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Recreational Drugs

Why are alcohol and tobacco legal recreational drugs - and other less harmful ones not?

 

Penn & Teller: Drug War

 

The Big Question: Is the 'war on drugs' really making the problem worse?

Why are we asking this now? Because if confirmation were needed that crackdowns on drug use in the UK were having little effect, it came in a report by the UK Drug Policy Commission (UKDPC), an independent group set up to examine the state of the nation's drug trade.

By Michael Savage
Thursday, 31 July 2008

The report, published yesterday, paints a grim picture, suggesting that the billions of pounds spent on attempts to reduce the availability of drugs on the streets have been in vain. It said there was "remarkably little evidence" that action by customs officials, police and the Serious Organised Crime Agency has had any significant effect in disrupting illegal drug markets. The report argued that the UK should try a radically different approach to tackling the misery brought about by drug-dealing and the crime and social disorder associated with it. Others advocate taking the ultimate step – legalisation.

What is the state of the UK drugs trade?

The report said the UK's illegal drug market was one of the most lucrative in the world, with the trade worth a hefty £5.3bn – a third of the size of the country's tobacco market and 41 per cent of the alcohol market, despite the vast sums spent on attempts to limit supply. Half of the trade centres on two of the most addictive and destructive drugs, crack cocaine and heroin.

The UK's drugs trade is made up of about 3,000 wholesalers and 70,000 street-level dealers. When it comes to the "Mr Bigs" keeping shipments of drugs flowing into the country, there are far fewer. About 300 major importers are bringing in the drugs, said the report.

What do we spend trying to cut supplies?

Taxpayers currently shell out £1.5bn on measures designed to tackle the UK's drugs problems. Within that is the £380m that goes towards the reduction of supply, the main target of the report's criticisms. A further £573m goes towards drug abuse treatment. That doesn't even include the massive bill that results from drug-related crime. In 2003-04, that was estimated to have cost the public purse £4bn.

Do seizures have any effect?

The report was unequivocal. It said: "Despite significant drug and asset seizures and drug-related convictions in recent years, drug markets have proven to be extremely resilient. They are highly fluid and adapt effectively to government and law enforcement interventions." It added: "While the availability of controlled drugs is restricted by definition, it appears that additional enforcement efforts have had little adverse effect on the availability of illicit drugs in the UK."

How do we know?

A sure sign that attempts to strangle the supply of drugs have come to little is the fact that prices have continued to fall. Street prices for heroin, cocaine, ecstasy and cannabis have all fallen since the start of the decade. The average price for a gram of heroin in 2000 was £70, but that had fallen to £45 by last year. Cocaine has more than halved in price in some areas – from £65 a gram in 2000 to as little as £30 a gram last year.

Even though the number of seizures more than doubled between 1996 and 2005, that only makes up 12 per cent of heroin and nine per cent of all cocaine. The crux of the problem is that experts believe authorities would need to seize between six and eight times more than that to make a real dent in the drugs business. That doesn't seem realistic, leading some – current and former policemen among them – to call for a change in tactics.

The results of the study came as no surprise to Danny Kushlick, head of policy at the pressure group Transform. He said: "This is nothing new – we've known that prohibition measures haven't worked for 20 years. But the situation is actually worse than the report suggests. It is the measures of prohibition that have caused drugs problems, and pushed the trade into the hands of organised crime and street corner dealers."

Why do current tactics have so little effect?

One of the problems is that the drug trade is extremely adaptable. According to the report, even when a major drug seizure is made or a high-level dealer is convicted, little changes on the streets. Other dealers move in, or the remaining supplies are made less pure so they last through the period of shortage. The dealing and buying, in most cases, carries on regardless.

What needs to change?

For a start, the obsession with big drugs busts. Police having their picture taken in front of table-loads of captured drugs may make a good photo opportunity, but do not do much to help the communities affected by drug dealing, the report said.

David Blakey, a former president of the Association of Chief Police Officers and a commissioner for UKDPC, said the police were still being judged on old measures, such as seizure rates. "This is a pity as it is very difficult to show that increasing drug seizures actually leads to less drug-related harm," he said. "Of course, drug dealers must be brought to justice, but we should recognise and encourage the wider role that the police and other law enforcement officials can play in reducing the impact of drug markets on our communities."

Instead, more emphasis should be placed on hitting drug markets that cause the most "collateral damage" to surrounding communities – such as dealing associated with prostitution, human trafficking and gang violence.

Anything else?

Instead of going after the never-ending supply of bad guys, it suggests tackling issues from the point of view of the communities hardest hit by the drugs trade. Above all, it claims that forming partnerships between police, local communities and other related workers is vital in ridding an area of drug problems. It also advocates prevention – tackling problem-spots before they get out of hand.

Should we just legalise drugs and have done with it?

According to its advocates, including the Chief Constable of North Wales Police, Richard Brunstrom, and Transform, legalisation would turn drug-taking from a crime issue into a health issue. Drugs could be vetted for their quality, while the trade would be taken from the grasps of criminal gangs and drug lords.
Legalisation seems to be making a lot of sense to many. Even some politicians admit to being sympathetic to the idea in private. But there is one glaring problem with the policy – the Amsterdam issue. When hedonists around the world got wind of the city's liberal drugs laws and hash cafes, they all started making the pilgrimage. Would many people really tolerate the influx of a new type of hedonist holiday-maker? Probably not. Until the whole world agrees to end prohibition at the same time, it will probably remain impossible.

So is the approach counter-productive?

Yes...

* Preventing supply has been very unsuccessful – the drugs trade is worth £5.3bn

* A sharp fall in street prices since 2000 suggests more than ever is getting through

* Even after big seizures and arrests, other dealers simply move in to fill the gap

No...

* Tackling supply is only one strand of the strategy – more is spent on treatment

* Police must make high-profile seizures for as long as they are judged on them

* Trying other approaches to the problem should not mean drug dealers escape justice


True cost of drug addicts revealed

A drug addict costs the taxpayer more than £800,000 over his or her lifetime, according to a shocking Government report. [Erm, and how much does alcohol abuse and nicotine use cost the tax payer???]

Press Assoc.
June 13, 2008

The study also advised Justice Secretary Jack Straw that drug-free prisons were not a realistic possibility, and raised the prospect of handing out clean needles to prisoners to inject heroin.

Ministers had attempted to keep the report secret for months. Prisons minister David Hanson finally released the data after "considerable interest in the report", which was drawn up by independent auditors PricewaterhouseCoopers.

The authors said: "The creation of drug-free prisons is an expensive option and was not considered to be practical in the current resource climate."

They added that it would be "an option" to give junkies a supervised "retoxification" course near the end of their sentences - in other words, to give them drugs to prevent them overdosing on release.

The report highlighted the failings of mandatory drug tests, which have frequently been hailed by ministers as a success in reducing drug use behind bars.

It said: "Staff and prisoners generally felt that mandatory drug testing should not be used to monitor the behaviour of individuals since it was open to manipulation (with clean urine often being used as a currency), and other problems such as recreational users of cannabis moving to opiate use to avoid detection."

The authors of the report admitted that even the massive £800,000 cost of each addict was likely to be an under-estimate, because they had adopted "the more conservative" figures throughout the exercise.

They calculated the astonishing sum from the additional cost on the NHS as well as other factors such as lost earnings and expenditure on law and order.

More than £730,000 could be saved if an addict was successfully brought into treatment by the age of 21, it added.
 
Now this IS funny:

METRO, 18 March, 2008


 
First person

Forty years ago Mary Finnigan stashed some cannabis in her handbag while researching a story on drugs. It was a mistake that would alter the course of her life ...

August 20, 2007
Guardian

At dusk on a warm evening towards the end of The Summer of Love I met a man called Larry at a shop called Time Out of Mind, just off Ladbroke Grove in west London. I'd taken on a journalistic assignment to investigate who was using what drugs, and where they were buying their supplies.

Larry and I took the tube to Shepherd's Bush - me in Biba mini-dress, he in crushed velvet bellbottoms, floral shirt and magician's cloak. I was enjoying his company and by the time we reached our destination I was in a cheerful mood. Larry plunged towards a basement doorway. As it opened we were welcomed into what seemed like a dream world from Hindu mythology. There were low lights and candles, mirrored hangings and gaudy pictures of Buddhist deities. Rose and sandalwood incense perfumed the air, mingling with a more acrid aroma, which even in 1967 I recognised as dope smoke. A raga tinkled from column speakers and in one corner, a chap with shoulder-length blond hair played along on a sitar.

Bemused and feeling somewhat square, I wandered from one room to another and in each the scene was much the same. The girls wore floaty hippy ensembles, the blokes velvet bellbottoms, beads and baubles. Some couples were entwined in overtly sexual embraces. Most were in their late teens or early 20s.

There was a tap on my shoulder:

"Did you come with Larry?"

I nodded - in the dim, smoky light discerning an older man in more conventional attire.

"I'm Pete," he said. "Larry says you want to score."

I said "yes please" and he asked "how much?" and "hash or grass?" I hadn't a clue, so I made a guess: "Oh ... er - grass will do fine, thank you, and about three quid's worth?" I wanted the photographer to take a picture of it for my report.

Pete vanished, to return a few minutes later with a 35mm film canister. I lifted the lid and sniffed the contents. It was extremely pungent.

"Good stuff," said Pete the dealer. "Durban Poison."

At this point I made a mistake that would alter the course of my life. Instead of keeping the canister in a pocket, I buried it deep inside my shoulder bag. A few moments later a blow smashed open the front door and a loud voice shouted, "Police - nobody move."

All around me people were emptying their pockets - I spotted Larry tipping a bagful of marijuana on to the floor. I was frozen in terror - body and brain immobilised. A detective barged into the room, switched on the overhead light and barked at us to form an orderly queue.

One by one we were marched into the kitchen to be searched. When my turn came, I extracted the film canister from my bag and handed it over - explaining my mission and the provenance of some prescription medicine I was carrying. The police officers were underwhelmed. I could see "a likely tale" from the expressions on their faces.

It turned out that only Pete and his two flatmates plus one other woman and I were arrested. Larry vanished into the night with a horror-stricken glance in my direction. I was charged with illegal possession of herbal cannabis and as yet unidentified pills - despite the fact that they were in a prescription bottle with my name on it. Some time after midnight a friend arrived to bail me out. He drove me to my home in the suburbs, where I lived with my two young children and a Swiss au pair. At the time my life was rooted in middle-class mores. I had no idea how drastically this was about to change.

