Ecstasy

Ecstasy, or methylene-dioxymethyl amphetamine (MDMA), is a synthetic hallucinogenic stimulant, which usually comes in pill form.

The active oral dose of MDMA is 75mg. On average, most pills contain under 100mg of MDMA - the rest is inactive pill filler which can cinlude food dye, starch, or talcum powder.

Pure MDMA is a white powder but street ecstasy is almost always pressed into pills, usually coloured and stamped with different 'brand logos' such as Mitsubishi, Rolls Royce etc

Brands are meant to help users guage what they are buying. Hah. Quality brands are quickly imitated by inferior pills. Unbranded pills are sometimes better. Sometimes worse.

Most brands come and go within six months to a year. The 'Mitsubishi' logo is an exception, however, as it's been out now for over two years and has been copied all over the world. Be warned: not all Mitsubishis are the same.

Purity

Ecstasy pills are sometimes mixed with other active substances, most commonly amphetamines (speed), caffeine, & ephedrine (a natural amphetamine-like substance)

Rarely, some pills have been found to contain: DXM (dextromethorphan) a dissociative psychedelic found in some cough medicine and PMA (paramethoxyamphetamine) - a highly toxic hallucinogenic stimulant

Rumours that pills contains a cocktail of heroin, cocaine or LSD are false - none of these have ever been found in extensive lab tests.

MDMA produces intense feelings of pleasure, empathy, warmth, and happiness. It also increases sensitivity to music, makes people more emotionally open, and has a stimulating, speedy physical effect.

When ecstasy is swallowed, the full effect is usually felt within one hour. It starts with tingling and little rushes of exhilaration. Some people may experience nausea or dizziness while coming up but it quickly passes.

The effect builds quickly, coming on in waves within the first two hours, strengthening with each pass. A lightness of mood and relaxation gives way to waves of physical pleasure, euphoria, openness and empathy to others around you. The awareness of touch is strongly heightened. The muscles relax.

The peak arrives and then the effects last 4-6 hours, with a gradual tapering come-down in the last two.

Jaw clenching and "clamping" is a common side-effect of E and many people get relief by chewing on dummies or gum, smoking cigarettes or sucking lollies.

Effects in the brain

E causes serotonin (5-hydroxytryptamine or 5-HT) and dopamine to flood the brain. Both are neurotransmitters which influence the flow of information throughout the brain. Changing the balance between the two changes your mood. E gives you a glow of well-being, happiness, empathy, euphoria, increases your sensitivity to rhythmic music, and makes you want to dance.

The latest studies show that Ecstasy use can impair the serotonin system and memory performance. Please see our guide - Can Ecstasy Impair Your Memory? - plus safe dancing tips on how to protect yourself.

Cognitive Effects

Chronic users of MDMA perform more poorly than nonusers on certain types of cognitive or memory tasks. Some of these effects may be due to the use of other drugs in combination with MDMA, among other factors.

Physical Effects

In high doses, MDMA can interfere with the body's ability to regulate temperature. This can lead to a sharp increase in body temperature (hyperthermia), resulting in liver, kidney, and cardiovascular system failure.

Because MDMA can interfere with its own metabolism (breakdown within the body), potentially harmful levels can be reached by repeated drug use within short intervals.

Users of MDMA face many of the same risks as users of other stimulants such as cocaine and amphetamines. These include increases in heart rate and blood pressure, a special risk for people with circulatory problems or heart disease, and other symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating.

Psychological Effects

These can include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during and sometimes days or weeks after taking MDMA.

Neurotoxicity

Research in animals links MDMA exposure to long-term damage to neurons that are involved in mood, thinking, and judgment. A study in nonhuman primates showed that exposure to MDMA for only 4 days caused damage to serotonin nerve terminals that was evident 6 to 7 years later. While similar neurotoxicity has not been definitively shown in humans, the wealth of animal research indicating MDMA's damaging properties suggests that MDMA is not a safe drug for human consumption.

Hidden Risk: Drug Purity

Other drugs chemically similar to MDMA, such as MDA (methylenedioxyamphetamine, the parent drug of MDMA) and PMA (paramethoxyamphetamine, associated with fatalities in the U.S. and Australia) are sometimes sold as ecstasy. These drugs can be neurotoxic or create additional health risks to the user. Also, ecstasy tablets may contain other substances in addition to MDMA, such as ephedrine (a stimulant); dextromethorphan (DXM, a cough suppressant that has PCP-like effects at high doses); ketamine (an anesthetic used mostly by veterinarians that also has PCP-like effects); caffeine; cocaine; and methamphetamine. While the combination of MDMA with one or more of these drugs may be inherently dangerous, users might also combine them with substances such as marijuana and alcohol, putting themselves at further physical risk.

Comedown

On come-down, you may feel physically and emotionally drained. Without the artificial stimulation of E, the body and mind can suffer from exhaustion and anxiety.

It's very important to have somewhere warm and comfortable to go back to, preferably stocked with refreshments, and gentle 'chill' music. General health and regularity of use play a very large part in the harshness of the after-effects.

Ecstasy is rapidly broken down by the liver but about 60% enters the urine unchanged. The urine could be drunk to recycle it, in the same way that Siberian tribesmen drink each other's urine after eating magic mushrooms. This is known in most circles as 'desperate'.

The days after

The first day or two after taking E, senses are a little blunted, but a general sense of contentment can result in 'Happy Mondays.' E temporarily depletes serotonin for several days, which can prompt mood swings or mild depression.

