Ted Oehmke

Indeed, they did. Within hours, she was in convulsions and had to be rushed to the hospital. There, she lapsed into a coma and her body temperature rose quickly, not stopping until it reached 108 degrees. “She was bleeding everywhere,” says her mother. “Her blood cells were just erupting. Her intestines were bleeding; her stomach was bleeding. She was bleeding from the mouth. She bit her lip when she had a seizure, and it wouldn’t stop bleeding, but she was not moving at all.”

By 3 the next afternoon, Mother’s Day, she was dead. Instead of taking methylenedioxymethamphetamine (MDMA), the only chemical contained in unadulterated ecstasy, she had unknowingly swallowed paramethoxymethamphetamine, a much more dangerous chemical known as PMA. The DuPage County coroner’s office determined that Sara died from an accidental overdose of PMA, a substance also believed to be responsible for at least two other recent deaths in the Chicago area.

Contaminated illegal drugs have never been a big issue in the United States. But if the demand for ecstasy continues to rise, as some researchers speculate it will, more and more dealers may start substituting deadly substances like PMA for less harmful drugs like MDMA.

“The ingredients for MDMA are highly controlled, and you have any number of people willing to make substitutes that are much more dangerous,” says Dr. David Nichols, professor of medicinal chemistry and molecular pharmacology at Purdue University and one of the few to ever study the effects of PMA. “If you make one drug illegal, it will be replaced by a more dangerous drug. No matter how much you try to control it, people will come up with substitutes.”

With the skyrocketing demand for ecstasy and its low production outlay — it costs only 10 to 50 cents to make a pill that sells on the street for $20 to $45 — there is a compelling economic incentive to sell the drug even if it’s entirely made of another substance. “The rave scene is a huge market of people willing to pay $20 or $30 per pill to get high, and a lot of people are taking advantage of it,” Nichols says.

The tablets and capsules sold as ecstasy might contain any number of adulterants. A quick look at the pill-testing results of DanceSafe, a harm reduction organization that analyzes such pills in a forensic laboratory, shows a cookbook’s worth of ingredients that the drug is often cut with or downright replaced by: caffeine, DXM (dextromethorphan, an ingredient in cough suppressants), the psychedelic PCP, Valium and ketamine (an anesthetic). Ingestion of DXM, for example, has led to hospitalizion of ravers in cities like Oakland, Calif., and London. Included on DanceSafe’s list of tested pills is a picture of white Mitsubishi, the variety of ecstasy that killed Sara.

But the problem of drug contamination and substance swapping by drug dealers is not widely recognized. An epidemiologist who attended a recent drug trends seminar in Washington, but who wishes to remain anonymous, says that a Drug Enforcement Administration representative at the conference commented that ecstasy is “a pretty pure drug.” And a slide show presented at the seminar revealed that the DEA had analyzed more than 3 million ecstasy pills in 1999 and found that “all tablets contained some MDMA.”

The Customs Service uses dogs to detect ecstasy being smuggled into the United States, but the canines can only detect MDMA, not adulterants. During the first four months of this year alone, around 5 million ecstasy pills were seized by customs, and in all probability the confiscated pills had some level of purity to them. The result is that the better-quality drugs are being taken off the market, increasing the ratio of contaminated pills to clean ones.

While there have always been risks involved in taking any illegal drugs — which are produced with no oversight by any agency monitoring safety concerns — drug contamination has traditionally been limited to substances like heroin.

R. Terry Furst, an associate professor of anthropology at John Jay College of Criminal Justice in New York, has studied the demographics of drug users. He believes the ecstasy-taking crowd, whose numbers have increased by more than 50 percent among high school seniors in the past two years, is a whole different demographic group than users of drugs like heroin, who are mostly from lower economic strata. Furst notes that “income is higher for ecstasy users because you have to be able to afford to go to a club, and you have to pay for the ecstasy, too.”

Users of ecstasy are generally associated more with ravers — who are likely to be found bunny-hopping on the dance floor while sucking on pacifiers — than with the traditional type of drug users who will do anything for a fix. In other words, many of these users aren’t aware of the inherent dangers of taking street drugs — especially since ecstasy isn’t often linked to fatal overdoses and its dangers are still being debated among scientists.

“After Sara died,” says her mother, “her friends came to see me. They talk about taking drugs as if they were taking milk and cookies.”

