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Drugs: they're what you overdose on

Elise Stolte and Laura Drake explain in the Edmonton Journal exactly what happened to a young lady at a party over the weekend:

An overdose of ecstasy Friday night shocked her small body so badly that her heart stopped beating in the middle of a West Edmonton Mall underage party.

As I've been trying to remind everyone, toxicology reports take 3-6 months in Alberta these days, but somehow the Edmonton Journal, in these hard times, is capable of staffing a newspaper with wizards who can perform remote precognitive autopsies. I just wonder how many more kids may have to die before someone other than me stops blurting out "overdose" and gets interested in the possibility of tainted or adulterated drugs in the local market.

[UPDATE: April 28: The Journal, to its credit, backs up and takes a more careful run at the issue today. Since I'm being criticized for being overpedantic here I will pass over the Zen koan about those "ecstasy tablets that contain no ecstasy whatsoever".]


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Comments (33)


Well, the article does mention that the pills may have been "triple strength" and that each girl took 6 of them.

Does 18 regular ecstasy pills cross the threshold?

There is NO known threshold for pure ecstasy, period.


They have managed to kill rats and primates with MDMA (hooray for science!) but apparently haven't really tried on humans (boooo!). The problem is that street "Ecstasy" is typically not pure; rather it's a cocktail of MDMA and assorted amphetamines or whatever is rolling around in the back of the manufacturer's cupboard. Or something else entirely. Which is Colby's point, of course: if these girls overdosed, it was almost certainly on something else that they thought was Ecstasy. I'm going to go ahead and take the next logical step, which is to speculate whether it might not be in the public interest to decriminalize and regulate Ecstasy in order to replace the mystery street drug with the much safer MDMA.

I found this nifty table of street Ecstasy sampled from around North America. It's striking to see just how little of it is pure. Interestingly, MDMA is extraordinarily cheap to manufacture. I imagine is takes a bit of chemistry know-how, so there must be a supply problem (or dealers wouldn't be substituting more expensive, more dangerous drugs). Another reason to do a proper study and consider legalizing...

Alex B.:

When you were diligently posting about the Paul First Nation cases, I specifically remember this paragraph:

It might be an idle question, were it not for the possible risk to other ecstasy users who have essentially been reassured by Cpl. Oakes that nobody’s rave needs to be postponed just because of that downer on the rez. I appeal to the Chief Medical Examiner of Alberta to exercise diligence in protecting the welfare of this region’s hippies, burnouts, flakes and slackers.

Eerie. Is there any chance of that message gaining any traction(there would seem to be an ongoing immediate risk), or will the Alberta public be bombarded with Regan era drug propaganda.

(I should note that there is no evidence that the two stories are directly related, which may be worse in some respects ie: more than one source of impure pills)

Alex B.:

Also, at what point are RCMP officials professionally negligent in failing to warn the public of specific imminent threats?


Meh. I think you are quibbling.

Not too many news reports have specified that the kids overdosed on MDMA. They have said that the kids overdosed on "ecstasy".

Unless, that is, you think that the apparent legion of teenagers buying and consuming "ecstasy" at WEM are really consciously equating "ecstasy" with "pure MDMA".

What % of "ecstasy" sold in Edmonton is actually pure MDMA? Does that mean that most "ecstasy" sold isn't really ecstasy? Or that most ecstasy is "tainted ecstasy"?

The bottom line is that the kids took a crap-load (one might even say "overdose") of ecstasy that was possibly less pure than average. On the other hand, given that nobody else died that night, perhaps it was simply pretty typical street "ecstasy" and they took too damn much of it.

Either way, it's an overdose, dude.


Put another way: it seems a tad pedantic of you to equate "ecstasy" with "pure MMD" when, (1) that isn't how it is understood in practical terms by the people who actually take the stuff and (2) the vast majority of "ecstasy" sold and consumed doesn't actually live up to your definition.

Using your definition, one wonders how many people in Edmonton have actually taken ecstasy . . .

