B.C.'s top health official says taking pure ecstasy can be "safe" when consumed responsibly by adults, but he says he is not advocating legalized recreational use of the drug.
Provincial Health Officer Dr. Perry Kendall says while the pure form of the drug has been proven safe in controlled clinical trials by psychiatrists, the type of ecstasy sold on the street is laced with potentially dangerous impurities.
"Unless you are getting it from a psychiatrist in a legitimate clinical trial, at the present time you can't guarantee what's in it, how much of it there is, or its safety, so I would say as we have said in the past — don't take it," Kendall told CBC News.
Kendall asserts the risks of MDMA — the pure substance originally synonymous with ecstasy — are overblown, and that its lethal dangers only arise when the man-made chemical is polluted by money-hungry gangs who cook it up.
The Canadian Press reported Kendall was advocating the legalization of MDMA, but in an interview on Thursday morning, the top government health officer told CBC News he has no opinion on the legalization issue.
Kendall said he was simply responding to a hypothetical question from The Canadian Press about how the drug should be controlled if it was regulated,
"I would just say that I was not advocating legalization. I was hypothetically talking about potential regimes whereby regulated access could be considered."
Strict government controls
When asked whether ecstasy, after further study around correct dosage and in a setting involving strict controls, could be safe, he responded, "Absolutely."
Kendall said if MDMA were ever legalized, the drug should be strictly regulated and sold through licensed, government-run stores.
Just like the growing chorus for marijuana legalization, Kendall believes crushing the dirty ecstasy-saturated black market and its associated violence requires an evidence-based strategy that revolves around public health.
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"(If) you knew what a safe dosage was, you might be able to buy ecstasy like you could buy alcohol from a government-regulated store," Kendall said in an interview.
"We accept the fact that alcohol, which is inherently dangerous, is a product over a certain age that anybody can access.
"So I don't think the issue is a technical one of how we would manage that. The issue is a political, perceptual one."
He suggests that usage rates would decrease, but he does not advocate promoting the drug for recreational use.
16 deaths in Western Canada
At least 16 people from B.C. to Saskatchewan have died since last July from a tainted batch of ecstasy they obtained from criminal dealers, the only way an average person can acquire the drug in Canada. It was cut with a toxin called PMMA.
Police say an average of 20 British Columbians who consume street ecstasy die each year.
Kendall and several other health colleagues liken the mutation of MDMA into a contaminated street drug to the wave of bootleg beverages during the 1920s prohibition era.
"Methyl alcohol led to huge rates of morbidity and mortality in the United States under alcohol prohibition because of illicit alcohol manufacturing," said Dr. Evan Wood, a lead researcher at the BC Centre for Excellence in HIV/AIDS and internationally-recognized expert in drug addiction and related policies.
"PMMA is a natural and expected consequence of the prohibition on ecstasy."
The RCMP in B.C., who have a team dedicated to dismantling clandestine drug labs, maintain no amount of the substance is safe.
"We would view ecstasy as extremely dangerous," said Sgt. Duncan Pound, adding police don't distinguish between MDMA and the street drug in terms of enforcement or prevention strategies.
"Not only given the fact that it's very hard to determine what might be in any given tablet, but the fact that there's such an individual reaction to those tablets."
Flood of serotonin
The medical literature says that MDMA — technically 3,4-methylenedioxymethamphetamine — sends waves of serotonin flooding through the brain. The natural brain chemical makes people feel happy, social and intimate with others.
According to Toronto's Centre for Addiction and Mental Health, MDMA carries a list of potential health effects that impact each user differently. They include teeth grinding, sweating, increased blood pressure and heart rate, anxiety, blurred vision, nausea, vomiting and convulsions, even at low doses.
The drug's letdown can include feelings of confusion, irritability, anxiety, paranoia and depression, and people may experience memory loss or sleep problems, jaundice or liver damage.
The deaths associated with street ecstasy, says the centre's website, usually result from dehydration and overheating when teens gulp down a pill and dance the night away.
It's also more likely to negatively impact people with other health problems and can interact with other medications people are taking, the centre said.
Research on effects
The medical establishment widely agrees MDMA is not addictive. But new research suggests some of the drug's long-stated ill effects are exaggerated.
Using MDMA does nothing to impair cognitive functioning, found one U.S. government-funded study published in the journal Addiction in February 2011.
Dr. John Halpern, a Harvard Medical School assistant professor who led the research, said pure MDMA can change core body temperature, heart rate and blood pressure in the short-term, and decrease immune resistance for a few days.
"But barring that, it appears … it can be safely administered, certainly through research," said Halpern, who has studied MDMA for 15 years and advocates for medical, prescription-based use of the drug.
He hopes Canada leads the way in crafting a "sensible" MDMA strategy.
"We've got to do something to make sure that the sanctity of life is protected," said Halpern, with McLean Hospital in Massachusetts. "It's certainly worthy of a healthy discussion."
The Canadian Press reported Kendall was advocating the legalization of MDMA, but in an interview on Thursday morning, Kendall told CBC News he has no opinion on the legalization issue.Jun 14, 2012 6:15 AM PT