The adulterant PMA is not known to be useful for much of anything. Like MDMA, PMA raises body temperature, but much more severely. Unlike MDMA, PMA is not known to have very pleasant effects. Chemist Alexander Shulgin, known for his outspokenness on the positive effects of MDMA, synthesized PMA and tested it on himself several years ago. In an e-mail interview, Shulgin says he tried it half a dozen times and found that “it was not too enjoyable.” He said that the chemical “compound is about twice as potent as MDMA.”

According to representatives of the DEA’s Chicago office, the PMA contamination found there was not a novice chemist’s mistake — it was deliberate. The process required to synthesize PMA is similar to the process of making MDMA, but the chemical precursors are totally different. As Mike Hillebran, a DEA spokesman says, it’s “like making angel food cake and coming up with chocolate chip cookies.”

The recent overdoses in the Chicago area are the first known instances of PMA in the illicit-drug market in the United States. However, it has shown up before. Between 1995 and 1996, at least six Australians were killed after ingesting PMA they thought was ecstasy, prompting scientists in that country to warn, in the American Journal of Forensic Medical Pathology, that “PMA has been associated with a much higher rate of lethal complications than other designer drugs, and that no guarantee can be made that tablets sold as Ecstasy are not PMA.”

The known incidence of contaminated or substituted drugs in the United States is relatively small. One of the more publicized cases occurred in the 1970s, when the U.S. government, under President Jimmy Carter, supported a Mexican program of spraying crops with the pesticide paraquat in an attempt to stem the flow of opium and marijuana from Mexico to the U.S. Keith Stroup, then president of the National Organization for the Reform of Marijuana Laws, was so infuriated that then-drug czar Peter Bourne had tolerated the spraying, which many believed could be harmful to pot smokers, that he leaked a report that Bourne had snorted some coke at a NORML party. Bourne was subsequently forced to resign.

And in the early ’80s, several people showed up at a neurology clinic in California, exhibiting signs of Parkinson’s disease. It turned out they had tried a form of synthetic heroin called MTPT, which caused damage to the nervous system in much the same way Parkinson’s does.

Drug overdoses are always hard to treat — doctors don’t know how much of the substance the user took, over how long a period it was taken, if there was any interaction with another drug already ingested — but physicians say the problem skyrockets when someone comes in after having ingested a drug of unknown origin. In Sara’s case lab technicians were unable to identify what she took until after she died.

“We don’t have tests for most of these drugs,” says Dr. Alan Kaplan, head of emergency services at Edward Hospital in McHenry, Ill., where Sara was taken. “We have to treat symptoms … We would treat someone with hyperthermia caused by a [PMA] overdose the same way we would treat a roofer with hyperthermia. But these drugs,” he adds, referring to so-called club drugs like PMA, “reset the body’s thermostat so that it’s very hard to control. Sometimes we just can’t get ahead of it.”

Six weeks after their only child’s death, Sara’s parents remain dazed. Robert, Sara’s father, has been “fixing things around the house that don’t need to be fixed,” says Janice, who just returned to work as a receptionist at an animal hospital, and the days without Sara “seem very empty and long.”

When she’s not having nightmares of Sara’s vacant eyes and her bleeding body lying on a hospital bed, what Janice Aeschlimann remembers is a daughter who “liked long walks in the woods” and had a pet parakeet who followed her around the house. “It’s very hard to not see her in my mind,” she says. “She is what I was. Now, I’m not that anymore. It’s hard to be, and not be empty.”

Sitting by Sara’s bedside at the hospital, the Aeschlimanns told their daughter they loved her, and Janice vowed that her death would not be for nothing. “We just hope she heard us,” she says. “We hope that she knows we were there.”

Trance music sounds the way you would think the circuits of a computer would sound if they were made into music. The trick of it is that it still manages to convey the spectrum of human emotion. At this moment, in a time when a generation has grown up looking at computer screens and playing with electronic gadgets, it’s the most popular style of electronic music in the world.

Fittingly, Sasha and Digweed’s double CD, “Communicate,” debuted at No. 149 on the Billboard charts, higher than any previous mix CD. The album represents an effort to reconcile the poundingly subtle journey of the dance floor experience, and the DJ/dancer interaction of a live show, with the demands of an album that can be listened to at home over and over again. More than any of their previous four recordings, it works: It’s about as close as someone can come to hearing what they sound like at Twilo without visiting the club.

