The National Institute of Drug Abuse describes it as a drug that has similarities to amphetamine and mescaline.
MDMA was originally used for treatment of various types of psychological disturbances and as an aid to therapy: however, it also became a popular drug of abuse due to the euphoria and strong social feelings the drug produces. At first, the drug was very popular drug in nightclubs and was used primarily by young Caucasians. The drug now is used by a more varied group of individuals, but still is most popular with younger individuals.
Facts about Ecstasy
- MDMA is known by a variety of names, such as ecstasy, Molly, XTC, X, disco biscuits, happy pill, hug drug, and vitamin X.
- It is classified by the United States Drug Enforcement Administration as a Schedule I drug, indicating that the drug has a high potential for addiction and is also potentially dangerous.
- Molly is most often taken in powder form or as a capsule, whereas ecstasy is taken in a pill form that may contain other drugs, such as caffeine PCP, or amphetamines. However, ecstasy and Molly refer to the drug MDMA in some form or another.
- Ecstasy use results in the release of the neurotransmitter serotonin, dopamine, and norepinephrine, leading to a rush of energy and also resulting in hallucinogenic effects.
- The drug produces increased energy, feelings of empathy towards others, emotional warmth, and sensory distortions.
- It is believed that the emotional and social feelings many users of ecstasy experience are caused by the release of the neurotransmitter serotonin, which is also believed to play an important role in mood regulation.
- Serotonin release in the brain also leads to the release of hormones, such as vasopressin and oxytocin, which have been linked feelings of love, trust in others, and sexual attraction and arousal. Thus, the hormones that are released as a result of using ecstasy may contribute to the feelings of emotional closeness to others that users experience when taking the drug.
- After individuals use ecstasy, it is not uncommon for them to experience depression 1-2 days later as part of a “crash,” due to depletion of neurotransmitters in the brain.
A number of side effects have been reported following use of ecstasy. Because ecstasy has stimulant properties, and is often taken in crowded social settings such as dance clubs, a rare but potentially dangerous side effect that can potentially occur is hyperthermia, an increase in body temperature. This rapid increase in body temperature can lead to a number of potential health concerns, such as overheating or dehydration. If it occurs, it should be treated immediately.
Other immediate side effects of ecstasy use may include:
- Blurred vision
- Excessive sweating
- Clenching or grinding the teeth
- Muscle cramps
Other unpleasant side effects occur following the use of ecstasy. These side effects can last relatively long after a person uses the drug, sometimes a week or even longer. They include:
- Irritability, with or without restlessness
- Loss of appetite
- Anxiety and feelings of dread
- Aggressive behavior
- A tendency to be impulsive or to act without thinking
- Insomnia or other issues with sleep
- Feeling extremely thirsty
- Anhedonia, or being unable to experience enjoyment or pleasure in things that used to be enjoyed
- Reduced interest in sexual activities
- Cognitive decline, including issues with attention, memory, and abstract reasoning
Because the drug results in such a massive release of so many different neurotransmitters in the brain, there is a compensatory lack of available neurotransmitters after one uses the drug. This decrease in available neurotransmitters is believed to be responsible for many of the immediate side effects that occur following the use of ecstasy. The cognitive aftereffects of ecstasy use can lead to potentially harmful situations, such as a greater probability of having a car accident or some other mishap due to forgetfulness or problems with attention.
The cognitive effects of ecstasy can also continue if an individual uses the drug habitually. These long-term cognitive effects are also believed to be related to potential neurotransmitter depletion and damage to the neural circuitry in the brain. Other potential harmful long-term effects of ecstasy abuse include:
- High blood pressure
- Cardiovascular issues, such as arrhythmias or potential heart failure
- Kidney failure
- Potential liver problems
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Is MDMA (Ecstasy) Addictive?
According to the National Institute of Drug Abuse, some individuals develop physical dependence (tolerance and withdrawal) on MDMA, and animal models suggest that it is addictive. As mentioned above, the United States Drug Enforcement Agency classifies it with other drugs that have a high potential for addiction. However, many sources report that the addictive properties of ecstasy may be mostly psychological.
