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March 21, 2001

America at Risk: The Ecstasy Threat

Jim McDonough
Director
Florida Office of Drug Control

Good Morning. It is a great pleasure and an honor to testify today before Chairman Charles Grassley, Co-chairman Joseph Biden and the distinguished senators of the Senate Caucus on International Narcotics Control. On behalf of Florida Governor Jeb Bush and the many state and community leaders, citizens, and parents involved in our combined efforts to bring down both the abuse and supply of illegal drugs in Florida, I am grateful for the national leadership you have given to the matter. I thank you for your time and attention to this most important issue and also for the opportunity to meet with you to discuss the urgency of what appears to be a growing problem with chemically-produced illegal drugs.

Specifically, I would like to address Florida’s concern with the so-called "club drug" scene in general and the drug popularly known as Ecstasy in particular. I am both well aware and appreciative of the past work that the Caucus has done in identifying the dangers of Ecstasy and the steps it has taken to check its spread. You can put me squarely in the camp of those who believe that Ecstasy is a dangerous and insidious drug, made more so by those, who despite mounting scientific evidence of Ecstasy’s damaging potential, try to portray its widespread use as harmless at least, and "benign" or "therapeutic" at best.

Today there can be no doubt that MDMA, the chemical acronym for Ecstasy (3,4 methylenedioxy methamphetamine), is a mind-altering synthetic drug with both stimulant and hallucinogenic properties. As Dr. Alan Leshner, The Director of the National Institute on Drug Abuse, [NIDA], has said, "[Ecstasy] is not a benign substance at all…it’s dangerous. It’s been shown from a decade of animal research, which is now being confirmed in humans, that Ecstasy is toxic to serotonin-containing neurons." Just as clear as the physiological harm is the fact that use of the drug is driven by its availability, a view held by NIDA as well as by the Office of National Drug Control Policy.

 

Recognizing a Problem

These are realities that Florida needed little verification of from federal authorities. Unfortunately, our own experience with the club drug scene and Ecstasy has been tragic. We first began to suspect in the spring of 1999 that the problem with club drugs was widespread. By that time we had received enough isolated reports from law enforcement specialists and medical emergency personnel to indicate that this genre of illegal drugs had become an integral part of Florida’s drug scene and was capable of doing grave damage. We did not know then, however, the deadly price these drugs were exacting.

Newspaper reports, about the only information source we had at the time, indicated that Florida had lost six of its citizens in recent months to club drug use. Interviews around the state told us, furthermore, that large numbers of young people had been rushed to emergency rooms suffering life-threatening effects from these drugs, and that many of the young women involved reported having been raped while under the influence of various club and other drugs. Simultaneously, individual law enforcement agents and concerned parents were telling us that the RAVE scene was integrally related to Ecstasy use and drug use in general. But we lacked a broad overview and a true sense of the extent to which Ecstasy had become accepted, even fashionable, among our young adults.

Our response was to undertake a state-wide, joint law enforcement operation that sought to determine the extent to which so-called RAVE clubs were associated with the illegal drug trade and the extent to which drug abuse activities were going on in and around the premises of these establishments. Simultaneously, we began to interview individuals in treatment services to learn of the extent of Ecstasy use. Our stated objectives were to: educate Floridians as to the prevalence of club drugs and their widespread use at many of the so-called RAVES and related activities; make it clear that the sale of illegal drugs to Florida’s youth would not be tolerated; target the networks that supply and distribute illegal drugs in our state; and curtail the operations of establishments that operated as de facto drug markets .

Operation Heat Rave, as it came to be called, proceeded in a number of stages that included undercover work in and around the RAVE scene, information gathering and training for law enforcement agencies, and, finally, a five day operation that ran from September 29 to October 4, 1999 targeting 57 RAVE clubs around the state. The operation involved all relevant federal and state agencies and local police departments involved in countering this particular aspect of the illegal drug trade. The net result of the operation was seizure of almost 140,000 doses of club drugs as well as quantities of marijuana, crack cocaine, cocaine and heroin, over 1200 arrests, several hundred warrants, and a cache of more than 70 firearms. The latter was an indication in itself, since confirmed many times over, that there is nothing "benign" about the illegal trade in Ecstasy and other club drugs. It is dangerous and potentially violent, as is all aspects of illegal drug use.

Interviews with clients at treatment centers also revealed that Ecstasy use was widespread. Most alarming was the report from more than half of the respondents interviewed at one major treatment center who said that they had been with a friend who had overdosed from one or more club drugs. A significant percentage reported that they knew a friend who had died from such overdoses.

