Ask Dr. Cracky

I sent my friend Michael a link to an article about the dangers of ecstasy use. He e-mailed me back:

Did [you] see in this article that people don't die from taking ecstasy, but die because they have had "too much water"?! Too much water? Can someone really die while dancing because they had too much water?

I replied:

Well, yes and no. It's not really the water itself that's the problem. It's the problem of maintaining a proper water-sodium balance.
If you're up dancing all night long, you lose a lot of water and sodium through your sweat. If you drink nothing but water, you replace the water lost through sweat but not the sodium. As you continue to dance, your blood sodium levels continue to drop.

The condition of abnormally low blood sodium levels is called hyponatremia. Symptoms of mild to moderate hyponatremia include nausea, muscle cramps, disorentation and confusion. Extreme hyponatremia can cause seizures, a coma or even death. The fact that you and everybody around you is cracked out probably means that you (and your friends) are less likely to identify when you have a problem and need treatment.

Cutting down on the amount of water you drink is not a good solution. Hyponatremia can occur when you are dehydrated as well.

The best solution is probably to (a) cut down on the amount and duration of dancing (and sweating), and (b) drink plenty of sodium-rich fluids (like Gatorade). Dancing all night on a sweaty dancefloor is like any other endurance event. You wouldn't run a marathon or compete in an Ironman without replacing both water and sodium, so why would you dance and sweat all night long without replacing them as well?