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Source of ecstasy experiencing "fatigue' with it

Published Jul. 30, 2001|Updated Sep. 10, 2005

When Dutch Prime Minister Wim Kok visited President Clinton last fall, talks quickly turned to a sore point in U.S.-Dutch relations: the "club" drug ecstasy.

The United States has seen a jump in ecstasy use, especially among teenagers, and a surge in violence involving dealers. As far as U.S. authorities are concerned, a root cause of the problem is the Netherlands, which produces up to 80 percent of the ecstasy tablets coming into the United States.

It is not known exactly what was discussed at the White House. But soon after Kok returned home, the Dutch government announced a major crackdown on ecstasy production and trafficking.

While the United States hailed the move, some Dutch critics saw it as yet another example of the world's biggest consumer of illicit drugs trying to blame other countries for its problems.

"You attack us ever more fiercely about producing ecstasy _ as if the drug trade can be blamed exclusively on the country where production takes place," Fredrick Polak, a psychiatrist with the Amsterdam health department, said in an open letter to the United States. "The truth is really very simple. As long as there is a strong demand for drugs, there will be production, and criminalization will only make the trade more lucrative."

The Netherlands is well-suited to the manufacture and distribution of ecstasy and other illicit synthetic drugs. It has a large chemical industry, which provides ready access to the required precursor chemicals. It boasts the world's biggest seaport and one of Europe's busiest airports, both major drug smuggling points.

Ecstasy, chemically known as MDMA, is related to amphetamines, which act as stimulants. Discovered in 1912, it was not until the 1980s that MDMA became popular in the United States and Europe with young people attending all night "rave" dance parties.

Within 20 minutes of taking ecstasy, most users feel a "rush" and a fluttery sensation in the stomach. That is followed by a warm, euphoric glow that lasts four to six hours.

After the glow wears off, users can become depressed, forgetful and extremely tired. Animal studies have suggested there may be long-term brain and memory damage. But the major short-term risk is that ecstasy's stimulant effects can lead to dehydration, seizures and kidney and heart failure.

In Florida, ecstasy has been blamed for at least 27 deaths since 1997, including two teenage boys in the Tampa Bay area. (By comparison, in 1998, 1,128 people in Florida died of cocaine overdoses and 206 from heroin overdoses.)

Nationwide, 8.2 percent of U.S. high school seniors said they had used ecstasy in the past year, nearly double the level in 1996.

In the Netherlands, use of the drug rose from 1993 to 1997 but has since leveled off, reflecting a "mild ecstasy fatigue," as one writer put it. Even at its peak, only about 3 percent of Amsterdam residents 12 and older reported taking ecstasy in the past year.

"We don't have a problem with ecstasy in the Netherlands," says Peter Cohen, a University of Amsterdam professor and expert on drug issues. "There are few overdoses, the big fashion has passed, the ecstasy market was always quite calm. You (in the United States) shouldn't have an ecstasy problem but you are constructing one."

Unlike the United States, where ecstasy use is treated as criminal, the Dutch have taken more of a public health approach.

Jellinek, a Dutch organization that runs drug prevention and counseling programs, has five centers in Amsterdam where users can bring ecstasy tablets for testing to see if they contain dangerous adulterants such as heroin.

Through pamphlets, a Web site and a hotline, Jellinek provides information on ecstasy's effects, pleasurable and negative. It also works with clubs to make sure plenty of water is available.

These "harm reduction" measures have been criticized by the International Narcotics Board, a U.N. agency that closely reflects the views of the United States.

"Such actions, though well-intended, lead to ambiguous messages and confusion," the board says in its 2000 report on global drug trends. "Thus many drug abusers are not aware that there is no safe use of such drugs."

Although crackdowns on ecstasy production might limit supplies, they can have harmful consequences, says Janhuib Blans, head of Jellinek's prevention programs.

In 1996, Dutch authorities seized enough precursor chemicals that ecstasymakers turned to more dangerous substances with which to manufacture the pills.

"The effect was that the market quality of pills was going up and down," Blans says. "People were so unsure of what they were buying that they moved to the next (drug), cocaine. In terms of health and prevention, the move from ecstasy to cocaine is not a happy one."

The most recent crackdown targets equipment used in making ecstasy pills. That could result in ecstasy being distributed in powder form, causing confusion between it and cocaine.

"People might try to shoot up or smoke it," Blans says. "It looks a lot like cocaine, so how do we tell the difference?"

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