Is ecstasy really safer than aspirin?
I have spent much time recently trying to inject some sense into the drugs debate. My latest foray was on the BBC Radio 4 ‘Today’ programme broadcast on New Year’s Day, in which I stated that ecstasy is safer than aspirin, a comment which has attracted much attention in the media – particularly from those sections of the tabloid press which, sadly, seek simplistically to demonise drugs rather than face the facts.
As a fact then, and one which deserves to be more widely known, UK government figures from the Office of National Statistics show that between 1993 & 2006, ecstasy was ‘mentioned’ on death certificates in England and Wales 456 times (and mentioned on its own, without other drugs being present, less than half that number of times – 234) , whereas aspirin was mentioned on 504 occasions (on 285 occasions in the absence of other drugs)¹. So in the last 14 years, as a fact, aspirin has been formally associated by the government with the death of more people than has ecstasy. That’s why I said on the radio that ecstasy’s safer than aspirin. The picture is not that simple of course, not least because the word ‘mentioned’ does not mean that ecstasy actually caused the death, merely that a person died who had taken it.
Aspirin is clearly not a completely safe substance, but it has huge medical benefit. As a result it is lawfully manufactured in conditions strictly regulated by the government and supplied with instructions to enable its safe use. As a user you can be confident that if you buy from a reputable source and follow the instructions then you will most probably come to no harm. But if you ignore the advice, or if you are unlucky enough to be susceptible, it can be a killer.
Ecstasy is also not an entirely safe substance, but it can only be purchased in the UK from a criminal. Its production is not regulated and you therefore cannot be sure what you have bought. Is your pill contaminated, and if so with what? As importantly, ecstasy does not come with government approved instructions for use. What is a safe dose, and what should you do to deal with the side effects? Ecstasy itself is a relatively safe substance – the very rare deaths seem to occur not from ecstasy toxicity, but usually from the user’s failure to take adequate steps to deal with its side effects - heatstroke, heart failure or excessive water intake. Much controversy remains over just how dangerous ecstasy really is; all that we can say with certainty at the moment is that it is demonstrably relatively safe compared to many other substances of abuse, both legal and illegal. There is no doubt, however, that alcohol, tobacco and barbiturates are far more harmful, even though legal. The position of ecstasy as a Class A drug is scientifically unsustainable but it’s still there, despite the evidence not because of it - the very opposite of the government’s oft-stated wish to work with evidence-based policy. Odd. You might like to ask your MP why.
All deaths following substance abuse are tragic, particularly so when a young life has been unintentionally or recklessly wasted. Ecstasy can cause potentially fatal side effects which can usually be successfully managed given sufficient knowledge by the user – and some luck, because it is not a harmless substance. Just like aspirin, it can kill. The tragedy is that so many ecstasy related deaths could have been avoided merely by following simple good practice – but its illegality makes this harder. For instance, properly equipped facilities in dance clubs to help deal with the potentially lethal side effects cannot currently be made mandatory because this would be seen as condoning illegal behaviour. The caring, harm reduction, approach that I and others advocate instead of the current punitive one would address this - and save young lives.
The scaremongering around ecstasy, and the refusal by many in politics and the media to face up to the realities of drug use and abuse is actually causing the unnecessary and tragic death of young people – a highly inconvenient truth, to adapt Al Gore’s very apt phrase. I look forward, in hope but not expectation, to a government minister explaining this to the parents of the next person to die avoidably having taken ecstasy. But this requires a maturity around the drugs debate that has been conspicuously lacking in our society hitherto, as the rabid hysteria which continues to emanate from some in the tabloid press so amply demonstrates.
But as ever I really do live in hope; although the cant and hypocrisy has not yet gone there are more serious people talking more seriously than ever before about changing our intellectually and scientifically bankrupt prohibitionist stance on drugs – including many in the media, in the police and in politics.
Change is coming. But not immediately - don’t hold your breath.
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https://www.statistics.gov.uk/STATBASE/Expodata/Spreadsheets/D7892.xls
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