ADVANCED PSYCHOPHARMACOLOGY
Psychology 572 Spring, 2003
Dr. John M. Morgan Monday & Wednesday, 8am to 9:20
Harry Griffith Hall, 117
Physiological, Psychological and Behavioral Changes
Associated with MDMA Use:
By Laramie L. Lesina
3, 4 methylenedioxymethamphetamine (MDMA) is a synthetic chemical that
can be derived from an essential oil of the sassafras tree. MDMA was
first synthesized by Merk pharmaceuticals in 1912 and patented in 1914,
but it wasn't until the mid 1970's that articles related to its
psychoactivity began showing up in scholarly journals. In the late
1970's and early 1980's MDMA was used as a psychotherapeutic tool and
also started to become available on the street. Its growing popularity
led to it being made illegal in the United States in 1985 and its
popularity has continued to increase since then. MDMA is also known, in
slang terms, as ecstasy, X, XTC, E, M, adam, bean, roll and the
experience is often labeled Xing, rolling, tripping and wigging (MDMA
Basics).
Usual doses of MDMA range from around 80 to 160 milligrams (orally),
though monks have used low doses 40 to 60 mg., to assist meditation and
therapists have sometimes taken similarly low doses to become more in
tune with clients. A benchmark standard dose is often considered to be 2
mg of MDMA per kilogram of body weight (though response to the drug is
not strictly proportional to body weight (Taylor). Depending on how much
and how recently one has eaten, MDMA generally takes 30 to 60 minutes
(although sometimes as long as 2 hours) to take effect. Unlike with
other psychoactives, the onset of MDMA is very quick. Often at the point
one realizes that perhaps they are starting to notice effects, they are
already launching quickly towards the peak. This quick and extremely
sharp launch can be unnerving, feeling a bit like it's too quick and
hard to know when it's going to end, but the feeling generally only
lasts a few minutes until the full effects are reached (MDMA Basics).
MDMA causes an increase in blood pressure and pulse rate, modest in most
people, similar to moderate exercise. Because of this, and because a few
people may have a more pronounced cardiac response to MDMA, people with
history of high blood pressure, heart trouble, or stroke are advised not
to use MDMA. The same warning applies to people who are hypersensitive
to drugs. Liver (hepatic) and kidney (renal) problems may also
contraindicate MDMA use. It is suggested to speak with a physician about
your overall health before ingesting any powerful substance. Deaths have
also been reported in users who are simultaneously taking Monoamine
Oxidase Inhibitors, often prescribed as anti depressants. MDMA is not
recommended to anyone taking MAOIs (Taylor, 2003). Such MOAIs may
include: Nardil (phenelzine), Parnate (tranylcypromine), Marplan
(isocarboxazid), Eldepryl (I Deprenyl) and, Aurorix/Manerix
(moclobemide). It is also suggested to avoid taking MDMA if you are
currently using the protease inhibitor Ritonavir, it may be a life
threatening combination (MDMA Heath).
The physical effects of usual doses of MDMA are subtle and variable.
Some users report dryness of mouth, jaw clenching, teeth grinding,
nystagmus (eye wiggles), sweating, or nausea. Others report feelings of
profound physical relaxation. At higher doses, the physical effects of
MDMA resemble those of amphetamines: fast or pounding heartbeat,
sweating, dizziness, restlessness, etc. The euphoria that MDMA induces
can make it easy to ignore bodily distress signals like dehydration,
muscle cramping, dizziness, exhaustion or overexertion. Several reports
from England tell of dosed ravers dancing themselves into severe
dehydration and heat exhaustion that required hospitalization and in a
few cases death (Taylor).
MDMA interferes with the body's ability to regulate internal
temperature. If "ravers" fail to drink enough water and take rest breaks
from dancing, they can suffer extreme heat stroke leading to seizures,
kidney and liver failure, and possibly, death (OH, 2000). It is alos
possible for "ravers" to become water intoxicated otherwise known as
hyponatremia. Some ecstasy users overreact to the overheating and
dehydration issue by obsessively over drinking. It is suggested that
when drinking large amounts of water it is important to mix in sports
drinks or salty snacks to avoid the dangers of hyponatremia, which may
cause serious health problems including death. MDMA can cause changes in
the body's diuretic hormone, leading to much higher susceptibility to
hyponatremia. It is suggestion to drink water, but not too much (MDMA
Health).
