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What is Ecstasy?
MDMA or ecstasy is a Schedule I synthetic, psychoactive
drug possessing stimulant and hallucinogenic properties.
Ecstasy possesses chemical variations of the stimulant
amphetamine or methamphetamine and a hallucinogen, most
often mescaline. Commonly referred to as Ecstasy or XTC,
MDMA was first synthesized in 1912 by a German company
possibly to be used as an appetite suppressant. Chemically,
it is an analogue of MDA, a drug that was popular in the
1960s. In the late 1970s, MDMA was used to facilitate
psychotherapy by a small group of therapists in the United
States. Illicit use of the drug did not become popular
until the late 1980s and early 1990s. Ecstasy is frequently
used in combination with other drugs. However, it is rarely
consumed with alcohol, as alcohol is believed to diminish
its effects. It is most often distributed at late-night
parties called "raves", nightclubs, and rock
concerts. As the rave and club scene expands to metropolitan
and suburban areas across the country, ecstasy use and
distribution are increasing as well.
How is Ecstasy used?
Ecstasy is most often available in tablet form and is usually
ingested orally. It is also available as a powder and is sometimes
snorted and occasionally smoked, but rarely injected. Its effects
last approximately four to six hours. Users of the drug say
that it produces profoundly positive feelings, empathy for others,
elimination of anxiety, and extreme relaxation. Ecstasy is also
said to suppress the need to eat, drink, or sleep, enabling
users to endure two- to three-day parties. Consequently, ecstasy
use sometimes results in severe dehydration or exhaustion.
Where does Ecstasy come from?
A.) Clandestine laboratories operating throughout Western Europe,
primarily the Netherlands and Belgium, manufacture significant
quantities of the drug in tablet, capsule, or powder form. Although
the vast majority of ecstasy consumed domestically is produced
in Europe, a limited number of ecstasy labs operate in the United
States. In addition, in recent years, Israeli organized crime
syndicates, some composed of Russian émigrés associated
with Russian organized crime syndicates, have forged relationships
with Western European traffickers and gained control over a
significant share of the European market. The Israeli syndicates
are currently the primary source to U.S. distribution groups.
Overseas ecstasy trafficking organizations smuggle the drug
in shipments of 10,000 or more tablets via express mail services,
couriers aboard commercial airline flights, or, more recently,
through air freight shipments from several major European cities
to cities in the United States. The drug is sold in bulk quantity
at the mid-wholesale level in the United States for approximately
eight dollars per dosage unit. The retail price of ecstasy sold
in clubs in the United States remains steady at twenty to thirty
dollars per dosage unit. Ecstasy traffickers consistently use
brand names and logos as marketing tools and to distinguish
their product from that of competitors. The logos are produced
to coincide with holidays or special events. Among the more
popular logos are butterflies, lightning bolts, and four-leaf
What are the short-term effects of Ecstasy?
A.) While it is not as addictive as heroin or cocaine, ecstasy
can cause other adverse effects including nausea, hallucinations,
chills, sweating, increases in body temperature, tremors, involuntary
teeth clenching, muscle cramping, and blurred vision. Ecstasy
users also report after-effects of anxiety, paranoia, and depression.
An ecstasy overdose is characterized by high blood pressure,
faintness, panic attacks, and, in more severe cases, loss of
consciousness, seizures, and a drastic rise in body temperature.
Ecstasy overdoses can be fatal, as they may result in heart
failure or extreme heat stroke.
The effects start after about 20 minutes and can last for hours.
These is a 'rush' feeling followed by a feeling of calm and
a sense of well being to those around, often with a heightened
perception of color and sound. Some people actually feel sick
and experience a stiffening up of arms, legs and particularly
the jaw along with sensations of thirst, sleeplessness, depression
and paranoia. Gives a feeling of energy. Some mild hallucinogenic
Many problems users encounter with Ecstasy are similar to those
found with the use of amphetamines and cocaine. They include
increases in heart rate and blood pressure, nausea, blurred
vision, faintness, chills, sweating, and such psychological
problems as confusion, depression, sleep problems, craving,
severe anxiety, paranoia, and psychotic episodes. Ecstasy's
chemical cousin, MDA, destroys cells that produce serotonin
in the brain. These cells play a direct roll in regulating aggression,
mood, sexual activity, sleep, and sensitivity to pain. Methamphetamine,
also similar to Ecstasy, damages brain cells that produce dopamine.
