Ecstasy Addiction, Abuse and Treatment

MDMA was first synthesized in Europe as a possible appetite suppressant but never caught on because of its side effects. MDMA (3, 4-Methylenedioxymethamphetamine) is a psychoactive synthetic drug possessing stimulant and hallucinogenic properties. The drug is analogous to amphetamine and LSD in terms of its hallucinogenic properties. Ecstasy is a slang or street name for MDMA. The drug has a tendency to alter perception of time and distance.

The drug was introduced in the USA in the 60s and was legally widely used to treat various psychiatric disorders. However, rather than cure any disorder, it made most patients worse and its use as a therapeutic agent was abandoned soon after. The drug became widely known for its psychedelic effects in the 1980s and its use for this purpose has increased over the past 3 decades. Today, it is the number one Club Drug abused among college students.

Effects of Ecstasy

The majority of individuals who take ecstasy tell of a pleasant, relaxant effect of the drug. The drug is known to heighten the senses of kindness, affection and a loving feeling, and it is this property which make its abuse potential high. The drug is also known to decrease appetite and sleep- a combination which is highly sought after by the college students.

However, the ability of this drug to decrease sleep and increase physical activity endurance combined with its ability to decrease to fluid intake has often resulted in dehydration, exhaustion and even death. Various studies have revealed that even recreational users of the drug might be at risk of developing permanent damage that can manifest depression, anxiety, memory loss, and psychotic disorders.

User Statistics

While MDMA abuse currently is not as widespread as that of many other illicit drugs (cocaine, marijuana), it nonetheless has increased significantly over the past 2 decades. Drug Abuse Warning Network (DAWN) estimates reveal that nationwide hospital emergency room admission for MDMD toxicity has increased significantly over the past decade. Seizures by law enforcement agencies indicate that MDMA is the most smuggled club drug. The drug is smuggled in from Europe, Mexico and even China. All these figures are expected to increase in the coming years.

MDMA is commonly used by individuals who frequent night clubs, raves, rock concerts and beach parties. Recent usage patterns indicate that MDMA is the most popular club drug used by teenagers and college students. Almost every town and city in North America has had the Ecstasy craze and the last decade has seen wider usage among high school adults.

Synthesis

MDMA is not a natural chemical but has to be synthesized in a laboratory. Because the use of this drug is illegal, the drug is manufactured illegal in clandestine laboratories all over the country. Because of government regulation, the precursor drugs required for synthesis are difficult to obtain. The manufactured MDMA has a lot of other chemicals added to it during the processing. Many of these chemicals are impure and include caffeine, dextromethorphan (cough syrup), amphetamines, cocaine and even chalk. Because of the lucrative market, a lot of manufacturers in unsophisticated laboratories add many impure chemicals to dilute the product and increase the profits. Thus, buyers of MDMA should always beware.

Like other illegally manufactured drugs, there are no controls on factors such as the strength and sterility of the drug. This increases the chances of a person overdosing, being poisoned or experiencing other adverse reactions after taking the drug. In most cases, when buying ecstasy, there is very little MDMA and lot of deadly junk.

MDMA/Ecstasy Synonyms

- Adam
- Beans
- Cloud 9
- Decadence, Domex
- E, Essence
- hug
- Kleenex
- Love drug, Love trip, lover’s speed
- M&M
- MDM
- Rave energy, Rolling, Running
- Shabu, Speed for lovers
- Ultimate X-phoria, X
- X-TC, X, X-ing


Dosing

Ecstasy is usually taken by mouth in a pill, tablet, or capsule. These pills come in different colors and sizes. They are sometimes inserted into the anus (known as "shafting" or "shelving"). Injecting ecstasy has increased in recent years. A typical dose has an onset of about 20 to 60 minutes. Users feel a euphoric effect that will last about 3 to 5 hour and the effects may last for up to 1-2 days. Prices range from $25 to $40 per pill.

Drug Schedule

MDMA is a Federal Drug Enforcement Administration (DEA) -- Schedule I Substance -- meaning that it has no medical use and high abuse potential. The Federal penalty for manufacturing or selling the drug are severe and long term prison sentences are not uncommon.

Effects of Ecstasy

The effects of ecstasy are not predictable and vary from individual to individual. The symptoms of ecstasy include the following:

Immediate Effects:

• Extreme confidence
• Sense of well being
• feelings of affection
• anxiety
• dilated pupils
• tensing of the facial muscles, jaw clenching, teeth grinding
• increase in heart rate, body temperature and blood pressure
• nausea
• loss of appetite
• sweating, chills
• rapid eye movements

At higher doses, the toxic complications may include:

• convulsions
• nausea & vomiting
• floating sensations
• manic or bizarre behavior
• hallucination
• paranoia
• psychosis


Who is at risk for MDMA TOXICITY?
Individuals with some disorders are at a slightly higher risk for MDMA toxicity. These individuals may have:

- hypertension
- heart disease
- diabetes
- liver disease
- history of seizures
- Individuals with panic attacks
- Psychiatric disorders

Overdose

Overdose from ecstasy can occur. It is usually presents with a very high body temperature and blood pressure, hallucinations and an increased heartbeat. This is especially dangerous for those who have preexisting heart or lung disease and for individuals with psychiatric disorders. Although the exact cause and number of deaths from ecstasy are difficult to determine, hospital admission records indicate that ecstasy is known to cause deaths by inducing :

• bleeding in the brain
• kidney failure
• overheating of the body, dehydration
• excessive increase in blood pressure
Ecstasy is associated with overheating of the body and for users some precautions should be taken. It is highly recommended that to prevent heat exhaustion and overheating, one drink a lot of water continuously. One should wear loose clothing to help reduce the risk of overheating. A number of individuals, who do develop toxicity from MDMA use, require urgent medical attention. Anyone who is unresponsive, has difficulty breathing or is dehydrated should be immediately transported to the closest Emergency room for treatment.

Tolerance and Dependence

MDMA is an addictive drug and can cause both physical and psychological dependence. Besides the side effects, the drug has severe social, behavioral and health consequences. As to who and when someone becomes addicted remains unknown. Even though long term use of MDMA is known to cause addiction, it is very likely that even short term use may cause partial dependence. There is no doubt that when Ecstasy is used for longer duration and in high doses, tolerance does occur over time. Unfortunately the tolerance is only to the pleasant hallucinogenic effects of the drug and not to the unpleasant side effects which increase in severity with an increase in dose.

Ecstasy can rapidly cause dependence and most individuals complain that they have a difficult time stopping the drug. Because the pleasant effects of Ecstasy diminish with time, most users tend not to use it for prolonged period. However, the addictive nature of the drug makes stopping the drug difficult and the vicious cycle of dependence continues.

Treatment Options

A number of drug treatment options are available to treat Ecstasy dependence. While abstinence may be a suitable management plan for those who have only used MDMA for the short term, it is not a valid solution for long term users. Long terms users develop severe withdrawal symptoms and abrupt abstinence is fraught with medical complications. Most treatment programs offer counseling, behaviors modification, and detoxification with the use of sedatives. Both in and outpatient detoxification programs are available. The aim of all programs is to reduce the risks of detoxification over time.

Pregnancy and HIV

The use of MDMA should be curtailed during pregnancy. The majority of illicit drugs can pass both through the placenta and even be found in breast milk. MDMA has been associated with delayed development and subtle abnormalities in the newborn.

Because certain individuals inject the drug using shared needles, the chances of contracting HIV, hepatitis or other sexually transmissible infections is always present.