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Who is abusing
MDMA?
MDMA first gained popularity among adolescents and young adults in the nightclub scene or weekend-long dance parties known as raves. However, recently the profile of the typical MDMA user has been changing. Community-level data from NIDA's Community Epidemiology Workgroup (CEWG), reported in June 2003, indicate that use of MDMA has spread beyond the rave and nightclub scene to a variety of urban, suburban and rural areas throughout the country, including greater use on college campuses. For example, reports from Chicago suggest that Ecstasy, or drugs sold as Ecstasy, are widely available among high school and college students.
Use of this drug has also increased among different ethnic groups. For example, reports from Texas indicate use spreading beyond predominantly White youth to a broader range of ethnic groups. In Chicago, where a single MDMA pill can be purchased for about $12 to $15, the drug continues to be predominantly used by White youth, but there are increasing reports of its use by African American adults in their twenties and thirties. Also indicators in New York suggest that both the distribution and use of club drugs are becoming more common in non-White communities.
MDMA has also become a more popular drug among urban gay males. Reports have shown that some gay and bisexual men take MDMA and other club-drugs in myriad venues. This is concerning given that the use of club drugs has been linked to high-risk sexual behaviors that may lead to HIV or other sexually transmitted diseases. Many gay males in big cities report using MDMA as part of a multiple-drug experience that includes marijuana, cocaine, methamphetamine, ketamine, and other legal and illegal substances.
What are the effects
of MDMA?
MDMA has become a popular drug, in part because of the positive effects that a person experiences within an hour or so after taking a single dose. Those effects include feelings of mental stimulation, emotional warmth, empathy toward others, a general sense of well being, and decreased anxiety. In addition, users report enhanced sensory perception as a hallmark of the MDMA experience. Because of the drug's stimulant properties, when used in club or dance settings MDMA can also enable users to dance for extended periods. However, there are some users who report undesirable effects immediately, including anxiety, agitation, and recklessness.
As noted, MDMA is not a benign drug. MDMA can produce a variety of adverse health effects, including nausea, chills, sweating, involuntary teeth clenching, muscle cramping, and blurred vision. MDMA overdose can also occur - the symptoms can include high blood pressure, faintness, panic attacks, and in severe cases, a loss of consciousness, and seizures.
Because of its stimulant properties and the environment in which it is often taken, MDMA is associated with vigorous physical activity for extended periods. This can lead to one of the most significant, although rare, acute adverse effects -- a marked rise in body temperature (hyperthermia). Treatment of hyperthermia requires prompt medical attention, as it can rapidly lead to muscle breakdown, which can in turn result in kidney failure. In addition, dehydration, hypertension, and heart failure may occur in susceptible individuals. MDMA can also reduce the pumping efficiency of the heart, of particular concern during periods of increased physical activity, thereby further complicating these problems.
MDMA is rapidly absorbed into the human blood stream, but once in the body MDMA interferes with the body's ability to metabolize, or break down, the drug. As a result, additional doses of MDMA can produce unexpectedly high blood levels, which could worsen the cardiovascular and other toxic effects of this drug. MDMA also interferes with the metabolism of other drugs, including some of the adulterants that may be found in MDMA tablets.
In the hours after taking the drug, MDMA produces significant reductions in mental abilities. These changes, particularly those affecting memory, can last for up to a week, and possibly longer in regular users. The fact that MDMA markedly impairs information processing emphasizes the potential dangers of performing complex or even skilled activities, such as driving a car, while under the influence of this drug.
Over the course of the week following moderate use of the drug, many MDMA users report feeling a range of emotions, including anxiety, restlessness, irritability, and sadness that in some individuals can be as severe as true clinical depression. Similarly, elevated anxiety, impulsiveness, and aggression, as well as sleep disturbances, lack of appetite and reduced interest in and pleasure from sex have been observed in regular MDMA users. Some of these disturbances may not be directly attributable to MDMA, but may be related to some of the other drugs often used in combination with MDMA, such as cocaine or marijuana, or to potential adulterants found in MDMA tablets.
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