Scientists have now shown that ecstasy not only makes the brain's
nerve branches and endings degenerate, but also makes them "re-grow,
but abnormally - failing to reconnect with some brain areas
and connecting elsewhere with the wrong areas. These reconnections
may be permanent, resulting in cognitive impairments, changes
in emotion, learning, memory, or hormone-like chemical abnormalities.
What are the long-term effects of Ecstasy?
The designer drug "Ecstasy," or MDMA, causes long-lasting
damage to brain areas that are critical for thought and memory,
according to new research findings in the June 15 issue of The
Journal of Neuroscience. In an experiment with red squirrel
monkeys, researchers at The Johns Hopkins University demonstrated
that 4 days of exposure to the drug caused damage that persisted
6 to 7 years later. These findings help to validate previous
research by the Hopkins team in humans, showing that people
who had taken ecstasy scored lower on memory tests.
serotonin system, which is compromised by ecstasy, is fundamental
to the brain's integration of information and emotion,"
says Dr. Alan I. Leshner, director of the National Institute
on Drug Abuse (NIDA), National Institutes of Health, which funded
the research. "At the very least, people who take ecstasy,
even just a few times, are risking long-term, perhaps permanent,
problems with learning and memory."
The researchers found that the nerve cells (neurons) damaged
by ecstasy are those that use the chemical serotonin to communicate
with other neurons. The Hopkins team had also previously conducted
brain imaging research in human ecstasy users, in collaboration
with the National Institute of Mental Health, which showed extensive
damage to serotonin neurons.
MDMA (3,4-methylenedioxymethamphetamine) has a stimulant effect,
causing similar euphoria and increased alertness as cocaine
and amphetamine. It also causes mescaline-like psychedelic effects.
First used in the 1980s, MDMA is often taken at large, all-night
In this new study, the Hopkins researchers administered either
MDMA or salt water to the monkeys twice a day for 4 days. After
2 weeks, the scientists examined the brains of half of the monkeys.
Then, after 6 to 7 years, the brains of the remaining monkeys
were examined, along with age-matched controls.
In the brains of the monkeys examined soon after the 2-week
period, Dr. George Ricaurte and his colleagues found that MDMA
caused more damage to serotonin neurons in some parts of the
brain than in others. Areas particularly affected were the neocortex
(the outer part of the brain where conscious thought occurs)
and the hippocampus (which plays a key role in forming long-term
This damage was also apparent, although to a lesser extent,
in the brains of monkeys who had received MDMA during the same
2-week period but who had received no MDMA for 6 to 7 years.
In contrast, no damage was noticeable in the brains of those
who had received salt water.
"Some recovery of serotonin neurons was apparent in the
brains of the monkeys given MDMA 6 to 7 years previously,"
says Dr. Ricaurte, "but this recovery occurred only in
certain regions, and was not always complete. Other brain regions
showed no evidence of recovery whatsoever."
A NIDA-supported study has provided the first direct evidence
that chronic use of MDMA, popularly known as "ecstasy,"
causes brain damage in people. Using advanced brain imaging
techniques, the study found that MDMA harms neurons that release
serotonin, a brain chemical thought to play an important role
in regulating memory and other functions. In a related study,
researchers found that heavy MDMA users have memory problems
that persist for at least 2 weeks after they have stopped using
the drug. Both studies suggest that the extent of damage is
directly correlated with the amount of MDMA use.
message from these studies is that MDMA does change the brain
and it looks like there are functional consequences to these
changes," says Dr. Joseph Frascella of NIDA's Division
of Treatment Research and Development. That message is particularly
significant for young people who participate in large, all-night
dance parties known as "raves," which are popular
in many cities around the Nation. NIDA's epidemiologic studies
indicate that MDMA (3,4-methylenedioxymethamphetamine) use has
escalated in recent years among college students and young adults
who attend these social gatherings.
In the brain imaging study, researchers used positron emission
tomography (PET) to take brain scans of 14 MDMA users who had
not used any psychoactive drug, including MDMA, for at least
3 weeks. Brain images also were taken of 15 people who had never
used MDMA. Both groups were similar in age and level of education
and had comparable numbers of men and women.
In people who had used MDMA, the PET images showed significant
reductions in the number of serotonin transporters, the sites
on neuron surfaces that reabsorb serotonin from the space between
cells after it has completed its work. The lasting reduction
of serotonin transporters occurred throughout the brain, and
people who had used MDMA more often lost more serotonin transporters
than those who had used the drug less.
