Across the country, teens and young adults enjoy all-night dance parties known as "raves" and increasingly encounter more than just music. Dangerous substances known collectively as club drugs, including Ecstasy are gaining popularity. Some slang or street names for Ecstasy are "X", "Adam", and "MDMA".
Ecstasy is comprised of MDMA or 3, 4-mthylenedioxymethamphetamine. It is an illegal drug that has characteristics of both stimulants and hallucinogens. While MDMA does not cause overt hallucinations, many people have reported distorted time and perception while under the influence of the drug. Although users may think these substances are harmless, research has shown that club drugs can produce a range of unwanted effects including paranoia, amnesia, and in some cases, death. When used with alcohol, these drugs can become even more harmful. There are also great differences among individuals and how they will react to these substances and no one can predict how he or she will react. Some people have been known to have extreme, even fatal, reactions the first time they try MDMA. MDMA causes an amphetamine-like hyperactivity in people and animals and it appears to have the ability to cause addiction. It increases heart rate, blood pressure and can disable the body's ability to regulate its own temperature. Because of its stimulant properties, when it is used in club or dance settings, it can enable users to dance vigorously for extended periods, but can also lead to severe rises in body temperature, what is referred to as hyperthermia, as well as dehydration, hypertension, and even heart or kidney failure in particularly susceptible people.
MDMA is a synthetic drug, meaning it is manufactured, in this case illegally. It is typically produced in capsule or tablet form and is usually taken orally, thought there are some documented cases that it is being administered by other routes, including injection and snorting. MDMA's acute effects typically last from three to six hours depending on the dosage, with the reported average dose of MDMA being between one and two tablets. Importantly, in many situations Ecstasy tablets contain not only MDMA, but a number of other drugs or drug combinations that can be harmful as well.
MDMA works in the brain by increasing the activity levels of at least three neurotransmitters: serotonin, dopamine, and norepinephrine. Much like the way amphetamines work, MDMA causes these neurotransmitters to be released from their storage sites in neurons resulting in increased brain activity. MDMA causes increased serotonin release. Serotonin is the neurotransmitter that plays an important role in regulation of mood, sleep, pain, emotion, appetite, and other behaviors. By releasing large amounts of serotonin and also interfering with its synthesis, MDMA causes the brain to become significantly depleted of this important neurotransmitter. As a result, it takes the human brain time to rebuild its serotonin levels. For people who take MDMA at moderate to high doses, depletion of serotonin may be long-term. These persistent deficits in serotonin are likely responsible for many of the long-lasting behavioral effects that the user experiences and what concerns us most about this drug.
MDMA is not a benign drug. In fact, all of the studies conducted to date in both animals and humans confirm that club drugs, particularly Ecstasy, are not harmless "fun party drugs" as they are often portrayed. While users of club drugs often take them simply for energy to keep on dancing or partying, research shows these drugs can have long lasting negative effects on the brain that can alter memory and other behaviors. There is substantial evidence to show that MDMA damages brain cells.
We know that even one dose of MDMA (10 mg) has the ability to decrease serotonin levels for up to two (2) weeks. Research has shown that MDMA is neurotoxic, meaning it literally destroys brain cells.
Using brain imaging and other state of the art equipment, researchers are able to show us in intricate detail how MDMA or Ecstasy affects the brain. We know from imaging that cerebral blood flow is affected by MDMA use. We also have evidence from brain images that MDMA abusers may have fewer serotonin producing neuronal processes in the brain than non-users. Another way researchers are determining the effects of MDMA is by looking at neurocognitive measures, such as standardized tests of mental abilities. A number of studies have consistently shown that repeated MDMA exposure is associated with significant impairments in visual and verbal memory.
It is very clear that the brain of the MDMA user has been significantly altered. Because of this advanced technology we are beginning to see that MDMA has the ability to impair one's cognitive abilities as well. In one study, MDMA users who also occasionally used marijuana were given a battery of performance tests. They fared significantly worse when compared to either marijuana users or non-drug users. Participants were tested for attention, memory and learning, frontal lobe function and general intelligence. In general, MDMA users had poorer performance results in three general intelligence tests, they also required more repetitions to learn a word than both the marijuana and the non-drug users, and when compared to the non-drug users, had poorer short term memory performance. The researchers concluded that MDMA use over a period of months or a few years may cause long-term impairment of cognitive performance even when MDMA is taken in relatively small doses.
In short, there is now a large body of evidence that links heavy and prolonged MDMA use to confusion, depression, sleep problems, persistent elevation of anxiety, aggressive and impulsive behavior and selective impairment of some working memory and attention processes.
The harm that MDMA causes is not limited to the user alone. Recent finding show that prenatal use of MDMA may cause memory loss and other impairments in offspring.
One encouraging thought to keep in mind as we discuss the effects of this drug on the human brain is not to underestimate the amazing capabilities of the brain and its ability to compensate and adjust to stressors. There is new research showing that neuronal functions and systems that have been damaged by chronic drug use can recover. This is a positive and hopeful note, though it is too soon to determine how functional the brain cells actually are after recovery and to determine if an individual's cognitive deficits resulting from the initial damage are completely reversed after time.
If your child or someone you know has been experimenting with Ecstasy or other club drugs, help is available. The longer you wait to get help, the more dangerous the consequences and long term effects of the drug will be.