John Thacker:

Bob, I completely disagree with you. Even if people who take ecstasy understand that it's generally not pure MDMA, there's a big difference between "took too much ecstasy, could happen to anyone who takes way too much ecstasy, but as long as you stay within normal limits you'll be fine" and "took too much of a particularly tainted ecstasy with really nasty additives that could kill you in doses that are perfectly safe with other stuff that's out there, so people need to be careful."

That's a very significant difference, and "an overdose of ecstasy" itself obscures the issue. So does "triple strength" ecstasy-- more MDMA in the pill wouldn't hurt anything, it's the problem of possibly worse adulterants.


Overheard today on E-Z-Rock*: "Tomorrow on [the morning show]: given that two teens have recently died of ecstasy overdoes near Edmonton, and since we already have great programs like DARE, what will it take to stop kids from using drugs?"

I gagged at "great programs like DARE."

* (1) That's right, it's "E-Z Rock," not "Easy Rock". (2) When the girlfriend drives, she picks the station.

Using your definition, one wonders how many people in Edmonton have actually taken ecstasy...

Well, using your definition, factory-grade MDMA, the active ingredient in the substance whose effects are being sought by the consumers, would not necessarily be "ecstasy", while an ineptly manufactured pill containing very little MDMA might be. But I recall also making the point that "ecstasy overdoses" reported carelessly in the press usually prove, on closer investigation, to be hyperthermia. (My interest in the original Paul Band case was that the girls weren't in a club setting where there could be an obvious alternative explanation for the deaths.)

Even garbage ecstasy in an uncontrolled setting harms very few users, so it arouses the interest of the pedant when kids are getting sick and dying two or three at a time. There's actually a tradition for newspapers to hire pedantic people and bestow the title of "editor" on them so that they can insist on careful use of language.


You really think that careful use of language is to reify "ecstasy" as "pure MDMA" despite the fact that Geoff's link shows 67 pages of unique "ecstasy" street formulae?

Look - I'll agree with you that evidence (such that it is) suggests that MDMA on its own is pretty hard to OD on and, perhaps, this should be reflected in the reporting.

But, in practice, the point is moot because "ecstasy" is rarely MDMA on its own. It is virtually always some concoction of various drugs. In practice, then, the girls OD'd on "ecstasy". To say that their batch was "tainted ecstasy" is like saying we shouldn't call tap water "water" because it isn't pure. Like "pure ecstasy", "pure water", doesn't exist in daily practice.

Would it be better to report "there might be a bad batch of ecstasy floating around town: be careful!" or to report that, "Because there is really no such thing as a single 'ecstasy', there is always the potential that you could OD on the stuff"?

It seems to me that the later is more honest.

OK, but even accepting your distinction between ecstasy and MDMA (you will not have trouble finding material describing ecstasy as MDMA if you bother to look at all; chemically we are "reifying" a thing as what it is here), the "ecstasy" that does exist "in daily practice" is taken by huge numbers of fucked-up people in entirely uncontrolled settings and it rarely kills any of them. Whereas just lately we've got girls falling ill and dropping dead in groups. So, yes, I'd say this gives us a good particular reason, if you really need one that badly, to exercise what would ordinarily be an overwhelming presumption in favour of semantic accuracy in the newspaper (and perhaps to inquire into the relative purity of the supply instead of pre-emptively accusing dead kids of irresponsibility, as fair as an actual investigation might somehow prove such a charge to be). The account I am criticizing, with its "small body" "shocked" by a "triple-strength" drug, is invented! I don't see how you can characterize it as some excusable colloquialism: it's a made-up recital of events, yeah?


... you will not have trouble finding material describing ecstasy as MDMA if you bother to look at all

Of course I won't. That's exactly my point. The two shouldn't be equated -- at least not until the Federales or some other entrepreneurial body decides to regulate the stuff. It is just as "made-up" as is the "Overdose" story.

MDMA is the stuff you make with your chemistry set. Ecstasy is the stuff you buy on the street and ingest which almost always consists of MDMA+.

I appreciate you pointing out that MDMA isn't easy to OD on and, thus, that it is almost certainly some additive that is the culprit along with dehydration, etc.

And, of course, I agree that recent events suggest that there is a particularly poor brand of E floating around E-town.