I was sure the charges against me would be dropped but it soon became clear that this was not the case. My medicine was analysed and found to contain small quantities of amphetamine. The pills stayed on the charge sheet. My doctor promised to exonerate me.

It transpired that Pete and his flatmates were big-time dealers. Kilos of hashish and marijuana and several hundred doses of LSD were found in the flat. The police had been watching the premises for weeks - it was my rotten luck they chose to pounce when they did.

On December 19 1967 I surrendered to bail. I had one brief meeting with my counsel, believing he had been comprehensively briefed by my solicitor. This confidence started to drain away when the prosecuting counsel turned his attention to me. His words were loaded with factual error. He claimed the police had "found" the film canister of cannabis, whereas I had volunteered it. He claimed I had not mentioned that my pills were on prescription. My counsel failed to challenge these errors and nor did he call my photographer colleague to give evidence in my favour.

I found myself remanded in custody to Holloway prison. By the time the court reconvened the following week I was a bewildered wreck. Before my arrest I had tried only a toke or two of cannabis. I had never been anywhere near psychedelic drugs. I pleaded guilty because technically I was guilty of possession. I was also guilty of extreme naivety. I don't think the judge recognised the difference between the 106 grains of herbal cannabis I was charged with and the kilos found in the flat. When he sentenced me to nine months in prison, I fainted into the arms of a prison officer.

A friend came to visit me in Holloway, shortly after my conviction. He told me to appeal against the sentence, dismiss my existing legal team and instruct a solicitor with experience of drug cases, recommended by the counselling service Release. Nine weeks passed before my case was heard at the court of appeal. During that time I spent three weeks in Holloway and six at an open prison called Hill Hall. The former was relentlessly grim. Hill Hall was an altogether different institution, with an atmosphere that reminded me of boarding school. I was given a plum job, working in the gardens. On February 14 1968, I was planting tomatoes in the greenhouses when the governor's assistant came striding by. When he told me I was free, I threw my bucket of compost into the air and danced with delight. I was granted an absolute discharge.

After my release I went to Switzerland to ski for a couple of weeks and took with me a small nugget of hashish. One of my pleasures was to smoke a joint in the chairlift then slip weightlessly over the crystalline slopes as the sun rose over the Alps. Those moments were a celebration of freedom - and an acknowledgment that a miscarriage of justice had turned me into a criminal.

I had been born into comfortable bourgeoisie in Manchester and had barely touched on the drug culture before I was busted, but the hippies and freaks I met between my arrest and imprisonment became friends who remain to this day - artists, poets, musicians, political activists, filmmakers and entrepreneurs. They turned me on to a whole new cultural landscape, and I became painfully aware of my conventional mindset. Over the months following my release, my lifestyle changed from respectable bourgeois single mother into hippy dropout. I joined CND and became fascinated by oriental cultures and religion. I went to meditation classes and transformed the family diet from meat and two veg to tofu and brown rice. I took a full-time job, but gave up after a year: alternative life was just too attractive.

One afternoon I was sunbathing in the garden of my flat in Beckenham, south London, under the influence of a dose of tincture of cannabis. The domestic chores were done and the kids were at school. Some very interesting music reached my ears from the top-floor flat.

"Who's playing?" I called.

A pale, thin face with a halo of blond curls appeared at the open window. It belonged to a young musician called David Bowie. I invited him to join me in the sunshine and the tincture. A week or so later he moved into our flat as a lodger. Our home became a music studio - with amplifiers, microphones and festoons of wiring cascading out of David's room. The children were delighted, they adored David and there were times when both of them bunked off school to hang out with him. He put the finishing touches to his first hit, Space Oddity, during this time, and dedicated the B-side to my son Richard.

Loosening the shackles of respectability was an enthralling learning curve - but it was not always so wonderful for my children. As my lifestyle changed, their needs were sidelined in favour of my great adventure. I frequently abandoned them for extended periods, and hosted loud, all-night parties. My mother and ex-husband were constantly berating me for my wicked ways. At one point my mother called in social services. Eventually the children went to live with their father and I ended up in a squat in north London.

That move signalled another turning point - but this time back towards a more conformist lifestyle. In the squatting community in Kentish Town I had one of the most elegant houses, beautifully restored by my architect boyfriend. Soon after moving in, I became pregnant with my third child, Daniel. When I went back to work I was probably the only person to have an au pair in a squat.

My total commitment to the counter-culture lasted about five years. Today I live an outwardly respectable life in a very nice house in the south-west of England, but I have remained true to the 1960s world view. All three children grew up into intelligent, capable adults. I am still a pacifist, still intrigued by the mysteries of consciousness, and a practising Buddhist in the Tibetan Dzogchen tradition. I still believe all drugs should be decriminalised but I hardly ever use cannabis these days and it's 20 years since my last dose of LSD.


Alcohol worse than ecstasy on shock new drug list

Some of Britain's leading drug experts demand today that the government's classification regime be scrapped and replaced by one that more honestly reflects the harm caused by alcohol and tobacco. They say the current ABC system is "arbitrary" and not based on evidence.

James Randerson, science correspondent
Friday March 23, 2007
Guardian

The scientists, including members of the government's top advisory committee on drug classification, have produced a rigorous assessment of the social and individual harm caused by 20 substances, and believe this should form the basis of any future ranking.

By their analysis, alcohol and tobacco are rated as more dangerous than cannabis, LSD and ecstasy.

They say that if the current ABC system is retained, alcohol would be rated a class A drug and tobacco class B.

"We face a huge problem," said Colin Blakemore, chief executive of the Medical Research Council and an author of the report, which is published in the Lancet medical journal. "Drugs ... have never been more easily available, have never been cheaper, never been more potent and never been more widely used.

"The policies we have had for the last 40 years ... clearly have not worked in terms of reducing drug use. So I think it does deserve a fresh look. The principal objective of this study was to bring a dispassionate approach to what is a very passionate issue."

David Nutt, a psychopharmacologist at Bristol University and member of the Advisory Council on Misuse of Drugs (ACMD) which advises ministers on drug policy, added: "What we are trying to say is we should review the penalties in the light of the harms and try to have a more proportionate legal response.

"The point we are making is that all drugs are dangerous, even the ones that people know and love and use regularly like alcohol."

Professor Nutt and his team analysed the evidence of harm caused by 20 drugs including heroin, cocaine, cannabis, ecstasy, LSD and tobacco.

They asked a group of 29 consultant psychiatrists who specialise in addiction to rate the drugs in nine categories. Three of these related to physical harm, three to the likelihood of addiction and three to social harms such as healthcare costs. The team also extended the analysis to another group of 16 experts spanning several fields including chemistry, pharmacology, psychiatry, forensics, police and legal services.

The final rankings placed heroin and cocaine as the most dangerous of the 20 drugs. Alcohol was fifth, the class C drug ketamine sixth and tobacco was in ninth place, just behind amphetamine or "speed".

Cannabis was 11th, while LSD and ecstasy were 14th and 18th respectively. The rankings do take into account new evidence that specially cultivated "skunk" varieties of cannabis available now are two to three times stronger than traditional cannabis resin.

Evan Harris MP, the Liberal Democrats' science spokesman, said the paper undermines the government's claim that drug policy is evidence-based. "This comes from the top echelons of the government's own advisory committee on the misuse of drugs. It blows a hole in the government's current classification system for drugs." He said the ACMD should make recommendations to ministers on how to change drug policy based on the findings.

But the shadow home secretary, David Davis, rejected any changes that would confuse the public. "Drugs wreck lives, destroy communities and fuel other sorts of crime - especially gun and knife crime. Thanks to the government's chaotic and confused approach to drugs policy, young people increasingly think it is OK to take drugs," he said, adding that he was against downgrading of ecstasy. "It is vital nothing else leads young people to believe drugs are OK."

The position of ecstasy near the bottom of the list was defended by Prof Nutt, who said that apart from some tragic isolated cases ecstasy is relatively safe. Despite about a third of young people having tried the drug and around half a million users every weekend, it causes fewer than 10 deaths a year. One person a day is killed by acute alcohol poisoning and thousands more from chronic use.

Prof Nutt said young people already know ecstasy is relatively safe, so having it in class A makes a mockery of the entire classification system for them. "The whole harm-reduction message disappears because people say, 'They are lying.' Let's treat people as adults, tell them the truth and hopefully work with them to minimise use."

Another advantage of the new system, according to Professor Blakemore, is that it would be easy to tweak the rankings based on new evidence.

The public furore over the downgrading of cannabis from B to C, he said, showed how hard it is to change drug classifications once they are fixed. "[Our system] would be easy to use on a rolling basis, to reassess the harms of drugs as evidence developed," he said.
 
The Metro, Friday 9 March, 2007

 
Smoking alters brain 'like drugs'

Smoking cigarettes causes the same changes to the brain as using illicit drugs like cocaine, a study suggests. US researchers compared post-mortem brain tissue samples from smokers, former smokers and non-smokers.

BBC Online
Feb 2007

Their findings, published in Journal of Neuroscience, suggested smoking causes changes to the brain which are evident years after someone has quit.

A UK expert said the changes might explain why smokers found it hard to stop - and why they then relapsed.

The researchers from the National Institute on Drug Abuse (Nida) looked at samples of human brain tissue from the nucleus accumbens and the ventral midbrain - brain regions that play a part in controlling addictive behaviours.

Eight samples were taken from people who had smoked until their deaths, eight from people who had smoked for up to 25 years before their death and eight non-smokers.

All died of causes unrelated to smoking.

Relapse

The scientists looked at levels of two enzymes - protein kinase A and adenylate cyclase. Both translate chemical signals, such as dopamine, which exist outside the cells, into a form that can be understood inside.

Smokers were found to have higher levels of these enzymes in the nucleus accumbens, a part of the brain that processes information related to motivation and reward, which virtually all illicit drugs act upon.

But levels of both enzymes were also found to be high in the area of the midbrain that responds to dopamine, which acts as a "reward chemical" in smokers and former smokers.

The same changes had previously been seen in the brains of rats given repeated injections of cocaine and morphine.

Writing in the Journal of Neuroscience, the team led by Dr Bruce Hope, said: "The present study confirms that drug-induced neuroadaptations [brain changes] observed in animals can also be observed in humans."

The researchers suggest that the differences seen in both smokers' and non-smokers' brains "may contribute to long-lasting alterations in nicotine-induced reward and addiction in humans".

The researchers say this suggests that the changes persist long after smoking has ceased and could contribute to drug relapse.

Dr John Stapleton, of the National Addictions Centre at King's College London, said: "It would be surprising if taking large doses of a drug such as nicotine many times a day over many years did not result in lasting changes in the brain.