There is more evidence that the widely popular, feel good rave drug,
MDMA, can have potentially devastating effects on brain cells. Women who
use the drug for extended periods of time are particularly susceptible
to this damage. Using the high tech scanning device known as SPECT,
Dutch researchers found that female heavy ecstasy users, when compared
to light users, ex users, and nonusers of either sex, had significant
changes and reductions in the brain cells that transport serotonin.
Serotonin imbalance is thought to underlie depression, anxiety, panic
disorder, and disorders of impulse control (Maltin, 2001). Ecstasy
causes release of the neurotransmitter serotonin, which regulates mood,
sex drive, appetite and sleep. Serotonin is also thought to be
associated with the high of being in love. That MDMA sparked surge of
feel good chemical leads to elation, heightened senses and increased
energy (OH, 2000).
Other research shows that just one night of MDMA use can do a lifetime
of brain damage. Tests on primates show that two or three doses caused
more neurological damage than previously thought, the kind of damage (to
dopamine carrying neurons) that can lead to a Parkinson's disease like
condition. Researchers first gave five monkeys two or three doses of
MDMA, the amount young adults typically take during an all night dance
party. They saw a profound loss of dopamine neurons in all monkeys,
including the animal that got only two MDMA doses. To further test the
effects on another species researchers gave baboons the same MDMA doses.
The baboons that received two doses had dopamine neuron losses just as
severe as those that got three doses. They also developed less severe,
but significant, long term reductions in serotonin carrying neurons,
which effect mood and behavior. One research stated, "I'm amazed at the
misperception about risks associated with MDMA use." "People
contemplating using MDMA should be aware that it can damage brain cells,
and should recognize that its neurotoxic effects are likely to occur
after doses that are commonly used in recreational settings"(Lerche
Davis, 2002).
The major psychological and behavioral effects of using MDMA include:
Entactogenesis (touching within). This is a generalized feeling that all
is right and good with the world. People on MDMA often describe feeling
at "peace" or experiencing a generalized "happy" feeling. Also, commonly
everyday things may seem to be abnormally beautiful or interesting
(Taylor).
Empathogenesis is a feeling of emotional closeness to others (and one's
self) coupled with a breakdown of personal communication barriers.
People on MDMA report feeling much more at ease talking to others and
that any hang-ups that one may have regarding opening up to others may
be reduced or even eliminated. This effect is partially responsible for
MDMA as being known as a "hug drug", the increased emotional closeness
makes personal contact quite rewarding. Many people use MDMA to achieve
this effect, reporting that it makes potentially awkward or
uncomfortable social situations (singles bars, dance clubs etc.) much
more easily dealt with (Taylor).
MDMA can significantly enhance, sometime distort, the senses (touch,
proprioception, vision, taste, and smell). MDMA users can sometimes be
seen running their hands over differently textured objects repeatedly
and tasting and smelling various foods and drinks. This, once again,
contributes to the "hug drug" effects because of the novel feeling of
running one's hands over skin and having one's skin rubbed by someone
else's hands (Taylor).
Affective and behavioral changes have been variously reported as
follows: MDMA makes the user more accepting and patient after use and
brings about positive changes in self image, in relationships to others,
and in attitudes and feelings in general. The user feels more alive,
euphoric, self confident, grounded, blessed and at peace. MDMA induces a
sense of emotional closeness and bonding with others, but does not
increase sexual desire or enhance sexual performance. It brings expanded
mental perspectives, insight, and better presence of mind. It
facilitates communication, empathy, and understanding, and produces a
sense of euphoria and ecstasy, and even religious experiences. MDMA
evokes an easily controlled, altered state with emotional and sensual
overtones (Palfai & jankiewicz, 2001).
As previously mentioned, the primary psychological effects of MDMA is to
make the user feel "safe", at peace with the world, pleasantly
reconciled to things as they are, and things however they will be. This
can remarkably diminished one's ability to make sound judgments.
