Susan Merle Gordon, director of research at the Caron Foundation, provides this description of the popular club drug and its effects.

Ecstasy is a commonly used name for the chemical substance methylene-dioxymethamphetamine, which is abbreviated as MDMA. Ecstasy is comprised of chemical variations of amphetamine or methamphetamine (stimulants) and a hallucinogen, such as mescaline. In addition to MDMA or the related compounds MDEA and MDA, drugs sold on the street as Ecstasy also contain other psychoactive or mind-altering drugs, like caffeine, ephedrine, selegiline and ketamine [1]. Numerous illegal laboratories produce MDMA and use a wide variety of drug combinations, some of which are more lethal than others.

MDMA is produced in tablet or capsule form and is usually taken orally, although there are documented cases of intravenous use [2]. MDMA¿s acute effects last from three to eight hours [1] and its short-lasting effects include feelings of euphoria, enhanced mental and emotional clarity, sensations of lightness and floating and other hallucinations. Users of MDMA also have suppressed appetite, thirst or need to sleep. Sometimes users who are attending two- to three-day parties suffer from severe dehydration or exhaustion [1].

Other unpleasant and/or dangerous acute effects include feelings of depersonalization, elevated anxiety, muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, chills and sweating, hypertension, tremors, seizures and increased body temperature. It is very possible to overdose on MDMA; these overdoses may produce fatality by heart failure or extreme heat stroke [3].

Increase in MDMA Abuse

MDMA is relatively inexpensive and easily accessible, especially in the northeastern part of the U.S. and western Europe. Most MDMA found in the U.S. has been manufactured abroad and smuggled into the country. It is estimated that more than two million tablets of MDMA are smuggled into the U.S. each week [3].

Abuse of MDMA has significantly increased, by 500 percent, from 1993 to 1999. In 1993 only 196 tablets of MDMA were submitted to the Drug Enforcement Agency (DEA) laboratories; in 1998, 143,600 tablets were confiscated and submitted to the DEA. Likewise, in 1993 only 79 cases of MDMA overdose were reported by hospital emergency rooms; in 1999, however, emergency rooms reported 2,850 MDMA cases [3].

MDMA often is used by adolescents and young adults at dance clubs, all-night dance parties (raves) and rock concerts. Use by young people sharply increased in 1999 from prior years of decline. Approximately one in 20 10th- and 12th-grade students reported they had used MDMA at least one time in 1999. MDMA appears to be easily available to young people, especially in the northeastern U.S. The proportion of high school seniors who think that MDMA is easy to obtain doubled from 1991 to 1997 [4].

Negative Consequences of MDMA Abuse

It is believed that many of the negative consequences of MDMA are a the result of the destruction of serotonin-producing neurons in the brain [5]. Serotonin is a brain chemical that plays an important role in regulating mood, aggressive behavior, sexual activity, sleep, and pain sensitivity. Some research also has linked a decrease in serotonin activity to cognitive problems, such as memory processes [5].

Research studies on nonhuman primates have found decreases in serotinin activity for as long as seven years following MDMA exposure [5]. Some scientists think that humans may be more susceptible to brain damage than are other primates. Cumulative doses of MDMA that are taken by moderate users over a prolonged time period may have similar negative consequences to the high experimental doses given within short time periods to nonhuman primates[5].

Other naturalistic research studies that assess the psychological and cognitive functioning of people who abuse MDMA also find long-lasting impairments. A recent review of the major research studies on MDMA concluded that there is a body of evidence that links heavy and prolonged MDMA use to confusion, depression, sleep problems, severe anxiety, and aggressive and impulsive behavior [1].

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