As with all mix CDs, “Communicate” is a collaborative effort between writers of original music, the producers who remix those songs and the DJs. Over more than two hours of continuous music, Sasha and Digweed act like editors, managing the transitions between tracks in an effort to create a seamless continuity between them, and arranging the tracks to foster an overall sense of cohesiveness within and between both CDs.

In this way, Sasha and Digweed (the latter made a cameo in the movie “Groove”) try to entice listeners into a journey that often feels like classical music turned on its head. Where classical seeks to tell a story and elicit emotions through melody and a background rhythm, trance ideally emphasizes the hypnotic powers of beat and rhythm, removing the emphasis on melody without taking away its storytelling power.

Since first joining forces behind the decks in 1994, Sasha and Digweed’s live style has recently evolved from a harder sound with seemingly guaranteed periods of ecstatic peaks, to something softer, subtler and more feminine. Their live shows have become more like an eight-hour tease, with a series of sonic mini-peaks that almost imperceptibly raise the level of intensity on the dance floor. On a good night, it can be kind of like having good sex for a really long time without ever having an orgasm. For some, it feels like torture, but others find it a type of pain that can also bring a sublime pleasure.

Disc 1 of “Communicate” best represents the slow build of their recent live sets. Opening with what sounds like a symphony of synthesizers tuning up its digital instruments, “Like a Bitch” builds anticipation; it’s the experience of waiting in line outside the club. By the next track, you’re in and getting your bearings with a remix of Eric Clapton’s “Get Lost,” which ever-so-slightly picks up the beat. The second, third and fourth tracks provide a good example of the cut-and-paste process of making a mix CD. Toward the end of “Get Lost,” Sasha and Digweed drop a hint of the next track into the mix, gradually ushering in the Deep Dish remix of Sven Vdth’s “Barbarella.”

As the third track, this version of “Barbarella” is a 10-minute descent into a quiet valley of rhythm and symphonic overtures. It begins with a bouncing midrange bass line, invoking an aural image of skipping through a fresh meadow with a cluster of smiley-face balloons. At five minutes and 38 seconds into the song, the sonic arrangement from the first part of the piece begins to deconstruct until about 6:20 on the counter, when nearly all sound fades away, except for a distant and friendly choo-choo. From then on, the first part of the song seeps back in, making for a sort of narrative within a song that plays a narrative role within the entire CD set.

Before the end of “Barbarella,” a more menacing beat from the next song, “Roaches,” crawls in until the track is handed over completely to a threat: “We just like roaches, never die, always livin’,” says a voice. But toward the end of the track, a different voice comes in, whispering, “You hear voices … premonitions.” It’s a rather unsubtle foreshadow of the next track, “Voices.” For a while “Roaches” competes with “Voices” until the former is aurally vaporized, making hollow the roach threat to “never die.”

Going from the beatific in “Barbarella” to the belligerence of “Roaches” to the comparative benevolence of “Voices” may be Sasha and Digweed’s attempt to stimulate the tension and energy of experiencing contrasting emotional states in rapid succession.

The rolling conclusion to Disc 1 provides a long, slow build to Disc 2, which promises to deliver the peaks left off the first. With trippy bleeps and tones, the second has a shorter distance between peaks and valleys; it seems to move faster. A deeper and more rapid bass line may inspire dancers to pump their arms and sway their heads. The sounds of computerized voices and nearly inaudible words are more prominent. Yet there is a link to Disc 1: The spoken-word sample from “Voices” comes back. This kind of distant spacing between spoken and sonic samples serves to enhance the mind and time-altering effect that is one of the hallmarks of trance music.

The major peak for the set hits its stride at about three minutes into the eighth track of Disc 2. (The first printing of the track listing for Disc 2 is out of order: The last song listed, “Lifestyles — Part 2,” is actually the third song. All of the other songs follow in the same order.) It begins as a densely layered synthesized rhythm that disappears for a full five minutes, reappearing with the addition of tablas in track nine. This is the kind of mathematically precise manipulation of sound (and emotions) that makes for vintage Sasha and Digweed. This is also the kind of peak activity that happens deeper into their live sets.