Following are some examples of behavioral safety concerns: It becomes to
want to prolong the MDMA state by taking more and more of the drug (or
of other drugs), beyond what you would judge wise or worthwhile when not
under its influence. It also may become easier to have unsafe sex. A
person may "forget" about the risk of infection or feel that infection
isn't that big of a risk or that it wouldn't be a terrible thing at all.
Another danger stems from MDMA's lessening of the awareness of pain.
Comibined with the extra energy produced by MDMA it becomes easy to
sustain bruises, blisters and other bodily damage. Under MDMA it might
seem "right" to make immediate changes in relationships of all kinds. It
is suggested that it is probably unwise to actually make lasting
relationship changes while under the influence of MDMA. Due to the fresh
points of view appreciated during and MDMA session, it is important to
see how one feels about life after the drug and its afterglow were off
(MDMA Health).
Lerche Davis, J. (2002). One Night of Ecstasy Can Damage Brain.
Retrieved February 23, 2003 from http://my.webmd.com
Maltin, L. (2001). Ecstasy Users Risk Brain Damage. Retrieved February
23,2003, from http://my.webmd.com
MDMA Basics. Retrieved February 24,2003, from
http://erowid.org/chemicals/mdma/mdma_basics.shtml
MDMA Health. Retrieved February 24,2003, from
http://www.erowid.org/chemicals/mdma/mdma_health.shtml
OH,Susan (2000). The Dark Side of Ecstasy. Maclean's, 133 (17), 44.
Palfai,T. & Jankiewicz, H.(2001)Drugs and Human Behavior (2nd. Ed.)
McGraw Hill Companies, Inc.
Taylor, J. MDMA Frequently Asked Questions. Retrieved February 24, 2003
from http://www.erowid.org/chemicals/mdma/mdma_faq.shtml
Chemistry of MDMA and route of access/Neurotoxicity of MDMA/Synaptic
Transmitters involved and part of the neuron affected with the use of
MDMA
By Darci Miranda
Between 1984 and 1985 home chemistry was making it possible to
manufacture analogues, drugs with chemical structures and effects
similar to those of psychoactive molecules
(Palfai and Jankiewicz, 2001). Of these compounds, the most
workable were amphetamines. From these compounds numerous
analogues were made, and synthetic drugs resembling heroin
(opioids) were manufactured. Chemically, hundreds of
thousands of analogues are possible, and these analogues may
have slightly less, slightly different, or even more
powerful effects than their parent substance (Palfai and
Jankiewicz, 2001). Since an amphetamine analogue is not
technically amphetamine, these analogues were not covered by
drug laws. The results were legal street trades in powerful
psychoactive compounds, many with untested effects. These
analogues became known as designer drugs (Palfai and
Jankiewicz, 2001).
A prominent drug of abuse that surfaced in the 1980s was MDMA, a
methylated amphetamine molecule known chemically as 3,4
methylenedioxymethamphetamine and known to its users as Ecstasy. This
chemical formula is C11H15NO2 (Palfai and Jankiewicz, 2001). Most MDMA
use is oral and is almost always consumed in tablet or capsule form. A
normal dose of ecstasy is between 100 and 125 mg (DanceSafe). Ecstasy
sold on the black market may contain other drugs and may vary widely in
strength. The effects of a normal dose of ecstasy last about four to
six hours (DanceSafe). The lethal dose of MDMA in humans is unknown;
however several deaths have been reported in relation to the ingestion
of MDMA, in combination with overexertion and dehydration from
overcrowded conditions and a lack of water. Overdosing is possible and
may even be fatal (Palfai and Jankiewicz, 2001).
Signs of neurotoxicity may include numbness and a tingling sensation in
the extremities, vomiting, crying, visual hallucinations, racing
heartbeat, hypertension progressing to hypotension, kidney failure, and
liver damage (Palfai and Jankiewicz, 2001). Confused states have also
been noticed in other amphetamine analogues including MDA and MMDA.
Residual symptoms may persist for hours to weeks. The release of
sensitive, emotional material may later bring MDMA users to seek
counseling (Palfai and Jankiewicz, 2001).
