About MDMA

In this paper I’m going the asses the level of danger associated with occasional as well as systematic use of MDMA, or 3,4-methylenedioxymethamphetamine. I’m going to explore the complex of effects it causes, including cognitive, physical, and psychological, with a specific focus on neurophysiologic consequences.

This synthetic and psychoactive drug is chemically similar to the stimulant methamphetamine and the hallucinogen mescaline.

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In 2002, an estimated 676,000 people in the U.S. age 12 and older used MDMA. (2002, http://www.drugabusestatistics.samhsa.gov/) The report “Ecstasy: What We Know and Don’t Know About MDMA” (2001, p.4) draws our attention to the following fact:

“Unfortunately, myths abound about both the acute effects and long-term consequences of this drug, also known as “Ecstasy,” with many young people believing that MDMA is safe…”

So there is a clear and consistent need for further research of ecstasy long-term consequences. Montoya, Sorrentino & Price’s study (2002, p.212) states the following:

“Additional research is necessary to determine whether the MDMA-induced destruction of serotonergic neurons can have long-term and possibly permanent neuropsychiatric consequences in humans.”

General public knows that MDMA is, on rare occasions, lethal. But it’s scarcely informed on the impact ecstasy has on physical health, psychological sustainability, and behavioural changes.

Montoya, Sorrentino & Price in their study investigate the consequences of MDMA chronic recreational use. The main thesis the study is that MDMA damages serotonergic neurons in animals, and the researchers extrapolate the results of these experiments on humans, too. Whether or not this is also true in humans is currently an area of intense investigation. The neurons damaged by MDMA are involved in mood, thinking, and judgment.

The report “Ecstasy: What We Know and Don’t Know About MDMA” (2001, p.13) states the following:

“MDMA works in the brain by increasing the activity levels of at least three Neurotransmitters…[which are] serotonin, dopamine, and norepinepherine.”

This report (2001, p.6) empathizes the danger of the drug:

“Though the changes in dopaminergic neurons appear transient, the data suggest that the changes in the serotonergic system are longer-lasting.”

The serotonin system plays an important role in regulating mood, aggression, sexual activity, sleep, and sensitivity to pain. So all this areas may suffer significant change after a period of MDMA abuse. The drug, according to the report “MDMA Abuse (Ecstasy) Research Report” (2004, http://www.nida.nih.gov/ResearchReports/MDMA/default.html), interferes within “regions involved in cognition, emotion, and motor function.”

In high doses, MDMA can interfere with the body’s ability to regulate temperature. This can lead to hyperthermia, resulting in liver, kidney, and cardiovascular system failure.

Montoya, Sorrentino & Price (2002, p.216) state the following:

“Adverse neurological and medical effects of acute ecstasy toxicity include sleep deprivation, hyperthermia, cardiac arrhythmias, hepatotoxicity, and hyponatremia.”

MDMA can interfere with its own metabolism, and potentially harmful levels can be reached by repeated drug use within relatively short intervals. Users of MDMA face significant and sudden 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, swearing and chills.

The report “Ecstasy: What We Know and Don’t Know About MDMA” (2001, p.32-33) says that ecstasy has even deeper effects, as “researchers using positron emission tomography have obtained more conclusive evidence that MDMA use does in fact damage the brain at a level beyond damage to the axons of individual serotonin neurons.”

If to take a more medical approach, we’ll see that the mechanism of MDMA’s effect is quite clear.

“Conclusive proof that chronic neuropsychiatric sequelae are induced by depletion of5-HT in some MDMA users…” has been noted but still need scientific follow-up, according to Montoya, Sorrentino & Price’s (2002, p.219).

It is synthesized in 5-HT neurons, and stored in synaptic vesicles, and MDMA blocks the reuptake of 5-HT.

The study of Montoya, Sorrentino & Price’s (2002, p.214) also speaks of cognitive and behavioural implications:

“Cognitive impairments reported in chronic MDMA users range from deficits in memory (including short-term, delayed, visual, verbal, working, and episodic memory, as well as memory for new information) to impairments in central executive functioning and reasoning and semantic recognition.”

Chronic users of MDMA perform more poorly than nonusers on certain types of cognitive or memory tasks. The report “MDMA Abuse (Ecstasy) Research Report” (2004, http://www.nida.nih.gov/ResearchReports/MDMA/default.html) explain the phenomenon in the following way:

“Such memory impairments have been associated with a decrease in serotonin metabolites or other markers of serotonin function.”

