The illegal drug ecstasy, already linked to brain and liver damage, may be causing more agony in the nation's streets and emergency rooms than anyone realizes, says a University of Florida medical expert.
Amphetamines Causing More Agony Than Anyone Realizes
Once confined to the "rave" subculture, ecstasy and closely related chemicals, known collectively as methylated amphetamines, have become mainstream street drugs and are increasingly associated with fatal car accidents and multiple drug overdoses, said Bruce Goldberger, a UF associate professor and forensic toxicologist.
"As these drugs have gained popularity, people have begun using them more recklessly," Goldberger said. "We believe this trend is occurring nationwide, but we don't have specific figures because most states don't track this information as thoroughly as Florida does."
The Florida Department of Law Enforcement, or FDLE, this month issued its annual report on drug-related deaths in the state. In 2001, methylated amphetamines were found in 147 of approximately 15,000 autopsies performed by the state's medical examiners. Sixty-nine percent of the deaths were due to accidental causes, including non-deliberate drug overdoses, motor vehicle collisions, drownings and other events.
FDLE first included methylated amphetamines in its previous report, which showed 59 deaths associated with the drugs during the last six months of 2000, out of 7,038 autopsies. Seventy-one percent of the deaths were due to accidental causes. The agency did not track deaths associated with methylated amphetamines prior to July 2000.
"The new report confirms what toxicologists already know from observation -- more people are dying," said Goldberger, who performs post-mortem drug screens for several medical examiner districts throughout the state. "What it doesn't tell us is how many people are using these drugs without adverse consequences. Rather than poor manufacturing of ecstasy causing overdose and death, ecstasy itself is now increasingly to blame."
Methylated amphetamines are stimulants and include the hallucinogenic "club drugs" MDMA (ecstasy), MDA and MDEA, said Dr. Mark Gold, a distinguished professor and chief of addiction medicine with UF's Evelyn F. and William L. McKnight Brain Institute. The best-known example of the group is methamphetamine, or "speed," which has been abused for decades in the United States but has minimal hallucinogenic effects.
Typical effects of methylated amphetamines include increased energy, wakefulness and a sense of euphoria, but users also can experience chest pain, shortness of breath, nervous energy and increased risks of anxiety, depression, Parkinson's disease, liver failure and heart attack, Gold said.
"We believe that many of the overdose cases we're seeing occur when people use methylated amphetamines and try to medicate the unpleasant effects by taking depressants such as alcohol, Xanax or Valium," he said. "It is a risky business to try and balance the short-acting stimulation with long-acting sedation."
Of the 1,304 drug overdose deaths in Florida last year, 621 involved multiple drugs and 31 of those involved methylated amphetamines, according to FDLE. The report collected data on 14 types of drugs used recreationally, including ethyl alcohol, cocaine, heroin, marijuana and related substances, oxycodone, hydrocodone and several "club drugs."
Drivers impaired by methylated amphetamines could experience distorted perceptions of time and space, impaired judgment, poor concentration, attraction to lights and possibly visual hallucinations, Gold said.
Goldberger has testified as an expert witness in criminal cases in which defendants were charged with causing accidents while driving under the influence of ecstasy. He said the lack of a fast, inexpensive test for the presence of methylated amphetamines often prevents law enforcement and medical personnel from detecting the drugs.
"In post-mortem drug screens, we use gas chromatography, which is very accurate but requires large, expensive instrumentation and highly trained operators," he said. "Most hospitals do not have access to this type of equipment, so there may be people being treated for injuries who are never tested for methylated amphetamines."
Detection of methylated amphetamines is a particular source of frustration for law enforcement officers, said Jennifer Cook Pritt, a special agent with FDLE's Office of Statewide Intelligence in Tallahassee.
"It's not always obvious when someone is high on these substances, and some of the indicators are different from those we see with alcohol," Pritt said. "Officers need specific training to recognize drivers impaired by methylated amphetamines, and right now there isn't enough training of this type available."
Goldberger said that in Europe, some law enforcement agencies now use an on-site saliva test to detect methylated amphetamines and other drugs in impaired drivers. But before such a test could be used in the United States, it would have to be approved by the federal Food and Drug Administration and accepted by the law enforcement community as a viable and effective technique.
Pritt said curbing methylated amphetamine use is one of the most pressing drug enforcement concerns today, particularly because users tend to be young.
"The increased availability of ecstasy, combined with the misperception that it is a 'harmless pill,' has increased its use among younger populations," she said. "Ecstasy is marketed specifically to appeal to children, using colorful pills with embossed logos, and unfortunately the market is responding. Every national survey I see shows that perceived availability and use of ecstasy are way up among kids." - By Tom Nordlie
[Contact: Tom Nordlie]