"The new results may take us closer to understanding these changes.

"The key question remains as to whether such changes are partly responsible for the intractable nature of smoking and relapse after many months or years of stopping."
 
Caffeine abuse becoming health problem

Use of caffeine as a stimulant is becoming a problem among U.S. young people who can't get enough of it, Northwestern University researchers say.

CHICAGO, Nov. 25
Science Daily.com

The Chicago Tribune reported Saturday that the researchers analyzed three years' of cases that were reported to the Illinois Poison Center and found more than 250 cases of medical complications resulting from ingesting too many caffeine supplements.

The findings were presented at this fall's annual meeting of the American College of Emergency Physicians held in New Orleans. Twelve percent of those overdose cases required hospitalization; some of the cases required intensive care, especially when simultaneous use of other substances, legal or illicit, was involved, according to the research. The average age of the caffeine abusers was 21.

Caffeine as a new drug of choice, lead researcher Dr. Danielle McCarthy suggested, was the result of "aggressive marketing of high-content caffeine-containing beverages."

Symptoms of caffeine overdose include "everything from nausea, vomiting and a racing heart to hallucinations, panic attacks, chest pains and trips to the emergency room," the Tribune said.

Small ecstasy use 'harms brain'  

Even small amounts of the illegal drug ecstasy can be harmful to the brains of first time users, researchers say.

BBC Online
30 Nov 2006 

The University of Amsterdam team took brain scans and carried out memory tests on 188 people with no history of ecstasy use but at risk in the future.  

They repeated the tests 18 months later, and found for the 59 people who had used ecstasy there was evidence of decreased blood flow and memory loss.

Long-term ecstasy use is already known to be harmful.

 The class A drug is used by about 500,000 people in the UK, mostly on the club scene.

  We know long-term use has a lasting impact so it makes sense that damage starts as soon as someone starts to use the drug
-Dr Fabrizio Schifano, of the University of Hertfordshire 

 Lead researcher Maartje de Win said: "We do not know if these effects are transient or permanent.

"Therefore, we cannot conclude that ecstasy, even in small doses, is safe for the brain, and people should be informed of this risk."  

Research has shown that long-term or heavy ecstasy use can damage neurons and cause depression, anxiety, confusion, difficulty sleeping and decrease memory.  

However, no previous studies have looked at the side-effects of low doses of the drug on first time users.

The study, presented to the annual meeting of the Radiological Society of North America, said there was no evidence of damage to the neurons or alteration to mood and it was unclear whether the effect of early use of the drug was permanent.

 Blood provides the brain with energy, and decreased flow can lead to memory loss and attention problems.

Of the people who were tested who had taken ecstasy, the average use was six tablets.  

Dr Fabrizio Schifano, professor of pharmacology at the University of Hertfordshire, said it was clear that early use of the drug did have some effect, but what there was not a consensus on was how long that would last.  

He said: "We know long-term use has a lasting impact, so it makes sense that damage starts as soon as someone starts to use the drug.  

"But we cannot say exactly how much damage is sustained at the start and need more research to be categorical about this."


MPs accuse ministers of twisting science for political purposes

Evidence distorted to give figleaf of respectability
Inquiry highlights drug policy and crime statistics


James Randerson, science correspondent
Nov 8, 2006
Guardian

The government often hides behind a figleaf of scientific respectability when spinning unpalatable or controversial policies to make them acceptable to voters, according to a report by MPs critical of the way science is used in policy.
The parliamentary science and technology select committee said that scientific evidence was often misused or distorted to justify policy decisions which were really based on ideological or social grounds.

The report, the culmination of a nine-month inquiry, calls for a "radical re-engineering" of the way the government uses science. "Abuse of the term 'evidence based' ... is a form of fraud which corrupts the whole use of science in government," said Evan Harris, the Liberal Democrats' science spokesman and a member of the committee. "It's critical that the currency of an evidence base is not devalued by false claims."

The investigation highlighted several examples of misuse of science, including a witness who told the MPs that his work on crime statistics had been twisted by the Home Office to give the best possible spin.

"I had pointed out prior to the Home Office publishing this that I thought their interpretation differed from our own and I had identified where I thought the difference lay," said Tim Hope, a criminologist at the University of Keele who appeared before the committee in May. "Despite that, they proceeded to publish their own analysis. The inferences from that analysis were, let us say, rather more favourable to the political interests in this programme than were my own."

Professor Hope added that several researchers at a conference in 2003 were told at the last minute not to present work paid for by the Home Office, even though they were already on the conference programme. He believed this was because the Home Office wanted to control the way the information was released.

Some of the worst examples of false claims, says the committee report, Scientific Advice, Risk and Evidence Based Policy Making, came in drug policy, which Dr Harris described as an "evidence-free zone". Magic mushrooms, for example, are classified in the most dangerous drug category, class A, even though there is scant evidence that they are harmful.

The committee also criticised government claims that the ABC drug classification system reduces crime, saying there was no evidence to back that up.

"Governments have a right when they are elected to make policy because of sociological reasons or because of political imperatives," said Phil Willis, the committee's chair, "but what they don't have a right to do is to say that that is based on sound scientific evidence when it isn't."

The report calls on government departments to state clearly when statements are based on scientific evidence, and when they are going against evidence for political reasons.

The MPs also recommend the creation of a government scientific service made up of independent expert advisers and that the government's chief scientific adviser, currently Sir David King, be given a seat on the Treasury board. The committee challenges the perception that industry representatives on scientific advisory committees are "frequently seen as less trustworthy" than representatives of non-government organisations. It said technical committees should not routinely have lay members.

The MPs call for change in the culture of the civil service, where a scientific background is often seen as a barrier to promotion.

A spokesman for the Department of Trade and Industry said it recognised there was room for improvement, but added: "The UK has rightly developed an international reputation for its world-leading use of science in government, for example in climate change, health issues and international development."

Facts and fallacies

The science and technology select committee found numerous examples of the misuse of science by government departments:

Government claims that the ABC drug classification system reduces crime.

Magic mushrooms placed in the most dangerous class A category.

Over-zealous regulations proposed for medical technicians using MRI scanners with no evidence base.

Homeopathic remedies allowed to be licensed by the Medicines and Healthcare Regulatory Agency despite not meeting the same standards of proof as conventional medicines.

Cost estimates on ID cards published before key technical decisions were taken.

Wide misuse of the term "precautionary principle".
 
Shocking! If you believe in imaginary gods in the sky you're allowed to take drugs legally, but not if you're dying of cancer!

From: The God Delusion by Richard Dawkins, p22  :


'25% of smokers' get lung disease

At least a quarter of long-term smokers will develop the incurable lung condition chronic obstructive pulmonary disease (COPD), a study suggests.

BBC Online
20 Oct 2006

COPD describes a range of conditions, including bronchitis and emphysema, which make it difficult to breathe. Over 8,000 people aged 30 to 60 were studied by UK and Danish researchers for 25 years in the Thorax study. A spokesman for the British Lung Foundation said the study should act as a "wake-up call" to UK smokers.

COPD
It is estimated that 13.3% of Britons over 35 may have developed features
Between 600,000 and 900,000 people in the UK have been diagnosed with COPD
COPD is the sixth most common cause of death in England and Wales, killing more than 30,000 a year

Of the people studied, who all lived around Copenhagen, 5,280 were smokers, 1,513 had never smoked and 1,252 were ex-smokers.

At the end of the study, the researchers found that at least 25% of the smokers without any initial symptoms of the disease had "clinically significant" COPD, while up to 40% had some signs of the condition.

Over the 25 years, 2,900 people died, with 109 dying from COPD.

Nine out of 10 of those who died were smokers at the start of the study, while just two non-smokers died of the disease.

The risk of COPD was reduced in those who gave up smoking early on in the study - none of the ex-smokers developed severe COPD and only seven died.

At the end of the study, the lungs of almost all the male non-smokers continued to function well.

However, the same was true for only six out of 10 of those who continued smoking.

Around nine out of 10 female non-smokers had lungs that functioned well at the end of the study compared with only seven out of 10 female smokers.

Most smokers 'susceptible'

Writing in Thorax, the researchers who were led by Dr Peter Lange of Hvidovre Hospital, Hvidovre, Denmark, said: "Our main finding is quite simple - the longer people smoke, the higher the risk of developing COPD."

In an editorial in the journal, Dr Nick Anthonisen of the University of Manitoba in Canada, said: "The message is that many smokers develop airway obstruction if they live long enough and continue to smoke, and that the number that do so is increasing.

"An argument can be made therefore that many, perhaps most, smokers are 'susceptible' to COPD if they live long enough."

But he said there were long-term smokers who did not develop the condition, and more work was needed to find out why there was such a distinction.

Professor Stephen Spiro, from the British Lung Foundation, said: "This is an important study showing that people are even more at risk of COPD than we previously thought.

"It should act as a further wake-up call to smokers to get their lungs tested and to get help to stop.

"It's also a wake-up call to the UK - COPD is our fifth biggest killer, yet it's a hidden disease."
 
Drugs and prohibition

Ben Goldacre
Saturday August 5, 2006
Guardian

Certain areas of human conduct lend themselves so readily to bad science that you have to wonder if there is a pattern emerging. Last week the parliamentary science and technology committee looked into the ABC classification of illegal drugs, and found it was rubbish. This is not an article about that report, but it is a good place to start: drugs, they found, are supposed to be ranked by harm, in classes A, B, and C, but they're not; and the ranking is supposed to act as a deterrent, but it doesn't.

Watching this small area of prohibition collapse like wet tissue paper got me thinking: how does the world of prohibition match up against our gold standards for bad science, like the nutritionists or the anti-MMR movement? Have any of the prominent academic papers been retracted? Yes, they have. Professor George Ricaurte, funded by the National Institute for Drug Abuse, published an article in Science, describing how he administered a comparable recreational dose of ecstasy to monkeys: this dose killed 20% of the monkeys, and another 20% were severely injured.

Even before it was announced - a year later - that they'd got the bottles mixed up and used the wrong drug, you didn't need to be Einstein to know this was duff research, because millions of clubbers have taken the "comparable" recreational dose of ecstasy, and 20% of them did not die. It's no wonder animal rights campaigners manage to persuade themselves that animal research makes a bad model for human physiology.

That's before you even get started on workaday bad science. Like the food gurus, prohibitionists will cherry pick research that suits them, measure inappropriate surrogate outcomes, and wishfully over-interpret data: a prohibitionist will observe that less cannabis has been seized, and declare that this means there is less cannabis on the streets, rather than less police interest.

