Abuse of MDMA

3,4-methylenedioxymethamphetamine (MDMA), popularly called Ecstasy, XTC or Adam, is one of the methamphetamine drugs. Its effects are a relatively mild psychedelic experience, usually without the hallucinations and loss of ego that LSD can cause. One of its attractions for recreational users is that it tends to make them feel more sensual and increases the pleasure of physical contact. Side effects appear to be mild: tiredness, nausea, jaw tension afterwards. However, Ecstasy can cause serious toxic reactions in users, including hyperthermia, raised blood pressure, increased heart rate, stroke, dehydration and renal failure. There is evidence of brain degeneration in the long-term. Some psychiatrists warn of an increased long-term risk of psychiatric illness, especially depression and memory loss; research in this area is not clear, however, as many of those who take Ecstasy say they were depressed before they started taking it. There is also a difficulty in isolating the effects of Ecstasy since over 50% of the drug sold on the streets is adulterated.

MDMA was patented by Merck Pharmaceuticals in Germany before World War I, but not tested on humans until the 1970s. Chemically, it has structural similarities to both amphetamine and mescaline, a hallucinogen. Early on, some mental health experts called MDMA "penicillin for the soul" because of its ability to get patients to drop defensive barriers and increase intimacy and communication. It has been used therapeutically in the treatment of reactive depression, addictive disorders, character neuroses, phobias, obsessive-compulsions, anorexia nervosa and post-traumatic stress disorder.

Many of the risks users face with MDMA use are similar to those found with the use of amphetamines and cocaine. They are: (a) psychological difficulties, including confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia – during and sometimes weeks after taking MDMA (even psychotic episodes have been reported); (b) physical symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, and chills or sweating; and (c) increases in heart rate and blood pressure, a special risk for people with circulatory or heart disease.

Scientists have found that Ecstasy causes changes in serotonin sites in the brain and also injures serotonin neurons. Although these can regrow, they do not grow back normally and might not grow back in the right location. Serotonin is a critical neurochemical that regulates mood, emotion, learning, memory, sleep, pain.

Numerous Ecstacy-related deaths have been reported around the world, particularly from countries with a 'disco club' culture. In the UK in 1995 it was estimated that about half a million young people took ecstasy each week. A survey of 4,000 users found that more than half said they would continue to take the drug even if someone they knew died after doing so.

Each year, the US National Household Survey on Drug Abuse (NHSDA) reports on the nature and extent of drug use among the American household population aged 12 and older. The 1998 survey found that an estimated 1.5 percent (3.4 million) of Americans at least 12 years old had used MDMA at least once during their lifetime. By age group, the heaviest use (5 percent or 1.4 million people) was reported for those between 18 and 25 years old.

A survey of American teenagers (2001) found that one in four questioned said they had a friend or classmate who had used Ecstasy, while 17 percent said they knew more than one user. In Boston, a 1996-97 survey of public schools in Boston found that about 14 percent of male and 7 percent of female 12th graders had used MDMA during their lifetime. Increased use of MDMA among youth was also reported in Seattle.

The street price of Ecstasy in the USA in 2001 was $20 to $35 a tablet. It has become increasingly popular to prolong Ecstasy's effect by "stacking" multiple doses in one night – or combining it with alcohol or other drugs. Hazards are raised by commonly used impure forms of Ecstasy, which are laced with other drugs, and look-alike pills. Dehydration and overheating, especially at dance clubs, have led to death in some cases.

MDMA has been illegal since 1977 in the UK, and since 1985 in the USA.