It’s worth mentioning that MDMA users suffer from confusion, depression, drug craving, severe anxiety, and sleep problems. Montoya, Sorrentino & Price’s (2002, p.212) study states that “repeated use of ecstasy is associated with sleep, mood, and anxiety disturbances, elevated impulsiveness, memory deficits, and attention problems…”

The report “Ecstasy: What We Know and Don’t Know About MDMA” (2001, p.13) states the following:

“MDMA users also report after-effects that include anxiety, paranoia, and depression.”

The same report (2001, p.7) speaks about long-term cognitive and psychological consequence of MDMA prolonged use:

“Because MDMA produces long-term deficits in serotonin function, and because serotonin function has been implicated in the etiology of many psychiatric disorders including depression and anxiety, investigators have suspected that MDMA users may experience more psychopathology than non-users.”

Montoya, Sorrentino & Price (2002, p.212) state that MDMA can cause “depression, anxiety, panic, eating disorders, and psychosis.” Their study (2002, p.215) also states the following:

“Longer-term adverse psychiatric effects have also been related to chronic use of MDMA. These are varied but primarily include affective disturbances such as depression, marked euphoria, or agitation.”

The peculiar feature of MDMA use is that the effects of it may last, as Montoya, Sorrentino & Price argue, “for up to 2 years after cessation.”

These notion is also advocated in the report “The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs” (2001, p.920):

“It has been suggested that the demonstrated neurotoxic effects of MDMA on the serotonin system may be the possible cause of a variety of mental and behavioural problems that outlast the actual drug experience by months or years.”

MDMA is specifically dangerous to young consumers, who basically constitute the drug’s “target audience.” The report “Ecstasy: What We Know and Don’t Know About MDMA” (2001, p.6) states that “it may be that the youngest, fastest developing brains – those of a developing fetus – could be particularly vulnerable to the effects of this apparent serotonin neurotoxin.”

Montoya, Sorrentino & Price (2002, p.217) support this idea with more evidence:

“The impact of MDMA on adolescents may be particularly deleterious because of the vulnerability of their cerebral and hormonal systems, which are still undergoing crucial maturational changes.”

We shall also keep in mind that ecstasy is often consumed in combination with other “club drugs”, marijuanna or alcohol. Also, ecstasy is rarely pure, and often such substances as dextromethorphan, methylenedioxyamphetamine, and paramethoxyamphetamine are added to ecstasy tablets and pills. So indirect risks contribute greatly to the particularly high level of danger associated with MDMA occasional and chronic use.

To sum up my paper, I would like to raw your attention to the report “The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs” (2001, p.917), which mentions such dangerous effects as “related fatalities, caused by hyperpyrexia, rhabdomyolysis, intravascular coagulopathy, hepatic necrosis, cardiac arrhythmias, cerebrovascular accidents, and drug-related accidents or suicide.”

Montoya, Sorrentino & Price (2002, p.212) refer to MDMA as to “one of the most common and dangerous designer drugs.” Unfortunately, their argument is strong and supported by much evidence. So we can make a conclusion that ecstasy is extremely harmful drug for human consumption.

Sources:

Montoya, A.G., Sorrentino, R, Lukas, S.E & Price, B.H, (2002). Long term neuropsychiatric consequences of “ecstasy” (MDMA): A review. Harvard review of Psychiatry, 10, 212-220
2.      DHHS’s Substance Abuse and Mental Health Services Administration. (2002). The National Survey on Drug Use and Health (NSDUH).

http://www.oas.samhsa.gov/2k4/stateGaps/stateGaps.pdf

MDMA/Ecstasy Research: Advances, Challenges, Future Directions
A Scientific Conference. (2001). Ecstasy: What We Know and Don’t Know About MDMA. A Scientific Review.
http://www.drugabuse.gov/PDF/MDMAConf.pdf

National Institute on Drug Abuse. (2004). MDMA Abuse (Ecstasy) Research Report.
http://www.nida.nih.gov/ResearchReports/MDMA/default.html

Kalant, H. (2001). The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. Canadian Medical Association Journal. 165 (7). 917-28.
 

 

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