Saturday, 13 February 2016

5 messages about ecstasy that every parent should discuss with their teen

During the week I met two mothers who had both recently discovered that their daughters had been taking ecstasy. Both were very worried and wanted advice on what to do now that they had this information. After finding out what their daughters were up to, both had confronted them with what they knew, aired their disappointment and concerns but were told in no uncertain terms that they had no intention of changing their behaviour and that they were worrying about nothing and that 'everyone does it'!

Both of these mums were pretty amazing. It seemed like they had been able to keep their cool when discussing the issue with their daughters, knowing only too well that if they had exploded and ranted and raved, they really did risk jeopardising the already tenuous relationship they had with their child. But you could really see how frightened they were and when one of them said to me - "I just don't want to wake up one weekend and find her face on the front page of the paper after something has gone terribly wrong!"- it truly broke my heart ...

The greatest problem for many parents around ecstasy is that it is a drug that they simply don't 'get'. It wasn't a drug that they used when they were younger (although there are certainly a growing number of parents who did experiment with the drug in the 90s - but that's another story and we may talk about them in another blog later in the year as they face another set of challenges!) and all they know about the drug is what they see and read in the media. Unfortunately, the only time the media covers the ecstasy issue is when there is a death and although ecstasy-related deaths certainly do occur, they are rare - that's why they receive so much attention! This coverage leads many to believe that ecstasy-related deaths are common and that death is a likely outcome should someone choose to use the drug - something that simply isn't true!

Ecstasy continues to be a popular drug in Australia. Although recent use (use in the past year) has decreased since 2007, those reporting ever having tried the drug has continued to rise to almost 11% of the Australian population aged 14 years and over (according to the UNODC, we are the world's largest consumers of ecstasy by some way). The number of school-based young people who reported recent use of the drug, however, had remained fairly steady for some time (around 4% of 12-17 year-olds) but dropped in the most recent survey to 2.7%. It'll be very interesting to see what the 2015 data looks like when it is released in the next few months.

Ecstasy is the street-term for a substance called MDMA (methylenedioxy-methamphetamine). Available in pills, capsules, powder and now crystal form, it is a notoriously impure drug with users never really being sure what they're actually taking. MDMA is a difficult drug to make and as such other drugs are often substituted during the manufacturing process, some of which can be highly toxic. Recently new processes have been developed and, as a result, we have seen a dramatic increase in MDMA quality across the world. This increased purity has led to questions being asked as to whether this could be the reason we saw far more ecstasy-related deaths in this country over the summer break - we will know more when toxicology results are released throughout the year.

One of the questions I'm usually asked by parents who know little about this drug is 'why do they use it?' With the only stories people read about ecstasy usually dealing with deaths or, at the very least, hospitalisations, why would young people want to use the drug and take the risk? Put simply, for most people who ever take this drug they describe their first experience as the 'best night of their lives' (so much so that for many of them, they continue to attempt to reach those heights again for the rest of their ecstasy-using career!). I know that many people don't like hearing that drugs can make the user feel good but that's the truth - of course things can go wrong but we need to understand why substances are used if we ever hope to effectively educate young people about them.

Without going into the science of the drug and its effects in any great detail, MDMA essentially 'tricks' your brain into releasing large amounts of serotonin (the brain's 'feel-good' transmitter). Our brains release small amounts of serotonin everyday, each time we laugh or something good happens to us - when MDMA is taken, much larger amounts are released and the 'reuptake' of this chemical is blocked resulting in serotonin staying in the brain for much longer and the user feeling good for a number of hours ...

