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Media coverage of "ecstasy overdoses" is dishonest and dangerous

poledriver

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Jul 21, 2005
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MEDIA COVERAGE OF "ECSTASY OVERDOSES" IS DISHONEST AND DANGEROUS

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The week following New Year's Eve has been sadly, but predictably filled with reports of drug-related hospitalizations and deaths. Much of the coverage of these incidents has been full of inaccuracies and misinformation - and dishonest or inaccurate reporting on this topic perpetuates misconceptions that can have deadly consequences.

It's important to start this discussion with some definitions. According to the US National Institute of Health's website MedlinePlus: "An overdose is when you take more than the normal or recommended amount of something, usually a drug. An overdose may result in serious, harmful symptoms or death."

"Ecstasy" is the most widely used street name for MDMA. MDMA is the abbreviation of 3,4-methylenedioxy-methamphetamine. Being a slang term for an illegal drug, there is no official medical definition for "ecstasy," and there are plenty of cases of substances other than MDMA being sold as "ecstasy." However, given the prevalent understanding that "ecstasy" refers to MDMA, it's appropriate to define it as such.

So an "ecstasy overdose" death would be a death that resulted directly from the consumption of an excessive quantity of MDMA, regardless of other factors. A brief survey of the medical literature on the matter indicates that these sorts of deaths are incredibly rare - despite what frequent media headlines might suggest.

The common use of "overdose" to describe drug-related deaths comes from the history of deaths resulting from actual overdoses of heroin and other opiate drugs. A majority of heroin-related deaths are true overdoses - an excessive quantity of the drug is introduced into the users body and directly causes fatal suppression of the respiratory system, severe drop in blood pressure leading to cardiac arrest, or other physiological conditions resulting in death.

By contrast, the vast majority of MDMA-related deaths are the result of heatstroke, which under normal circumstances is not an effect of even large doses of MDMA. Taking MDMA does cause a slight increase in body temperature, and a reduction in the body's normal ability to regulate temperature. When combined with long periods of intense physical activity (like dancing) in a very hot environment (like a 100°F+ dance floor at a music festival) and dehydration, these factors can become deadly.

It's crucial to note that normal recreational doses of MDMA will cause this danger under these conditions. When media outlets describe deaths involving heatstroke and MDMA as "ecstasy overdoses," they are creating the false sense that users who take normal doses are not in danger. When users see headlines about "overdose" deaths, they may assume that as long as they don't take too much, they are avoiding these risks - which is absolutely not true.

The primary dangers associated with MDMA use at concerts or festivals - excessive heat and insufficient water - are easily avoided if users are educated, and event organizers implement simple harm-reduction measures like abundant free water and cooler temperatures in dance spaces. It's also important to realize that heatstroke commonly causes harm among attendees at music events who haven't taken any drugs, or who've only consumed alcohol. So these measures would protect every attendee, regardless of drug use. [A reader brought it to our attention that we should note excessive consumption of water can also be a problem for those on MDMA. Consuming too much water, in conjunction with the water-retention that MDMA causes can lead to hyponatremia, a potentially dangerous sodium deficiency in the bloodstream. Drinking a moderate amount of water every hour should ensure hydration, without risking hyponatremia. Electrolyte rich sports drinks like Gatorade will provide ample hydration while also providing enough sodium to maintain safe levels.]

Calling MDMA-related deaths "overdoses" also distracts from some of the other risk factors that come with normal (or even small) doses of MDMA for certain people - specifically for people who have preexisting heart problems, and those who are taking certain prescription medications which have dangerous interactions with MDMA.

The slight increase in blood pressure and heart rate that MDMA causes are typically not dangerous for healthy people, but in individuals with high blood-pressure, enlarged hearts, arrhythmia, or a number of other heart conditions, these normal side effects can be very dangerous. MDMA affects the body's regulation of the neurotransmitter serotonin in such a way that is not typically dangerous for most people. However, for individuals that are on prescription MAOI (Monoamine Oxidase Inhibiting) drugs, the interaction of the MDMA and the MAOI can cause a dangerous, potentially deadly excessive buildup of serotonin in the body, referred to as serotonin syndrome. In both of these cases, a normal dose of MDMA that would pose little danger to most people, could be fatal.

Of course there is another factor that contributes to "ecstasy" deaths - the myriad other drugs that are sold as "ecstasy," many of which are much more dangerous than MDMA. When media outlets report deaths and injuries resulting from drugs other than MDMA, and refer to them as "ecstasy overdoses," they are parroting the dangerous lies of manufacturers and dealers, and perpetuating more dangerous misinformation. Because again, users hear the term "overdose" and assume that as long as they take a reasonable amount, they are avoiding danger. But many of the other drugs sold as "ecstasy" can be deadly at doses that MDMA would be relatively harmless at.

The proliferation of these dangerous compounds is the direct result of prohibition, as production is pushed into unregulated black markets, and drug manufacturers constantly invent new compounds to circumvent laws prohibiting known drugs such as MDMA. The simplest solution to this danger would be to encourage users to test their drugs before ingesting, to ensure they are not taking something far more dangerous than they expected. But sadly, disastrous legislation such as The RAVE Act has instead made drug testing less accessible by threatening event organizers with harsh penalties for any harm reduction measures that could be construed as encouraging or facilitating use.

While there are countless social, political, and economic factors needed to end the incredible harm caused by the War on Drugs, the media plays an essential role. Taking a drug like MDMA can never be totally safe, but accurate knowledge of the real dangers, and of measures to minimize these dangers, can prevent a huge percentage of tragic outcomes. It is long past time media outlets take greater responsibility for reporting accurately and honestly on drug related harm - instead of exploiting tragedies for the sake of sensational headlines.


Some of the information in, and inspiration for this editorial came from this article written by Emanuel Sferios and Missi Wooldridge of DanceSafe.

If you want to help fight to make life saving education and harm reduction more accessible at music events, sign the petition to amend The RAVE ACT:

http://edm.com/articles/2016-01-06/media-coverage-ecstasy-overdoses-dishonest-dangerous
 
Very good and important article. The media care nothing for accuracy only what allows for more sale of advertising and that comes with sensationalism.

I do have one problem with the article. The effects of MDMA on blood pressure are not slight, they are significant and really one of the more under looked effects that I see discussed. For some reason body temperature gets all the focus and MDMA actually has very slight effects on body temp.

I've done measurements on myself and have confirmed what I've found in literature and the results were frightening. I have slightly high BP but after dosing I was elevated into dangerous ranges and luckily I just chill at home and am not dancing around like some people.

I doubt many people even know what their baseline BP or pulse is and fewer still know the effect of MDMA on it and the potential harm that can arise.

Here's a journal article that shows some testing results and as I said have been in line with my own measurements at home:

http://jpet.aspetjournals.org/content/290/1/136.full
 
That's a very good point, avcpl. I also have slightly high BP and as such I've been cautious with MDMA and other amphetamines, avoiding them in general. But I imagine, as you said, few people know they have a heart problem and even fewer know that MDMA can cause a bad reaction.
 
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