Tuesday, May 30, 2000

Many questions left
unanswered
Issues surrounding designer drug use
remain cloudy

Jennifer Prittie
National Post

Everything about Allen Ho's death makes for a powerful story.

Over the course of his high-profile inquest, the city has heard
repeatedly how he collapsed at an underground rave, which was
held in a hot, stuffy parking garage with no lighting and insufficient
fire exits.

It's not known how much Ecstasy Mr. Ho took, but it is clear that
when a friend stumbled across him at 3:30 a.m., he had already
succumbed to terrible convulsions.

But while Mr. Ho's inquest has turned underground raves into
dinner-table conversation, it has also created a false view of
designer drug fatalities in the province. (The term "designer drugs"
has come to include substances such as Ecstasy and GHB.)

It's easy enough to trace the way that came about. When the
coroner's office saw Ecstasy-related deaths in Ontario jump during
the past year, it decided to hold an inquest into the drug.

Mr. Ho's case was eventually chosen as a representative case, but
the other deaths were also to play a significant part.

What actually happened -- during a remarkably adversarial hearing
that was more trial than public inquiry -- is that those other deaths
were introduced, and then largely ignored. Mr. Ho's death, as it
turned out, was hardly representative at all.

The statistics presented to the coroner's jury concerned 13
Ecstasy-related deaths, encompassing one in 1998, nine in 1999
and three that occurred earlier this year. What was most striking
about the cases is the range of circumstances and substances
involved.

To begin with, seven of the deaths involved cocktails of drugs,
including heroin, cocaine, and methadone. The most reliable
conclusion to be drawn from the deaths, in fact, might be that users
need to be warned against taking more than one powerful drug at a
time.

Furthermore, it's questionable whether those seven cases should be
labelled Ecstasy-related deaths at all. One witness explained that it's
not possible to know which drug in the cocktail caused death, so
they could just as easily be grouped under heroin- or
cocaine-related deaths.

Only three of the 13 deaths had any connection with raves, and only
one, Mr. Ho's, involved an underground rave.

Three of the deaths occurred at home, and two at bars in small
Ontario cities. Another user was found in a park, and yet another at
a construction site.

The deaths evoke a drug that can be found in a variety of
circumstances. What they don't show is any evidence that Ecstasy
and raves are any more deadly a combination than Ecstasy and
other environments.

For those who have followed coverage of Mr. Ho's inquest, that
could be a difficult point to accept. But it's reinforced by three
additional deaths involving Ecstasy that occurred over the May 24
weekend in the Oshawa and Ajax areas.

According to Dr. Jim Cairns, Ontario's deputy chief coroner, none
of the three had any connection with raves. (The deaths occurred
separately, and tests to see whether other drugs were present
should be available in several weeks.)

There is another set of numbers that shows a broader view of local
designer drug use. It was supposed to be discussed at Mr. Ho's
inquest, but curiously was not introduced as evidence at all.

Those numbers come from a study of designer drug admissions at
the emergency department of St. Michael's Hospital. It shows that,
of 62 such admissions on weekends last year, 40% involved the
drug GHB, and only 18% involved Ecstasy.

The study showed patients coming from two big downtown clubs --
where raves are occasionally held -- but also from bars and parties.

Frequently, when witnesses at the inquest tried to talk about drug
use in venues other than raves, they were shut down. That was
typified by an unpleasant exchange in which a witness attempted to
discuss drug use in downtown bars.

"We're just dealing with raves and Ecstasy here," snapped coroner's
counsel Paul McDermott.

Furthermore, testimony repeatedly showed just how poor most
rave-related information is.

Instead of presenting reliable data about the age of ravers, and the
percentage of them who may be taking drugs, experts proffered a
series of bad guesses, proving only that such numbers should always
include a proviso explaining how they were arrived at. Indeed, while
it is now received wisdom that designer drugs are targeted at the
city's "early teens," the St. Michael's study showed patients' average
age to be just over 22. Among the 13 dead, ages ranged from 17 to
28, with nine cases over the age of 20.

There is still no accurate, broader picture of designer drug use in
Toronto. At times, witnesses did refer to Ecstasy use in venues from
nightclubs to homes to bush parties.

And David Collins, of the Toronto Harm Reduction Task Force,
told the jury that while Ecstasy use may have once been the
province of ravers, it has now spread to an older, thirtysomething
demographic.

But it's important to know those things for certain: If they're right,
then a central point of Mr. McDermott's case -- that raves and
Ecstasy have a particular connection -- may be long outdated.

Why is poor and missing information, and a lack of context, such a
potential problem?

For one, it means that, to prevent more designer drug deaths,
education efforts may have to be targeted not just at the rave
community, but much farther afield.

(In fact, it could be argued that cracking down on raves means
dispersing a group of people that knows far more about safe
designer drug use than any other group).

It means that continual reference to Ecstasy and other designer
drugs as rave drugs is misleading, and that, in future, the coroner's