Ecstasy and the agony

Whenever you swallow a pill, from paracetamol to Prozac, you take a risk. Yet some are called wonder drugs while others are demonised. Why? asks Polly Toynbee

Leah Betts's tragic case is a story to terrify every parent. What more could careful parents do? Her ex-policeman father supervised her 18th birthday party at home. Her stepmother was a professional in warning children about drugs. Yet there she was, slumped on the bathroom floor, her brain swelling, a rite of passage turned into a rite of death by an ecstasy tablet imprinted with an apple.

The Home Office does not know how many people die from taking ecstasy, but the highest estimate, produced by Dr John Henry of the National Poisons Information Service, puts it at about 50 a year, far higher than the total of 50usually quoted. Whatever the precise number, even one death from a recreational drug seems tragically unnecessary.

How dangerous is it? "In the short-term," Dr Henry says, "ecstasy is a relatively safe drug. Given that maybe half a million young people are taking it, then relatively few people have adverse effects. We get about 120 reports a week where ecstasy has usually caused over-heating and dehydration." He points out that when large numbers of people take any drug, a small proportion will react badly. He does not believe the real issue is impurity. That knee-jerk rush to find the rogue batch of ecstasy that could have been cut with aquarium cleaner or dog-worming pills may be a myth deliberately designed to suggest that the drug itself is safe.

For Dr Henry does not regard it as safe. He fears for its as yet unknown long-term effects. Those who have used ecstasy have lower seratonin levels in their spinal fluid, a condition that is shared with depressives. Dr Henry suspects that when this generation reaches their thirties there may be a higher depression rate among those who have taken ecstasy. But he has no idea by how much.

Low seratonin? Isn't that what people take Prozac for? Doesn't Prozac raise their seratonin to make them feel better? Just so, he says. Prozac was first prescribed in Britain in 1989, only a little before ecstasy arrived on the rave scene. The drug company Eli Lilley, which manufactures Prozac, does not reveal how many British people take the drug, but 19 million people take it worldwide at a value of pounds 1.7bn. Some people allege serious adverse reactions, implicating it in acts of violence and even murder, though this is hotly disputed and it has been hard to prove cause and effect. Do we yet know Prozac's long-term effect? No, says Dr Henry.

So what is the real difference between Prozac and ecstasy? Why should the law take such a very different view of each drug? It depends on its provenance. Drugs that come via drug companies get licences even when the long-term effects are not known. Drugs that come up from the underworld and youth culture are hounded by the police. Both drugs are promoted as magical mind-alterers. But clean medical names ending -ac, -ine, -oid, -ium sound good, while drugs called Lebanese Gold or Nepalese Temple Balls are plainly bad. We are not very rational about all this.

How should we view these figures for deaths from ecstasy? How frightened of ecstasy should we be for our children? Of course we would prefer it if our children eschewed all risk. But panic at the very word "drug" often stops people looking squarely at the risks in relation to the rest of their lives.

For instance, we teach them to drive for their own pleasure. How many of us give them driving lessons as a happy 17th birthday present, without panicking unduly over the 3,650 people killed on the road every year? We may encourage swimming, but we don't consider the 448 people drowned every year. We urge them not to smoke, and sigh with disappointment when they do, but we don't call in the counsellors - yet 100,000 people die of smoking each year. If they have dropped into the pub, we do not lie awake terrified by the 25,000 people who die from alcohol-related causes every year. There is horror in the very word "drug" that drives out all rational risk assessment.

The Home Office reports a total of 255 deaths last year from drugs of every kind, all the way from ecstasy to crack. (The number for each drug is not collated, so Dr Henry's 50 from ecstasy is the best guess.) Meanwhile, 170 people a year die of paracetamol poisoning.

Life is not risk free, neither in work nor pleasure. Everything we do, day and night, has a risk ratio attached. Yet when people think about drugs, they seem to start from some imaginary zero-risk state of mind. Perhaps that is because drugs seem to serve no purpose to those who do not use them. But since a very high proportion of young people do take drugs for pleasure, you might as well spit in the wind and call for the closure of pubs as imagine that it can be stamped out. When virtually every song on Top of the Pops extols ecstasy in not-so-subtle lyrics, what is the point in prohibition?

Politicians sometimes shake their heads in despair at the younger generation's rejection of Westminster and all its works. But it might be truer to say that politics had rejected them. If even to raise the subject of reforming the law on soft drugs has become political death, then Westminster has become as dangerously out of touch as the court of Marie Antoinette, Catherine the Great or the Shah of Iran.

Leah Betts's story shows how very little parents can do about drugs and their children. You can talk about it, you can hope for the best and most of all try not to lose them by refusal to admit that it goes on. We are right to be terrified of lives destroyed by crack or heroin addiction. But the head-in-the-sand posture of most MPs and opinion-formers just won't do. As a very occasional cannabis smoker, from a family with a long bloodline of alcoholics, I can't see that soft drugs are exceptionally dangerous.

Perhaps the long-term effect of soft drugs will prove worse than seems likely at present, though the death statistics suggest otherwise. Ironically, no one will know unless and until they are decriminalised as there can be no effective scientific study while they remain illegal. In the meantime, most recent figures show that 56,000 people a year are prosecuted for cannabis - by far the most widely used illegal drug - and some 1,565 are arrested for ecstasy-related offences. What is the point?