Kuhn, Swartzwelder, and Wilson (1998) suggest that MDMA acts like other
drugs that are neurotoxic to serotonin neurons in every animal model
that has been used. In both rats and primates, MDMA not only produced
the temporary loss of serotonin, but also produced the same kind of
damage that other amphetamines like drugs produce (Kuhn, Swartzwelder, &
Wilson, 1998). Amphetamine like drugs can produce permanent destruction
or long term damage to either dopamine or serotonin neurons in the
brain. The ends of the neuron that release the serotonin onto its
receptors are gone, along with all other components of the terminal
(Kuhn, Swartzwelder, & Wilson, 1998). Transport molecules that
accumulate serotonin and the vesicles that store serotonin disappear.
This damage, however, is dose related. At small doses there is little
to no damage. At moderate doses, some damage will occur, but serotonin
systems are still functional. Large doses of amphetamine like drugs
will completely destroy and eliminate the ability of neurons to release
serotonin (Kuhn, Swartzwelder, & Wilson, 1998).
MDMA is a distinctive drug in its selectivity for inducing positive
emotional effects. MDMA belongs to a new class of drugs called
entactogens, which literally means "touching within." Other drugs in
this category include MDA, MDE, and MBDB (DanceSafe). When MDMA became
valueless to pharmaceutical houses after its patent expired, it entered
psychotherapy on a small scale due to MDA, which psychotherapists had
been using as an adjunct to therapy(Palfai and Jankiewicz, 2001).
MDA is 3,4 methylenedioxyamphetamine. MDA has two isomers, which are
both active and have different effects. The d isomer is the more active
and has amphetamine like effects. The l isomer resembles LSD (Palfai
and Jankiewicz, 2001). MDA is not a hallucinogen, but has reported
effects resembling those of MDMA. Like MDMA, MDA is a potent serotonin
releasing agent. An addition of one carbon methyl group to the nitrogen
is the necessary process to synthesize MDMA from MDA (Palfai and
Jankiewicz, 2001).
MDMA acts on a number of transmitter systems, but its primary mechanism
of action appears to be to release serotonin (5HT) and block its
reuptake (Palfai and Jankiewicz, 2001). This release of serotonin may
elevate moods and in turn act as a short term antidepressant
(DanceSafe). MDMA enters the serotonin axon terminal by going through
uptake transporters. MDMA has a higher affinity for the uptake
transporters than the serotonin. This higher affinity means that the
MDMA will be the first thing to get into the axon terminal, not the
serotonin (DanceSafe).
When a dose of Ecstasy is taken, the vesicles in the brain release a
massive amount of serotonin into the synapse. This vast release of
serotonin significantly increases serotonin receptor binding, meaning
there is a greater chance for serotonin already in the synapse to bind
to these receptors (DanceSafe). Increasing the receptor activity leads
to the significant changes in the brain's electrical firing and is
responsible for the MDMA experience. This experience is characterized
by feelings of happiness, empathy, increased social interactions, and an
enhanced sensation of touch. A dose of MDMA also activates the dopamine
receptors (DanceSafe).
Serotonin molecules also bind to reuptake transporters on the axon's
membrane. These reuptake transporters reduce the amount of serotonin in
the synapse. As the reuptake transporters are pulling the serotonin
back into the axon, some of the serotonin may find its way back into the
vesicles, where the MDMA may cause the serotonin to be released again
(DanceSafe).
Three hours after taking the dose of ecstasy, much of the serotonin has
been removed from the synapse. At this time, there is still plenty of
the serotonin floating around to continue to activate the receptors,
allowing the user to still feel the desired effects of the drug
(DanceSafe). Soon following, the reuptake transporters will remove most
of the serotonin from the synapse. This is when the user will feel the
effects of "coming down" (DanceSafe). Serotonin that has been removed
by the reuptake transporters will be broken down by monoamine oxidase
(MAO). Dopamine receptors are still activated at this point
(DanceSafe).
