E for Ecstasy by Nicholas Saunders
Appendix 1: Reference Section
- 30 Visit to Dr. John Henry at the National Poisons Unit at Guy's
Hospital, London, 11/12/92
- The unit offers a 24-hour telephone enquiry service to doctors throughout
the UK who are presented with symptoms that they cannot clearly identify.
All telephone enquirers are asked to send blood and urine samples for testing,
which is usually carried out using one of three types of chromatography.
Most samples are taken from live patients, but some are taken during a post
mortem. Some drugs are easier to detect through blood and urine samples
than others. Cannabis "can be detected 5 weeks after a single reefer";
LSD is very hard to detect.
- Recently, a large proportion of samples of Ecstasy sent in for testing
have been found to contain MDEA instead of MDMA. Dr. Henry thinks MDEA is
less toxic than MDMA because it produces less jaw clench.
- Asked what advance symptoms people who have taken MDMA should look out
for as signs of the onset of overheating, Dr. Henry said that excessive
sweating, staggering, thirst and exhaustion were the main symptoms. He said
that overheating was unlikely to occur if enough water was drunk. Dr. Henry
said that he believes that MDMA stimulates opiods, a neurotransmitter that
acts as an internal anaesthetic. Opiods go into action when people bruise
themselves badly playing football. Dr. Henry compares dancing at a rave
with running a marathon - it involves four hours of exhausting exercise.
- Neurotransmitters such as 5HT and opiods can be stimulated either by
chemicals such as MDMA or by feelings of excitement. Dr. Henry says that
this could explain why people who go to raves without taking drugs pick
up on the same mood: the environment may cause them to produce their own
neurotransmitters and this affects their mood.
- Asked about the dangers of Paracetamol relative to those of MDMA, Dr.
Henry said that Paracetamol causes over 200 deaths a year, but is very safe
in normal doses. Overdosing affects the liver, and can cause death at doses
of between 15 and 200 tablets. He said that MDMA is broken down by the liver
into MDA and metabolites, which are excreted by the kidneys into the urine.
- I asked Dr. Henry what evidence there was of a link between liver damage
and Ecstasy use, mentioning that liver damage associated with Ecstasy use
has not been reported in the USA and suggesting that cases in Britain might
be the result of parallel use of alcohol or other drugs. Dr. Henry said
that he has no doubt that MDMA causes hepatitis because some patients have
exhibited the symptoms of hepatitis after each of several ingestions of
- I also asked about kidney failure (or 'acute renal failure' as reported
in the medical journals) associated with Ecstasy use. Dr. Henry said that
he believes this is the result of muscular breakdown overloading the kidneys
with myoglobin. Muscular breakdown can also be caused by intense bouts of
- Dr. Henry explained the mechanism of heatstroke. Dissolute Intravascular
Coagulation (DIC) - blood clotting in the arteries - occurs at 42-43 degrees
C (c.108 degrees F) and tiny blood clots stick to the artery walls. This
is harmless in itself, as the blood clots are too small to cause a blockage,
but the process can use up all the clotting agent, with the result that
the blood will pour out of any of the tiny haemorrhages which occur throughout
the cardiovascular system as part of the normal process of breakdown and
repair. Such internal bleeding can be fatal. Internal bleeding in the brain,
combined with high, pulsating blood pressure can cause strokes.
- Out of all the millions of brain cells only 10,000 hold the chemical
serotonin which is affected by MDMA. Serotonin levels have a marked effect
on mood and a statistically significant proportion of suicide victims have
been found to have depleted serotonin. Antidepressants of the SSRI type
such as Prozac (Fluoxetine) inhibit the re-uptake of serotonin.
- I asked Dr. Sheila Dorling, a lab researcher at the National Poisons
Unit, what had been found in samples of E besides MDMA and MDEA. She said
some MDA had been found plus various available drugs such as paracetamol
and codeine; other samples only contained amphetamine. None contained LSD.
The poisons unit does not analyse many Ecstasy pills.
E is for Ecstasy by Nicholas Saunders (firstname.lastname@example.org)
HTMLized by Lamont Granquist (email@example.com)
by Nicholas Saunders