Wednesday is usually the bleakest day before moods stabilise again. Often, weekly users do not regain neurochemical balance before they dose again. Permanently fluctuating moods can be a symptom of over-use.

Some users take the food supplement 5-HTP, a chemical precursor of serotonin (available from most health food shops), during, and after an E experience. It can help rebalance moods, as can tryptophyan-heavy foods such as bananas, milk, apples, turkey, chicken, yoghurt and chocolate.

The risk of death from Ecstasy use is extremely low. Between 1988 and 1997 some 50-100 UK deaths have been connected to Ecstasy use. The current rate is 7 deaths per million users per year. More people die fishing or eating peanuts.

The US figures are much lower, only one death per million users, largely due to the enduring preference for warehouse or outdoor parties rather than hot packed-out nightclubs. There is also less of a booze culture amongst American kids. Most E-related deaths are related to alcohol-consumption and over-heating.

Overheating

The most common cause of Ecstacy -related death is overheating (hyperthermia). MDMA interfers with the body's ability to thermoregulate itself, allowing the body to overheat without discomfort and other warning signs, especially when dancing for hours in hot clubs.

In a worse case scenario, the body can reach extreme temperatures (41-42°C) - a severe heatstroke which causes unpredictable and often medically-untreatable problems, including unstoppable bleeding, liver and kidney failure and ultimately death. Not the nicest way to go.

Most fatalities occur amongst inexperienced users, who have not learnt how to read the body's response to Ecstasy.

Drinking alcohol heavily also disrupts your body temperature, making Ecstasy-related over-heating much easier. Avoid alcohol

All users should be familiar with safe dancing practices.

Drinking too much water

Inexperienced users who are worried about overheating and dehydration may over-compensate, drink huge amounts of water and suffer from 'water-poisoning' or hyponatraemia.

When excessive amounts of water or fluid are consumed, the sodium balance of the body is disturbed and the organs swell. This is very dangerous for the brain, which cannot expand inside the skull. It becomes compressed, putting pressure on the brain stem which controls heart and breathing functions. This can lead to coma and death. Leah Betts is a tragic case in point.

This can be avoided by drinking only 500ml of water per hour and eating salty snacks, or by drinking orange juice.

Adiction

Ecstasy is not physically addictive in the way that drugs like cocaine, nicotine and heroin are. Many users are, however, addicted to the emotional state they reach on the drug. Some feel they cannot live without it and become regular weekly users.

Ecstasy is seductive - many users secretly know they would have difficulty going without it in the future, but wouldn't like to admit to it in terms of addiction. Calling a regular ecstasy user an addict usually provokes a negative reaction.

Tolerance

Frequent ecstasy use increases tolerance very quickly. Increasingly higher doses are needed to reach an 'acceptable' high. The more you use it the less you feel the loved up empathic feelings and the more the speedy amphetamine buzz takes over.

Regular users rarely come close to the novelty and surprise of first discovering the ecstasy state. To avoid the build-up of tolerance long breaks should be left between use (at least two months).

Long-term effects

The after-effects and long-term effects seem a little hushed up, often by the users themselves. The majority of regular users try to ignore the increases in tolerance, the harder come-downs, the mood swings, the short-term memory loss, the inability to concentrate and just see it as an acceptable price to pay.

There is evidence that even moderate regular use of ecstasy can lead to memory impairment.

Mixing with other drugs

As a general rule, don't mix E with other drugs, especially not alcohol. Deaths involving contaminants are rare but do happen, as do deaths involving drug cocktails: ecstasy-DXM and ecstasy-cocaine-viagra are current potentially dangerous mixes.

Please note: there have been very few scientific studies into the effects of combining psychoactive drugs. The information presented here is anecdotal. It is based on the subjective reports of experienced users. Different people will respond differently to different drugs and drug combination. Know your body.

alcohol reduces the clarity of the E high; places a greater strain on the kidneys; delays onset; heavy drinking can lead to dehydration and a much worse come-down; makes overheating much more likely; alcohol is involved in most Ecstasy-related deaths

amphetamines commonly used to prolong the energised ecstasy state but too much places a greater strain on the kidneys and heart; can also lead to anxiety, paranoia and burn-out

anti-depressants some research suggests that SSRI-type anti-depressants (such as Prozac) taken after E may reduce neurotoxicity. Many SSRI users report weaker E trips. MAOI (mono amine oxidase inhibitor) type anti-depressants should be avoided

cannabis used to help bring on the high, it mellows the intense rushes and helps with the come-down; makes the ecstasy more psychedelic.

heroin smoking heroin to come down after a hard weekend's partying, usually on a number of drugs rather than just E, is becoming slightly more popular, but not to the level reported in the media

ketamine can overpower the ecstasy very easily, leaving the user sat in the corner staring at the ceiling for an hour; is increasingly used to transform the last few hours of the E into a contemplative, calming-down period or to 'bump' up the effect

LSD aka "Candyflipping"; more common in America, extremely psychedelic, less chance of a bad LSD trip.

mushrooms as above, sometimes known as "flowerflipping"

tobacco many smokers smoke more heavily while on E, but there are no adverse side effects

Legal Considerations

In the UK, Ecstasy is a class-A drug, alongside heroin and cocaine, with extreme penalties for possession and supply.

In the US, MDMA is a Schedule I illicit drug with no accepted medical use or benefit, alongside LSD, cannabis, and heroin.

The US Government recently enacted harsh new penalties for those supplying Ecstasy.