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Primer: What You Need to Know About Ecstasy

Many young people abuse a so-called club drug known as Ecstasy. Learning about the drug can help you explain its dangers to your children and help them avoid the sometimes fatal consequences of taking it.

What is Ecstasy?

Ecstasy, or MDMA (3,4-methylenedioxymethamphetamine)—called "Adam," "E," "Ecstasy," "X," or "XTC" on the street—is a synthetic, psychoactive (mind-altering) drug with hallucinogenic and amphetamine-like properties. It is chemically similar to methamphetamine and the hallucinogen mescaline.

Because many different recipes are used in the illegal manufacture of Ecstasy, other toxic substances may be inadvertently created during the production. These other substances have been fatal to users.

Ecstasy is not a legal drug. It is classified as a "schedule 1" controlled substance, along with other dangerous substances like heroin, peyote, and LSD.

MDMA was developed in 1914 as an appetite suppressant. It was a legal prescription drug until 1985, given by psychiatrists and psychologists for certain psychological and emotional problems.

As an illegal substance, Ecstasy is made as a tablet, capsule or powder, and is usually taken orally. Sometimes it is packaged to imitate prescription drugs. Users combine it with methadone, LSD, opiates, or anesthetics.

Young adults and teens use Ecstasy most often—usually at clubs, rock concerts and raves (large, all-night dance parties). The number of 12- to 18-year-olds who use it is increasing.

Many problems that users encounter with MDMA are similar to those associated with the use of amphetamines and cocaine.

Among the problems:

  • Psychological effects. An Ecstasy high can last six to 24 hours, with the average "trip" about three to four hours. At moderate doses, Ecstasy can cause euphoria, feelings of well-being, enhanced mental or emotional clarity, anxiety, and paranoia. Heavier doses can cause hallucinations, sensations of lightness and floating, depression, paranoid thinking, and violent, irrational behavior. There is no evidence that Ecstasy is an aphrodisiac.

  • Physical effects include loss of appetite, nausea, vomiting, blurred vision, increased heart rate and blood pressure, muscle tension, faintness, chills, sweating, tremors, reduced appetite, bruxism (grinding teeth), insomnia, convulsions, and a loss of control of voluntary body movements. Serious to fatal side effects include hyperthermia (elevated body heat) and “serotonin syndrome,” a cluster of findings including hyperthermia, destruction of muscle cells (rhabdomyolysis), brain swelling (cerebral edema), liver failure (hepatic necrosis), and kidney failure (acute renal failure), adult respiratory distress syndrome (ARDS), and disseminated intravascular coagulopathy (DIC). The outcome to this constellation of problems is frequently fatal. Some effects may last up to two weeks after taking the drug. People who are pregnant, have a heart condition, are epileptic or have high blood pressure are at high risk of adverse effects. Users are also at high risk for heat exhaustion and dehydration, especially when the drug is taken during a dance party. Research also has found the possibility that Ecstasy damages the part of the brain that controls muscle movement.

MDMA is related in structure to methamphetamine, which causes degeneration of neurons containing the neurotransmitter dopamine. Damage to dopamine-containing neurons causes the motor disturbances seen in people with Parkinson's disease.

Symptoms of this disease include tremors and lack of coordination early on, and possibly paralysis in later stages.

Nearly 18,000 young people were seen in emergency rooms in 2008 due to MDMA abuse.

What about herbal Ecstasy?

The herbal forms of Ecstasy are ephedrine (called ma huang) or pseudoephedrine and caffeine (called kola nut). The effects of these substances are nearly identical to Ecstasy. Herbal Ecstasy is sold in tablet form as Cloud 9, Herbal Bliss, Ritual Spirit, Herbal X, GWM, Rave Energy, Ultimate Xphoria, and X.

The amounts of ephedrine and caffeine in these substances can vary widely. More than 800 adverse reactions have been reported, including high blood pressure, seizures, heart attacks, strokes, and death.