When a person starts to come down following the use of ecstasy, it is
because there is no more serotonin left to be released. Although the
MDMA may be trying to make the vesicles release more, there isn't enough
serotonin left to be released (DanceSafe). In a span of about four
hours, MDMA has used up most of the individuals serotonin. At this
point many individuals will take another dose. However, because there
is not enough serotonin left, the person will not experience the same
ecstasy feeling. There does come a point when serotonin levels have
been depleted so much that ecstasy does not work. Some people become
very depressed, feel irritable, tired, and nonsocial when this occurs
(DanceSafe). Following the use of MDMA, the user's brain needs time to
replenish its serotonin levels. For some, this may take up to two
weeks. The larger the serotonin depletion, the longer it takes for the
brain to replenish it (DanceSafe).
Serotonin brain cells produce serotonin when an amino acid called 5
Hydroxy Tryptophan (5HT) enters the cell.
Serotonin, 5HT, is synthesized in the body from an amino acid called
tryptophan and is then converted by two enzymes (Palfai and Jankiewicz,
2001). The first is tryptophan hydroxylase and the second is the
synthesizing enzyme dopa decarboxylase, which is common to the synthesis
of serotonin, dopamine, and norepinephrine (Palfai and Jankiewicz,
2001). The 5HT enters the cell directly through its membrane and unlike
previously released serotonin; 5HT does not have to go through the
reuptake transporters (DanceSafe).
Once inside the axon, the decarboxylese turns the 5HT into serotonin and
then enters the vesicles. A diet high in tryptophan containing proteins
can help increase the amount of 5HT in the brain, thus building
serotonin levels more quickly (DanceSafe). However, tryptophan must go
through a number of metabolic changes before it is turned into 5HT.
Some users of ecstasy will take 5HT supplements to help restore their
depleted serotonin levels more quickly.
Some antagonistic serotonergic effects have also been noted with the use
of MDMA (Palfai and Jankiewicz, 2001). Moderate to high doses of MDMA
have decreased tryptophan hydroxylase activity in certain brain sites of
rats. This decreased activity suggests that the synthesis of 5HT is
impaired. High acute doses of MDMA deplete brain 5HT in the
hippocampus. Experimental monkeys stop sleeping with high acute doses
of MDMA. This loss of sleep is another sign of serotonin loss (Palfai
and Jankiewicz, 2001).
A prominent concern with the use of MDMA is evidence of significant
neurological damage to serotonergic systems (Palfai and Jankiewicz,
2001). This damage has been shown to some extent in rodent studies, but
it is much clearer in studies of primates. These primate studies are
more predictive in the effects of humans (Palfai and Jankiewicz, 2001).
In humans, studies show reduced 5HT metabolism that implies damage like
that seen in animal studies. This selective destruction of serotonergic
nerve endings remain the key point of concern regarding the use of MDMA
because it is unknown if this destruction is reversible (Palfai and
Jankiewicz, 2001).
References
DanceSafe, retrieved February 11, 2003 from www.DanceSafe.org.
Kuhn, C., Swartzwelder, S.,& Wilson, W. (1998). Buzzed. Norton and
Company: New York.
Palfai, T. & Jankiewicz, H. (2001). Drugs and Human Behavior (2nd ed.).
New York: McGraw Hill.
Side Effects of MDMA (Ecstasy), and Personal Experiences Reported by
Users.
by Joanna Rocco
MDMA (3,4 methylenedioxymethamphetamine), most commonly known as
ecstasy, is a popular illicit drug. MDMA is a mood elevator that
produces a relaxed and euphoric state. Ecstasy belongs to a family of
drugs called "entactogens" which literally means "touching within."
Sensations are enhanced and the user experiences heightened feelings of
empathy, emotional warmth, and self-acceptance. MDMA has structural
similarities to both amphetamine and the hallucinogen mescaline (Freese,
Miotto, & Reback, 2002). Ecstasy is often termed a "club drug" due to
its use at dance clubs and "raves," allowing users to dance and remain
active for long periods of time.
Use of the drug is on the rise, especially among teens and young adults.
According to the 2001 National Household Survey on Drug Abuse, an
estimated 8.1 million Americans age 12 or older have tried MDMA at least
once in their lifetimes. Use of the drug is also on the rise in Europe
and South America (Drug facts, club drugs). MDMA is now being used in
urban, suburban, and rural areas throughout the country. Ecstasy use is
becoming more common on college campuses and at small group gatherings
(Mathias & Zickler, 2001).
