Ecstasy is the street form of MDMA , often shortened to "E", "X", "XTC" or “eccy”, usually referring to its pill form, although this term may also include the presence of possible other substances and impurities. It is a psychoactive and stimulatory drug that induces a sense of euphoria and an increased of intimacy coupled with a decreased sense of anxiety. These effects have lead to it often being referred to as the “hug drug” as users like to be touched. The pill form comes in various shapes and colours, often with various designs stamped on them (e.g., hearts, stars, butterflies, clover leaves). These marks are no guarantee of the quality or purity of the product. The dose of MDMA in one tablet can vary from 10 mg to 150 mg, so the effects can also vary considerably. It first came into widespread use with the emergence of techno music and parties known as raves, where users stayed up all night dancing for hours on end. It is also known as ADAM or Eden Tablet, the yuppie drug, clarity, essence, doctor, and insight amongst others. When it is on powder or crystalline form it is sometimes also known as “molly” or “mandy” which is inhaled through the nose (snorted) or smoked. Rarely, some people inject ecstasy.
MDMA was first developed as an appetite suppressant in 1914 by the German company, Merck.
There have long been suggestions that MDMA might be useful in psychotherapy, facilitating self-examination with reduced fear. Some Psychotherapists used MDMA in their practices until it was made illegal. The authors of the first phase-II double-blind randomized controlled clinical trial into the potential therapeutic benefits of using the drug as an augment to psychotherapy concluded that "MDMA-assisted psychotherapy can be administered to post traumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments."
So why is it illegal?
In the United Kingdom, MDMA was made illegal in 1977. In the United States, it was made illegal in 1985 and many other countries followed suit. It was becoming very popular as a club drug and first coming into widespread use with the emergence of techno music and parties known as raves, where users stayed up all night dancing for hours on end. Scientific research then linked it to a series or deaths that had occurred. It was found later that the drug that caused the deaths was in fact either ketamine or crystal methamphetamine mixed with other impurities. However, other studies have shown that it causes a reduction in the concentration of serotonin (a neurotransmitter) transporters in the brain. The serotonin spike from MDMA can result in what doctors call "serotonin syndrome," which can be lethal. It has also been shown to lead to possible long term brain damage. It was found that people seem to develop a tolerance to ecstasy fairly rapidly. Thus with repeated use, it becomes difficult, if not impossible, to experience the same effects experienced with the first dose. In an attempt to do so, users were taking larger and larger doses of the drug increasing the associated risks. Thus it has remained illegal
What are its effects?
The effects of ecstasy depend on:
- How much you take
- your height and weight
- your general health
- your mood
- your past experience with the ecstasy
- whether you use ecstasy on its own or with other drugs
- whether you are alone or with others, at home or at a party, etc
Small amounts
When you take a small amount of ecstasy, the effects can start within an hour and last up to about six hours. Some effects may continue for up to 32 hours.
You may feel:
• very good and confident
• close or affectionate to other people
• anxious
• paranoid (fear that others want to hurt you).
Effects on your body may include:
• your heart beats faster
• your blood pressure rises
• your body temperature rises
• you sweat more
• your body loses moisture (dehydration)
• you grind your teeth or clench your jaw
• you feel sick in the stomach (nausea).
Large amounts
If you take a large amount of ecstasy you might:
• see, smell, hear or feel things that are not there (have hallucinations)
• feel as though you are floating
• behave strangely - do or say things you normally would not
• have a fit
• vomit.
There is some evidence that you can have a hangover effect after the effects of ecstasy have worn off. Symptoms of this include:
• not being hungry
• sleep problems
• feeling depressed
• muscle aches
• finding it hard to concentrate.
To re-emphasize,ecstasy is not a controlled substance. Thus the dose of MDMA in one tablet can vary from 10 mg to 150 mg so there is no way to be certain if you're getting a small, or large amount.
Ecstasy and HIV
As with all recreational drugs it is wise to consider how use could impact on adherence to your HIV treatment or other areas of your health or life. All protease inhibitors, especially Ritonavir (Novir), which is almost always taken with other protease inhibitors or is a component of ones such as Aluvia (Kaletra), as well as Efavirenz (Sustiva), can cause a large increase in the amount of ecstasy in the blood. There have already been deaths reported from this drug interaction. People can have an allergic reaction to the drug, which can be fatal. It has also been associated with heart and lung problems, dramatic increases in body temperature, kidney failure, and liver damage. The potential liver toxicities of ecstasy and other recreational drugs are of particular concern to people with HIV as liver damage can make you very ill in its own right, and stop the body from processing anti-HIV drugs properly. Allied with this, it is difficult to know what the ecstasy tablet you are using really contains. The doses found in street drugs are not controlled, and the ecstasy pill you buy might contain much larger quantities of the drug. Also, the ecstasy may have been ‘cut’ with other substances or with other drug thus leading to toxicity from chemicals other than MDMA. Pills may also contain other active substances meant to stimulate in a way similar to MDMA, such as amphetamine, mephedrone, methamphetamine, ephedrine and paramethoxyamphetamine (PMA) amongst others. These are comparatively cheap to produce and can help to boost overall profits but they are also highly neurotoxic. In some cases, tablets sold as ecstasy do not even contain any MDMA at all. Instead they may contain theses drugs and an assortment of undesirable packing substances, such as talcum powder etc. Thus, long-term use has been linked to poor mental health, depression, psychotic episodes and memory problems. These problems are often exacerbated in HIV+ people and anyone can have an allergic reaction to the drug, which can be fatal.
What does an over dose look like and should I do if I, or someone uses it and overdoses?
Overdose of ecstasy, or a bad reaction to ecstasy, can happen to anyone who uses it. When a person overdoses, it may cause:
• very high blood pressure
• fast heartbeat
• very high body temperature.
Some people have died after having a very bad reaction to ecstasy. These deaths are often caused by the body overheating and losing moisture (dehydrating).
To prevent dehydration it is important to keep sipping water. Doctors recommend that you drink 500ml per hour if you are moving around (eg dancing), and 250ml per hour if you are not moving around.
To avoid any unwanted side effects of any drug, don’t use the drug. Drug use is not a moral issue, it is a health issue. If you are using it and have become dependent, please consider enrolling in a rehabilitation program run by well informed health care professionals and drug counselors.
I hope readers have found this post useful help
Get tested, stay healthy and, if you’re HIV+, compliant with your ARV regimen,
Malcolm Brown.
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