For textbook bad science we'd also want to see the media distorting research: overstating the stuff it likes, and ignoring stuff it doesn't, especially negative findings. We used to read a lot about cannabis and lung cancer in the papers. The largest ever study of whether cannabis causes lung cancer reported its findings recently, to total UK media silence. Lifelong cannabis users, who had smoked more than 22,000 joints, showed no greater risk of cancer than people who had never smoked cannabis.

While no journalist has written a single word on that study, the Times did manage to make a front page story headed "Cocaine floods the playground: use of the addictive drug by children doubles in a year," out of their misinterpretation of a government report that showed nothing of the sort.

There are even optimists who believe in quick fix treatments for drug habits - the heroin detox in five days, or painless withdrawal in just 48 hours, under general anaesthesia.

Why are drugs such a bad science magnet? Partly, of course, it's the moral panic. But more than that, sat squarely at the heart of our discourse on drugs, is one fabulously reductionist notion: it is the idea that a complex web of social, moral, criminal, health, and political problems can be simplified to, blamed on, or treated via a molecule or a plant. You'd have a job keeping that idea afloat.


Drug 'treats depression in hours'

An anaesthetic can treat depression within hours, US research suggests.

BBC Online
Aug 2006

The study involving 17 patients found ketamine - used as an anaesthetic but also taken as a recreational drug - relieved symptoms of depression.

Most existing treatments for depression take weeks or even months to relieve people's symptoms.

But the team, writing in Archives of General Psychiatry, said ketamine would need to be altered so it lost its existing hallucinatory side-effects.

This is the first report of any medication or other treatment that results in such a pronounced, rapid, prolonged response
Dr Thomas Insel, NIMH

Scientists from the National Institute of Mental Health (NIMH) injected 17 patients with either a very low dose of ketamine or a placebo of saline solution.

The participants were all depression sufferers who had tried an average of six treatments that had failed.

The researchers then measured their levels of depression minutes, hours and days after the dose was given.

Lead researcher Dr Carlos Zarate Junior, head of the mood and anxiety disorders programme at NIMH, said: "Within 110 minutes, half of the patients given ketamine showed a 50% decrease in symptoms."

By the end of day one, he added, 71% had responded to the drug. And at this point the team found 29% of these patients were nearly symptom free.

The researchers also discovered one dose lasted for at least a week in more than one-third of the participants.

Brain pathways

Dr Thomas Insel, director of NIMH, commented: "To my knowledge, this is the first report of any medication or other treatment that results in such a pronounced, rapid, prolonged response with a single dose.

"These were very treatment-resistant patients."

Many antidepressants target levels of brain chemicals, such as serotonin and dopamine, and, over time, the accumulation of these chemicals can affect a patient's mood. But this can take several weeks.

But the team believes ketamine is having a faster effect because it is targeting a different brain-protein, called the NMDA receptor, which is thought to play a critical role in learning and memory.

The team says ketamine, in its current form, would not be appropriate for medication because of side-effects at higher doses, which include hallucinations and euphoria.

Dr Zarate said: "This study is a tool to help us understand what part of ketamine is causing this effect so we can refine and develop better drugs.

"We are also looking at ways that we could use ketamine maybe in lower doses or with drugs that block its perceptual effects so we could perhaps use it clinically."

Professor John Henry, a clinical toxicologist at St Mary's Hospital in London, said: "This is a very interesting piece of work, very neatly done, with promising results.

"More studies need to be done to see if ketamine would work over a longer period given in repeated doses.

"The benefit of having a fast-working drug would mean people could return to work quickly, and it could reduce risk of self-harm or suicide that could happen during the time-lag that occurs with other drugs."
 
Drug classification rethink urged

The designation of drugs in classes A, B and C should be replaced with one more closely reflecting the harm they cause, a committee of MPs has said. The Science Select Committee said the present system was based on historical assumptions, not scientific assessment.

By Pallab Ghosh
Science correspondent, BBC News
Aug 2006


BBC News has seen details of a system devised by government advisers which was considered by former Home Secretary Charles Clarke but is now on hold.

It rates some illegal drugs as less harmful than alcohol and tobacco.

The new system was based on the first scientific assessment of 20 legal and illegal stimulants used in contemporary Britain.

Alcohol was rated the fifth most harmful drug, ahead of some current class A drugs, while tobacco was listed as ninth. Cannabis, currently rated a class C drug, was below both those legal stimulants at 11th.

The MPs said including alcohol and tobacco in the classification would give the public "a better sense of the relative harms involved".

They also denounced the Advisory Council on the Misuse of Drugs - which provides scientific guidance to the government - for "dereliction of duty" in failing to alert ministers of "serious flaws" in the rating system.

Phil Willis, who chairs the committee, said the current classifications were "riddled with anomalies" and "clearly not fit for purpose".

Controlled drugs are currently put into alphabetical categories, reflecting the level of penalties offences such as possession and dealing can attract.

Class A, which is the highest category, contains substances such as heroin, cocaine, ecstasy and magic mushrooms.

Class B includes speed and barbiturates. Cannabis and some tranquilisers are graded as class C substances.

Systematic

Mr Willis said the only way to get "an accurate and up to date classification system" was to "remove the link with penalties and just focus on harm", adding that this meant social consequences as well as harm to the user.

He went on: "It's time to bring in a more systematic and scientific approach to drug classification - how can we get the message across to young people if what we are saying is not based on evidence?"

Speaking on BBC Radio 4's Today programme, he said: "In 1971 when the classification system was launched, that was right for the time.

"What we've had is a huge societal change over that period and what we've seen is that putting a drug into Class A does not stop people using it at all."

Alcohol

The alternative system was prepared by Professor David Nutt, a senior member of the Committee that advises the government on drug classification, and Professor Colin Blakemore - chief Executive of the Medical Research Council.

There are three class A drugs in the top five of the system, as well as one Class B and alcohol.

Tobacco is listed as the ninth most harmful drug and cannabis, a class C drug, comes in at number 11.

Perhaps most surprising is the presence of two Class A drugs - ecstasy and LSD - in the bottom six.
This places them well below tobacco and alcohol and a number of class B and C drugs.

Professor Blakemore told BBC News alcohol and tobacco were included in the ranking to give a "calibration of what these levels of harm mean".

He added: "That's not to say there's any argument that alcohol should be banned but it does give one a feel for the relative harm".


CURRENT DRUG CLASSIFICATION
Class A
Cocaine/crack
Heroin
Ecstasy
LSD
Magic mushrooms
Crystal meth (pending)
Class A/B
Amphetamines
Class C
Cannabis
Ketamine


MOST HARMFUL DRUGS


 
GLOSSARY
Benzodiazepines: Wide-ranging class of prescription tranquilisers
Buprenorphine: Opioid drug used in treatment of opiate addiction
4-MTA : Amphetamine derivative sold as 'flatliners' and ecstasy
Methylphenidate: Amphetamine-like drug used to treat ADHD
Alkyl nitrites: Stimulant often called amyl nitrites or 'poppers'
 
Study finds no marijuana-lung cancer link

Marijuana smoking does not increase a person's risk of developing lung cancer, according to the findings of a new study at the University of California Los Angeles that surprised even the researchers

CNN.com
May 2006

They had expected to find that a history of heavy marijuana use, like cigarette smoking, would increase the risk of cancer.

Instead, the study, which compared the lifestyles of 611 Los Angeles County lung cancer patients and 601 patients with head and neck cancers with those of 1,040 people without cancer, found no elevated cancer risk for even the heaviest pot smokers. It did find a 20-fold increased risk of lung cancer in people who smoked two or more packs of cigarettes a day.

The study results were presented in San Diego Tuesday at a meeting of the American Thoracic Society.

The study was confined to people under age 60 since baby boomers were the most likely age group to have long-term exposure to marijuana, said Dr. Donald Tashkin, senior researcher and professor at the UCLA School of Medicine.

The results should not be taken as a blank check to smoke pot, which has been associated with problems including cognitive impairment and chronic bronchitis, said Dr. John Hansen-Flaschen, chief of pulmonary and critical care at the University of Pennsylvania Health System in Philadelphia. He was not involved in the study.

Previous studies showed marijuana tar contained about 50 percent more of the chemicals linked to lung cancer, compared with tobacco tar, Tashkin said. In addition, smoking a marijuana joint deposits four times more tar in the lungs than smoking an equivalent amount of tobacco.

"Marijuana is packed more loosely than tobacco, so there's less filtration through the rod of the cigarette, so more particles will be inhaled," Tashkin said in a statement. "And marijuana smokers typically smoke differently than tobacco smokers -- they hold their breath about four times longer, allowing more time for extra fine particles to deposit in the lung."

He theorized that tetrahydrocannabinol, or THC, a chemical in marijuana smoke that produces its psychotropic effect, may encourage aging, damaged cells to die off before they become cancerous.

Hansen-Flaschen also cautioned a cancer-marijuana link could emerge as baby boomers age and there may be smaller population groups, based on genetics or other factors, still at risk for marijuana-related cancers.
 
Magic mushroom users turn to exotic alternatives to get high without breaking law

They have exotic names like Funk Pills, Amsterdam Gold, Kratom Leaf and Ayahuasca Sacrament and promise effects which range from the mildly euphoric to "ecstasy-style" energy rushes and hallucinogenic experiences.

Terry Kirby, Chief Reporter, The Independent
30 May 2006

But these are not drugs where you have to break the law to sell, buy or consume them - they are all completely legal. Dozens of new and ancient types of "legal highs" - derived from herbs, plants and cacti from South America and Asia and synthetic stimulants from New Zealand - are available. They can be bought, often at low prices, from internet-based companies and an increasing number of high-street "head" shops.

Ironically, the trade has been stimulated by the Government's decision last year to ban "magic mushrooms", which contain the hallucinogenic psilocin, which had been sold openly through the internet and in places such as Camden market in north London. The ban left a gap in the market, with consumers and vendors looking for new products.

Mark Evans, of everyonedoesit.com, one of the leading internet-based mail order operations, said the increase in trade since last year had been "massive". He added: "There is a huge gap in the market. These consumers are not going to disappear, they are just looking for alternatives." Mr Evans, whose company also sells cannabis seeds for growing, said there had been a change in the culture of people who consumed recreational drugs. "We do a lot of festivals and speak to people who say they are fed up with dealers and taking drugs - like ecstasy - where they cannot always be confident that they know what is in the pill. People want something which will not poison them and they [want to] know what they are buying."

