Ecstasy
From Drug Rehab Wiki
Ecstasy (or MDMA) is a psychoactive amphetamine drug with psychedelic and stimulant effects. When ingested, it creates a sense of intimacy with others and diminished feelings of fear, anxiety, and depression. It is one of the most widely used recreational drugs in the world and is commonly associated with dance parties (or "raves") and electronic dance music. Studies suggest that long-term use of MDMA may cause brain damage. Ecstasy or MDMA (3, 4-mthylenedioxy-methamphetamine) is listed by the DEA as a Schedule I drug which has no legitimate medical use or manufacturer in the U.S. Its use, possession and distribution are illegal. Ecstasy is also called X, XTC, E).
Contents |
Origin and History
Ecstasy was originally developed in 1912 by the German chemist Anton Kollisch at Merck and Company in Darmstadt, Germany. It was created in efforts to develop a medication for vasoconstriction and an aid to clotting of the blood to prevent excessive bleeding. MDMA was researched by the CIA in the 1950s for its truth serum potential and by SmithKline Pharmaceutical for its antidepressant effects. It was used in psychotherapy in the 1980s to treat a range of issues from family discord to PTSD. Non-medical and illicit use, however, has far exceeded any of its medical uses.
Alexander Shulgin
Pharmacology researcher Alexander Shulgin is credited with the introduction of MDMA to popular use. Shulgin was born in Russian and immigrated to the U.S. in 1925. He obtained a PhD in biochemistry from the University of California at Berkeley. Shulgin worked in various capacities in pharmacological research including employment as a senior research chemist at Dow Chemical. Shulgin worked privately for some time specializing in psychopharmacology in which he studied the use of psychoactive and psychedelic substances. During the time of his private research, Shulgin worked in collaboration with the DEA as a private consultant.
Shulgin developed a new synthesis process for MDMA based on the original research done by Merck and Company in 1912. Using himself as the subject, he produced the first human studies research for the drug. Shulgin introduced MDMA to the Californian psychologist Leo Zeff in 1976. Zeff used MDMA as an augmentation to therapy and introduced MDMA to many psychologists. The name “Ecstasy” is thought to have been first used in California in the mid-1980s. By 1985 MDMA had became a Schedule I controlled substance. As a Schedule I drug MDMA was categorized along with heroin and LSD as a substance with no legitimate medical use that is illegal to manufacture, possess or sell in the United States. Most other countries now have similar laws. Between the years 1976 and 1985 the consumption of MDMA in the United States rose from 10,000 doses in one year to 30,000 doses in one month.
Method of Use
MDMA is primarily used in tablet form although it can be formulated in powder and liquid and has been found in capsule form. Typically ingested orally, smoking, intranasal use and injection have been reported.
Effects of Use
MDMA has both stimulant and hallucinogenic effects and is known as an entactogen and empathogen. These are terms used to describe the effects of MDMA and its chemical structure. Entactogens are classified as phenethylamines, substances of abuse that are similar in structure to amphetamines. As an empathogen, MDMA induces and enhances mood-altering experiences that include empathy, openness, emotional responsiveness and a sense of intimacy with others. Both terms, entactogen and empathogen, refer to the same drugs and are used interchangeably.
Biochemical Effects of MDMA
MDMA induces high concentrations of neurotransmitters that cause the characteristic and desired effects of its abuse.
MDMA dramatically affects the serotonin level by inhibiting the reuptake of serotonin and increasing its production. Increased serotonin levels act directly upon the brain’s reward center producing pleasure, euphoria and hyperactivity. MDMA’s serotonergic effect is stronger than that of amphetamines.
MDMA causes elevated levels of dopamine due to inhibition of dopamine reuptake. Dopamine induces hyperactivity, pleasure and euphoria with similar dynamics as serotonin.
Adverse Effects of MDMA
The negative effects of MDMA include psychological and biological distress. Psychologically MDMA can cause the type of severe and distressful “trip” typically associated with other hallucinogens such as LSD. Tolerance to MDMA develops with prolonged use resulting in significant neurological consequences including the depletion of serotonin, the reduction of serotonin synthesis and inference with nerve cell receptor functioning. Consequently, with continued use the desired effects of MDMA decline over time. An episode of use can result in an impaired sleep cycle, mood disturbance and memory deficits that persist for weeks. Prolonged use appears to predispose one to depressive illness due to its interference with neurotransmitter functioning. Other possible adverse effects of MDMA include:
• tachycardia
• nausea
• vomiting
• anxiety
• panic
• stroke
• paralysis
• Parkinsonian symptoms
• kidney failure
• liver failure
• shivers
• Buxism (grinding teeth)
• muscle stiffness
• dehydration
• memory loss
• lack of co-ordination
• depression
• paranoia
• body temperature dysregulation
• unconsciousness
MDMA Fatalities
MDMA has been associated with near-death events and fatalities due to neurological effects in which hypertensive emergencies are precipitated by use resulting in vascular disruption in the brain. Subarachnoid hemorrhage, cerebral infarction and intracranial bleeding have been reported. There have also been cases related to tainted drugs bought at clubs.
A significant number of fatalities have occurred due to the use of MDMA in club settings. The stimulant effects of the drug cause users to exert themselves for long periods in which dehydration, heat stroke, rhabdomyolysis (breakdown of muscle), hyperthermia (elevated body temperature) and kidney failure can occur.
Hyponatremia, an electrolyte imbalance, resulting in deficient sodium levels in the blood, can be caused by the use of large quantities of fluids for body temperature regulation in club settings. Subsequent cerebral swelling and seizures can result in fatalities.
Fatal heart arrhythmias, liver toxicity and liver failure have also been linked to MDMA-related deaths.
Abuse and Dependence
MDMA use for some individuals meets the diagnostic criteria for the disorders of substance abuse and substance dependence as given in the Diagnostic and Statistical Manual of Mental Disorders (DSM). MDMA is therefore considered an “addictive” substance.
Treatment
Treatment for MDMA abuse and dependence involves use of typical treatment modalities for other substance disorders. These include cessation of use, detoxification, individual and group therapy, family counseling, education, cognitive behavioral therapy, nutrition, exercise, relaxation, stress management and self-help groups.