Unfortunately, young people are provided very little quality information on ecstasy and rely on friends and the Internet when making choices around this drug. What is provided to them through school-based drug education programs or government mass media campaigns is often regarded as unbalanced, 'propaganda' that focuses on possible, but less likely outcomes such as death. We therefore need to look for other opportunities to provide information that is accurate, credible and useful.
Of course, it is unreasonable to expect most parents to be 'experts' on drugs like ecstasy (and if you tried to sell yourself as one to your teen they are likely to laugh in your face) but here are 5 simple messages that could and should be conveyed if the opportunity arises. I totally get that the first two may be difficult for some parents to discuss, particularly with a teen who has carried out a little research on the topic and may try to bamboozle you with what they have read or heard from others - but the final three are not complex and can easily be handled by even the most drug-naïve parent:
  • MDMA is not a safe drug. Over the years I have heard from many parents that when they start talking about their fears around ecstasy the first thing that is thrown back at them is that it is safer than alcohol. I'm not going to go into whether I believe one drug is any safer than another - the fact is that all drugs, legal, illegal or pharmaceutical, can potentially cause harm. MDMA is not a 'safe' drug - of course there are risks associated with its use. Are you likely to die when you use the drug? No, deaths are rare, but they certainly do happen. It should be noted that many of the deaths that have recently occurred in Europe have been proven to be MDMA overdoses due, we believe, to the increase in MDMA quality now found in pills, powder and crystal. It is true that many deaths that have occurred in the past have been due to adulterants (most often PMA, a highly toxic form of amphetamine) and that has led to some believing that if you have MDMA in your pill then it will be safe. It needs to made very clear that too much MDMA can result in death.
  • Even if you know what's in a pill, it doesn't mean it's safe. There's been lots of discussion around pill testing lately and how this strategy could save lives. The theory (as far as some users are concerned) is that if you know what you're taking then that makes it safer. Undoubtedly, knowing what is in the pill is better than not knowing, but young people must realize that they have no way of knowing how those substances contained in the pill or powder will affect them should they choose to use it. Of course we should have pill testing in this country and we should be getting far more information out to users about the drugs they are considering using, whether they are illegal or not (this does not condone use as some people suggest), but at the same time we need to make sure that young people are aware that even if you do know what you're taking, there can be no certainty as to how it will affect you ...
  • Ecstasy is illegal and more people are being busted for use than ever before. Young people need to be reminded that if they do get caught with ecstasy and receive a conviction, their life will change. A drug conviction will mean they will not be able to get certain jobs and they will not be able to travel to certain countries, just because you got caught with one pill in your pocket. Drug detection dogs and roadside (or mobile) drug testing are part of their world – they need to know the law – ignorance is no excuse!
  • Different drugs affect different people in different ways. This is such a simple message but one that often gets forgotten and it applies to all drugs, including alcohol. Everybody will be affected in a different way when they use a drug and it's likely that they will be affected in a different way each time they choose to use it. Just because someone they know took a pill and had a 'great time' on it does not mean that they will have the same experience. People who have died after taking a pill or capsule were not the only ones who used that drug, many others did and they didn't die. Sometimes a death can be put down to something as simple as 'bad luck' – they just had a tragic reaction to that drug on that day!
  • If something goes wrong, call 000 ASAP. When in doubt, don't hesitate to call for help. Ecstasy deaths are rare but they do happen and when things go wrong, they go wrong very quickly. Young people need to know that they don't have time to wait and see if their friend is going to get better, they need to call for help immediately. Police are not routinely called to illicit drug overdoses, if you call an ambulance, that's what you get! Ensure that your teen knows that they have your 100% support in calling an ambulance and that you want them to call you straight after and you will be there to help them should they need it. Calling an ambulance for a friend who has suffered an illicit drug overdose is terrifying - they need to know that you will be there, no questions asked, no matter what they have been doing.
As I have said, I get that the first two may be difficult, particularly if the whole illicit drug scene is completely alien to you, but the final three are not hard. Finding the opportunity to discuss this issue can be challenging but to be honest, with all the media coverage around a death (when one occurs) or drug detection dog operations and subsequent arrests, starting a conversation about ecstasy and your concerns can be much easier than you think.

Just one word of warning however - if you do discover your son or daughter is using ecstasy, don't start the discussion with your fears about death ... As already said, ecstasy deaths are rare and you can almost guarantee that it is not part of your child's experience if they are taking the drug or hanging out with friends who do ...Of course, you need to express your concerns and fears for their safety but if you only go down the 'death' discussion you will undoubtedly lose them pretty quickly. The truth is that their experience is usually overwhelmingly positive (and most of them certainly do not know anyone who has died after using this drug), acknowledge why they have made the decision to use it (you certainly don't have to be happy about it!) and then discuss the points above.

Do I believe that this will stop them taking the drug? Most probably not, but it certainly makes it very clear to your son or daughter how you feel about the situation and proves to them that this is not a 'knee-jerk' response from a hysterical parent but rather an educated discussion with someone who loves them very much and wants them to be as safe as possible ...

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