But I'd hate for one misleading message ("Ecstasy Overdose!") to be replaced by another misleading message ("Ecstasy: perfectly safe so long as it isn't tainted"). At least not without the qualification that "Ecstasy" is, in practice if not in theory, by definition "tainted".

Can't we spread all three gospels?
(1) MDMA, by itself, is hard to OD on;
(2) Most Ecstasy you buy on the street isn't MDMA, so buyer beware
(3) Currently there might be a particularly bad batch in circulation, so buyer really beware.

Sure, that's a close approximation of what I'm asking for. Geoff's chart actually appears to suggest something more like "Most of it is mostly MDMA; much of the adulteration in the supply involves consumer ripoffs like caffeine or cough syrup; sometimes, as with all illegal drugs, there could be something completely crazy and/or dangerous in there."

Great Walls of Fire:

Sorry, Colby, but I'm in the "overpedantic" camp. If I'm following your line of thought in this and your National Post submission correctly, you are pointing out that an incomplete and potentially wrong message is being conveyed by these media reports that (in your view) mistakenly refer to the deaths as resulting from "overdoses", i.e. the media accounts imply the problem is irresponsibility on the part of the user, when the problem is more likely tainted drugs. This potentially leads, according to you (again if I'm following your reasoning correctly) to some kind of false security on the part of local ecstasy users that they are OK to continue to use it it as long as they're careful not to OD on it.

To which I say:

(a) the ultimate message of any story about people dying after taking illegal street drugs is "don't take them" and I think the media accounts you are critizing for referring to the deaths as coming from overdoses DO, in fact, deliver that message.

(b) To the extent there's an element of truth in your categorization of ecstacy users as "hippies, burnouts, flakes and slackers", correct semantics in reporting the recent deaths is highly unlikely to deter such persons from continuing to use ecstasy anyway.

(c) At the risk of overpenantics myself, isn't the imbibing of even a single dose of a drug that kills you technically an "overdose"? Surely the fact that you have a different tolerance for a drug than me is irrelevant for purposes of defining my death from that drug as an "overdose". There may be more accurate or precise ways to describe a death that results from taking drugs as an "overdose", but it is not incorrect to use that word to describe it.

So if you ask me for an aspirin, and I gave you an aspirin that was 10% cyanide, and you dropped dead, you'd be totally fine with being described as the victim of an "aspirin overdose"?


the ultimate message of any story about people dying after taking illegal street drugs is "don't take them" and I think the media accounts you are critizing for referring to the deaths as coming from overdoses DO, in fact, deliver that message.

You're sort of right. The ultimate message is, "Don't do anything unless big brother tells you it's OK, establishes a licensed semi-monopoly for their cronies to operate, and squeezes the largest possible amount of taxes out of it."

And I think that the media has been delivering that message quite effectively for some time now.

I guess all those listeriosis deaths in Ontario were all "lunchmeat overdoses".

Actually, another implication is that people who die from peanut allergies have had a peanut overdose.


And if I accidently cross the street against the light while reading the Post and get hit by a bus, I have had a Cosh overdose.


my take on Mr. Cosh's efforts here is that current MSM information on any events that have any angle that interesects with science pre se is un-informative at the least impactful instance, wrong, at its widest instance, and, harmful at its most impactful instance.
I'm sick of media stories completely misstating the actual scientific bases of these events.
Good on ya Mr. Cosh.

John Thacker:

I think perhaps the closest analogy would simply be that if you die from methanol or glycol or anything else in moonshine, that's alcohol poisoning. Which would then be defended on the grounds that, hey, methanol and propylene glycol are alcohols, and moonshine is bad for you anyway, so it should be demonized.

Great Walls of Fire:

So if you ask me for an aspirin, and I gave you an aspirin that was 10% cyanide, and you dropped dead, you'd be totally fine with being described as the victim of an "aspirin overdose"?

Well, now you're assuming the pills that caused the deaths were tainted, notwithstanding your criticisms of the media reports that assume they're not. Dying from taking a single aspirin laced with cyanide would be more accurately described as a "poisoning" than a "overdose", but if I read a news story detailing how several people had recently died from ingesting single aspirin pills, I'd probably not eat one, regardless of whether said story described the deaths as being from "overdoses".