Although many of the organic-based legal highs have, it is claimed, been used in primitive communities for millennia, the current biggest seller, Funk Pills, have only been in existence for a few years. Sales have rocketed in the past six months. Selling for between 5 and 7, they come from New Zealand, where they are made by companies licensed by the government there, after it decided that they were a less-harmful substitute for illegal drugs such as methamphetamine.

Also known as pep pills, they contain the stimulant benzylpiperazine - banned in the US, Denmark and Australia - with other chemicals from the piperazine family, which are also used to create Viagra.

According to DrugScope, the independent advice body, while some users are keen on the pills, attributing genuine ecstasy-style effects, others are more sceptical. The pills come with warnings about dosage, driving or using machinery, and side effects can include those normally associated with ecstasy or amphetamines, such as dehydration, anxiety and insomnia.

Another big seller is the Spice Smoking Blend, a new version of the herbal mixes which are traditional legal alternatives to cannabis. "Herbal substitutes were always a bit of a joke, but many people say these are the closest thing to marijuana yet," said Mr Evans.

At the other end of the scale from Funk Pills are the 12 peyote cacti sold by Chris Bovey, who runs another mail-order company, Potseeds.co.uk, based in Totnes in Devon. Peyote cacti contain the hallucinogenic drug mescaline, which has a similar effect to LSD and was the drug used by Aldous Huxley before he wrote The Doors of Perception, which encouraged the use of mind-altering drugs in the 1960s. Native American tribes have used it for centuries as a shamanic plant that can create visions of an alternative world. "It is a lot more in demand since the mushroom ban," he said.

Mr Bovey said consumers broadly divided into two groups - older "hippie" types, used to smoking cannabis and younger buyers seeking to replicate the "E" experience. Instances of addiction, abuse or harmful effects were almost non-existent. The Home Office said there was no reason to examine the legal status of any of the substances on the market.

Nevertheless, DrugScope issued advice to students in London earlier this year, cautioning that any drug which has a psychological effect can prove difficult to stop if used regularly. It added: "Proper controlled research is sparse, and therefore side effects and possible dangers when taken with other drugs and even foods is not known."

Harry Shapiro, a spokesman for DrugScope, added: "People with mental health problems should not take them. If you are going to experiment, do so in a safe and secure environment."

Herbal pleasures

* PEP PILLS: Marketed as Funk Pills or Party Pills and made from a chemical derived from the pepper plant. Developed as a worming treatment for cattle. Replicates the rush of ecstasy, but users should be careful of overdosing. 5-7 for 2-3 pills

* AMANITA MUSCARIA (FLY AGARIC): Red- capped, white-spotted mushroomlong known for its psychoactive effects. Not covered by the Government's ban on "magic mushrooms" since it does not contain psilocin. Users should start with low doses. 14 for 12g

* KRATOM LEAF (above): Leaves of the Mitragyna speciosa tree of Malaysia and Thailand. Described by PotSeeds as "one of the most effective and pleasurable psychoactive herbs". Said to cause a dreamy sensation. Can be addictive. 9 for 5g

* SALVIA DIVINORUM: Herb that can create an intense high lasting less than an hour. Not recommended as a recreational drug. 10-17 a bag

* AYAHUASCA SACRAMENT: A shamanic plant potion, it can induce vomiting before narcotic effects begin. Should not be mixed with with antidepressant drugs. 4.99 for 30g
 
A mountain of anomalies

Politicians need to face up to the fact that there is no rhyme or reason in the (UK) drug classification system

James Randerson
Monday April 24, 2006
Guardian

'It's there because it's there." That was the frank answer from the head of the government's top drug advisory body on why magic mushrooms are in the most dangerous category - with heroin, crack and cocaine. Professor Sir Michael Rawlins was admitting to MPs last month that the UK's drug classification system is stacked with inconsistencies, ad hoc judgments and historical accidents.
His testimony as chair of the Advisory Council on the Misuse of Drugs (ACMD) blew the gaff on government claims that its drug policy is "evidence-based". The reality is that the classification system for illegal drugs is riddled with anomalies and doesn't work.

On Wednesday, there will be another difficult hearing before the parliamentary science and technology committee to probe the evidence base for the entire drug classification system. The answers matter: No home secretary has ever gone against the ACMD's recommendations.

You don't need to be a pharmacologist to realise that heroin is a lot more dangerous than magic mushrooms. Between 1993 and 2000 there was one death in the UK from magic mushrooms, but 5,700 from heroin. The government's Talk to Frank drug education website says: "Magic mushrooms are not addictive in any way."

Putting magic mushrooms into class A is indefensible by any "evidence-based" criteria, but it was refreshing that Prof Rawlins did not try to defend it. Moving it down would be unwise, though, he said, because it might encourage use of what is undoubtedly a dangerous substance.

Another anomaly is the position of methamphetamine or crystal meth, a highly addictive and dangerous dance drug that has yet to take off in Britain. In November, the ACMD reviewed its status in class B and, despite deciding it was more dangerous than other class B drugs, opted not to move it up to class A. "Why?" asked the MPs.

Moving it could have the perverse effect of making it a more desirable product for users and so stimulate demand, Prof David Nutt, a distinguished psychopharmacologist and chair of the ACMD's technical committee told the MPs. So moving mushrooms down might stimulate demand, but moving crystal meth up would have the same effect?

A shift up the scale could well give a drug more kudos, as Prof Nutt suggests. But that undermines one of the key tenets of UK drug laws - that more dangerous drugs are placed in higher categories because of their greater risks. The higher penalties attached to those drugs tell would-be users that cocaine, for example, is more dangerous than cannabis.

Next up is the distinction between cocaine and coca leaves, both placed in class A despite solid evidence that the unrefined plant is far less dangerous. Amphetamines are classed differently depending on what form they are in, so why not cocaine as well? "That's a very good question," said Prof Nutt. But he didn't have an answer. And, asked why ecstasy sat in class A, he replied that it too was "an anomaly".

Drug treatment charities have argued for years that the classification system is inconsistent and is failing to protect the most vulnerable. Why, if it is really designed to reduce harm to the user and to society, do the two most dangerous drugs not form part of it? Alcohol contributes to around 1.2m assaults a year and smoking kills 130,000.

That these are not classified is the biggest anomaly in an antiquated system that has utterly failed to prevent drug use from rocketing. The blame lies not with the ACMD, but with the framework within which it is forced to operate. Only if politicians acknowledge the system's faults will we have any hope of building a legal framework that will protect users and society effectively.

James Randerson is the Guardian's science correspondent
 


Credit: The Onion


The strange case of the man who took 40,000 ecstasy pills in nine years

Usage increased to 25 tablets a day at peak
Memory problems and paranoia may be lasting


David McCandless
Tuesday April 4, 2006

Guardian

Doctors from London University have revealed details of what they believe is the largest amount of ecstasy ever consumed by a single person. Consultants from the addiction centre at St George's Medical School, London, have published a case report of a British man estimated to have taken around 40,000 pills of MDMA, the active ingredient in ecstasy, over nine years. The heaviest previous lifetime intake on record is 2,000 pills.
Though the man, who is now 37, stopped taking the drug seven years ago, he still suffers from severe physical and mental health side-effects, including extreme memory problems, paranoia, hallucinations and depression. He also suffers from painful muscle rigidity around his neck and jaw which often prevents him from opening his mouth. The doctors believe many of these symptoms may be permanent.

The man, known as Mr A in the report in the scientific journal Psychosomatics, started using ecstasy at 21. For the first two years his use was an average of five pills per weekend. Gradually this escalated until he was taking around three and a half pills a day. At the peak, the man was taking an estimated 25 pills every day for four years. After several severe collapses at parties, Mr A decided to stop taking ecstasy. For several months, he still felt he was under the influence of the drug, despite being bedridden.

Hallucinations

His condition deteriorated and he began to experience recurrent tunnel vision and other problems including hallucinations, paranoia and muscle rigidity. "He came to us after deciding that he couldn't go on any more," said Dr Christos Kouimtsidis, the consultant psychiatrist at St George's Medical School in Tooting who treated him for five months. "He was having trouble functioning in everyday life."

The doctors discovered that the man was suffering from severe short-term memory problems of a type usually only seen in lifetime alcoholics. But evaluating the full extent of his condition was difficult as his concentration and attention was so impaired he was unable to follow the simple tasks involved in the test.

"This was an exceptional case. His long- term memory was fine but he could not remember day to day things - the time, the day, what was in his supermarket trolley," said Dr Kouimtsidis. "More worryingly, he did not seem aware himself that he had these memory problems."

With no mental illness in his family and no prior psychiatric history, the doctors concluded that his unique condition was direct result of his intense ecstasy use.

"This is obviously an extreme case so we should not blow any observations out of proportion," says Dr Kouimtsidis. "But if this is what is happening to very heavy users, it might be an indication that daily use of ecstasy over a long period of time can lead to irreversible memory problems and other cognitive deficits."

For 10 years, MDMA has been suspected of causing these kinds of effects in heavy users. It is thought to be due to its disruption of the regulation of serotonin, a brain chemical believed to play a role in mood and memory. It remains unclear whether these effects are the result of permanent neurotoxic damage or just temporary reversible alterations in the brain.

A special two-part MDMA study in recent issues of the Journal of Psychopharmacology (available online at sagepub), suggests long-term side-effects may be temporary. The researchers from the University Of Louisiana could find no significant relationship between depression and recreational ecstasy use.

In the case of Mr A, a structural MRI brain scan failed to show any obvious damage or atrophy in his brain. However, these results, says Dr Kouimtsidis, are difficult to interpret. "A scan of this type is not sensitive enough," he said.

Such limitations in brain scanning technology, along with ethical and legal barriers to giving MDMA to human test subjects, have limited direct observation of the drug's effects in humans.

Instead, scientists have had to use recreational drug users as subjects in their studies. Conclusions from this are often flawed because few, if any, drugs users use ecstasy in isolation.

Cannabis user

Mr A was also a heavy cannabis user, and when he was encouraged to decrease his use, his paranoia and hallucinations disappeared and his anxiety abated. But his memory and concentration problems remained, leading the doctors to suspect that these may be permanent disabilities.

When he was admitted to a specialist brain injury unit and put on anti-psychotic medication, he did start to show some improvement. "Unfortunately, he discharged himself before we were able to complete the assessment," says Dr Kouimtsidis. "We continued to support him. But he started to use cannabis again and he dropped out. We tried to re-engage him but we lost him about a year ago."

The Guardian made several attempts to find the man without success.