Previous PET studies with baboons also produced images indicating
MDMA had induced long-term reductions in the number of serotonin
transporters. Examinations of brain tissue from the animals
provided further confirmation that the decrease in serotonin
transporters seen in the PET images corresponded to actual loss
of serotonin nerve endings containing transporters in the baboons'
brains. "Based on what we found with our animal studies,
we maintain that the changes revealed by PET imaging are probably
related to damage of serotonin nerve endings in humans who had
used MDMA," says Dr. George Ricaurte of The Johns Hopkins
Medical Institutions in Baltimore. Dr. Ricaurte is the principal
investigator for both studies, which are part of a clinical
research project that is assessing the long-term effects of
real question in all imaging studies is what these changes mean
when it comes to functional consequences," says NIDA's
Dr. Frascella. To help answer that question, a team of researchers,
which included scientists from Johns Hopkins and the National
Institute of Mental Health who had worked on the imaging study,
attempted to assess the effects of chronic MDMA use on memory.
In this study, researchers administered several standardized
memory tests to 24 MDMA users who had not used the drug for
at least 2 weeks and 24 people who had never used the drug.
Both groups were matched for age, gender, education, and vocabulary
The study found that, compared to the nonusers, heavy MDMA users
had significant impairments in visual and verbal memory. As
had been found in the brain imaging study, MDMA's harmful effects
were dose-related the more MDMA people used, the greater difficulty
they had in recalling what they had seen and heard during testing.
The memory impairments found in MDMA users are among the first
functional consequences of MDMA-induced damage of serotonin
neurons to emerge. Recent studies conducted in the United Kingdom
also have reported memory problems in MDMA users assessed within
a few days of their last drug use. "Our study extends the
MDMA-induced memory impairment to at least 2 weeks since last
drug use and thus shows that MDMA's effects on memory cannot
be attributed to withdrawal or residual drug effects,"
says Dr. Karen Bolla of Johns Hopkins, who helped conduct the
The Johns Hopkins/NIMH researchers also were able to link poorer
memory performance by MDMA users to loss of brain serotonin
function by measuring the levels of a serotonin metabolite in
study participants' spinal fluid. These measurements showed
that MDMA users had lower levels of the metabolite than people
who had not used the drug; that the more MDMA they reported
using, the lower the level of the metabolite; and that the people
with the lowest levels of the metabolite had the poorest memory
performance. Taken together, these findings support the conclusion
that MDMA-induced brain serotonin neurotoxicity may account
for the persistent memory impairment found in MDMA users, Dr.
Research on the functional consequences of MDMA-induced damage
of serotonin-producing neurons in humans is at an early stage,
and the scientists who conducted the studies cannot say definitively
that the harm to brain serotonin neurons shown in the imaging
study accounts for the memory impairments found among chronic
users of the drug. However, "that's the concern, and it's
certainly the most obvious basis for the memory problems that
some MDMA users have developed," Dr. Ricaurte says.
Findings from another Johns Hopkins/NIMH study now suggest that
MDMA use may lead to impairments in other cognitive functions
besides memory, such as the ability to reason verbally or sustain
attention. Researchers are continuing to examine the effects
of chronic MDMA use on memory and other functions in which serotonin
has been implicated, such as mood, impulse control, and sleep
cycles. How long MDMA-induced brain damage persists and the
long-term consequences of that damage are other questions researchers
are trying to answer. Animal studies, which first documented
the neurotoxic effects of the drug, suggest that the loss of
serotonin neurons in humans may last for many years and possibly
be permanent. "We now know that brain damage is still present
in monkeys 7 years after discontinuing the drug," Dr. Ricaurte
says. "We don't know just yet if we're dealing with such
a long-lasting effect in people."
Is Ecstasy addictive?
Ecstasy users may encounter problems similar to those experienced
by amphetamine and cocaine users, including addiction. In addition
to its seemingly rewarding effects, ecstasy's psychological
effects can include confusion, depression, sleep problems, anxiety,
and paranoia during, and sometimes weeks after, taking the drug.
Physical effects can include muscle tension, involuntary teeth-clenching,
nausea, blurred vision, faintness, and chills or sweating. Increases
in heart rate and blood pressure are a special risk for people
with circulatory or heart disease. Ecstasy-related fatalities
at raves have been reported. The stimulant effects of the drug,
which enable the user to dance for extended periods, combined
with the hot, crowded conditions usually found at raves can
lead to dehydration, hyperthermia, and heart or kidney failure.
Ecstasy use damages brain serotonin neurons. Serotonin is thought
to play a role in regulating mood, memory, sleep, and appetite.
Recent research indicates heavy ecstasy use causes persistent
memory problems in humans.
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