MDMA as popular as alcohol at Schoolies
"It's about making smart choices. If the choice is taking a tablet that you don't know exactly what's in it, the consequences of that could be absolutely tragic. We see those consequences at the hospital and we are the ones who have to talk to family members and friends. When a young person comes into hospital and dies in the emergency department or intensive care, you can palpably feel that amongst the staff, you can hear the upset families all around the ED and intensive care. We don't like delivering that news to anybody or family. I guess they're the decisions and the choices that you're making in life." - Emergency specialist Dr Jeff Hooper
OVER the past 20 years Dr Jeff Hooper has seen the full gamut of drug use and abuse, and for the past 11 years while working on the frontline as an emergency specialist at the Gold Coast University Hospital.
Once heroin was the drug of choice, but it has been replaced with the likes of methamphetamine (ice) and MDMA or ecstasy, with alcohol abuse also remaining a major problem.
Dr Hooper said the use of MDMA among young people was evident at the Schoolies festival this year.
"I think MDMA is probably the 'party drug' of choice and certainly on Schoolies we've seen a massive increase on that over the last five years." Dr Hooper said.
"People presenting to the Schoolies (medical) tent, the majority of those 10 years ago (involved) probably alcohol, and now it's probably closer to 50/50 (alcohol and MDMA use) in terms of presentations and often a mix of alcohol and ecstasy too."
He said the normalisation of MDMA had almost reached the point where naive users perceived it as a drug with little or no consequence.
"The use of MDMA has become more normalised over the last few years. It's easily available and I think that people have the tendency to think that it's a drug without any consequence,'' he said.
"There's no safe level of drug use, particularly with any of these pills. You don't know what's in them. Potentially they could be mixed with other agents and typically what we see is that they're mixed with amphetamines, things like ice or speed mixed in.
"The effects can be really variable and people aren't making these drugs for your benefit, they're making them for profit. They can be cut with all sorts of things.
"Then we see people who have a one-off, bad event, and we've seen that certainly with the deaths in New South Wales that are involved in that coronial inquiry, but the deaths are the tip of the iceberg of what you see. Along with those deaths there are those who get intubated in the emergency department.
"Those people don't come into the death statistics, but they come with significant issues and can have lifelong problems. Just because they don't die doesn't mean they haven't been injured in some way."
Dr Hooper said while the drug might be taken for the euphoric effect it had on people, the risks associated with chasing that high could be fatal.
"You get tachycardia, a rapid pulse. You can end up getting hyperthermia, really high temperature, which is exacerbated by going out and having a good time, dancing.
"If you are drinking a lot of water, you can get what's called hyponatremia, which means you get really low salt in your body that causes problems. Initially that can cause things like confusion, but eventually that causes seizures and then coma, then death unfortunately.
"People die from the effects of cerebral edema, which means swelling of the brain and people end up in intensive care because of that and it can be potentially irreversible."
With no reversal agent, Dr Hooper said all medical teams could do was support people through the crisis.
"Most of what we do is just supportive care. There's no reversal agent for these drugs, like there is for opioids and things like that.
"Mostly what we do is looking after people. The worst case scenario is that we have to put people in an induced coma, ending up in intensive care on a ventilator - that's for people at the high end."
Dr Hooper said pill testing was not a silver bullet to deal with MDMA use.
"There's no silver bullet for this stuff. I think pill testing is a harm minimisation strategy that's a broader strategy for lots of stuff,'' he said.
"Pill testing doesn't say drug use is safe. What it says is that we're going to try to minimise the harm, we're going to test the pills and tell you what's in it, then give you some counselling to make an informed decision about whether you're going to take that pill or not.
"There's been pill testing trials at Groovin the Moo in Canberra and from my understanding the results show that if people are able to make an informed choice, it will reduce the amount of drugs they use and the combinations of drugs that they use which lead to overdose.
"People who are naive to drugs, they'll take one tablet, won't see an effect, then take two or three more, or combine it with other drugs and then you see the catastrophic collapse that we see later on.
"That was quite common at Schoolies (for) people to take a few tablets, because they haven't used it before and end up with us in the tent with problems."
He said educating teens about drug use and its dangers, played a key role in reducing the risk of drug abuse.
"We do a lot of work here at the hospital. We have a party program, which talks to school groups about things, not only drugs and alcohol, but other harm minimisation.
"The reality is that it's a group of 16, 17, 18-year-olds involved in risk-taking behaviour, you're never going to be able to 100 per cent say they're not going to make bad decisions.
"If any of us as adults can look back and say we didn't make bad decisions at that age, we're probably lying."