Effects of ecstasy

MDMA is one of the most intensely studied recreational drugs in history. But despite thousands of research papers and studies, scientific evidence on the side-effects remains inconclusive.

Death by overdose

Undoubtedly, large amounts of ecstasy can lead to over-heating which in turn, in rare cases, can trigger fatal heat stroke. Many factors contribute: number and strength of pills taken, environment, alcohol-consumption, body weight - but women seem more at risk. The bulk of ecstasy-related deaths around the world have been young women.

Water-poisoning

Panicking users, fearing they are overdosing, drink too much water and provoke hyponaetraemia (water-poisoning). Leah Betts died after drinking 14 pints in just 90 minutes. The recommended amount of water to drink per hour is one pint.

Toxic reactions

Much of the reports of toxic reactions are muddled with overdose or water-poisoning deaths. There is no clear evidence that some people suffer allergic reactions to ecstasy. However, around 10% of Western users do lack a key liver enzyme CYP2D6 needed to break down MDMA. This may make them more sensitive to the effects and more prone to accidental overdose.

Depression

Many weekend users report a mid-week mood dip. This is suspected to be related MDMA's effect on serotonin, but hard evidence is lacking. In heavy users, dips can turn to crashes and depression. However studies suggest this effect reverses after a 2-3 month abstinence.

Positive effects

Users still claim "long lasting improvements in self-awareness, self-esteem, openness and insight into personal problems", reports the study from the University Of Louisiana. In the US, research continues into the use of MDMA-assisted psychotherapy to treat Post Traumatic Stress Disorder.
 

The Onion
Report: 92 Percent Of Souls In Hell There On Drug Charges

October 12, 2005
 
The cocaine paradox

Cocaine is an addictive Class A drug, its use widely deplored. Yet, as recent events perhaps show, its sphere of influence is wider than we might think. So, do we have a paradoxical attitude to the drug?

By Jonathan Duffy
BBC News Magazine
Oct 2005

Everyone enjoys a party now and again, so who could begrudge those celebrities who populate the pages of the tabloid press with tales of their "partying" antics? Yet all is not what it might seem with such stories.

One interesting aspect to emerge from the deluge of coverage following last month's allegations that Kate Moss had snorted cocaine was the use of the word "partying". Frequently it is a euphemism for doing drugs.

"Celebrities are forever saying in interviews: 'X was partying a lot at that time'," wrote author and journalist Anna Blundy. "What they mean is that they were addicted to drugs."

This revelation will come as no surprise to many insiders. From LA to London, cocaine has long been known as a social lubricant.

It is a stimulant, helping users feel alert and socially confident. It dulls the inhibitions that most of us have, to a greater or lesser extent, when mixing with a bunch of people we don't know very well.

In some parts of some industries - fashion, public relations, the media, city trading, pop music, to name just a few - socialising into the small hours is part of the job. And coke is part of the scene.
Robbie Williams last weekend highlighted what he saw as hypocritical views towards the drug in the media, saying he had personally taken cocaine with journalists who had criticised Kate Moss for doing the same.

For all its associations of glamour, cocaine use is not condoned by modern mainstream society - though things were different in the 19th Century, when it could be found in dozens of medicines on sale in High Street chemists.

While legalisation of cannabis, a so-called soft drug, is a perennial debate, heroin and crack occupy the other end of the spectrum. Hard and highly addictive, they draw in the desperate, and turn them into junkies.

But despite having the same Class A status, cocaine occupies a more paradoxical place. While the media overtly abhors it, in the very same breath it laps up the glamorised celebrity culture that cocaine helps perpetuate.

What's more, sections of society have increasingly come to imitate these values, as individuals become accustomed to spending more on going out and enjoying themselves. The falling cost of cocaine has also made it more accessible.

Mark is 33, owns his own flat, rides a scooter around London and knows how to apply himself in his skilled job of website development. He also enjoys cocaine.

'Socially acceptable'

He is just the sort of person Sir Ian Blair, the Metropolitan Police commissioner, had in his sights when last year he vowed to target middle class cocaine users who think it is "socially acceptable".


COCAINE FACTS
Street price has fallen to about 40 per gram
Bought as a 'wrap', can be padded out with sugar, starch etc
Effects are short-lived, can result in a flu-like 'hangover'

Cocaine use has risen sharply in the past nine years, albeit from a low base. Latest figures show 2.4% of 16-59-year-olds in England and Wales had used cocaine in the past 12 months - up from 0.6% in 1996.
In the mid-90s ecstasy and hallucinogenic drugs were more popular than cocaine. Today, coke is the second most popular illegal drug, after cannabis. The steepest rise has been within the 25-34 age group - which includes Mark - where almost 6% took coke in the previous year.

Mark first tried cocaine when he was 19 and his usage now goes in fits and starts.

"I'm waiting for a delivery now, for the weekend. It's a friend's birthday. But it's been six weeks since I last took it," he says. Last year, though, there was a two-month stretch where he took cocaine every weekend.

He likes the drug's ability to "perk you up" on a Friday night, at a bar with a drink after a tiring week, and how it oils the wheels in a social situation.

"There's also the social aspect of going to the loos with a friend and giving them a line of coke. It's a friendly act, and it's also a bit naughty."

Health issues

The drawbacks of snorting coke include damage to the lining of the nose, which leads to surges in blood pressure caused by the narrowing of coronary arteries. Users can suffer chest pains which can lead to heart attacks or strokes, and some experience an itch, known as "cocaine bugs".


Aside from the physical problems, regular use can also lead to psychosis and severe depression, say experts. And, as with all illegal drugs, it can create a divide between those friends and family who also use them, and those who don't.
So far though, Mark has seen nothing of these effects - either in him, or his network of about 15 friends who also take coke.

"You might have a bad night, but you'd have that on alcohol. None of us has been hospitalised from coke."

The alcohol point is an important one for Mark and those like him, who argue there is a moral equivalence between alcohol and drugs like cocaine. Yet one is legal and one is banned.

"You go into the bars where I work and you know people are taking it. It's going on and everyone knows it. Celebrities take coke all the time, but it's just not reported. It's like [comedian] Bill Hicks said - you've got to have a war on something."

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I'm a 30 year old professional who uses coke from time to time. I like to party every now and then, for special occasions. Sometimes it's very infrequent, with several months in between, other times you might have a more hectic month. The media are hypocrites. Cocaine use by the press, and by people in TV in general is rife. However, I'm glad it's illegal because it would get out of hand - like drink is for wider society today. But generally speaking, the addictiveness and social corruption that is portrayed as going hand-in-hand with cocaine is one of those urban myths. Most users do it very casually, in modest amounts every now and then and it is not a problem.
Andy, London, UK

Although I do not condone drug use of any kind, cocaine is so over rated . I have seen more deaths, violence and anti social behaviour from effects of alcohol. But this is a nice taxable drug so nothing is ever done about it. I would like to see figures comparing deaths from drug related abuse compared with deaths from alcohol related abuse, I think the figures speak for themselves. Let's face it, at around 60 a gram who can afford cocaine, apart from the rich and socialites. You can get 24 cans of Carling for 10..
TC, UK

I occasionally take cocaine, and so do most of my friends. I know several people who have had problems with drink, but no one who has become addicted with cocaine, mainly because its to expensive to take regularly.
Neil, Birmingham

Quite apart from the legal and health questions, what strikes me as odd is that the same metropolitan types who would only ever buy organic and fair-trade food see it as "socially acceptable" to perpetuate the world's most immoral industry, which thinks nothing of participating in every crime from arms dealing to people trafficking, prostitution and murder. How can they say it is just like alcohol?
Seb, London

Would the person in the story be happy about taking those drugs if he was aware of the misery caused to get him his 15 minutes of happiness?
Chris Wills, UK

Good to see a more honest, less knee-jerk report on cocaine use. One thing that the article fails to mention is that people on coke generally become arrogant and obnoxious.
Will, UK

I'm not sure where this view of Cocaine being socially deplored comes from. Certainly no-one in my group of friends has a particularly negative attitude towards it. It seems the only people thinking cocaine is the worst thing since the invention of the gun are those enforcing its illegality.
Andy, Reading, UK

Why is Cocaine socially unacceptable? It is used in every walk of life, from plumbers to policemen. I don't use it myself, but would never condemn someone else for it - it's very small minded to portray it as a celebrity drug - or that people taking it are aping celebrities. It's been in every area of society for a long time and I'm surprised it's even a topic for discussion.
Magnus, Switzerland

You have totally missed one fundamental point about cocaine in your story. And that is the effect on other people around you. For several years I worked with a few people who had coke habits. And the whole experience was a nightmare. It makes people paranoid, utterly selfish and gives them a hugely inflated opinion of themselves and their abilities. It was the hardest job I ever had, purely because of this horrible substance that they thought was "fashionable" to take.
John, UK

Thank you for publishing this interesting and thought-provoking article. It's great to see journalists moving beyond the far too simplistic "drugs are bad" mantra. Although it's for each to make up his/her own mind on this difficult issue, at least different sides of the debate are being aired.
Deepak Nambisan, London

Why waste your lives on addictive drugs? There is a lot more mature ways to enjoy yourself out there! Take a drink or play a sport. It's healthier!
Dennis O Rourke, Ireland

One thing not mentioned in the article about regular consumers of cocaine is how obnoxious many people become when on the drug. That's what does the long-term damage.
Anna, UK

My friends got into cocaine, and after a few months of dabbling, they couldn't go out without it. The mix of alcohol and coke always turned them into violent, aggressive people, and they became more and more selfish and self-consumed, turning their backs on family and friends alike, just to get high. I am no longer friends with these people, and personally I don't think the drug should be treated as 'recreational'. It is almost more damaging to society than binge-drinking and turns even the nicest person into an angry, and needy being, sometimes even a criminal, just for the sake of a line.
Hazel Miller, England

A friend of mine takes an awful lot of coke which started off as a weekend thing and then he suddenly realised that he was doing it on a Monday... Tuesday and then my goodness, is it really Thursday? Almost the weekend again and time for more 'sniff!' When I pointed out that he will end up suffering from "Westbrooke nostril syndrome" he said, "Ah, well... I will be able to fit more in that way!"
Sean C, UK

Quote: "Celebrities are forever saying in interviews: 'X was partying a lot at that time'," wrote author and journalist Anna Blundy. "What they mean is that they were addicted to drugs. "No what they mean is that they were TAKING drugs. How can a supposedly bona-fide journalist twist the term 'partying' into addiction. Christ!
Edd, UK

