Can use of ecstacy cause fatal fever? Plus: what “indignities” are grounds for divorce?

Illustration by Slug Signorino

Cecil replies:

I know what you’re thinking: urban legend. I confess that’s what I thought, until I remembered an article that appeared on the Straight Dope Web site a couple years ago courtesy of trusted friend of science Hawkeye, in real life a forensic biologist. Hawk had written that frighteningly high (and often fatal) body temperatures due to drug use were entirely plausible. Thinking perhaps he might’ve learned something since then that would cast doubt on this conclusion, I called Hawk to check. Answer: No. On the contrary — this bizarre phenomenon really happens.

Ecstasy impairs the body’s ability to regulate temperature and can cause a condition known as hyperthermia or hyperpyrexia. In a German medical journal earlier this year doctors told of a 21-year-old man who took a suicidal dose of ecstasy, formally known as 3,4-methylenedioxymethamphetamine (MDMA for short). The patient’s body temperature topped 109 degrees — and this guy lived (albeit with immediate medical assistance). Some ecstasy users don’t — including quite a few who aren’t trying to kill themselves. According to another journal article, at least 87 ecstasy-related deaths had been reported as of 2001. Hawk tells me that body temperature at the time of those deaths could’ve been as high as 117 — a temperature of 115 has been confirmed. Even if we assume a more conservative 109 at the decisive moment, a corpse cools at roughly 1.5 degrees per hour — slow enough that a temperature of 104 three hours later is about right.

To be fair, not all ecstasy deaths result from hyperpyrexia. Other causes of death include rhabdomyolysis (toxic muscle breakdown), kidney and liver failure, cardiac arrhythmia, blood clotting leading to hemorrhage and stroke, and accidents or suicides while under the influence. Contributing factors can include hyponatremia (low blood sodium) and cerebral edema (brain swelling) caused by a combination of heavy sweating and excessive water consumption.

You may say: 87 deaths, considering the millions who’ve used ecstasy, is a pretty low mortality rate. True enough. Serious adverse reactions to the drug are infrequent, but they’re also unpredictable and sometimes spectacular. (Cooking yourself from the inside is nobody’s idea of a fun night out.) Claims of harm related to chronic use remain controversial — one study reporting that ecstasy caused brain damage in lab animals was retracted recently after researchers found they’d fed the critters the wrong drug. But there’s still plenty of evidence suggesting that ecstasy is bad news. It causes the brain to flood with serotonin and other neurotransmitters by interfering with the usual reuptake mechanisms, and some think it may compromise your ability to process serotonin naturally. Research also suggests that ecstasy abuse can lead to other long-term neurological deficits, including problems with memory, learning ability, sleep patterns, and appetite.

Assuming none of this fazes you — and I admit that, in my youth, dire warnings never got me to switch to lemonade — take some elementary precautions: Keep cool (not easy to do in a crowded club, I realize), consume fluids in moderation (sports drinks are better than water), and seek medical attention at once should it dawn on you that you’re not feeling all that ecstatic.

Dear Cecil:

Recently I purchased a 1957 Information Please Almanac just to see if I had missed anything of importance. And indeed I had! Its table of “Grounds for Divorce” shows a mystery category of “Indignities,” which I had never heard of. What are these “Indignities”? They cannot be “Crimes Against Nature,” for footnote number five reveals that this is grounds only in Alabama, Virginia, North Carolina, and Arizona. Hurry, Cecil — I would hate to inflict indignities on my wife out of negligence or ignorance.

— R.M. Schultz, Chicago

PS: What exactly is the “Loathsome Disease” that is grounds for divorce in Kentucky? If it’s hay fever I’m in trouble.

Cecil replies:

Silly boy. Prior to the introduction of no-fault divorce in the 1970s, “indignities” was the catchall term for whatever bugged you about the old battle-ax (or inconsiderate pig) your adoring spouse had turned out to be, and as such was the most common grounds for a split. Sample indignities, lifted from a Pennsylvania lawyer’s Web site: “vulgarity; unmerited reproach; habitual laziness; studied neglect; intentional incivility; manifest disdain; abusive language; [and] malignant ridicule” — any of which can supposedly “render [the injured party’s] condition intolerable and his or her life burdensome.” Loathsome disease, a traditional grounds for divorce in many cultures, is commonly understood to mean something like leprosy — not your typical marital problem these days. Manifest disdain, on the other hand … if I were you, I’d be careful about leaving the toilet seat up.

Cecil Adams

Send questions to Cecil via cecil@straightdope.com.