Dede Goldsmith lost her daughter Shelley to heat stroke on August 31, 2013. Shelley was at a dance club with soaring temperatures and little space or air. The energizing and euphoric effects of MDMA (often called “Molly” and “Ecstasy”) masked bodily signals that would normally cause someone to seek out rest, coolness and water. It was a death brought on most directly by hyperthermia and dehydration. The dangers were sharpened by public policy rooted in zero tolerance for drug use. Now, Dede Goldsmith is leading the charge to amend a bill that has had the unintended consequence of discouraging harm reduction practices in dance clubs and festivals.

The Reducing American’s Vulnerability to Ecstasy Act, or RAVE Act, which passed in 2003, allows law enforcement officials to go after proprietors of dance clubs, festivals and other businesses that maintain a “drug-involved premises.” The intention was to put a damper on rave culture and shut down dance clubs that encouraged the use of illicit drugs, namely “club drugs” such as amphetamines and MDMA. Afraid of being prosecuted, many club owners have shied away from any actions that tacitly acknowledge that some of their patrons use these drugs, such as drug education services, and even air-conditioned “chill out” rooms. Goldsmith is petitioning Congress to amend the RAVE Act to both provide immunity on these harm reducing measures and encourage clubs to use best practices for keeping their patrons safe.

“The RAVE Act discourages pretty much anything except strict medical intervention, which is oftentimes too late,” explains Emanuel Sferios, founder of DanceSafe, a nonprofit public health organization promoting health and safety within the nightlife and electronic music community. Sferios provided consulting to the Amend the Rave Act movement, and is producing a documentary on MDMA.

“The vast majority of medical emergencies [in dance clubs] are after someone has heat stroke, which results from a combination of factors,” Sferios said. “[Drug users] are taking a normal dose, but they’re in a 100 degree temperature, dancing aerobically, packed in like sardines.” Furthermore, Sferios explains, drugs that work on monoamines, like serotonin, as MDMA does, increase one’s chance of overheating.

The push to amend the RAVE Act resembles progressive movements in sexual education: rather than preach abstinence with no plan B, Goldsmith advocates for education and safety. With both sex and drugs, abstinence-only policies have been shown to fail, while policies that acknowledge that people are going to have sex and use drugs are much more effective at reducing unintended consequences.

Though MDMA-related deaths are rare (statistics compiled from news reports place the number at 10-20 annually in the U.S.) these deaths are largely preventable, and have been increasing, according to Sferios and Goldsmith.

The issue of MDMA-related heat stroke is both exacerbated and confused by the abundance of fake alternatives on the market masquerading as MDMA. PMA, PMMA, and methylone are three chemicals commonly sold as MDMA.

“There are thousands, probably tens of thousands of people that think they have taken MDMA, but have probably only taken methylone,” says Sferios. This is a dangerous confusion, because the typical MDMA dose is 70-125mg, and for methylone those figures are more like 250-300mg.

“You’re used to taking 300mg of Molly,” Sferios describes. “Then you get MDMA for the first time and you take 300mg, and it’s a significant overdose. It [likely] won’t kill you [directly]*, but you’ll be out of your mind, and you increase your risk of hyperthermia and heat stroke.”

Compounding this problem, these drugs are often sold as powders, not tablets, and so users are left to administer their own quantities.

Sferios believes that this is what happened to Shelley Goldsmith. Texts found on her phone show that she was looking for 500mg of MDMA to split with a friend.

“She would never do that if she knew the difference between MDMA and methylone,” he said.

For this reason, DanceSafe promotes drug testing, in which users can test their drugs and verify what they are. Clubs and festivals are quite hesitant to allow a practice that openly acknowledges drug use, but they also eschew much more mundane harm reduction practices, such as chill rooms. While the RAVE Act has led to few actual crackdowns, the larger effect has been to cause clubs and festivals to self-police. Proprietors “play it safe” by disallowing any education or safety practices that indicate that their patrons use drugs.

This is not just paranoia on the part of club owners. The actual language of the bill mentions chill rooms:

“Because rave promoters know that Ecstasy causes the body temperature in a user to rise and as a result causes the user to become very thirsty, many rave promoters facilitate and profit from flagrant drug use at rave parties or events by selling over-priced bottles of water and charging entrance fees to `chill-rooms’ where users can cool down.”

The text goes on to mention glow sticks, massage oil and pacifiers as other ways that clubs profit off of drug use.

“The RAVE Act has sent a chill through the industry,” says Sferios. “Lawyers are advising clubs not to work with harm reduction groups. The RAVE Act is written so vaguely that people are afraid to do anything that acknowledges that drugs are being used in their venue.”

In the background of all of this, of course, is national drug prohibition. If MDMA were not criminalized, fake drugs and lack of education would be a fraction of the problem that they are today.

“It’s easier to get Molly than alcohol, because at least with alcohol you have to get an adult to buy it for you,” Sferios noted.

Shelley Goldsmith was a casualty of a culture with inherent risks that become much more acute under current policy. If her mother is successful in amending the more destructive effects of the RAVE Act, many fewer parents will have to endure what has driven her to this cause.

**The original version of this article quoted Emanuel Sferios as saying “300mg won’t kill you.” He has since written asking us to include the word likely, adding in his email: “The truth is people have died after taking even less MDMA than that, and I would never make the statement that MDMA ‘won’t kill you.’ The issue (as you explain well in the rest of the article), is that there are multiple factors involved.”