Ecstasy, or MDMA (methylenedioxymethamphetamine), is a popular, primarily recreational drug, taken for its psychoactive effects. The drug creates a heightened sensory experience for the user, combined with increased empathy and feelings of euphoria, making it a popular rave and festival drug. However, with no current approved medical uses, and a wide variety of adverse side effects, MDMA is illegal in most countries.
Despite that, there is a thriving illegal ecstasy trade, with nearly 1 million people in the United States admitting to using it regularly. In one study, as many as 37% of regular club goers admitted to using it within the last year. At the same time, MDMA contributes to illegal drug use, may act as a gateway drug, and creates adverse side effects in users.
Early History and Synthesis
Ecstasy was first synthesized in 1912 by the German chemist Anton Köllisch at the Merk Group (A German pharmaceutical company). Köllisch was attempting to circumvent a patent held by Bayer for hydrastine by developing Merk’s own compound for the drug. It was his belief that the drug, then called methylsafrylamin, was an intermediate compound that could be used to synthesize hydrastine. In December of 1912, Köllisch filed a patent for the production of MDMA. Over the following 30 years, MDMA was studied intermittently, first for its ability to synthesize hydrastine, then for its effects on the body which is similar to high doses of adrenaline or ephedrine.
By the 1950s, the drug had reached experimental use in the United States, where it was rumored to be used in the military as a truth agent, and where its effects on blood pressure were being studied. However, experiments were dropped due to the high cost of the compounds used for synthesis.
Therapy and Recreational Usage
In 1965, American chemist Alexander Shulgin synthesized MDMA cheaply, and the drug was quickly brought back into research. At this time, Shulgin shared his research, where it was brought to the Midwest and then to California and Texas, and the recreational use of the drug was born. Shulgin went on to continue his research with other compounds, but in the 1970s, returned to MDMA after a student recognized psychoactive properties which were described as ‘similar to amphetamines’. These reports were from ‘self-trial’ or students who were actually using the drug recreationally. Shulgin began experimenting himself. He was impressed with the drug’s disinhibiting effects and recommended it for therapy. Over the following years, psychotherapist Leo Zeff, who was exposed to MDMA through Shulgin, trained an estimated 4,000 therapists across Europe and the United States to use MDMA for therapy.
At the same time, MDMA was rapidly becoming a mainstay of the rave and party culture of the 1970s. However, adoption was slow, largely due to a combination of difficulty synthesizing the drug and no large-scale manufacture because of fear of legal repercussions. As a result, ecstasy was primarily a college party drug starting in California and Texas, where it could be synthesized using lab materials until it began to spread to club scenes in Boston and New York.
However, by 1985, MDMA was being mass-produced and widely distributed to campuses, bars, and discos across the United States.
Awareness and Drug Scheduling
In 1982, the widespread use of MDMA for recreational use was becoming more known to the public. The drug was repeatedly seized in large doses during drug raids for recognized drugs like cocaine and marijuana. By 1984, Nancy Reagan’s “Just Say No” campaign was at its height, and combined with media publishing estimates that over 30,000 ecstasy pills were being produced in Texas each day, MDMA was given an emergency DEA Schedule 1 classification, effectively making it illegal to use or sell. MDMA was compared to MDA, an amphetamine already classified as a schedule 1.
The case went to court, as psychotherapists attempted to defend their use of the drug, but with no recorded medical testing and no double-blind studies, most medical uses stopped.
In 1986, the Multidisciplinary Association for Psychedelic Studies (MAPS) opened a file, enabling MDMA to be used for research purposes. Today, there are multiple studies trialing the controlled use of ecstasy to treat PTSD and other trauma. For example, in August of 2017, the FDA approved a stage 3 clinical trial for this purpose.
While MDMA was illegal in the United States, the drug scheduling did not slow its adoption. By the 2000s, MDMA was one of the four most common recreational drugs, second only to marijuana for first-time users.
Ecstasy also spread internationally, becoming a mainstay in clubs and raves, famously so in Ibiza, London, San Francisco, Amsterdam, and many more as early as the 1980s.
