British Columbia's top health officer is backpedalling from his position that ecstasy can be safe, saying that even the purest form may be deadly and that his message is not to use street drugs.
Perry Kendall addressed the media in the wake of an interview that made headlines across the country. A story from The Canadian Press had him calling for legalization of the rave drug, which he insists was a mischaracterization based on a hypothetical discussion.
The wire service also asked whether ecstasy, subject to strict quality controls and research on appropriate dosages, could be safe to use.
"Absolutely," British Columbia's chief medical officer of health reportedly said. "We accept that alcohol, which is inherently dangerous, is a product over a certain age that anybody can access. So I don't think the issue is a technical one of how we would manage that. The issue is a political, perceptual one."
Dr. Kendall appeared before reporters Thursday to offer what he called a clarification.
"Certainly, even with pure ecstasy, if you take too much, you can clearly overdose," he said. "As we have seen from a recent spate of deaths and overdoses associated with street ecstasy, using street drugs can be extremely dangerous and even fatal and the best advice is clearly not to use."
Observers were cautious in responding, later Thursday, to his follow-up comments.
Mike Farnworth, health critic for the BC New Democrats, said Dr. Kendall was entitled to his views as a physician, but there was no interest in B.C. in easing restrictions on ecstasy.
John Cummins, leader of the BC Conservatives, said he was opposed to any move to ease restrictions on ecstasy and would support programs to break addictions to such drugs. "The real role of government is to help people shake their dependency," he said.
B.C. Health Minister Mike de Jong, attending a caucus retreat in Williams Lake, was unavailable for comment.
In his follow-up remarks, Dr. Kendall also warned that the current regulatory system is not working. He would be open to a debate on legalization, he said, and argued that anti-drug efforts have to be credible to work.
"We run the risk … of having all our advice dismissed and ignored," he said.
However, he said he is not advocating legalization as the solution, but saying there should be a discussion about ways of doing things other than the current losing war on drugs. "There's perhaps a subtle distinction here," he said.
"I do think that we should be looking at that approach for current illicit psychoactive drugs because I think we can come up with a better mechanism of control. What I did not say was that I was advocating for MDMA [the active ingredient in ecstasy] to be legalized at the present time and distributed through government stores. I said if it were to be legalized, then it should be strictly regulated."
The medical literature on the drug is evolving – a Harvard study published in February found no cognitive impacts among users – but police who have dealt with ecstasy-related deaths believe the only message should be that there is no level of safe use.
Stephen Kish, head of the human neurochemical pathology laboratory at Toronto's Centre for Addiction and Mental Health, says that ecstasy can cause changes in the serotonin system of the brain, adding that it is still unclear whether those changes amount to brain damage.
He was not convinced by Dr. Kendall's argument, as published by CP, that it is contaminants often packaged with ecstasy that are the real danger of the drug. Although hazardous substances can be added to the tablets – recent deaths from Saskatchewan to British Columbia are thought related to the addition of PMMA, a toxic amphetamine – Dr. Kish argues that ecstasy itself poses a potentially severe risk.
While death from ecstasy use is "very rare," he said, it can be brought on by taking even one tablet. He pointed to fatal hyperthermia, an overheating of the body leading to death, and said there can be cardiovascular effects as well.
Police say an average of 20 British Columbians who consume street ecstasy die each year.