WHAT ARE THE EFFECTS OF THE DRUG ECSTASY?

Susan Merle Gordon, director of research at the Caron Foundation,
provides this description of the popular club drug and its effects.

Ecstasy is a commonly used name for the chemical substance
methylene-dioxymethamphetamine, which is abbreviated as MDMA. Ecstasy
is comprised of chemical variations of amphetamine or methamphetamine
(stimulants) and a hallucinogen, such as mescaline. In addition to
MDMA or the related compounds MDEA and MDA, drugs sold on the street
as Ecstasy also contain other psychoactive or mind-altering drugs,
like caffeine, ephedrine, selegiline and ketamine [1]. Numerous
illegal laboratories produce MDMA and use a wide variety of drug
combinations, some of which are more lethal than others.

MDMA is produced in tablet or capsule form and is usually taken
orally, although there are documented cases of intravenous use [2].
MDMA's acute effects last from three to eight hours [1] and its
short-lasting effects include feelings of euphoria, enhanced mental
and emotional clarity, sensations of lightness and floating and other
hallucinations. Users of MDMA also have suppressed appetite, thirst
or need to sleep. Sometimes users who are attending two- to three-day
parties suffer from severe dehydration or exhaustion [1].

Other unpleasant and/or dangerous acute effects include feelings of
depersonalization, elevated anxiety, muscle tension, involuntary
teeth clenching, nausea, blurred vision, faintness, chills and
sweating, hypertension, tremors, seizures and increased body
temperature. It is very possible to overdose on MDMA; these overdoses
may produce fatality by heart failure or extreme heat stroke [3].

Increase in MDMA Abuse

MDMA is relatively inexpensive and easily accessible, especially in
the northeastern part of the U.S. and western Europe. Most MDMA found
in the U.S. has been manufactured abroad and smuggled into the
country. It is estimated that more than two million tablets of MDMA
are smuggled into the U.S. each week [3].

Abuse of MDMA has significantly increased, by 500 percent, from 1993
to 1999. In 1993 only 196 tablets of MDMA were submitted to the Drug
Enforcement Agency (DEA) laboratories; in 1998, 143,600 tablets were
confiscated and submitted to the DEA. Likewise, in 1993 only 79 cases
of MDMA overdose were reported by hospital emergency rooms; in 1999,
however, emergency rooms reported 2,850 MDMA cases [3].

MDMA often is used by adolescents and young adults at dance clubs,
all-night dance parties (raves) and rock concerts. Use by young
people sharply increased in 1999 from prior years of decline.
Approximately one in 20 10th- and 12th-grade students reported they
had used MDMA at least one time in 1999. MDMA appears to be easily
available to young people, especially in the northeastern U.S. The
proportion of high school seniors who think that MDMA is easy to
obtain doubled from 1991 to 1997 [4].

Negative Consequences of MDMA Abuse

It is believed that many of the negative consequences of MDMA are a
the result of the destruction of serotonin-producing neurons in the
brain [5]. Serotonin is a brain chemical that plays an important role
in regulating mood, aggressive behavior, sexual activity, sleep, and
pain sensitivity. Some research also has linked a decrease in
serotonin activity to cognitive problems, such as memory processes
[5].

Research studies on nonhuman primates have found decreases in
serotinin activity for as long as seven years following MDMA exposure
[5]. Some scientists think that humans may be more susceptible to
brain damage than are other primates. Cumulative doses of MDMA that
are taken by moderate users over a prolonged time period may have
similar negative consequences to the high experimental doses given
within short time periods to nonhuman primates[5].

Other naturalistic research studies that assess the psychological and
cognitive functioning of people who abuse MDMA also find long-lasting
impairments. A recent review of the major research studies on MDMA
concluded that there is a body of evidence that links heavy and
prolonged MDMA use to confusion, depression, sleep problems, severe
anxiety, and aggressive and impulsive behavior [1].

Because many regular users of MDMA also use marijuana, a recent
research study compared people who use both marijuana and MDMA with
people who use only marijuana and to people who use neither drug. The
study found that MDMA users performed worse than the other two groups
on complex cognitive tasks of attention, memory, learning and general
intelligence. People who heavily used MDMA and marijuana had lower
levels of cognitive performance than lighter users [5]. Other
research has confirmed that moderate to heavy use of MDMA is linked
to impairments in memory [1].

Although MDMA generally is not considered to be an addictive
substance, recent reports in the scientific literature suggest that
some people may become dependent on or addicted to the drug. Most
people who use MDMA restrict their use to weekends because frequent
use quickly reduces the positive effects as tolerance to the drug
develops [1]. Tolerance is a major symptom of drug dependence.
Withdrawal symptoms are also among the necessary criteria for
dependence. Another important symptom of drug dependence is
difficulty in controlling or abstaining from drug use despite
negative social, psychological or physical consequences.

A case study of three young, male, heavy and prolonged MDMA users
identified these symptoms of dependence. All three realized that
their daily functioning had become impaired as a result of MDMA; they
each unsuccessfully attempted to abstain from the drug; and during
detoxification, they experienced fatigue, low mood, anxiety and sleep
disturbances as withdrawal symptoms. The authors concluded that each
of the three cases met criteria for MDMA dependence [2].

Conclusions

MDMA is marketed by street drug dealers as a "safe," nonaddictive
recreational drug that enhances a person's enjoyment and ability to
interact with others. Nothing could be further from the truth. Even
occasional light users of MDMA risk overdose and premature death.
Moderate to heavy users risk addiction, as well as long-term
impairments in psychological and cognitive functioning. All users of
MDMA at least temporarily lose their ability to relate to and enjoy
being with other people without the influence of a mind-altering,
dangerous substance.

RELATED LINKS:

Ecstasy's Legacy

Popular Club Drug May Impair Memory

FURTHER READING:

1. Morgan, J.M. (2000). Ecstasy (MDMA): A review of its possible
persistent psychological effects. Psychopharmacology, 152: 230-248.

2. Jansen, K.L.R. (1999). Ecstasy (MDMA) dependence. Drug and Alcohol
Dependence, 53: 121-124.

3. U.S. Department of Justice, Drug Enforcement Administration.
(accessed February 12, 2001). MDMA (Ecstasy) [On-line]. Available:
http://www/usdoj.gov/dea/concern/mdma/mdma/htm.

4. Johnston, L.D., O'Malley, P.M., Bachman, J.G. (2000). The
Monitoring the Future National Results on Adolescent Drug Use:
Overview of Key Findings, 1999. (NIH Publication No. 00-4690).
Bethesda, MD: National Institute on Drug Abuse.

5. Gouzoulis-Mayfrank, E., et al. (2000). Impaired cognitive
performance in drug free users of recreational ecstasy (MDMA).
Journal of Neurology, Neurosurgery, & Psychiatry, 68: 719-725. July
05, 2001