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What is MDMA?

MDMA is an illegal drug that acts as both a stimulant and hallucinogen, producing an energizing effect, as well as distortions in time and perception and enhanced enjoyment from tactile experiences. Typically, MDMA (an acronym for its chemical name 3,4-methylenedioxymethamphetamine) is taken orally, usually in a tablet or capsule, and its effects last approximately 3 to 6 hours. The average reported dose is one to two tablets, with each tablet typically containing between 60 and 120 milligrams of MDMA. It is not uncommon for users to take a second dose of the drug as the effects of the first dose begin to fade.

MDMA can affect the brain by altering the activity of chemical messengers, or neurotransmitters, which enable nerve cells in many regions of the brain to communicate with one another. Research in animals has shown that MDMA in moderate to high doses can be toxic to nerve cells that contain serotonin and can cause long-lasting damage to them. Further, MDMA can interfere with the body's ability to control its temperature, which has on rare occasions led to severe medical consequences, including death. Also, MDMA causes the release of another neurotransmitter, norepinehrine, which is likely what causes the increase in heart rate and blood pressure that often accompanies MDMA use.

Although MDMA is known universally among users as Ecstasy, researchers have determined that many Ecstasy tablets contain not only MDMA but a number of other drugs or drug combinations that can be harmful as well. Adulterants found in MDMA tablets purchased on the street include methamphetamine, caffeine, the over the counter cough suppressant dextromethorphan, the diet drug ephedrine, and cocaine. Also, as with many other drugs of abuse, MDMA is rarely used alone. It is not uncommon for users to mix MDMA with other substances, such as alcohol and marijuana.

A Brief History of MDMA

MDMA was developed in Germany in the early 1900s as a parent compound to be used to synthesize other pharmaceuticals. During the 1970s in the United States some psychiatrists began using MDMA as a psychotherapeutic tool despite the fact that the drug had never undergone formal clinical trials nor received approval from the U.S. Food and Drug Administration (FDA) for use in people. In fact, it was only in late 2000 that the FDA approved the first small clinical trial for MDMA that will determine if the drug can be used safely under carefully monitored conditions to treat post-traumatic stress disorder. Nevertheless, the drug gained a small following among psychiatrists in the late 1970s and early 1980s, with some even calling it "penicillin for the soul" because it was perceived to enhance communication in patient sessions and reportedly allowed users to achieve insights about their problems. It was also during this time that MDMA first started becoming available on the street. In 1985, the U.S. Drug Enforcement Agency banned the drug, placing it on the list of Schedule I drugs with no proven therapeutic value.

What is the scope of MDMA abuse in the U.S.?

It is difficult to determine the exact scope of this problem because MDMA is often used in combination with other substances, and does not appear in some traditional data sources, such as treatment admission rates. MDMA does, however, appear to be a drug that has increased in popularity and become more widespread, particularly among people under the age of 25.

In 2002, over 10 million persons aged 12 or older reported using Ecstasy at least once in their lifetime according to the 2002 National Survey on Drug Use and Health, up from 6.4 million in 2000. The number of current users in 2002 was estimated to be 676,000. The initiation of Ecstasy use in the U.S. has been rising steadily since 1992, with 1.8 million new users in 2001.

The Drug Abuse Warning Network, maintained by the Substance Abuse and Mental Health Services Administration, reported that mentions of MDMA in drug abuse related cases in hospital emergency departments increased 94% from 1999 to 2001 (from 2,850 to 5,542); 86% of these cases also involved other substances, such as alcohol, marijuana, cocaine and heroin. More than three-quarters (77%) of the patients who came to emergency departments mentioning MDMA as a factor in their admission in 2001 were age 25 and under, suggesting that MDMA is used predominantly by adolescents and young adults.

There is, however, some encouraging news from NIDA's Monitoring the Future Study (MTF), an annual survey used to track drug abuse trends among adolescents in middle and high schools across the country. Over the last 2 years Ecstasy use decreased by almost 50% in 8th, 10th, and 12th graders combined. In fact, rates of MDMA use decreased significantly from 2002 to 2003 in all three grades surveyed. For 12th graders past year use declined from 7.4 percent to 4.5 percent. These decreases may be due in part to negative attitudes about MDMA use and increased awareness about the harmful consequences associated with this drug. Disapproval of MDMA use increased significantly from 2002 to 2003 for 8th and 10th graders but remained stable for 12th graders, and perceived risk associated with use increased in selected categories in each grade. For example, 56 percent of 12th graders said they were aware of the harm associated with the drug, an increase of 18 percentage points over three years ago. The percent of 12th graders who felt they could easily obtain the drug remained stable at 59% and 58% in 2002 and 2003, respectively, whereas the perceived availability among 10th graders decreased from 41% in 2002 to 36.3% in 2003. While the rates of MDMA use may be declining in high school students, the drug is still easy to get, and its use remains prevalent. The MTF data also show that MDMA use extends across many demographic subgroups. Among 12th graders, for example, 6.4 percent of Whites, 5.3 percent of Hispanic students, and 1.4 percent of African Americans reported using MDMA in the year prior to the survey.

Used with permission from the National Institute on Drug Abuse

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