How Much Truth Is Behind “Alcohol Is Worse Than MDMA”?

By: The Department of Potentially Risque Youth Based Publications.
The Office of Smoko Henderson, Substitute Protagonist.

From Pedestrian.tv to the NT News, news outlets were all over the death of 25 year old pharmacist Sylvia Choi over the late weekend who allegedly died of an ecstasy overdose while at Stereosonic in Sydney. Without wanting to bring bad voodoo on the festival, I’m doubting this will be the first drug related incident coming out of Stereosonic’s 2015 circuit to make the news. I’m not really going to delve into that issue at all (tuck it in your undies & don’t double drop pills you haven’t had before) but I do want to delve into something that keeps on coming up every time a festival overdose happens, so long as you accept my definition of ‘coming up’ as “reading facebook comments:”

alcohol vs e 1

It’s not hard to find the phrase “MDMA is safer than alcohol” – especially in the comment feed for a site like pedestrian, all things granted – but it’s hard to understand those words without having a firm grasp on where the information comes from. Most of this information post-2007, it turns out, comes from ex-chief drug adviser to the Government of the United Kingdom, Dr. David Nutt.

When he was the acting in this role during 2009, Nutt proposed to reporters during a conference that MDMA or ‘ecstasy’ was a far safer activity than horse riding, and he was promptly sacked shortly after. A little while after that, Nutt came out at a conference and straight up said that “alcohol is the most damaging drug to the brain.” Nutt, who was a psychiatrist and pharmacist before a member of Government – and still remains as a practicing psychopharmacologist –  isn’t rambling on about things he doesn’t understand: this man was advising the United Kingdom’s leaders on drug policy at one stage due to the level of his legitimate expertise, until, of course, he stepped over a line in the sand.

While the alcohol vs MDMA discussion has become very popular on drug enthusiast websites like Bluelight and Erowid, the question has also attracted attention from publications everywhere in the anglosphere. And in most of those articles, the name Nutt keeps popping up.

Australian publications haven’t been too slow to pick up on the issue, and in recent years we’ve been seeing some talk about this at home. Melbourne’s The Age ran a solid article on the issue in 2012. In it, a journo writes that a ‘large number’ of professionals (presumably domestic) who were contacted to fact check the story agreed with the statement that ecstasy was, on the whole, safer than alcohol.

So, clearly the idea has some pretty legitimate support behind it – but how much reassurance can we put into the claim? This is where it gets tricky.

Back in 2007, the Medical Research Council in Britain released a report in which a committee of scientists, informed by health professionals, analysed 20 of the most abused illicit compounds in the UK. After consulting senior chief policy officials, the report came out with a proposed revision for the drug ratings schedule used in Britain, which determined that alcohol was more dangerous than cannabis, marijuana and LSD, much to the interest of European journalists everywhere at the time.

Additionally, this report in question was subjected at multiple stages to the peer review of an advisory group made up of 29 practicing psychiatrists in the United Kingdom, effectively driving home the fact that yes, they’re serious. It is this report which has been underlining most of the related coverage and discussions since, which I suspect is due to the fact that the report has too many official titles supporting it to be easily dismissable. Interestingly, Nutt was one of the leading researchers in this report which was released two years before his comments in 2009, making his resignation seem even stranger. But let’s get back to the report – there’s a hiccup in the answer to our question.

The only problem is this report was less about hard psychiatric and medical peer reviewed research than it was about reshuffling the legislation used in Britain to organise illicit drugs into degrees of severity and punishment. So, despite the fact that a huge number of practicing professionals from diverse fields worked on the report and pledged their support for it, The Medical Research Council still didn’t actually go out into society and dose people with drugs as part of clinical experiments.

The issue the report was addressing was that ecstasy is labelled as a class A drug – up there with the most dangerous of the bunch – despite the fact that alcohol continues to cause a far higher amount of deaths, harm and stress on the healthcare system.

And indeed, this is the same situation we have in Australia. As cited in the facebook screenshot up above, the Foundation for Alcohol Research and Education along with the Victorian health department recently released a report which stated that alcohol causes 15 deaths a day on an average day in Australia, which is 450 deaths a month, which under our national security alertness ranking, probably qualifies drinking games as a death cult.

So what actual research is out there beyond David Nutt and a few good articles? Heaps, actually, but the full-on med student jargon is enough to make you shrivel.

It should come as a surprise to no one that heavy MDMA usage has been linked with a decline in cognitive ability in some studies (and probably a fair deal of shriveling too, heh heh), additional research has found that long term morbid usage of MDMA can result in damage to the brain via the loss of structural composure to axons in the brainstem

Here’s what’s weird though – there is no specific definition for “damage” in this context.

The general consensus is that there are changes to axons in the brainstems, but we don’t know what those changes actually cause. This in no way means it’s a moot concern – with research on casual users, the observation that many were found to have high impulsiveness could be indicative of changes in the brain brought about by ecstasy use – but this is unlikely. And, the Catch 22 fan in me needs to point out that we don’t have a solid definition for “safety,” either.

Essentially, the research shows that the higher the dosages of MDMA are, and the more regularly they are taken, the more observable changes there will be to various parts of the brain. But there is no firm understanding of what the consequences of those changes will be or how those changes occur. Research suggests that there is a threshold in the human body at which point, if crossed, excess dosages of MDMA will begin to metabolise into compounds that take longer to break down in the brain, and may “build up” over time.

To contrast this however, research with casual users has found no evidence of a decline in the cognitive ability of ecstasy users. Additionally, the term ‘neurotoxicity,’ which dominates much literature surrounding MDMA, has no definition and is generally defined as anything from headaches to physical cell change to the loss of cognitive functions.

So, MDMA getting all up in your axons and brainstems sounds startling, but then you can’t forget there’s a fair deal of research showing that casual usage of MDMA at “medium” dosages presents no observable changes in cognitive ability – and some research which fails to find physical brain changes in scans of recreational users at all. But most important at this point is to consider the following about booze: high dosages of alcohol cause the body to metabolise a chemical known as acetaldehyde, an organic compound which is toxic and used in the production of industrial solventsThink about that the next time you hear a cop on the radio waxing lyrical about how ecstasy is made from “rat poison in bathtubs.” It’s hard to verify the accuracy of that claim, but the general inclination is to wonder why, if that is always the case, does alcohol continue to dwarf ecstasy in weekly death tolls, across all demographics? It’s additionally hard to see how having a liver full of floor cleaner sounds any better than finding out what the ‘chemicals’ in pills will do to you.

Interestingly, research on alcohol finds that the constant metabolism of alcohol brought on by a lifetime of hard drinking can directly cause cancer of the respiratory tract, liver, stomach and lymph nodes – however, it is noted that genetic resilience has a strong part to play in alcohol’s effects on the human body.

Essentially, to answer this question, we need to wait for the intersecting fields of research it concerns to not only adapt the technologies needed to answer it but also come together on a consensus, something which may never happen, because trying to find a general consensus in any academic field is like trying to find decorum in a room full of abandoned children.

But in trying to answer the question for ourselves:
a) it is hard to ignore the large body of professional opinion that states ecstasy is safer than alcohol,
b) it is hard to ignore the reputable studies that have failed to find evidence of harm to the mental health of casual ecstasy users,
c) and it’s hard to ignore the fact that alcohol continues to take far, far more lives than all recreational drugs combined each year.

So, statistically, I feel confident in saying: yes, MDMA is actually safer than alcohol.

Don’t hold your breath waiting for lawmakers to agree, though.