The collusion between the media and celebrities over the years has served to make cocaine usage seem very normal, fashionable, a bit naughty but ultimately safe. On the one hand, says the press, it's OK as long as you don't get found out, but if you do get found out we will feign horror. None of the coverage is at all helpful to ordinary people like me trying to raise children to aware of the dangers of drugs.
Lorraine, St Albans, UK

Compare how many people die from class A substance use with the number killed by 'socially acceptable' drugs such as alcohol, and the danger of illegal substances is shown to be negligible. Politicians and journalists alike love a tipple of course, so no stigma is attached to G&Ts. Some people would call that hypocrisy.
Chris Lockie, UK

Well done for showing a balanced view on this subject.
,

The one thing that puts me off cocaine ahead of anything else is the sheer misery it causes in the countries where it's produced, and the manipulation and intimidation of the "mules" - usually vulnerable women - who are used to bring it into the country. Reading your recent story on here about Sonia who was forced to choke down cocaine or face threats to her children, I wonder that anyone can justify their weekend high when it costs such a high price to someone else.
Chandra, England

Take it - or don't - but it's unfair of the media and politicians to accept that the use of cocaine is rife when it suits them and to stigmatise people on a whim.
Cheryl,

If anyone wants a moral reason not to do cocaine, it's because it's the worst cash crop in existence - there are many thousands of farmers in South America who are forced to grow it because it's the only crop that will make them any money. Developed countries dump subsidised surpluses on them, and local farmers can't compete with the prices. This means they get locked into a cycle of poverty where they have to grow coke - they hardly see any profits, as most of the money is taken by the local cartels who then rule with an iron fist. It's ironic that celebrities and the middle class, who are so eager to support fair trade initiatives on one hand, should nonetheless effectively support such a corrupt system with the other.
Rob, UK

I think there are some very pertinent questions raised in this article, especially about the hypocrisy of tabloid journalists. They scream for the sacking of Kate Moss but one wonders how many of them would go straight from work and do much the same.
Chris, UK
 


Coming soon: the recreational drug with no side-effects

The Independent
Colin Brown, Deputy Political Editor
12 August 2005

It is the news that clubbers have been waiting for. Scientists are working on a range of recreational drugs that can produce similar effects to alcohol but with fewer of the side-effects.

Experts looked 20 years into the future to discover what kind of drugs we would be taking, and came up with a surprising range of findings, that open up the prospect of Sunday mornings without a thumping hangover or the "parrot's cage" mouth.

They have also been able to separate the effect of one psychoactive substance from its addictive properties, leading an expert panel to advise Government ministers that "this could pave the way to non-addictive recreational drugs".

One of the new substances has even been found to reduce the side effects of recreational drugs. "Such compounds might allow users to shape their drug experience," said the panel headed by Sir David King, the Government's chief scientific adviser.

His report to the Trade and Industry Secretary, Alan Johnson, raises the possibility that, in a generation, Britain's dinner parties could become more like Woody Allen's "orb" scene in the futuristic film Sleeper, where guests get high by rubbing the orb instead of inhaling a joint.

The report said: "There are a number of new and developing technologies that could be used to deliver drugs in new ways. Examples include patches, vaporisers, depot injection and direct neural stimulation ... this may encourage the development of technology for the slower release of recreational psychoactive substances, which could reduce the risk of addiction."

Some drugs developed to tackle health problems are capable of being used for improving the performance of the brain. Madafinil, which was introduced to treat narcolepsy, can keep normal people awake for three days, says the report.

Other drugs could be used to stop alcohol triggering a need for a cigarette. "Drinking with friends might no longer create a trigger for an individual to smoke tobacco," the panel said.

Illicit laboratories that have supplied the black market with drugs for years may also accidentally discover drugs that could help sufferers from degenerative diseases in old age. "Perhaps the next major breakthrough in treatments for Parkinson's or Alzheimer's, may come from some informal developer seeking to find the next rush," says the report.

However, the report could give ministers a hangover. It raises questions that they would prefer to be swept under the carpet.

In addition to raising the possibility that new drugs could remove the nasty side-effects of recreational drugs, it raises taboo subjects such as whether in future, prohibition is the right way to stop young people using drugs such as ecstasy.

It says an early warning of new drugs on the scene is essential in order to manage their use. "Such insights could play a key role in limiting the harm of any new recreational substances. It might also become apparent that some psychoactive substances are less harmful. Their use might be encouraged to replace more harmful ones."

Such a move would require a change in the drug laws because such drugs would be illegal. Sir David says in a foreword to the report: "We are on the verge of developments which could possibly move us into a world where we could take a drug to help us learn, think faster, relax, sleep more efficiently or even subtly alter our mood to match that of our friends."

The expert team ran a number of different workshops with members of the public to find out their views on how society would react to new drugs, and also did extensive scientific reviews. They also looked into the prospect of medical advances for tackling mental illnesses -such as clinical depression - by incorporating drugs in food.
 
Pupils 'reject more drug offers'

BBC NEWS
2005/06/06

Teenagers are five times more likely to have been offered illegal drugs than in the late 1980s. But the number of school pupils actually taking drugs is similar to a decade ago, shows research from the Schools Health Education Unit.

The unit's research manager, David Regis, says this suggests that young people are being successfully taught to reject drugs.

"There is evidence here that schools' efforts are working," he says.

The report looks at changes in the availability and the use of drugs among secondary school pupils between 1987 and 2004.

'Refusal skills'

It shows a very steep increase in availability between the late 1980s and the early 2000s - with the number of 14 and 15-year-olds reporting that they had been offered drugs rising about fivefold to around one in two.

This growth in pushing drugs at school-age youngsters, which includes a range of narcotics including cannabis, ecstasy and heroin, appears to have flattened off in the past few years.

But the figures for the numbers of young people saying they have taken drugs peaked in the mid-1990s and since then has generally fluctuated between 20% and 30% of 14 to 15-year-olds.

When the sampling methods have been taken into account, this is seen as showing that illegal drug use has flattened off and remained broadly constant for the past decade.

At present, the survey finds that 29% of 14 to 15-year-olds have taken cannabis.

In the mid-1980s, before the decade-long surge in drug use, there were only about 5% of young people who had taken any illegal drug.

This overview of two decades shows a pattern of young people having a great deal more opportunity to experiment with drugs - but that since the mid-1990s, the increase in supply has not been matched by a similar surge in demand.

Dr Regis says that this could mean that the "market is saturated" in terms of how many young people are susceptible to offers of illegal drugs - and regardless of availability, larger numbers are not going to be tempted to experiment.

But he says it also demonstrates that young people are being successfully equipped with the skills to reject offers of drugs.

Drug education lessons in schools can include role play where pupils practise rejecting the temptation to experiment, he says.

"They practise in the classroom where a pupil says 'just try one, it won't do any harm' and the other pupil has to learn to find a form of words to hold their line.

"They are being trained in refusal skills and clearly a lot of young people have this capacity to refuse unwelcome offers, which is good news," said Dr Regis.

The survey from the Exeter-based unit, based on a sample of 370,000 people aged between 10 and 15, also disproved stereotypes that inner-city areas were more likely to experience drug problems than rural schools, said Dr Regis.

Instead, he said that the biggest differences were often between schools close together, but which had entirely different experiences of drug problems.

"You can walk across a road and see a dramatic difference between two schools - in one drugs are around and in the other one they are not. You can cross a street and be in a different social world," he says.

The survey also found little evidence of a widespread problem with hard drugs such as heroin.

And Dr Regis cautioned that despite the attention paid to illegal drugs, "the drugs that they are most likely to experiment with and which are most likely to kill them are tobacco and alcohol".
 



Real-world information about recreational drugs from
OCADU (Oxfordshire Council on Alcohol and Drug Use)
here


'Infomania' worse than marijuana

Workers distracted by email and phone calls suffer a fall in IQ more than twice that found in marijuana smokers, new research has claimed.

BBC NEWS   22/04/05

The study for computing firm Hewlett Packard warned of a rise in "infomania", with people becoming addicted to email and text messages.

Researchers found 62% of people checked work messages at home or on holiday.

The firm said new technology can help productivity, but users must learn to switch computers and phones off.

Losing sleep

The study, carried out at the Institute of Psychiatry, found excessive use of technology reduced workers' intelligence.

Those distracted by incoming email and phone calls saw a 10-point fall in their IQ - more than twice that found in studies of the impact of smoking marijuana, said researchers.

More than half of the 1,100 respondents said they always responded to an email "immediately" or as soon as possible, with 21% admitting they would interrupt a meeting to do so.

The University of London psychologist who carried out the study, Dr Glenn Wilson, told the Daily Mail that unchecked infomania could reduce workers' mental sharpness.

Those who are constantly breaking away from tasks to react to email or text messages suffer similar effects on the mind as losing a night's sleep, he said.
 
Ecstasy trials for combat stress

American soldiers traumatised by fighting in Iraq and Afghanistan are to be offered the drug ecstasy to help free them of flashbacks and recurring nightmares.

David Adam, science correspondent
Thursday February 17 2005
The Guardian

The US food and drug administration has given the go-ahead for the soldiers to be included in an experiment to see if MDMA, the active ingredient in ecstasy, can treat post-traumatic stress disorder. 

Scientists behind the trial in South Carolina think the feelings of emotional closeness reported by those taking the drug could help the soldiers talk about their experiences to therapists. Several victims of rape and sexual abuse with post-traumatic stress disorder, for whom existing treatments are ineffective, have been given MDMA since the research began last year. 

Michael Mithoefer, the psychiatrist leading the trial, said: "It's looking very promising. It's too early to draw any conclusions but in these treatment-resistant people so far the results are encouraging. 

"People are able to connect more deeply on an emotional level with the fact they are safe now." 

He is about to advertise for war veterans who fought in the last five years to join the study. 

According to the US national centre for post-traumatic stress disorder, up to 30% of combat veterans suffer from the condition at some point in their lives. 

Known as shell shock during the first world war and combat fatigue in the second, the   condition is characterised by intrusive memories, panic attacks and the avoidance of situations which might force sufferers to relive their wartime experiences. 

Dr Mithoefer said the MDMA helped people discuss traumatic situations without triggering anxiety. 

"It appears to act as a catalyst to help people move through whatever's been blocking their success in therapy." 

The existing drug-assisted therapy sessions last up to eight hours, during music is played. The patients swallow a capsule containing a placebo or 125mg of MDMA - about the same or a little more than a typical ecstasy tablet. 

Psychologists assess the patients before and after the trial to judge whether the drug has helped. 