It’s a more understated moment than the explosive peaks created by other popular trance DJs, like Paul Oakenfold or Paul van Dyk. The Sasha and Digweed sound is deeper and less reliant on crowd-pleasing gimmicks, and is consequently more demanding of its listeners. Much like European classical music, the trance of Sasha and John Digweed is an acquired taste, and it requires a little bit of work in order to be truly appreciated. But the music is well worth it. The way the two DJs are composing sets, in 200 years this could be classical music.

Three of the 68 pills DanceSafe will test this day contain DXM, a drug sometimes sold as ecstasy that has been responsible for some recent injuries to ravers. Roinick tells the pill holders at the table that DXM is not ecstasy, and, when mixed with MDMA, can lead to severe overheating. Two people say they would not take the DXM because they are already on E. Another guy says he will take it later, after his ecstasy wears off. On a humid 95-degree day, that bit of advice may have saved a couple of trips to the hospital.

In an attempt to stem the growing popularity of a drug taken mainly by young, affluent, white people, Sen. Bob Graham, D-Fla., recently introduced the “Ecstasy Anti-Proliferation Act of 2000.” The bill would stiffen legal penalties for ecstasy dealers. But much of the language is aimed at controlling information about the drug. An aide to Graham said the main targets are Web sites that extol its virtues and announce the raves where people can buy it.

But the bill goes beyond even this questionable assault on free speech. It would ban the teaching, demonstration or distribution of information about ecstasy or any other drug defined as illicit — marijuana, cocaine, LSD, even Valium used without a prescription — if the people distributing that information know that someone will commit a crime based on what he has learned. Naturally, this alarms DanceSafe founder Emanuel Sferios, whose organization does exactly that.

“Banning lifesaving information is going to jeopardize the health and lives of young people,” he says. “Politicians want to appear tough on drugs, so they come up with this bill. But it’s only going to exacerbate the problem. It should be called the Club-Drug Harm Maximization Act.”

At a press conference in May to announce the bill, Graham said, “Ecstasy is a proven killer — and it is on the loose. We need to shatter the dangerous myth that this risky designer drug is safe for consumption.” The bill would provide funding to “educate young people on the negative effects of ecstasy,” and would order the head of every federal agency to post “anti-drug messages” on their Web sites.

A nearly identical bill will be discussed in the House Judiciary Subcommittee on Crime on Thursday. Perfect timing: On Wednesday, the U.S. Customs Service announced that it had busted an international ring that allegedly smuggled roughly 9 million tablets of ecstasy to the United States — the largest trafficking syndicate Customs claims to have cracked. Since April, 25 people have been arrested in connection with the group. The House bill is sponsored by Rep. Judy Biggert, R-Ill. In a press release, Biggert says she was moved to introduce the bill after a high school student from her district “died after ingesting what she thought was ecstasy, but was actually PMA.” (Paramethoxyamphetamine is another, more toxic amphetamine.)

Of course, this is the sort of tragedy that pill testing tries to prevent, but the bill shows no recognition of this. A spokesman for Biggert says a legal analysis by the Congressional Research Service concluded that DanceSafe would only be “tangentially targeted under this law because what they are doing probably already constitutes a felony offense.”

But Eric Sterling, who served eight years as the counsel to the House Judiciary Subcomittee on Crime and is now the president of the Criminal Justice Policy Foundation, which advocates drug law reform, has a different view. “This bill is designed to chill any discussion of drugs that is contrary to the government line,” he says. “Fear of felony prosecution in the drug arena is an enormously heavy blanket. Small programs like DanceSafe run the risk of being destroyed.”

Founded in February 1999 by Sferios, 30, DanceSafe is part of the “harm reduction” movement in the United States. Other such organizations, including the Harm Reduction Coalition and the Lindesmith Center, advocate a shift in national drug policy to view the issue of illegal drug use as a matter of public health, rather than law enforcement. People are going to use drugs anyway, the reasoning goes. Sferios says it’s especially important to serve the dance community. “All drug use has inherent risk, and dance drugs in particular pose certain risks, which are increased by the lack of information,” he says.

The anti-ecstasy bill, say civil libertarians and reduction advocates, could easily be used against programs like DanceSafe. “When you prohibit information about use, you are targeting people involved in harm reduction,” says Rachel King, legislative counsel for the American Civil Liberties Union. She adds that “there are not that many people who care about the First Amendment in the context of the war on drugs.”

Those prosecuted for distributing information on the use of E and other club drugs would face a maximum prison sentence of 10 years along with fines.

