MDMA (3,4-methylenedioxymethamphetamine) is a synthetic, psychoactive drug that is chemically similar to the stimulant methamphetamine and the hallucinogen mescaline. MDMA produces feelings of increased energy, euphoria, emotional warmth, and distortions in time, perception, and tactile experiences. The origin of the drug MDMA was patented in 1913 (patent #274. 350) by the German chemical company Merck supposedly to be sold as a diet pill (the patent does not mention any intended use), the company decided against marketing the drug and had nothing more to do with it.
The US army experimented with MDMA in 1953, possibly as truth serum. They have not revealed their reasons. MDMA is taken orally, usually as a capsule or tablet. Ecstasy is nearly always swallowed as a tablet or capsule. However, ecstasy is occasionally snorted, smoked or injected. It was initially popular among Caucasian adolescents and young adults in the nightclub scene or at weekend-long dance parties known as raves. More recently, the profile of the typical MDMA user has changed, with the drug now affecting a broader range of ethnic groups.
MDMA is also popular among urban gay males—some report using MDMA as part of a multiple-drug experience that includes marijuana, cocaine, methamphetamine, ketamine, sildenafil (Viagra), and other legal and illegal substances. MDMA has the full chemical name of ‘3,4 Methylene-dioxy-N-methyl amphetamine’ or ‘Methylenedioxymethamphetamine’. The 3,4 indicates the way in which the components of the molecule are joined together, as it is possible to produce an isomer, which has all the same components but is joined differently.
Although it is derived from organic material, MDMA itself does not occur in nature, and must be created in a complex laboratory process. There are various popular street names for MDMA such as Ecstasy, E, Adam, X and Empathy. Ecstasy is small, round and has a chalky texture. They come in all colors and shapes and some have stamps on the front of them, which is used to name the pill. The thickness of the pill varies also. There are single, double, and triple stack pills and the thickness doesn’t necessarily determine the uality of the pill. Some break very easily and others are hard. Occasionally, ecstasy may come as a capsule, which can be yellow, pink or clear and very rarely as powder. MDMA exerts its primary effects in the brain on neurons that use the chemical (or neurotransmitter) serotonin to communicate with other neurons. The serotonin system plays an important role in regulating mood, aggression, sexual activity, sleep, and sensitivity to pain.
MDMA binds to the serotonin transporter, which is responsible for removing serotonin from the synapse (or space between adjacent neurons) to terminate the signal between neurons; thus MDMA increases and prolongs the serotonin signal. MDMA also enters the serotonergic neurons via the transporter (because MDMA resembles serotonin in chemical structure) where it causes excessive release of serotonin from the neurons. MDMA has similar effects on another neurotransmitter—norepinephrine, which can cause increases in heart rate and blood pressure.
MDMA also releases dopamine, but to a much lesser extent. MDMA can produce confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur soon after taking the drug or, sometimes, even days or weeks after taking MDMA. In addition, chronic users of MDMA perform more poorly than nonusers on certain types of cognitive or memory tasks, although some of these effects may be due to the use of other drugs in combination with MDMA.
Research in animals indicates that MDMA can be harmful to the brain. One study in nonhuman primates showed that exposure to MDMA for only 4 days caused damage to serotonin nerve terminals that was still evident 6 to 7 years later. Although similar neurotoxicity has not been shown definitively in humans, the wealth of animal research indicating MDMA’s damaging properties strongly suggests that MDMA is not a safe drug for human consumption. For some people, MDMA can be addictive.
A survey of young adult and adolescent MDMA users found that 43 percent of those who reported ecstasy use met the accepted diagnostic criteria for dependence, as evidenced by continued use despite knowledge of physical or psychological harm, withdrawal effects, and tolerance (or diminished response). These results are consistent with those from similar studies in other countries that suggest a high rate of MDMA dependence among users. MDMA abstinence-associated withdrawal symptoms include fatigue, loss of appetite, depressed feelings, and trouble concentrating.
MDMA can also be dangerous to overall health and, on rare occasions, lethal. MDMA can have many of the same physical effects as other stimulants, such as cocaine and amphetamines. These include increases in heart rate and blood pressure, which present risks of particular concern for people with circulatory problems or heart disease and other symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating. In high doses, MDMA can interfere with the body’s ability to regulate temperature.
On rare but unpredictable occasions, this can lead to a sharp increase in body temperature (hyperthermia), which can result in liver, kidney, cardiovascular system failure, or death. MDMA can interfere with its own metabolism (breakdown within the body), therefore, potentially harmful levels can be reached by repeated MDMA administration within short periods of time. Other drugs that are chemically similar to MDMA, such as MDA (methylenedioxyamphetamine, the parent drug of MDMA) and PMA (paramethoxyamphetamine, associated with fatalities in the United States and Australia) are sometimes sold as ecstasy.
