ECSTASY USE RISES DESPITE BRAIN DANGER

The drug MDMA - better known on the streets and dance clubs as ecstasy or
XTC - is rising in use and popularity among young people, despite a growing
body of evidence that it can cause brain damage.

While drug use among American teenagers in junior high and high school held
steady for the most part in 1999, the use of MDMA/ecstasy rose slightly,
according to the annual "Monitoring the Future" report by the University of
Michigan Institute for Social Research (ISR). The report found that ecstasy
use increased among the older teens, specifically 10th and 12th graders.

"The base numbers for high school use rates of ecstasy are really quite
small, and the increase this year was small," says Alan I. Leshner, director
of the National Institute on Drug Abuse. An estimated 4.4% of 1999's
surveyed 10th graders reported some use of ecstasy during the prior 12
months, up from 3.3% in 1998. Among 12th graders, 5.6% admitting use of the
street drug, up from 3.6% in the previous year.

But that's only the tip of the iceberg.

According to the Drug Enforcement Administration (DEA), areas of
concentrated ecstasy use include California, Texas, Florida, New York, and
New England. But, Leshner points out: "We know from the community
epidemiology workgroup that in virtually every city in this country, we're
seeing substantially larger numbers of older young adults, those beyond high
school, using ecstasy, and that causes us great concern."

Designer drug

MDMA/ecstasy is a synthetic, psychoactive drug with hallucinogenic and
amphetamine-like properties. Its chemical structure -
3,4-methylenedioxymethamphetamine - is similar to two other synthetic drugs,
MDA and methamphetamine, both of which have been shown to cause brain
damage.

Because it is a substance that is a chemical analog or variation of another
psychoactive drug, ecstasy is a so-called "designer drug." It's also known
as a "club drug" because of its popularity at music clubs, rock concerts and
"raves" - large, organized, dance parties.

So where did MDMA come from and how long has it been around?

According to UCLA psychopharmacologist Ronald K. Siegel, the German
pharmaceutical company Merck filed for a patent on MDA in 1912, but the
patent was allowed to expire without being used. In the mid-1950s MDA and
the derivative MDMA turned up in laboratories commissioned by the U.S. Army
to research various hallucinogens and other substances as potential truth
serums. Although unsuitable for this purpose, MDA became popular in the
recreational drug culture in the 1960s

By the early 1970s, MDMA was identified as a street drug. It acquired its
present name - ecstasy or XTC - in the early 1980s. About the same time, its
popularity began to rise in the USA, quickly garnering a reputation as "the
feel-good drug," often symbolized by the "Have a Nice Day" happy face.

According to users, ecstasy produces an easily controllable altered state of
consciousness with positive emotional and sensual overtones. As one user
puts it: "The drug removes all your neuroses. It takes away your fears, and
you feel an overwhelming sense of peace. You feel open and close to other
people, and all anger, selfishness or defensiveness dissipates. You also get
real insight into yourself, which you hold on to after the experience is
gone."

In fact, prior to 1985, "MDMA was used by some psychiatrists and
psychologists as an aid in psychotherapy," says Siegel, to break down
psychological barriers and ease tensions between patients, lovers, and/or
family members.

Dangerous drug

But in the mid-1980s, researchers established that MDA was neurotoxic in
animals. In June 1985, the DEA banned MDMA, placing the drug alongside
heroin, LSD, and MDA on the Schedule I classification list of the Controlled
Substances Act. Schedule I drugs are defined as dangerous compounds that
have a high potential for abuse and no medical usefulness outside of
experimental settings.

In spite of its illegal status - or perhaps because of it - use of the drug
became increasingly fashionable. But along with the ecstasy came the agony.

Many of the negative side effects and aftereffects of MDMA use are similar
to those found with the use of amphetamines and cocaine:

Confusion Depression Sleeping problems Craving more or other drugs Anxiety
Paranoia, during and sometimes weeks after ingestion Psychoses

Ecstasy can also impart such physical symptoms as:

Muscle tension Involuntary grinding or clenching of the teeth Nausea Blurred
vision Rapid eye movements Faintness Chills or sweating Increases in heart
rate and blood pressure Serious or fatal heat injury Fluid and electrolyte
depletion

"This is not a benign fun drug," says Leshner. "One of the big issues with
ecstasy is that young people just don't know what the dangers are."

The real problems are the unseen, long-term effects of using the drug.
Chemically, MDMA increases the secretion of serotonin - an important
neurotransmitter - in the brain's synapses and inhibits the reuptake of
serotonin. While several antidepressant medications and natural substances
do the same thing, MDMA exacts a price.

"Ecstasy damages very important brain circuitry," says Leshner. "It destroys
serotonin and dopamine neurons. Not only has that been shown in animals,
it's now been documented in humans. Those effects have residual,
long-lasting consequences that get expressed in memory function, cognitive
function and in mood disturbances."

Researchers don't know just how much ecstasy it takes to damage the brain.
"But there are cases where people have died the first time they tried
ecstasy, and we don't know why," Leshner says.

Ecstasy also can cause hyperthermia, or overheating of the body. "If you go
into a rave, in an enclosed space where the ambient temperature goes up
tremendously, you could get your body temperature up to lethal heights if
you're particularly susceptible," says Leshner. "And one of the problems
with all drugs is that you can't predict what your individual susceptibility
is."

As with all street or club drugs, you never really know what you're getting.
A large number of substances are sold under the name of ecstasy or XTC,
including amphetamine, ketamine, PCP, even caffeine, as well as a range of
over-the-counter medicines.

What to do

How can you determine if your child is doing ecstasy or something being
called XTC? The only foolproof way, says Siegel, "is to ask them." Even if
they deny it, be vigilant. "If you know your child is going to raves," warns
Leshner, "you need to begin with the assumption that your child is likely to
be exposed. Ecstasy and the other club drugs are tremendously prevalent
compounds at these scenes."

What do you do then?

"The message for any drug use," says Leshner, "is always the same."

Talk to your kids about what's going on in their lives, and go beyond their
drug use. "If you just hone in on their drug use, they'll hate you," he
cautions.

Become involved in what your kids' problems are, who their friends are, what
they're thinking about.

Once you become sincerely involved in the whole life of your child, says
Leshner, "you can then begin to engage in serious, heartfelt discussions
about drug use."