MDMA: A first person account

Abel Pharmboy’s recent post remembering his father is evocative, emotional and an all around brilliant bit of writing. I can’t help but note, DearReader, that his post strikes me hard as a father and as a son. I think it had a similar effect on many of his readers. There is an additional component, though, in that it puts a personal face on the motivations of those of us who work on issues related to substance abuse. It isn’t a collection of incontrovertible data. No. It is a personal anecdote. But pain distributed is pain diffused. And the statistics loose much of their impact this way. This memorial of Abel’s though. This is concentrated. And for those of you lucky enough to never have a substance dependent individual in your lives, perhaps even this is not enough. For many of us, however, only a couple of stories like this are sufficient justification.

When I think back, though, I believe you died some eight years earlier, just after your 50th birthday party. For your wife, my Mom, it was even long before that – she is a saint for staying with you as long as she did – no offense, Dad – and I know she still loves you no matter what.
Our family runs rich with depression and alcoholism but you died exceptionally early; my Dad – the young, fit, handsome fella you were in those pictures with little me at the Jersey shore, at home, or with me in that horrible Easter outfit – had died back then and was replaced for the last eight, ten, fourteen years by someone else.

Go read the rest, this can wait.

I ran across a bit in the Guardian which tells a sad story:

In the late 80s I dabbled with speed to give me the energy to dance all night…Then came acid house and ecstasy. Suddenly, there was music that I loved complete with its own drug that let you dance like there was no tomorrow…As for the warnings against the drug… they didn’t bother me. Everyone knew (Leah Betts) died because she drank too much water and her brain swelled up. She listened to the government scaremongering about the effects of ecstasy. Besides, I reasoned, I wasn’t feckless. I combined my juvenile behaviour with very responsible jobs – until last year I was a manager with a charity. Also, as I got older I naturally went clubbing less and less.Then, last year I went to see the Pet Shop Boys play a benefit gig at Heaven. I hadn’t been to a club for four years and after turning 40 had promised myself that I would grow up and start acting my age.

return to huntNo problem, right? Experienced clubber dude. Multiple Ecstasy experiences under his belt, ditto the amphetamine, maybe methamphetamine. Going about his daily life with no detrimental effects of his drug use, by his account. Not addicted, not damaged. “Knows his limits”, I bet, all about the Ecstasy too. Opines on how safe recreational drug use is, no doubt. I know the type.

So, that evening I got home from work and got changed. And that’s it. That’s all I remember. A month later when I woke up I didn’t even know I had left the house. I felt like the gig was about to start. I knew nothing about being in a coma, or my mum and brother deciding not to turn off my life-support machine. I didn’t hear the discussions about what might happen if I woke up. I certainly did not know about my mum and brother being told on three occasions that I might die.
It transpired that I had taken powdered ecstasy, or MDMA, before going into Heaven.

-snip-

I later found out that I was one of four people in the hospital that weekend to have taken an E – and the only one to survive. My friend was told by a consultant that you could take E or MDMA 100 times and suffer no ill-effects or you could take it only once and that would be it.

Well, he doesn’t remember exactly what happens and relates few details in the article. It sounds pretty familiar though, doesn’t it? Seen to be dancing oddly, later collapsed. Found to have a sky high body temperature once under emergency care. Multiple organ failure. Read the case report literature and you’ll find this is a depressingly familiar tale. The only thing unusual is that he survived. I wonder about that though. Easy to write up a case report when the subject dies in the ER. Not so easy to write up a many month history on someone who nearly died and then slowly recovered back toward normalcy.
Rare? Yes, the stats show that pretty clearly. The unfortunate Mr. Hennessy did not have dependence issues nor, going by his prior use, some unique constitutive factors. Alcoholism, in contrast, is not rare at all. Many of the more devastating personal effects of alcohol use result from dependence. Yet there is a common thread in that lives were disrupted by recreational drugs. Multiple lives, because most people have family and friends who care about them. Disrupted terribly. Sometimes for multiple generations.
One at a time is a win. For me, anyway. So what if each new pharmacotherapy or other approach to treating alcoholism only works to get a few more percent of alcoholics clean? Each success is a big win for the family and friends. So what if MDMA-related medical emergencies and deaths are relatively rare? Rarer than equestrian accidents*? So what? Does it comfort the family to know that 10X or 100X or 1,000X more people died from various other causes when they are putting their loved one in the ground?
We don’t yet generate magic bullets in the drug abuse fields. Most therapies- talk, pharmaco or other – don’t work terribly well to rescue the drug-dependent. We know relatively little about precise danger thresholds when it comes to making predictions about acute toxicity in the individual recreational consumer. Yet…we make some progress. We design better therapies and invent new approaches…that pick up a few more percent of the population. We understand more about drug toxicities- in the case of MDMA this has a direct effect on user practices. Some users anyway.
And so we save a few more people. It is a Very Good Thing.
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*and oh yes, we shall be taking up the unfortunately named Professor Nutt’s issue at a later time, DearReader. Never fear.