MDMA (Ecstasy)

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MDMA is a synthetic, psychoactive drug with both stimulant (amphetamine-like) and hallucinogenic (LSD-like) properties. Street names for MDMA include Ecstasy, Adam, XTC, hug, beans, and love drug. Its chemical structure (3-4 methylenedioxymethamphetamine, "MDMA") is similar to methamphetamine, methylenedioxyamphetamine (MDA), and mescaline - other synthetic drugs known to cause brain damage.

MDMA also is neurotoxic. In addition, in high doses it can cause a sharp increase in body temperature (malignant hyperthermia) leading to muscle breakdown and kidney and cardiovascular system failure.

Raves

from School Health Reporter, Winter 2004
By Eric Sigel, MD, The Children's Hospital

Recognizing what raves are is important to understanding the evolution of club drugs into popular culture. Raves began in the late ’80s; they are all-night dance parties that began underground, hidden from the law and from conventional culture. They represented an alternative to mainstream socialization, an outlet for teens and young adults who did not identify with the popular peer groups. Because of the desire to stay separate and away from the law, notices would go out at the last moment, letting concert-goers know where the upcoming event was being held – usually in abandoned warehouses and remote areas of the countryside. The music initially was noncommercial, computer-generated that reflected the techno age. It has been described as repetitive, remorseless, loud and fast, surging past the listener in mind-numbing waves. Over the last 10 to 15 years, the music of raves has evolved into a new genre, appealing to a wide range of teenagers and adults. Different types of music within this genre that have arisen are referred to as “techno,” “house” and “trance,” among others. Raves also have become mainstream. It is easy to log on to the Internet and find where a rave is being held on any given night. Concert promoters sponsor raves at the major concert venues in every city.

The link between raves and drugs can be found in part by the nature of raves. Typically raves last all night. Dancing to techno music is an essential component of the rave. Drug use helps participants stay up all night, and then come down when dawn arrives. Additionally, the hallucinogens enable people to dismiss classic social barriers and let them connect to peers – regardless of sex, ethnic background or social class. Some of the more frequently used drugs at raves include Ecstasy, GHB, ketamine, rohypnol and methamphetamine.

Ecstasy is an amphetamine that has hallucinogenic properties similar to mescaline. People use Ecstasy to achieve the effect of increasing one’s sensory input. People report that they feel extremely happy, peaceful and euphoric with enhanced sensation from touch and other sensory systems. Social inhibitions disappear, sexual sensation is increased and people feel close or connected to others. Originally psychiatrists used Ecstasy with their patients, as it was found to decrease patients’ inhibitions, allowing them to talk freely and openly. Once the physical danger of Ecstasy was realized, it became a banned substance.

Ecstasy is the one drug whose usage has increased dramatically over the last five years, though for the first time in 2001 the rate of increase has slowed somewhat. Nearly 12 percent of high school seniors have tried Ecstasy at least once in their lifetime. There has been increased media attention focused on Ecstasy use, both due to the rapid rise in use as well as much-publicized deaths from using Ecstasy. Ecstasy is readily available, with more than 50 percent of high school students saying they could obtain it easily. Ecstasy comes in a tablet form that is often branded, as Playboy bunnies, Nike swoosh, CK. People believe that each insignia means it has a slightly different effect. It can be made in home labs, though most often it is imported from Europe . Studies have shown anywhere from 0 mg to 140 mg of MDMA present in any given pill. Average dose is 100 mg. One teaching point for patients is that one has no control over what is actually in the tablet; it may be cut with any one of a number of drugs that are undesirable to the user. Ecstasy is taken orally in pill form. Onset of action begins 20 minutes after ingestion and can last up to six hours. Toxicity is potentiated when taken with alcohol.

Deaths from Ecstasy use have been attributed to a wide range of medical complications, including muscle breakdown, elevated body temperature, blood clotting abnormalities, liver damage, heart arrhythmias, stroke and suicide. Studies have shown impaired cognitive performance occurring in those individuals who have used Ecstasy recreationally, performing worse in complex tasks of attention, memory and learning tasks, and tasks that reflect general intelligence. Performance is worse with heavier use of Ecstasy.

Short-term psychological difficulties associated with Ecstasy use include confusion, depression, sleep problems, drug craving, severe anxiety and paranoia, during and sometimes weeks after taking the drug. Additional psychologic effects include increased physical complaints, obsessive thoughts and hostility.

There are myths about Ecstasy use that school personnel will encounter frequently with the students they work with. Many believe that if one uses Ecstasy “the right way” there will be no adverse effects. The right way includes drinking the appropriate fluids, not getting overheated and having enough energy in the system. As with any drug, people believe they cannot get addicted to Ecstasy, which is false. Since there is so much appeal to Ecstasy use, counseling is important in the early teen years.from School Health Reporter, Winter 2004
By Eric Sigel, MD, The Children's Hospital

Depending on your level of addiction to Ecstasy, you may neeed a specific type of treatment. There are many terms that are used to describe clinical actions related to Ecstasy. Some terms you may have come across are: Ecstasy Detox Center, a Ecstasy Rehab, Ecstasy Treatment, Ecstasy Addiction Treatment, Ecstasy Addiction Counseling, Ecstasy In-Patient Treatment and Ecstasy Out-Patient Treatment.

Health Hazards

Brain imaging research in humans indicates that MDMA causes injury to the brain, affecting neurons that use the chemical serotonin to communicate with other neurons. The serotonin system plays a direct role in regulating mood, aggression, sexual activity, sleep, and sensitivity to pain. Many of the risks users face with MDMA use are similar to those found with the use of cocaine and amphetamines:

• Psychological difficulties, including confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia - during and sometimes weeks after taking MDMA.
  
  
• Physical symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, and chills or sweating.
  
  
• Increases in heart rate and blood pressure, a special risk for people with circulatory or heart disease.
  
  
• Also, there is evidence that people who develop a rash that looks like acne after using MDMA may be risking severe side effects, including liver damage, if they continue to use the drug.
  
  

Research links MDMA use to long-term damage to those parts of the brain critical to thought and memory. One study, in primates, showed that exposure to MDMA for 4 days caused brain damage that was evident 6 to 7 years later.

MDA, the parent drug of MDMA, is an amphetamine-like drug that has also been abused and is similar in chemical structure to MDMA. Research shows that MDA also destroys serotonin-producing neurons in the brain.

MDMA also is related in its structure and effects to methamphetamine, which has been shown to cause degeneration of neurons containing the neurotransmitter dopamine. Damage to these neurons is the underlying cause of the motor disturbances seen in Parkinson's disease. Symptoms of this disease begin with lack of coordination and tremors and can eventually result in a form of paralysis.

Increases in heart rate and blood pressure, a special risk for people with circulatory or heart disease.
Beliefs about MDMA are reminiscent of similar claims made about LSD in the 1950s and 1960s, which proved to be untrue. According to its proponents, MDMA can make people trust each other and can break down barriers between therapists and patients, lovers, and family members.

Depending on your level of addiction to Ecstacy, you may neeed a specific type of treatment. There are many terms that are used to describe clinical actions related to Ecstacy. Some terms you may have come across are: Ecstacy Detox Center, a Ecstacy Rehab, Ecstacy Treatment, Ecstacy Addiction Treatment, Ecstacy Addiction Counseling, Ecstacy In-Patient Treatment and Ecstacy Out-Patient Treatment.