In May 2010, 12 people attending a rave party at a venue called the Cow Palace in Daly City, California, experienced life-threatening complications requiring immediate medical attention; symptoms included seizures and hyperthermia with resultant muscle breakdown and kidney failure.
Two died and four had permanent brain and muscle damage and/or kidney injury. Blood samples from those affected and confiscated tablets from the event identified Ecstasy without evidence of other recreational drugs.
Ecstasy, also known as methylenedioxymethamphetamine or MDMA, is a recreational drug that is widely used in the party scene in part because of its perceived low toxicity and its recognised euphoric properties. It is an amphetamine-like drug in the same class as methamphetamine, amphetamine and the various "bath salts". Most of the drugs within this class cause similar adverse effects, though the intensity and risk of injury may vary.
While the majority of people who use Ecstasy may not experience obvious complications, described effects that have developed after use include agitation, hallucinations, increased heart rate and high blood-pressure, clenching or grinding of the teeth, and sweating. Although these effects are transient and may not require medical attention, complications of severe toxicity have occurred; these include psychosis, seizure, hyperthermia, muscle breakdown, acute kidney failure, liver injury, adult respiratory distress syndrome, cardiovascular collapse, and death. A further complication resulting from profuse sweating and excessive water consumption can lead to seizure, swelling of the brain and death.
More insidious, and less obvious to the users, is the risk of changes within the brain following long-term recreational use of Ecstasy. Animal studies and investigations of human volunteers have consistently shown evidence of such changes, reflected in measurable deficits on some tests of attention, executive function and memory.
Many would argue the risk of adverse events following Ecstasy use is low and, in light of other more dangerous amphetamines, it could be regarded as a legitimate alternative to other recreational drugs.
Of course, when compared with its chemical cousins amphetamine and methamphetamine, Ecstasy is less harmful. However, caution needs to be applied to such an argument.
The difference between amphetamine and methamphetamine is one methyl group attached to the molecule, making methamphetamine more potent and more toxic. By comparison, therefore, amphetamine has a lower risk of toxicity than methamphetamine; however, to then argue that amphetamine could therefore be available as a safer alternative for recreational use is nonsense.
It may be less toxic, but it is still dangerous.
The same argument has been applied to Ecstasy, and also to the synthetic cannabinoids and benzylpiperazine (remember that drug, it was touted as a safe herbal high).
Yes, Ecstasy has a lower risk of toxicity when compared with other recreational drugs, but that risk still remains (I counted 202 published reports of toxicity requiring medical attention).
It is still an amphetamine and, as with all drugs of that class, there is a real risk of suffering adverse events that in some instances may be life-threatening.
In light of what we know about Ecstasy, it should remain banned and not become available for legal recreational use.
Dr Leo Schep is a toxicologist at the National Poisons Centre,
University of Otago.