IN RECENT years, ecstasy has become a common "club drug" in the United States as well as in the Charlottesville area. Unfortunately though, "ecstasy," "Adam," "XTC" or "E," as it is known on the street, may not be as safe and gentle as many profess. With its increasing popularity, local physicians are beginning to see more patients with complications related to this drug's use. This makes it increasingly important for everyone to be aware of its potential effects on the body.
Ecstasy's chemical name is 3,4-Methylenedioxymethamphetamine, or MDMA. First manufactured in 1912 by the pharmaceutical company Merck, by the 1970s and early 1980s, psychotherapists began prescribing ecstasy to help break down patients' emotional barriers.
Due to reports of abuse, addiction and possible permanent psychological effects, the Drug Enforcement Agency and the Food and Drug Administration reclassified it as a Schedule I drug in 1985. Schedule I drugs have no approved medical use and are restricted to scientific investigational studies. Thus, aside from the medical risks, the social and legal consequences of its use, possession and distribution are formidable.
A "designer drug," ecstasy comes from a class of compounds known as hallucinogenic amphetamines. It both alters the user's perceptions (though less intensely than hallucinogens like LSD and mescaline) and provides an amphetamine-like "high." This high is not without cost.
Ecstasy directly affects the neurotransmitter serotonin, causing neurons in the brain to release large amounts of this chemical. Serotonin plays an important role in regulating aggression, emotions, sexual activity, sleep and learning. This is why many users experience some anxiety and depression in the days after ecstasy use. Brain cell serotonin levels are depleted - hopefully only temporarily.
Research, however, has demonstrated that frequent ecstasy users may actually damage these neurons, causing long term or possibly permanant impairment in memory and mood regulation. Students may casually use Ecstasy without apparent short term consequence. However, the uncertain long term effect on brain function (e.g. permanent memory or mood disorders) should be a serious consideration before using this drug.
Because of the initial dramatic increase in serotonin levels, ecstasy is known to enhance emotional and sensual perceptions while heightening the user's sense of well-being and self-acceptance. Users of ecstasy tend to focus on interpersonal relationships and have a strong desire to be with, and converse with, other people. Although the drug has no aphrodisiac effect, it can lower inhibitions, producing extremely warm and empathetic feelings toward others.
In addition, its stimulant qualities cause increased awareness and energy, allowing the user to stay up or dance for extended periods of time. This effect, however, can also lead to increased body temperature and heart rate, dehydration, elevated blood pressure, temporary appetite suppression and heart or kidney failure. Death from some of these severe, and often unpredictable, reactions can occur, either from an overdose, or possibly from just one pill. Thankfully, we are unaware of any deaths related to ecstasy use among University students.
In the spring of 2000, 6.7 percent of University students reported using ecstasy at least once in the previous year. While this is still a small percentage, it has grown. As a result, reports to University hospital physicians and to other medical facilities nationwide indicate a definite increase in those experiencing severe reactions to ecstasy.
The types of reactions observed in University students include hallucinations, high blood pressure, rapid or irregular heartbeat and sleeplessness. Since street drugs can contain impurities and variations in strength, even casual or recreational users could experience a wide array of symptoms.
In addition, physicians and emergency rooms have been alerted that some pills sold as ecstasy are now being found to contain other substances, many of which could cause unpredictable and more dangerous reactions.
University students pride themselves on having a sound knowledge base. It's important to share this information so students can make informed decisions and prevent danger.
Remember that even pure ecstasy can have significant short-term health effects. However, what should be of particular concern to users is the uncertain or potential role of ecstasy in causing permanent brain dysfunction.
Before using, each student should ask the question: Are the "highs" worth the "lows"?
(Dr. James Turner is Executive Director of Student Health and Associate Professor of Clinical Internal Medicine at the School of Medicine.)
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