also seen the age of initiation dropping
steadily. While one in 10 of 15- to 34-year-olds has tried the
drug, drug charities in some parts of the country are reporting
children as young as nine replacing alcohol with ecstasy as a
social lubricant.

This trend is due in part to falling prices. In 1994, an ecstasy
pill cost £16.50 on average. This had dropped 70% to £5.30 in
2003. Today, the price matches that of a pint of beer, £2.50.

The study also confirms the folklore among drug users that
ecstasy pills are getting weaker. The average amount of MDMA per
tablet has dropped by a quarter over seven years from 100
milligrams to 74mg; 100mg is generally considered the lowest
amount to get the full effect.

The lower strength of pills makes them potentially more
dangerous. "Users taking one of today's weaker pills are not
happy with the result so they take two pills," says the author
of the study, Fabrizio Schifano, an honorary lecturer at St
George's Hospital, Tooting. "So instead of taking 100mg they
take 140."

MDMA has an effect on the body known as "non-linear
pharmacokinetics". This means taking two pills does not simply
double the dose. It triples or even quadruples the level of the
drug in the blood. "So there will be moment when the blood level
will increase massively and unexpectedly," Dr Schifano said.
"The user may enter a chain reaction that may prove very
dangerous."

One surprise in the statistics is a drop in the number of
ecstasy-related deaths. In 2002 there were 78 recorded. In 2003,
that fell to 48 and the figure is believed to have dropped
further in the last two years.

"It is difficult to say why this is happening," Dr Schifano
said. "We need to see how this pattern develops over time."

In mainland Europe, ecstasy-related deaths remain rare, with 26
reported across the continent in 2004, compared with the UK's
average of 40 a year. This disparity may be due in part to
better recording procedures in the UK.

Effects of ecstasy

MDMA is one the most intensely studied recreational drugs in
history. But despite thousands of research papers and studies,
scientific evidence on the side-effects remains inconclusive.

Death by overdose

Undoubtedly, large amounts of ecstasy can lead to over-heating
which in turn, in rare cases, can trigger fatal heat stroke.
Many factors contribute: number and strength of pills taken,
environment, alcohol-consumption, body weight - but women seem
more at risk. The bulk of ecstasy-related deaths around the
world have been young women.

Water-poisoning

Panicking users, fearing they are overdosing, drink too much
water and provoke hyponaetraemia (water-poisoning). Leah Betts
died after drinking 14 pints in just 90 minutes. The recommended
amount of water to drink per hour is one pint.

Toxic reactions

Much of the reports of toxic reactions are muddled with overdose
or water-poisoning deaths. There is no clear evidence that some
people suffer allergic reactions to ecstasy. However, around 10%
of Western users do lack a key liver enzyme CYP2D6 needed to
break down MDMA. This may make them more sensitive to the
effects and more prone to accidental overdose.

Depression

Many weekend users report a mid-week mood dip. This is suspected
to be related MDMA's effect on serotonin, but hard evidence is
lacking. In heavy users, dips can turn to crashes and
depression. However studies suggest this effect reverses after a
2-3 month abstinence.

Positive effects

Users still claim "long lasting improvements in self-awareness,
self-esteem, openness and insight into personal problems",
reports the study from the University Of Louisiana. In the US,
research continues into the use of MDMA-assisted psychotherapy
to treat Post Traumatic Stress Disorder.

Ecstasy (MDMA, MDA, MDEA, MBDB) consumption, seizures, related
offences, prices, dosage levels and deaths in the UK (1994-2003)