Actually, another implication is that people who die from peanut allergies have had a peanut overdose.

Not sure the conventional view is that "peanuts" are pharmaceuticals, unlike the little white (or whatever colour they are) tablets that guy from your Chem 20 class is selling outside the McDonalds at Westmount. As should be evident by now, ecstasy is not how I roll, so tell me, in light of the information in the linked Journal article that some people can die from ingesting a single (presumably untainted) hit, just what is the accepted doseage, beyond which one can properly describe the fatality as an "overdose"?

My points were that a) the media has no business INVENTING CONCLUSIONS about a cause of death before investigators have arrived at one, and indeed it should be stunningly fucking obvious that they can legitimately be criticized for this even if their bet is right, and b) deaths from a "single hit", or from any amount of untainted ecstasy at all, are rare enough that they should not, statistically, be happening in pairs. An implied related point is that c) even a death legitimately caused by an ordinary amount of ecstasy may well be properly considered more an adverse event than an "overdose".

if I read a news story detailing how several people had recently died from ingesting single aspirin pills, I'd probably not eat one, regardless of whether said story described the deaths as being from "overdoses".

Here's a news story for you: hundreds of Canadians have ALREADY died this year from the effects of pharmaceutical-grade aspirin and other non-steroidal anti-inflammatories. Aspirin saves far more lives (since it has well-attested cardioprotective effects) than it takes, but it kills rather a lot of people all the same. Some of these deaths are overdoses, and will be described as such on a death certificate; many aren't, and won't.


For anyone who has yet to grasp the point, if the media says 'overdose', the people say 'who gives a rats ass', the police say, 'let's buy another donut'. If reality kicks in, and someone says 'somebody is deliberately playing russian roulette with kids by putting shit in pills', maybe somebody will investigate that.


And to sum up thus thread, take it away National Post.

Curious quote from a UCLA professor:

Fifty per cent or more of pills marketed on the street as Ecstasy are actually a cocktail of a different sort: some MDMA mixed with tranquilizers, caffeine, cocaine or "whatever is in the back of the [manufacturer's] cupboard," Dr. Grob says.

Either Dr. Grob has been reading Colby's blog or else he and I sampled the same tainted figures of speech (I swear to god I thought they were cliche free...)


Oh man.

Yet another case of MSM plagiarism. Looks like you have a topic for your next Editorial Board meeting at the Post, Cosh . . .

Not plagiarism, just teamwork.


Not plagiarism, just teamwork.

That's just what my students say when they forget to put in citations . . .


Ecstasy is a stimulant. It is similar in action to both amphetamine and SSRI/ANRI (antidepressant). It is quite possible to overdose on it and die, especially if one is exerting, as in dancing at a rave. Serotonin syndrome can cause death by heat prostration even in people who are physically restrained.

It is also true that most street drugs are deliberately contaminated. This complicates the matter, but does not in any way negate the possibility of an overdose, if only an overdose of a drug other than the one that was advertised. Tainted drugs are not necessarily lethal by design. In the case of heroin, cutting it with something usually reduces its toxicity considerably and lowers the risk to the user.

Toxicology tests take as long as they take. I suspect that 6 months is an exaggeration, particularly when death is involved. However, in the interests of journalistic integrity, it should at least have been a 'suspected overdose'.

The researchers think it might be clinically possible for MDMA to induce a serotonin fatality even in the absence of co-factors; it just doesn't seem to happen very much in the real world, and it is not the most obvious explanation for two simultaneous ecstasy deaths outside of a club setting. Moreover, I would argue that "overdose" can be a misleading term where co-factors are present (since it does not imply that you have to avoid the co-factors—you need only be careful in taking the "right" amount of the drug).

And in what sense can the Alberta medical examiners actually investigating these cases be "exaggerating" when they tell us when they expect to have the results? Libin and I are not reporting how long the work might take in the lab, we are directly reporting when the authorities have told us the autopsy reports will actually be released.


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