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  HEALTHWIRE I AUGUST, 2002 I CONTACT: FRED MCTAGGART, Ph.D. (616) 344-1946
   
  Ecstasy: What Are Consequences?
   
 
   
  Ecstasy has made a notorious name for itself. Also known as "E" and "the hug drug," methylenedioxy-methamphetamine (MDMA) has recently been the subject of countless news accounts.

Americans are familiar with the images of raves, all night parties where the Ecstasy subculture is known to thrive. News segments have taken the viewer inside the rave, where young Ecstasy users are shown sucking on pacifiers, playing with glow-sticks and blowing on each other’s skin to the backdrop of flashing lights and electronic music.
Ecstasy use is rising among young people at a time when use of other drugs has leveled off or begun to decline. Because raves are alcohol-free, people of all ages may attend. As a result, studies show the drug becoming increasingly popular among high school students down to eighth grade.

Ecstasy use is also increasing on college campuses. According to one study, Ecstasy users were found more likely to spend a lot of time socializing, attend a residential college and belong to a sorority or fraternity. However, according to the researchers, Ecstasy users did not differ from other students in grade point average or commitment to community service and the arts. The reputation and novelty of the drug is thought to be responsible for the rise in Ecstasy use.

Dangers Widely Reported
The potential deadliness of the drug is widely stressed by the news media and anti-drug awareness groups. All too often, however, anti-Ecstasy messages are centered around a "just say no" rhetoric which provides little objective information about the drug. As a result, these prevention messages are not taken seriously, and Ecstasy, widely believed to be a "safe" drug, continues to gain popularity among high school and college students.
At a recent conference of the National Institute on Drug Abuse (NIDA), a panel of Ecstacy experts criticized the NIDA’s campaign of scare tactics, urging instead a realistic message that reflects both the drug’s attractions and the potential perils of abuse.
Claire Sterk, Ph.D. of Emory University’s Rollins School of Public Health, said: "We need to stop exaggerating the negative consequences and stop using extreme cases. . . We’ll be better off having a campaign [poster] that says, ‘Ecstasy can . . . make you feel really good’...It’s okay to acknowledge that. And then have a big comma and say, ‘But there are consequences.’”

Sterk and other experts advocated measures to reduce the harm of ecstasy on current users, including making certain plenty of water is provided at raves to prevent dehydration and offering purity tests to detect other harmful substances often present in Ecstasy tablets.

Ecstasy was discovered in 1912 by Merck Pharmaceutical company in Germany. Originally tested as an appetite suppressant, it was soon rejected due to its side effects and long remained forgotten. In the 1970s, the drug was rediscovered and used in conjunction with psychotherapy. Because it enhanced emotional warmth and feelings of closeness, MDMA was believed to be helpful in establishing patient/therapist communication.
In the early 1980s, however, MDMA became popular as a recreational drug and in 1985 was made illegal and classified a Schedule 1 drug, the most restricted type.
Although the drug can no longer be used for medical purposes, many continue to advocate MDMA for its potential therapeutic benefits. Studies are currently underway to test MDMA’s effectiveness in treating posttraumatic stress disorder (PTSD), with studies of its further therapeutic benefits under consideration.

MDMA belongs to a family of drugs known as "enactogens," having an effect similar to both stimulants and hallucinogens. Like these groups of drugs, MDMA affects receptors for the neurotransmitters dopamine and serotonin. Like serotonin specific reuptake inhibitors (SSRIs), it blocks the reuptake of serotonin. Unlike SSRIs, however, it also provokes the release of serotonin.

The drug produces a relaxed, euphoric state in which users feel at peace and accepting of both themselves and others. Although Ecstasy can, like hallucinogens, enhance sensory experience, users are rarely subject to visual distortions, sudden mood swings or psychotic reactions.

It can be smoked, snorted or injected but is almost always taken in the form of a pill. At normal doses of 100 to 125 milligrams, effects begin after 20 to 40 minutes and can last up to six hours.

Ecstasy users feel a boost of energy and are able to dance for hours without desire for food, drink or rest. Without rest and water consumption, the body temperature can rise to dangerously high levels, which can cause heat stroke, collapse and ultimately death.
Other immediate effects of the drug include increased heart rate and blood pressure, dry mouth, nausea and sometimes teeth grinding. Bruxism (or teeth grinding), a common side effect, can completely erode surfaces of the teeth, prompting many users to suck on infant pacifiers.

Feelings of depression and exhaustion are common in the days following Ecstasy use. A recent study was conducted to assess the mid-week effects of the drug on the mood of weekend Ecstasy users and to determine whether the effects differed for males and females. The researchers found that women were more susceptible than men to feelings of depression a half week after Ecstasy use; both male and female users showed increased self-rated aggression mid-week compared to their counterparts in a control group.
These changes in mood may be connected with neurotoxicity, or degeneration of brain serotonin (5-HT) neurons. Serotonin is a neurotransmitter that plays an important role in regulating mood, and low levels of serotonin are associated with clinical depression. One of the ways Ecstasy makes the user feel so good is by flooding the brain with serotonin, something that if done repeatedly could cause long-term damage to the serotonin-transmitting axons.

Although little is known about the long-term neurotoxic effects of Ecstasy use, studies suggest long-lasting, though possibly reversible, effects on memory, mood, impulsivity, logical reasoning and calculation.

In a recent article, Edward Skidelsky argued that Ecstasy, as opposed to other drugs which supposedly encouraged users to question the status quo, is a capitalist drug. “With Ecstasy,” he writes, “happiness has finally become a commodity. The Ecstasy user is the consumer par excellence; he consumes not merely the means to happiness, but happiness itself.” Ecstasy’s immediate effects are entirely predictable and are attractive to many; it is, in essence, brain candy.

Whatever its potential therapeutic benefits, MDMA has its share of negative effects. A dearth of information has led many to believe that the good outweighs the bad and that Ecstasy is a “safe” drug. As more studies each year shed light on the damage done by Ecstasy abuse, it is important to disseminate this new information in a balanced and rational manner.

REFERENCES:
Betsy Bates, “Kids Who Use Ecstasy Are Playing Russian Roulette with Their Lives,” Pediatric News, October, 2001.
“Effects of Ecstasy on Mood, Gender Studies,” The Brown University Digest of Addiction Theory and Application, May, 2002.
“FDA Reported To Approve Ecstasy for PTSD Clinical Trial,” Alcoholism & Drug Abuse Weekly, November 12, 2001.
“From MDMA to Ecstasy,” The Brown University child and Adolescent Behavior Letter, August, 2001.
“MDMA (Ecstasy Effects),” Harvard Mental Health Letter, July, 2001.
George A. Ricaurte and Una D. McCann, “Assessing Long-Term Effects of MDMA (Ecstasy),” The Lancet, December 1, 2001.
Edward Skidelsky, “Why Ecstasy Is the Capitalist Pill,” New Statesman, April 24, 2000.
“Study Finds More College Students Using Ecstasy,” The Brown University Child and Adolescent Behavior Letter, April, 2002.
Brian Vastag, “Ecstasy Experts Want Realistic Messages,” JAMA, August 15, 2001.
“What Is MDMA Neurotoxicity?” The Brown University Child and Adolescent Letter, August, 2001.

   
 
 
 
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