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Is long-term effect of Ecstasy merely iatrogenic?

Posted by trialerror on September 3, 2002, at 20:54:55

In reply to Re: Ecstasy and the use of Benadryl the next morning, posted by crepuscular on September 3, 2002, at 11:18:39

http://www.guardian.co.uk/uk_news/story/0,3604,784711,00.html

ECSTASY NOT DANGEROUS, SAY SCIENTISTS

Sarah Boseley, health editor
Monday September 2, 2002
The Guardian

Three leading psychologists have provoked an outcry by claiming that the dance drug ecstasy may not be dangerous and that some of its ill-effects may be imaginary.

The drug has been blamed for causing deaths and permanent brain damage, but the psychologists are strongly critical of animal and human studies into its effects, claiming that they are misleading and overestimate the harm ecstasy - scientifically known as MDMA - can cause.

Other scientists insisted that those who took ecstasy were undoubtedly risking their health and their life.

Two of the scientists challenging the established view are British and the third is American. Dr Jon Cole is a reader in addictive behaviour and Harry Sumnall is a postdoctoral researcher, both at Liverpool University. Professor Charles Grob is director of the division of child and adolescent psychiatry at the Harbor-UCLA Medical Centre in California.

Writing in the magazine the Psychologist, published by the British Psychological Society, they claim that many of the studies since 1995 have been flawed. They also accuse researchers of bias.

Ecstasy is said to affect cells in the brain which produce serotonin, the chemical known to influence mood. But the changes observed involved the degeneration of nerve fibres, which can be regrown, and not the cell bodies themselves, the psychologists say.

They accuse other scientists of minimising the impact of data suggesting that ecstasy exposure had no long-term effects. Although numerous tests were run on volunteers, only positive results were reported in detail, they say. "This suggests that hypotheses concerning the long-term effects of ecstasy are not being uniformly substantiated and lends support to the idea that ecstasy is not causing long-term effects associated with the loss of serotonin," write the authors.

The article is critical of the way studies involving young users have been conducted. They point out that many psychological problems start in adolescence anyway, ecstasy users invariably took other drugs as well, and some of the symptoms reported mirrored those caused by simply staying awake all night and dancing.

Most of the young people in the studies were volunteers from universities which raised questions about how representative they were of the population, the article says.

Most studies have failed to pinpoint ecstasy as the cause of problems, they say, and the animal studies were flawed and inconclusive.

They suggested that the long-term effects of the drug might be "iatrogenic", which is defined by the New Webster's dictionary as "caused by the mannerisms or treatment of a physician, an imaginary illness of the patient brought about by the physician".

Paul Betts, whose daughter, Leah, died after taking the drug in 1995, called the article "despicable".

Three other ecstasy experts writing in the Psychologist dismissed the notion that symptoms of long-term ecstasy use were all in the mind.

Dr Rodney Croft, a research fellow at the Swinburne University of Technology in Hawthorn, Australia, said: "There is strong evidence that ecstasy does cause impairment... although conclusions drawn from such evidence cannot be infallible, I believe the strength of this evidence makes 'danger' the most reasonable message for the researchers to be broadcasting."

About two million ecstasy tablets are believed to be taken by clubbers in the UK every weekend. Deaths linked to the drug have risen in the past decade. Between 1993 and 1997, there were 72. In 2000, there were 27, although 19 had other drugs in their system.

The exact cause of death cannot always be established, but where it has been, it was often dehydration.



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