There are several important considerations regarding ecstasy use that point to the potential for abuse and/or addiction:
- While ecstasy is a pill that contains MDMA, it often contains other potentially dangerous and addictive drugs, such as PCP or cocaine. Thus, even if MDMA is not addictive, many of the other substances in pills sold as “ecstasy” may have the potential for addiction.
- Tolerance to ecstasy develops rapidly, such that individuals will take increasingly higher amounts of the drug to achieve the same effects they used to achieve with smaller doses. This means that the potential for negative side effects will also increase over time.
- Because depression and other effects that occur when one stops taking the drug are so powerful, many ecstasy users start taking other drugs such as heroin to counteract these feelings.
- Individuals who use ecstasy regularly may begin to believe that they can only achieve feelings of euphoria, empathy, love, etc. when they take the drug. This leads to increased potential for psychological addiction.
Signs and Symptoms of Ecstasy Use/Abuse
People, especially younger people, who frequent clubs are at risk for taking designer drugs like ecstasy. High school students who use other drugs are also at high risk for using these drugs. Though people from various age groups use ecstasy, those between 16 and 24 years old are most likely to use the drug.
If a person is abusing ecstasy, the following signs might be apparent:
- Exhibiting a sudden rush of energy or is hyperactive
- Unusually high levels of energy
- Dancing for long periods of time
- Sweating excessively
- Complaining of chills
- Clenched jaw or grinding teeth
- Muscle cramps
- Dilated pupils
- Overheating rather easily
- Being unusually friendly and talkative
- Appearing very sensitive to light or sound
- Appearing to have a dulled sense of pain
- Becoming very “touchy/feely” and even exhibiting unusual satisfaction or pleasure from touching or being touched
If the person has been abusing ecstasy regularly, treatment options will include therapy, perhaps combined with a prescription for medications to treat specific issues, such as antidepressant medications that might address the depression and sadness that individuals experience when they discontinue use of the drug. There are no drugs that are specifically designed to assist with recovery from ecstasy addiction/abuse.
Therapy most often consists of Cognitive Behavioral Therapy (CBT) or therapy that uses the principles of CBT. CBT or any therapy for recovery from ecstasy abuse can either be performed on an individual basis or in a group format, with other recovering individuals. CBT attempts to:
- Assist the individual with identifying personal expectations regarding use of the drug.
- Identify misconceptions that the person has about drug use, happiness, success, etc.
- Help the individual to recognize irrational modes of thinking and irrational expectations.
- Assist the individual in developing new coping strategies that reflect more realistic expectations.
- Assist the individual in developing a support group.
- Identify potential pitfalls and signs of relapse.
- Prepare the individual for long-term recovery.
In addition, individuals have the option of attending community support groups such as 12-Step groups or other peer support groups. Twelve-Step groups are often strong sources of social support that provide structure for individuals who are willing to follow the principles of the group.
Yes. Even pure MDMA is associated with life threatening toxicity at high enough doses. As much of the illicit product is adulterated with other substances with significant physiological effects, overdose risks may be even greater. Additionally, as ecstasy is frequently taken in a setting of polysubstance consumption (e.g., concurrent use of ecstasy and alcohol, cocaine, DXM, etc.), overdose risks are compounded accordingly.
There are several potential life-threatening syndromes of toxicity associated with ecstasy use, including significant cardiovascular, hepatic (liver), and renal (kidney) issues. Perhaps the most commonly reported life-threatening emergency results from severe hyperthermia—or pathologically elevated body temperature—which may result from direct drug effects coupled with increased activity (e.g., dancing), warm environments, and dehydration.
It is difficult to precisely gauge the number of deaths from ecstasy in the U.S. because many sources that provide morbidity and mortality statistics report a pooled number of “psychostimulant”-related deaths which, in addition to MDMA, includes fatalities that occurred in association with substances like Adderall and Ritalin. Also complicating this picture are the issues of purity (many ecstasy street samples test for additional substances) and prevalent co-occurring use with other drugs that could be increasing the mortality estimates.
Though the duration of action will be influenced by the full range of substances actually present in an ecstasy tablet, people may feel the initial euphoric effects of MDMA for half an hour to an hour, with other subjective effects persisting for several hours beyond that.
Symptoms are generally relatively mild and might include fatigue, depression, anxiety, concentration difficulties, and some body aches and pains.