The effect of MDMA that has drawn the most attention is the subjective
effect of inducing positive mood changes. Users of ecstasy most
commonly report a feeling of euphoria. Some perceptual effects may
include vibratory movements in the visual field and the sensation of
objects moving in peripheral vision. MDMA may also produce increased
sweating, blurred vision, nausea, pupil dilation, nystagmus (quick,
jerky movements of the eye up and down or back and forth).
Hallucinatory effects include a sense of lightness or floating, a sense
of falling, or a feeling of disembodiment (Palfai & Jankiewicz, 2001).
MDMA's cardiovascular effects include increases in blood pressure and
heart rate. MDMA is not processed and removed from the body quickly and
may remain active for long periods. If users take multiple doses over
brief time periods an increase in toxicity can lead to harmful reactions
such as dehydration, hyperthermia, and seizures (Mathias & Zickler,
2001). Overheating and dehydration can also be exasperated by
conditions such as being in a hot, crowded place, and overexertion due
to prolonged movement such as dancing which causes one to sweat.
It is estimated that over half of those who take ecstasy suffer some
negative consequence. The most common were a feeling of losing control,
fear, fatigue and bad mood, disagreeable hallucinations, paranoia,
nausea, gait disturbance, feeling faint, bruxism (teeth clenching and
grinding), and a general increase of tension, tightness, and achiness in
muscles (Ecstasy Drug). Some users report residual effects of anxiety,
nervousness, and panic attacks during and/or after use. Other side
effects are appetite suppression, headaches, a feeling of coldness,
tingling or numbing in the extremities, and insomnia. The emotional
aftermath may also be unpleasant for some, involving loneliness,
sadness, vulnerability, rage, racing thoughts, and a sense of emotional
imbalance (Palfai & Jankiewicz, 2001).
Experimental studies indicate that MDMA damages serotonergic neurons in
animals and possibly in humans. Repeated use may induce long-term
neurotoxic effects, with cognitive and behavioral implications.
Prolonged use of ecstasy is associated with sleep, mood, and anxiety
disturbances, elevated impulsiveness, memory deficits, and attention
problems. Younger ecstasy users may be more vulnerable with regard to
neurotoxicity (Obrocki, et.al., 2002). Depletion of serotonin by MDMA
use may enhance vulnerability to a wide array of neuropsychiatric
problems and the MDMA induced destruction of serotonergic neurons may
have long-term and possibly permanent neuropsychiatric consequences in
humans (Montoya, Sorrentino, Lukas, & Price, 2002).
Research has shown that MDMA use is associated with verbal and visual
memory problems in individuals who have not used the drug for up to two
years. Users and former users have been found to perform more poorly on
some tests of memory, attention and learning than do nonusers. Ecstasy
may cause long lasting damage to brain areas that are critical for
thought and memory. MDMA is also associated with psychological problems,
especially depression (Mathias & Zickler, 2001). Other psychopathology
found in users of MDMA include psychotic disorders, cognitive
impairment, eating disorders, agoraphobia, and panic attacks, though it
cannot be completely determined whether mental disorders precede or
follow the initiation of ecstasy use. Suicidal ideation was
significantly more often reported by users of ecstasy and related
compounds than by those without use of illicit substances (Lieb, et.al.,
2002).
It is important to note that most people who use ecstasy also use other
drugs, especially marijuana. Interpreting findings on the association
between MDMA use and impaired memory is complicated by the frequent use
of other recreational drugs (e.g., cannabis, prescription drugs, and
amphetamine). Drug interactions from other illicit drugs or adulterants
in the MDMA preparations may interfere with the metabolism of MDMA
(Freese, Miotto, & Reback, 2002). It is important to note that the
strength varies among ecstasy pills, so one never knows for sure what
dosage one is getting.
