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A view on drug use

The following article appeared in the Sydney Morning Herald August 11, 2008, and I thought it had something to say and was worth reproducing here so I contacted the author Raymond Seidler Addiction medicine specialist, Potts Point and asked him if if that was alright. He said ‘yes’ and so here it is. One of his titles on his website is ‘Street GP’. I knid of like that. Thanks for the borrow of the article Raymond.

ECSTASY JUST ANOTHER IN LONG LINE OF NATIONAL PASTIMES

World record hauls of ecstasy have occurred in Australia since 2004 but nothing approaches the 4.4 tonnes detected in tomato cans in June in Melbourne with a street value of $440 million. It seems that despite extensive education and interdiction, Australia’s youth have embraced this drug like no other. The market remains buoyant.
As a GP in Kings Cross, I have seen hundreds of ecstasy users over the past decade, and despite horror stories in the press most take this drug with impunity. The phenomenon of “Eckie Monday” (the weekend “come-down” from a binge requiring a medical certificate for work absence) is common. So, too, is the weight loss and lack of vitality in habitual users who dance themselves into exhaustion and grind their teeth in clubs all over Sydney.
Early mornings in the Cross provide a cavalcade of burnt-out E users heading home after an all-nighter. But for the most part they do not suffer serious medical problems. A few may develop overheating or hyperthermia and require a short admission for hydration with a litre of fluid or two intravenously in an emergency department. Seizures and drug-induced psychosis do happen, but at a very low rate. Even this outcome does little to dissuade users to quit their drug of choice.
Sure there are horror stories of PMA (para methoxy amphetamine), a cheaper, dangerous substitute for ecstasy causing sudden death, but this is so rare as to not affect demand. Ecstasy testing kits are now available over the internet. These testing kits are common in Europe outside clubs and should be encouraged here.
Young people are educated on the risks and dangers of all illicit drugs. Most schools now have excellent drug education programs covering all illicit drugs in Australia. Children use the internet to plug holes in their knowledge and successive government programs portraying ecstasy as a danger have done little to reduce ecstasy use in Australia.
Most young users have observed their friends taking the drug without adverse effects. Combine this with the boundless optimism of youth and an unshakeable belief that they are bulletproof and you have a recipe for an explosion in demand.
Drug use follows fashion cycles, and in many ways governments’ demonisation, with their horrific video footage, entrenches the inevitable generational warfare between the young and their parent’s generation. It is unusual in my experience for a young person to request treatment for ecstasy abuse unless they are dragged kicking and screaming by a concerned parent. They do not want treatment if their recreational use is limited to weekend recreation, and will show a therapist bored disinterest
Price is a keen indicator of availability and none of my patients ever complain of difficulty obtaining ecstasy. So we can conclude that despite these huge hauls by federal police and the national crime authority, significant stockpiling must occur around the country.
Drug trafficking will go on as long as there is demand. Australia has always been at the forefront of illicit drug use worldwide. In 1936 we had the highest use per capita in the Western world of cocaine and heroin. And now we appear to have won a gold medal for ecstasy. Very little has changed.

Raymond Seidler Addiction medicine specialist, Potts Point’

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