“I dont think its unreasonable for politicians to be worried,” says Mark Kleiman, a professor of policy studies at UCLA. He points to studies from England showing that frequent weekend users of ecstasy are depressed by midweek, every week. “But passing a law thats grossly unconstitutional is a different question,” he says.

He has no doubt that if the legislation becomes law, the courts will throw it out. This, he says, is “part of a childish cycle the legislature has set up where the courts are the only ones left to defend the Constitution. They can vote for this knowing its going to get thrown out, but then they get to go home and tell their constituents that theyre doing something about drugs.”

Chad Thevenot of the Criminal Justice Policy Foundation says it’s ludicrous to block safe-drug information in the name of drug-abuse prevention. He draws an analogy to safe-sex programs. “Giving someone a condom doesn’t make them horny; they’re horny by nature,” he says. “People make better decisions when they have better information.”

There is no good research on the effectiveness of harm-reduction efforts. But there is solid evidence that the official approach to drug information has done nothing to stop drug use. Marijuana use among high school students nearly doubled from 1991 to 1999, according to the Centers for Disease Control — years when the “just say no” slogan made famous by Nancy Reagan became the cornerstone of school-based drug education. Use of cocaine more than doubled in the same period.

“All of our research has shown that the messages so far dont work,” says Joel Brown, executive director of the Center for Educational Excellence in Berkeley, Calif. Young people, he says, don’t fall for scare tactics, and often turn to uninformed sources who may downplay the risks.

“You have to win people’s trust,” says Sferios. “If part of the overall strategy is to see the drug situation as a war, well … the first casualty in war is the truth.”

Sferios and others point to a recent example in Florida, a hotbed of rave culture, of what happens when the government tries to control information related to drugs. As reported by Henry Pierson Curtis in a May 21 Page 1 article in the Orlando Sentinel, Florida drug czar Jim McDonough, a former Army colonel, was so eager to show that his efforts against club drugs were necessary that his office grossly overstated the number of deaths caused by them. The Sentinel reviewed the autopsy reports of those supposedly killed by club drugs in Central Florida, their main coverage area. Over a three-year period, they found that at least 35 of the 60 deaths were in fact completely unrelated to ecstasy or rave culture.

Two days after the story appeared, Graham introduced the ecstasy bill. DanceSafe is reviewing the Florida autopsy reports, and will publish its own conclusions.

A therapeutic dose (2mg/kg of body weight) of MDMA will flood the synapses of brain cells with nearly the entire supply of the brain’s serotonin, and prevents it from being naturally recycled so it lingers longer. Serotonin is a neurotransmitter known to play an important role in determining a person’s mood and regulation of body temperature. MDMA also triggers the release of dopamine and norepinephrine, which increase the feeling of energy. The three- to five-hour effect is usually one of seemingly boundless energy, combined with an overall heightened physical sensitivity and an increased feeling of empathy toward others. Hence the “marriage made in heaven,” cited by one raver, between ecstasy and dancing in close quarters with lots of other people.

Ecstasy is most likely not without biological risks, but its effects on the brain are unclear. The most often cited studies on the neurotoxicity of MDMA are by Dr. George Ricuarte, a neurotoxicolgist at Johns Hopkins University. Ricuarte says MDMA causes damage to the ends of axons and may impair memory function. Other scientists, however, say his findings are inconclusive.

Dr. Julie Holland, a psychiatrist at Bellevue Medical Center and a psychopharmacologist in Manhattan, says Ricuarte’s memory study compared multiple drug users with graduate students. “The best you could say from a study like that is that people who take a lot of drugs and go to raves don’t perform as well on memory tests as grad students,” Holland says.

She adds, “Nothing is conclusive about the brain and its chemistry — the more you look, the more complicated it gets.”

Her suggestion to ravers: “Use the chill-out rooms and stay cool. Drink plenty of water, but only as much as you feel you’re losing. And get your pills tested.”

A couple of hours before the finish of the rave on Randall’s Island, an emergency medical technician, who has worked for several years at venues like Madison Square Garden and Yankee Stadium, is impressed. “It’s much better than we expected,” she said. “With two hours to go, we’ve only taken five people to the hospital, one was because of alcohol and another because he got in a fight. The other three … we don’t know what happened.”

A leap of faith: The other three were probably not the three young people who decided against taking DXM pills disguised as ecstasy after having them tested by DanceSafe.