An issue of major concern are fake ecstasy tablets in circulation that
contain a number of drugs that aren't MDMA. These include caffeine,
ephedrine, methamphetamine (speed),LSD, and more dangerous substances
such as PMA and DXM. PMA or paramethozyamphetamine is a hallucinogenic
stimulant that is highly toxic. It increases heart rate, blood pressure
and body temperature to dangerously high levels that can lead to
convulsions, coma and death. High doses cause difficulty breathing,
muscle spasms and vomiting. DXM or dextromethorphan is a legal cough
suppressant which at high doses causes loss of motor control, audio and
visual hallucinations, nausea and itchy skin (DanceSafe, DrugInfo). It
is becoming a common practice to test ecstasy pills before taking them
to ensure purity using kits that are available on the internet and at
clubs and raves
One can die from ecstasy. Many deaths have resulted from heat stroke.
Other dangers may include liver damage, irregular heartbeat, and kidney
failure. According to the Drug Abuse Warning Network, from 1998 through
1999, deaths from ecstasy increased %400. Between 1996 and 1999,
emergency room visits involving ecstasy grew nine times, from 319 to
2,850. The majority of these cases involved users under 25 years old.
Overdosing is possible. Toxic symptoms include numbness and tingling in
the extremities, vomiting, ataxia racing heart beat, hypertension, and
loss of consciousness (Palfai & Jankiewicz, 2001; Freese, Miotto, &
Reback, 2002. Lastly, it is important to note that MDMA is illegal.
Ecstasy is a controlled substance and has been labeled a Schedule 1 drug
since 1998. This opens up the possibility of social stigma associated
with illicit drug use (McMillan & Conner, 2000). Therefore, one must
also take into account risks of legal trouble, and ensuing financial,
family, and relationship problems associated with use of the drug (Drug
facts, club drugs).
People seem very open to sharing their experiences with ecstasy, both
positive and negative. A major theme in many people's use of the drug
was the need for moderation and recuperation periods between "dosing."
Here are a few personal accounts of ecstasy use.
Over the past year I have used ecstasy as a stimulant, as an
antidepressant, as a creative aid, or just to get my mind going. The
best I ever felt on ecstasy was a profound and perfect sense of unity of
mind, body, spirit and soul. I understood in an instant what happiness
and being happy involved. I don't see ecstasy as escapism, but rather
it helps to break down mental and emotional inhibitions. It gives new
hope and shows how good you can feel, and how good life can appear to
be.
On my second trip my limbs felt weightless. I could move in ways I
never imagined, and I felt such a unity with the music, as if it was
moving me. I loved every minute of it, and I didn't want it to stop. I
felt I could carry on all night, all morning. The music was touching my
soul, breaking through all my inhibitions and defenses, searching,
reaching, probing, pushing, and exploring the boundaries of possibility.
No light entered my eyes, but I saw everything… time in an instant, the
future, past and present.
Angeline (A 22 year old computer graphics student).
When I took a full pill for the first time, it was the most amazing
experience I have ever felt. I went to the dance floor. A wave of
warmth overcame me on my way down. For the first time in my life, I
knew what empathy felt like. I thought that everyone was my friend,
simply due to the fact that those around me (even if I didn't know them)
shared and enhanced this feeling just be being around me. The world
seemed like a better place. There was no war, no poverty, no pain while
I was rolling. I have never felt closer to my friends. We were sharing
something that we all knew the others were feeling. We were all in tune
with each other's thoughts, feelings, emotions. The colors were
brighter, the world looked sharper and more beautiful. My eyes were
finally truly opened up to the world as it should be seen.
Anonymous
The first two or three times I rolled I had a super time. The last time
I went to a club in Toronto. This time I had a blue tablet. About 20
minutes later I started to feel the usual euphoria. Then I started to
feel a bit weird and nauseated. My legs became real weak, everything
started to fade a bit and in the next few seconds I open my eyes and I'm
lying face down side ways on the floor looking at everyone looking down
at me. A bouncer took me backstage to the paramedic's section. I was
sweating like mad, and couldn't really walk straight. My crazy high
went away in about 5 minutes. So I just sit and chill for about two
hours, and have a few drags of weed too. Anyways, I get up to walk and
this intense rush sweeps over me like none I had experienced before…
from my feet up to my head. It was scary. I started to lose control of
my legs and held on to someone for support. Everyone just became
shadows and voices, then it became clear again, but I was still sweating
profusely. I eventually went home. I don't ever want to feel that kind
of rush or black out ever again, but I don't want to quit e either.