But despite the results of Operation Heat Rave and interviews such as those cited above, we still did not have the hard data to measure the full extent of the personal health damage being done by club drugs to Florida’s citizens. We did have anecdotal reports from hospital emergency rooms and emergency medical response units who told us of many overdose emergencies, near deaths, and suspected date-rapes. In regard to the latter, our five-day seizure totals of Rohypnol and GHB - both notorious for their association with date-rape - had been 1001 and 21,441 dosages respectively. But these data had not been routinely compiled and for the most part privacy laws negated any possibility of official reporting on medical emergency cases.

Nor were there at that time, any state or local records on club drug deaths. The problem had simply never received official attention. Therefore, no requirement existed to report such data. For years we had collected statistics on heroin and cocaine related deaths. And ample data had been assembled over the years for arrests, addiction, treatment, and usage rates related to inhalants, marijuana, cocaine, crack cocaine, heroin and other opiates, and - more recently - methamphetamines. But virtually all club drugs (methamphetamines and amphetamines being exceptions) had been ignored.

This presented us with a dilemma. There were various factions - RAVE club owners and their business associates, hedonists, libertarians, RAVERS, and others - who preferred to deny either that illegal drugs were associated with the RAVE scene, or, if present, of any dangerous consequence. We had, however, seen enough to know that club drugs were dangerous. That knowledge was reinforced in December of 1999 when NIDA announced that club drugs constituted a new epidemic of dangerous drugs affecting the nation.

Determining A Data Base

About that time the Florida Office of Drug Control determined to learn the extent of club drug related deaths in Florida. We requested of Florida’s Medical Examiner’s Commission submission of suspicious death autopsies the twenty-four medical examiners had compiled from 1997 to 1999 wherein the toxicology reports indicated club drug presence in the blood. We realized from the outset that it would be difficult in some percent of the cases to determine if the toxiciology reports indicated use of one or more illegal drugs and to what extent such use either directly or indirectly caused the subsequent death. We understood from the examiners that in some cases it would not be entirely clear that the club drug was either the immediate cause of death or strongly related to it. In others, we were told, making such a tie would be problematic. We, therefore, determined to scrutinize all submitted case reports, dismissing the obvious unrelated cases and vetting the others with the medical examiners.

The first indication of the surprising number of apparent club drug related deaths was given at the Florida Drug Control Summit in Tallahassee in February 2000. At that time, I reported that as many as 72 deaths had as their "proximate" cause the illegal use of designer drugs. The cumulative list (the numbers compiled through medical examiner reports but not yet vetted) was given at 214. By the end of March, the cumulative list stood at 230, but by meticulously eliminating cases that were not clearly related to club drug use, the totals for the 3 year period (1997 to 1999) were adjusted to 174, with 88 of those indicating club drugs as the "direct" cause of death and 86 others with designer drugs as related to the cause of death. These were conservative figures; it remains likely that the actual numbers of overdose deaths were in fact higher.

Several things became clear to us through this process. First, seldom were club drugs used in isolation. They generally were used in combination with one another and often used with more "traditional" illegal drugs, such as marijuana, cocaine, and heroin. This, of course, exacerbated their danger. Second, Ecstasy use all by itself could be fatal. Of the 1997-1999 fatalities, it appeared that at least 7 had died from Ecstasy use alone, while 33 more indicated that Ecstasy was closely related to the immediate cause of death. As we continued to collect data on overdose deaths for last year (2000), the trends continued. Although Florida law enforcement agents now tell me that our efforts to curtail the Ecstasy trade have checked its rapid growth, Ecstasy remains in widespread use and overdoses are still far too frequent.

Just how dangerous Ecstasy can be was made terribly clear to us when variants of MDMA know as paramethoxymethamphetamine and paramethoxyamphetamine (PMMA and PMA) killed 6 young Floridians over the summer months of 2000. In all of these cases, the hyperthermic reaction to the drug was so great that hours after death medical authorities reported exaggerated body temperatures, some as high as 106-108 degrees Fahrenheit. Bruises and rug burns on the bodies were indicative of the agony suffered by the deceased as they thrashed around in their death throes, their brains literally on fire. Investigations indicated that the victims were seeking to purchase Ecstasy or Ecstasy laced with heroin and/or cocaine. It must be noted that in the opinion of forensic toxicologists, (and contrary to the claim of "harm reductionists", a misnomer if ever there was one) no presumptive "test kits" can readily determine the presence of either PMA or PMMA in pills sold as Ecstasy. 2

What we have been able to determine in Florida, therefore, is that the club drug scene and Ecstasy in particular poses a serious health and criminal threat. The overdose rates are compelling; so is the science. Medical authorities across the nation and from contending schools of thought are united in their view on the dangers of Ecstasy. Dr. Sally Satel of the American Enterprise Institute in Washington, D.C. has been unequivocal in asserting that MDMA and its analogs have been demonstrated to negatively affect dopamine and seratonin neural receptors in the brain. Testimony by Dr. Alan Leshner and, today, Dr. Don Vereen of the Office of National Drug Control Policy leave little doubt that Ecstasy is indeed a dangerous drug.

