Although I welcome the call to reassess the dangers associated with alcohol consumption by David Nutt and colleagues (March 24, p 1047),there are grounds for concern that the dangers of ecstasy might have been underestimated by this study. The literature on ecstasy-related neurotoxicity is complex, as is that on ecstasy-related deficits in cognitive performance regarding such things as the specific abilities affected, and the potentially confounding effects of other drugs. Verbal memory deficits in some ecstasy users have been reported 2·5 years after the last use of the drug.Given these complexities, it is questionable whether one 4-point rating scale under the subgroup “Physical harm: chronic” is sufficiently robust a measure. Furthermore, of the seven review articles provided by the research team for their experts, one was dated 1983, one 1993, and six predated (by their submission dates) two recent important reviews of ecstasy-related mortality. and  The remaining article was concerned exclusively with the drug γ-hydroxybutyrate (GHB). Evidence discussed in the two reviews of ecstasy-related mortality not shown to the experts in this study suggests an average rate of at least one death every 2 weeks over periods of about 7 years4 and 10 years.5 Nevertheless, there are undoubtedly many good arguments for revising current UK drug laws and, despite these problems, the work of Nutt and colleagues might prove to be an important step on the way to change. I declare that I have no conflict of interest.