Stranger (anonymous)
I take ecstasy about every six months, which assures that you have
progressed psychologically and emotionally if you're in a path of
growth. Whenever someone asks me about E, I always like to get friends
to understand it's actually not the pill… It is irreverence, to
YOURSELF, to think otherwise. The second time I did ecstasy I was with
my best friend in the woods. It was what psychotherapy was supposed to
be about. E is what life should be like. Overall, the E experience has
made me a more serene person. Everything feels like "things work." E
has played a part in my spiritual development. I am now in the process
of being able to rest while I act. People take ecstasy and their Selves
are revealed. Make your consciousness a better place. Ecstasy is a tool
for that.
A 22 year old engineering student in Mexico City
I am a frequent user of E. When I go beyond 10 hours of tripping I
always experience dizziness that feels as if I am lifted by a wave when
swimming in the ocean. The waves start about 48 hours after taking the
last pill and last one to five days. In the beginning they occur about
every 30 to 120 minutes and then decrease in the following days. I can
feel it in my whole body, but the center of the sensation is in my head,
behind my eyes. After five days I always feel completely recovered.
I also experience nightmares after extended sessions. They are full
color and sound experiences that sometimes end with my waking up,
screaming, almost with my nails in the ceiling. Two days after an
extended session I can get emotionally unstable. I am easily irritated
and become intolerant, vulnerable and closed off. My relationship to
thoughts and feelings has completely changed. Using E in a therapeutic
way was extremely hard. You stop touching the illness in your character
and simply look at it in a very concentrated way.
An anonymous Dutch man
The most profound experience I have ever had has been with ecstasy. I
was searching for that feeling, that amazing warmth of allowing love to
flow through your body like waves. I would like to achieve that
beautiful state without the assistance of psychoactive drugs, but I
haven't found it yet. When I first took E I began to feel extremely
spontaneous and clear, like nothing I had felt before. I did become
nauseous, but it didn't dampen my experience as I was sharing the world
with everybody and everything that was alive in that moment of that
second of that minute of that hour of that day of that year of this
existence. The experience lasted for roughly four hours.
When I was coming off the drug at first I felt a little sad and for a
brief moment extremely paranoid. This was brief. I cannot stress the
importance of this experience to me. I now have a new outlook on life
and feel that this has helped me in my journey to enlightenment. I was
born on a journey to achieve this state of ecstasy and now know that I
am just farther along in my adventure called life.
An 18 year old American Woman
(All personal experiences were obtained from www.ecstasy.org).
References
Drug Info. (n.d.) PMA warning. Retrieved March 1, 2003, from
http://www.dancesafe.org
Experiences. (n.d.) Retrieved February 28, 2003, from
http://ecstacy.org./experiences/trip30.html
Freese, T.E., Miotto, K., & Reback, C.J. (2002). The effects
and consequences of selected club drugs. Journal of Substance
Abuse Treatment, 23, 151-156.
Lieb, R., Schuetz, C.G., Pfister, H., von Sydow, K., &
Wittchen, H.U. (2002). Mental disorders in ecstasy users: A
prospective longitudinal investigation. Drug and Alcohol
Dependence, 68, 195-207.
Mathias, R., & Zickler, P. (2001). Nida conference
highlights scientific findings on MDMA/ecstasy. Nida Notes, 16, 1-
7.
McMillan, B. & Conner, M. (2000). Drug use and cognitions
about drug use amongst students: Changes over the
University career. Journal of Youth and Adolescence, 31, 221-229.
Montoya, A.G., Sorrentino, R., Lukas, S.E., & Price, B.H.
(2002). Long term neuropsychiatric consequences of "ecstasy"
(MDMA): A review. Harvard Review of Psychiatry, 10(4), 212-220
Obrocki, J., Schmoldt, A., Buchert, R., Andresen, B.,
Petersen, K., & Thomasius, R. (2002). Specific neurotoxicity of
chronic use of ecstasy. Toxicology Letters, 127, 285-297.
Palfai, T. & Jankiewicz, H. (2001). Drugs and human behavior
2nd ed.). New York: McGraw-Hill.
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Copyright © 2003, Dr. John M. Morgan, All rights reserved -
This page last edited 25-Nov, 2002
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