Effects of Illegalization
While the illegalization of MDMA has done little to control its use or spread, it has had dramatic impacts on the quality, availability, and cost of the drug. For example, many MDMA pills sold as ecstasy are actually MDA, a stronger and potentially more harmful drug. Pills are often cut with other substances such as methylone, ethylone, MDPV, and mephedrone (Commonly known as bath salts). Many commercially available ecstasy pills include only an average of about 40-60% MDMA, with substitutes often being more harmful than the original drug.
While high-purity ecstasy pills are available, and frequently sold in capsules, they are expensive compared to the ‘cut’ versions available in clubs and at raves, and therefore more difficult to acquire.
Effects of Ecstasy
Ecstasy users generally report feeling a strong sense of euphoria or wellbeing, increased self-confidence and lack of inhibitions, increased empathy, relaxation, a sense of inner peace, enhanced sensation and feeling, and an altered sense of time. Some users experience mild hallucinations, especially in combination with flashing lights and music at raves.
Most users begin to experience effects between 30-60 minutes after consuming MDMA, which peaks at 75-120 minutes and begins to decrease after about 3.5 hours.
Adverse Effects of Ecstasy
While Ecstasy is ranked #18 on the harmless to least harmless (20 is the least harmful) of the 20 most popular drugs in the world, it does cause adverse side effects during use, long-term side effects, and has the potential of overdose.
Short-Term Effects – MDMA causes dehydration, increased heart rate and blood pressure, diarrhea, nausea and vomiting, bruxism (grinding teeth), insomnia, loss of appetite, and increased sweating. These can result in life-threatening problems. For example, many MDMA users attempt to make up for dehydration by consuming excessive amounts of water, resulting in hyperthermia, where the body’s salt and electrolyte levels are too low.
Medium term effects including insomnia, sweating, loss of appetite, paranoia or anxiety, depression, impulsiveness, and memory impairment, which can last for up to a week after taking MDMA.
Long-Term Effects – Consistent and prolonged use of MDMA is not well understood or studied. For example, extreme or very high doses of MDMA over a long period of time results in brain lesions (a type of sore on the brain). However, it is not understood if moderate usage over the same time would produce similar effects.
Consistent heavy users have higher rates of anxiety, depression, and major illness – because MDMA eventually permeates the blood-brain barrier. MDMA is also a mild immunosuppressive and a mild inflammatory agent in the central nervous system, which causes symptoms of illness over time.
MDMA is moderately toxic to fetal development during pregnancy and can cause permanent or semi-permanent motor development issues in infants.
Overdose – While MDMA overdose is rare, it is exacerbated by substances used to cut the drug. For example, MDMA is often mixed with caffeine and bath salts. The most common symptom of overdose is hyperthermia, but users experiencing a severe overdose may also go into cardiac arrest, suffer cognitive and memory impairment, suffer convulsions and seizures, suffer kidney failure, or go into acute respiratory distress.
However, MDMA related deaths are very rarely the result of an overdose, but rather from side effects of the drug or actions taken on the drug.
Addiction and Recovery
While MDMA does not show many of the strong addictive symptoms of other Schedule 1 drugs, it is addictive. For example, studies show that around 60% of long-term MDMA users experience withdrawal symptoms such as fatigue, loss of appetite, and depression when stopping the drug. Many also experience increased tolerance over time, but slower than many other drugs.
At the same time, another study showed that approximately 15% of all MDM users meet criteria for heavy substance dependence.
MDMA, like other amphetamines, is addictive, and many users also heavily use other types of drugs, which are often more harmful. As a result, users, especially heavy users, are highly recommended to seek out help and therapy. Because MDMA often causes long-term depression and anxiety, getting help in the form of cognitive behavioral therapy or similar treatment can help to ensure that anyone who is addicted can learn how to live a healthy and happy life without the drug, and without having to rely on other substances to feel normal or okay after stopping ecstasy.
If you or someone you love is struggling with drug addiction or alcoholism, or you just have questions, please call Lighthouse Treatment Center today. We are happy to provide a no-cost, no-obligation consultation with one of our experienced treatment advisors. Help is available today.