The study has provoked controversy, because significant doubts remain about the long-term risks of ecstasy. 

Animal studies suggest that it lowers levels of the brain chemical serotonin, and some politicians and anti-drug campaigners have argued that research into possible medical benefits of illegal drugs presents a falsely reassuring message. 

The South Carolina study marks a resurgence of interest in the use of controlled psychedelic and hallucinogenic drugs. Several studies in the US are planned or are under way to investigate whether MDMA, LSD and psilocybin, the active ingredient in magic mushrooms, can treat conditions ranging from obsessive compulsive disorder to anxiety in terminal cancer patients.   
 
Treating agony with ecstasy

Dancefloor drugs dismissed as merely recreational may have medicinal benefits - helping patients to get the most out of therapy. David Adam investigates

David Adam
Thursday February 17, 2005
Guardian

In 1960 a 40-year-old psychology lecturer at Harvard University took a trip that changed his life. In Mexico for a holiday, the academic tried magic mushrooms, triggering an interest in the psychological effects of hallucinogenic drugs that would ultimately lead to him being sacked, arrested, kidnapped and having seven grams of his mortal remains blasted into space after he died.

The lecturer was Timothy Leary, better known as the 1960s drug guru who urged America's youngsters to "turn on, tune in, drop out". Leary believed that hallucinogens could alter behaviour in unprecedented and beneficial ways, and in experiments at Harvard he doped graduate students with psilocybin - the active compound in magic mushrooms - and LSD.

He argued that the results of his experiments could help to treat alcoholics and reform criminals; but they enraged parents and unsettled colleagues. Harvard sacked Leary and his colleague Richard Alpert (later known as Ram Dass) in 1963 and the episode has left an embarrassing stain on the university's reputation ever since.

Now, more than 40 years later, research using psychedelic drugs is returning to Harvard.

John Halpern, a psychiatrist at the university's McLean Hospital, is set to study whether a compound called MDMA can help ease anxiety in terminal cancer patients. MDMA - or to chemists 3,4-methylenedioxymethamphetamine - is better known as the dancefloor drug ecstasy.

The study is the latest example of revived interest in the medicinal properties of controlled hallucinogenic or psychedelic drugs, loosely defined by their ability to alter perception, cognition or mood. Some researchers place MDMA in a different class, the empathogens, because it influences emotions.

Trials of MDMA for post-traumatic stress disorder are already under way in America, and psilocybin is being tried for anxiety and obsessive-compulsive disorder. There are even moves to reintroduce research on LSD at Harvard, where Halpern wants to test its abilities to treat cluster headaches - severe attacks that strike at the same time each day for weeks at a time.

"Drugs can be controlled but that doesn't stop them being useful," Halpern says. "That's what doctors are supposed to focus on and that's what I'm trying to do. The Leary connotations are understandable for a popular culture that is still struggling to resolve what happened in the 1960s.

"Let's face it, it was a huge fiasco back then, but Tim Leary was not a physician and didn't come to this from a medical approach."

Halpern's MDMA trial is different: 12 cancer patients with less than a year to live will be given varying doses under controlled conditions and strict supervision. Crucially, the trial was given the green light by several ethical review boards and approval from the US Food and Drug Administration (FDA) in December. One hurdle remains: Halpern has yet to receive a licence from the Drug Enforcement Administration (DEA) to handle the drug, though he expects to obtain one within weeks.

The ecstasy is not a chemical fix for the patients' anxiety, instead it is intended to help them to open up and get the most from conventional counselling. Halpern says the drug allows people to talk about topics they would otherwise avoid.

"It's really tough doing psychotherapy with people who have anxiety disorders because when you get to the heart of the matter it causes a panic attack. For somebody who has a particularly gruesome time trying to talk about important end-of-life issues it bubbles into anxiety and nothing gets achieved," Halpern says.

"MDMA may be potentially useful in that it doesn't induce that reaction. We want to see if that can translate into decreased anxiety and meaningful increases in the quality of life for these people."

The alternative, he says, is heavy doses of sedatives such as Valium. "At the moment these people have a choice of being over-sedated and not having anxiety or being alert and suffering panic attacks."

Patients volunteering for the trial will receive up to 125mg of MDMA over two experimental sessions several hours apart - about the same or a little more than in a typical ecstasy tablet. They will also receive more conventional help during several non-drug sessions. Psychologists will assess their mental state before and after the trial to judge whether the drug has helped.

Rick Doblin, the founder and head of the Multidisciplinary Association for Psychedelic Studies, which funds the Harvard research, says the study could bring one step closer his goal of making MDMA a prescription medicine.

"It's going to be a hurdle but as we get pilot studies that show promise I think it will get easier and easier to raise money for the research," Doblin says. "A lot of people think what we're trying to do is impossible and so don't bother to help out. Now we've shown that it is possible."

His group is funding the world's only current clinical trial of MDMA. At his South Carolina clinic, psychiatrist Michael Mithoefer has given the drug or a placebo to victims of rape and sexual abuse who suffer from post-traumatic stress disorder. The trial started almost a year ago and five of a total of 20 patients have been treated so far. Two more - the victim of a random shooting and a police officer involved in a violent incident - are lined up, and Mithoefer is preparing to extend the study to American soldiers traumatised by fighting in Iraq and Afghanistan after receiving permission from the FDA.

The research is controversial and getting it off the ground proved difficult. The FDA originally approved the South Carolina study in November 2001 but insisted that Doblin's group also get permission from an independent ethics review board; these oversee research and are usually attached to universities. The first seven applications to separate boards were rejected because of fears of legal action, experimental bias or in some cases with no explanation at all.

The dangers of ecstasy remain uncertain. In 2003, researchers at Johns Hopkins School of Medicine led by George Ricaurte were forced to retract claims that a single tablet could cause irreversible brain damage and even death in monkeys after they discovered a labelling mix-up meant they used the wrong drug in their experiments. Just 18 days later, the South Carolina trial got the go-ahead from its eighth ethics review board.

But significant doubts over the long-term risks of MDMA remain: animal studies show that it can lower levels of the neurotransmitter serotonin. It is difficult to judge whether similar changes occur in the brains of human users - though there is indirect evidence to suggest they do - and there is little evidence on what long-term effect, if any, this could have.

Some politicians and anti-drug campaigners have argued that research into the medical potential of illegal drugs presents a false reassuring message about their safety.

Doblin rejects this, arguing that several controlled drugs already have "dual use" and are used both for recreation and medicine. Heroin is routinely prescribed as a painkiller (though not in the US where synthetic versions are used) and cocaine is used as a local anaesthetic for surgery around the nose because it numbs tissue so effectively. "No one has been saying that the rise in street use of methamphetamine is because some kids with attention deficit disorder get prescribed it," Doblin says.

"We have to recognise there is no risk-free strategy. We're not trying to sell what we're doing as the way to solve all the problems with drugs. You look at the people who are taking MDMA for post-traumatic stress disorder and you would say that's the opposite of ecstasy. They're crying and shaking. They're not saying 'Oh I'm so happy and I love the guy who did this to me,'" he adds.

Some people who take ecstasy in clubs break through emotional barriers to memories of childhood or other abuse, he says. Deliberately suppressing these feelings if they feel unable to talk about them with their friends at the time can then make the situation worse. "I think that's the real risk of MDMA, more significant than the few cases of people who overheat and die and drink too much water and die."

The results of the South Carolina trial are expected at some point next year. Doblin says the next stage will be two larger trials involving hundreds of people: one would take place in the US and the second probably in Israel or Spain, where smaller studies are already planned.

Jose Carlos Bouso of the Autonomous University of Madrid started his own study of MDMA for patients with post traumatic stress disorder in 2001. Spanish drug-enforcement officials halted the work in 2002 after political pressure, but Doblin is hopeful that it will restart soon.

It's not just interest in MDMA that is on the rise. Francisco Moreno at the University of Arizona at Tuscon is currently writing up the results of a trial of eight people with obsessive-compulsive disorder treated with psilocybin. Psychiatrist Charles Grob at the University of California, Los Angeles, is also testing psilocybin, to relieve anxiety in terminal cancer patients.

Elsewhere, a team at the Orenda Institute in Baltimore has asked the FDA for permission to give cancer sufferers LSD and a Russian group in St Petersburg led by Evgeny Krupitsky are investigating whether heroin addicts can be helped by treatment with the psychedelic drug ketamine, which is commonly used as a horse tranquilliser.

A small clinic in Peru is also treating drug addicts with a hallucinogen - the native brew Ayahuasca, which is unusual because it contains dimethyltryptamine or DMT, the only psychedelic compound our bodies produce naturally.

Mithoefer, who leads the South Carolina MDMA trial, says it is too early to tell if the compound has clinical benefits, though the early signs are good. "The trend that we're noticing so far is that people are able to connect more deeply on an emotional level with the fact that they are safe now."

The trial is double-blind - meaning neither the patients nor the scientists know who has been given the MDMA - but Mithoefer says there are several tell-tale signs, not least that pulse rate and blood pressure increase.

"It's a little hard to describe, there's just a real sense of somebody having a new experience and connecting with their trauma."

Each drug-assisted session lasts about eight hours, during which patients lie down and music is played - though psychedelic classics such as the Beatles' Sergeant Pepper are out. "None of that stuff, because it has lyrics," Doblin says. "Lyrics plant images into people's minds and we really want people to be free to bring up their own content."

Halpern at Harvard hopes to get his trial of MDMA in cancer patients under way by the spring. "If it doesn't work then I'll feel bad about that but I'll get another paper published and that will further my career and I suppose that's nice," he says.

"But if it [MDMA] does help it should be compelling, and that shouldn't be thrown away because of the controversy over how some people end up abusing it."


Anger over 'harmless heroin' study

A new study claiming that heroin can be taken without damaging health or job prospects has been condemned by drug addiction groups.

Debbie Andalo and agencies
Thursday February 3, 2005
SocietyGuardian.co.uk

Researchers said the study proved that some users of the class A drug can find work, hold down a job and achieve educational qualifications which compare to non-drug users.

The study was based on 126 long-term heroin users who were not in treatment recruited in Glasgow over a four-year period. All had used opiates at least 10 times in the past two years, and had been using heroin for seven years.

Of those users, the majority were married, 74% were employed and 64% had gone into higher or further education. Only 5% had no educational qualifications and 15% were unemployed.

David Shewan from Glasgow Caledonian University, who carried out the research with colleague Phil Dalgarno, said the findings exposed a hidden population of drug users who have previously been ignored.

He said: "The important thing about the study is that it shows while there are heroin users with problems, there