These drugs can be neurotoxic or create additional health risks to the user. Furthermore, ecstasy tablets may contain other substances, such as ephedrine (a stimulant), dextromethorphan (DXM, a cough suppressant); ketamine (an anesthetic used mostly by veterinarians), caffeine, cocaine, and methamphetamine. Although the combination of MDMA with one or more of these drugs may be inherently dangerous, users who also combine these with additional substances such as marijuana and alcohol may be putting themselves at even higher risk for adverse health effects.
Short term effects of ecstasy are gives you energy, distorts time and perception, increases enjoyment from touching, inability to regulate temperature, sharp increase in body temperature, hyperthermia, heatstroke, Liver, kidney, and cardiovascular system failure, perceptual changes, anxiety, jaw-clenching, dry mouth, and appetite changes, blood pressure increases, headaches, chills, eye-twitching, blurred vision, nausea, dehydration, muscle tension, severe sweating, faintness, seizures, day-after depression. Heatstroke (hyperthermia) is the primary cause of death from ecstasy.
Taking ecstasy with in combination with other drugs, such as alcohol, can increase the risk. Long term effects of taking ecstasy are dramatic increase in heart rate, leading to serious complications for people with cardiovascular disease, dehydration can lead to liver and kidney failure, disturbing emotional reactions, confusion, depression, sleep, problems, drug craving, severe anxiety, and heart palpitations, symptoms last a long time after taking the drug, depletes the amount of serotonin in the brain and blocks uptake of serotonin, toxic to the brain, impairs memory, and brain damage is directly related to amount and frequency of usage.
There are no specific treatments for MDMA abuse and addiction. The most effective treatments for drug abuse and addiction in general are cognitive-behavioral interventions that are designed to help modify the patient’s thinking, expectancies, and behaviors related to their drug use and to increase skills in coping with life stressors. Drug abuse recovery support groups may also be effective in combination with behavioral interventions to support long-term, drug-free recovery. There are currently no pharmacological treatments for addiction to MDMA.
Antidepressant medications might be helpful in combating the depressive symptoms frequently seen in MDMA users who have recently become abstinent. Some treatments for ecstasy abuse are psychological therapy, which is a treatment of emotional, behavioral, personality, and psychiatric disorders based primarily upon verbal or nonverbal communication and interventions with the patient. Another treatment is counseling, talking to a social worker or psychotherapist. Emergency treatment is required for ecstasy overdose, severe symptoms, or acute complications.
After sharp declines in ecstasy use since its peak in 2000/2001, current and past-year use of MDMA has risen among 8th and 10th graders. This follows several years of decreases in the perceived risk and disapproval of using MDMA. In 2009, an estimated 760,000 people (0. 3 percent of the population) in the United States aged 12 or older used MDMA in the month prior to being surveyed. Lifetime use increased significantly among individuals aged 12 years or older, from 4. 3 percent (10. 2 million) in 2002 to 5. 7 percent (14. million) in 2009, however, past-year use of ecstasy decreased from 1. 3 percent to 1. 1 percent during the same period.
Approximately 1. 1 million Americans used ecstasy for the first time in 2009, which is a significant increase from the 894,000 first-time users reported in 2008. Global use of ecstasy group substances, estimated at 0. 2- 0. 6 per cent of the population aged 15-64 (between 10. 5 million and 28 million users), is at levels comparable to those of cocaine use. But while ecstasy use is on the decline in Oceania, where its prevalence remains high at 2. per cent, essentially reflecting the situation in Australia and New Zealand. There is evidence that there is a possible resurgence in ecstasy use in both Europe and the United States. References: 1- Ricaurte GA and McCann UD. Experimental studies on 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) and its potential to damage brain serotonin neurons. Neurotox Res 3(1):85–99, 2001. 2- Stone AL, Storr CL, and Anthony JC. Evidence for a hallucinogen dependence syndrome developing soon after onset of hallucinogen use during adolescence.
Int J Methods Psychiatr Res 15:116–130, 2006. 3- Cottler LB, Womack SB, Compton WM, Ben-Abdallah A. Ecstasy abuse and dependence among adolescents and young adults: Applicability and reliability of DSM-IV criteria. Human Psychopharmacol 16:599–606, 2001. 4- Leung KS, Cottler LB. Ecstasy and other club drugs: A review of recent epidemiological studies. Curr Opin Psychiatry 21:234–241, 2008. 5- Kraner JC, McCoy DJ, Evans MA, Evans LE, Sweeney BJ. Fatalities caused by the MDMA-related drug paramethoxyamphetamine (PMA). J Anal Toxicol 25(7):645–648, 2001.