Addressing The Issue:

Florida has taken a unique stand against illegal drug use. Governor Jeb Bush has made bringing down crime and drug abuse one of the top priorities of his administration. He campaigned for office with the promise that if elected he would work at bringing down both the level of illegal drug use and the level of illegal drug trafficking in Florida. Upon election to office, he acted on that promise. The state held the first of what has now been three annual drug summits in February of 1999, two months into the new administration. At this event, Governor Bush announced the creation of the Florida Office of Drug Control and appointed its first Director, a distinction I am honored to have. During the 1999 Florida legislative session, the Office of Drug Control was enacted in law and charged to coordinate the state’s prevention/education, treatment, and law enforcement counter-drug efforts. Additionally, the Florida Legislature directed the creation of 25-member Drug Advisory Policy Council with the Director of the Florida Office of Drug Control and the Director of the Governor’s Office of Policy and Budget as its co-chairs. The members of the Council are drawn from the three branches of government, private business, and community leadership. They are directed to meet quarterly and guide state leadership on policy to lower both the demand for and supply of illegal substances.

Specifically, in regard to Ecstasy, Florida law was changed to make it a Schedule I drug. Moreover, penalties for trafficking in Ecstasy were made proportional to illegal trafficking in other drugs: between 10 and 200 grams, (i.e., approximately 40 to 800 doses) begets a mandatory minimum term of 3 years and a $50,000 fine; 200 to 400 grams, 7 years and $100,000; 400 grams and more, 15 years and $250,000. These laws are aimed at the traffickers. Our intent in regard to the users has always been to inform them of the risks they are taking with Ecstasy and other drugs. We believe that information and education, along with clear guidelines within the law, are the key to prevention. In the end, if there is no demand for drugs such as Ecstasy, the supply will go away.

In the meantime, supply--and therefore availability--feeds demand. Therefore we have taken concerted efforts in Florida to interdict the supply of Ecstasy. Our formula has been to mount joint law enforcement operations that combine federal, state, and local agencies in common effort. As much as possible, we seek to inform these operations by good intelligence that gives the advantage to those who would ensure the rule of law. We do this in all of our counter drug operations, as epitomized recently by Operation Riverwalk on the Miami River, a multi-agency, sustained (2 year) operation that intends to interdict the heavy trafficking in cocaine on that river (simultaneously we have enhanced counter drug security measures at Florida’s 14 deep water ports). We tie all of those operations to a prosecutorial effort, which both removes traffickers from their illegal enterprise and simultaneously develops further intelligence, which we then apply to law enforcement operations. It has proven to be a cycle of activity that gives us the initiative over the traffickers.

The net result for counter-Ecstasy efforts has been a series of large seizures recently in Florida. Whereas we used to interdict at levels that saw dozens or, occasionally, hundreds of pills seized, we now are making arrests that net hundreds of thousands in one fell swoop. For example, last November in Fort Lauderdale a related series of seizures netted 700,000 Ecstasy pills. In December, we seized 300,000 pills at the Miami Airport, bringing the total for the final quarter of the year at just that airport to 500,000. Recently we seized yet another 135,000 pills at Miami Airport.

We have worked hard in Florida to bring down both the demand and supply of illegal drugs. We feel we have had some major successes. We continue to organize our interdiction efforts to make it even more difficult to get drugs into and through Florida and the drug money back out. We will most likely set a national record for the amount of cocaine seized, as well as club drugs interdicted. Our heroin and cocaine overdose rates are going down, after a long-term rise. But most importantly, our teenagers are turning away from illegal drugs-compared to where we were in 1995, marijuana use down 38%, cocaine use down 66%, and inhalant use down 18%. In middle school, where we have focused our prevention efforts, we have seen cocaine and marijuana use plummet by 80 and 90 percent, respectively.

Ecstasy, like many harmful drugs before it, has crept with cat’s feet into our country and into the social life of many of our youth, its use encouraged by those who seek to profit from it and supported by those who are either uninformed or, for ideologically reasons, are blind to its danger. Similar to the historical cycles of escalating damage caused by cocaine, heroin, crack, and methamphetimine in their own heydays, Ecstasy has come to reveal its ugliness over time. I appreciate what this Senate Caucus is doing to arrest the damage Ecstasy threatens to do to our country.