Ecstasy

MDMA most commonly known by the street names ecstasy or XTC (for more names see the full list), is a semisynthetic entactogen of the phenethylamine family, whose primary effect is believed to be the stimulation of secretion as well as inhibition of re-uptake of large amounts of serotonin as well as dopamine and norepinephrine in the brain, inducing a general sense of openness, empathy, energy, euphoria, and well-being. Tactile sensations are enhanced for some users, making general physical contact with others more pleasurable; but, contrary to popular mythology it generally does not have aphrodisiac effects. Its reported ability to facilitate self-examination with reduced fear may prove useful in some therapeutic settings, leading in 2001 to permission from the United States FDA for testing in patients with post-traumatic stress disorder in conjunction with psychotherapy.

Acute dehydration is a risk among users who are highly physically active and forget to drink water, as the drug may mask one's normal sense of exhaustion and thirst. Also the opposite, "water intoxication," resulting in acute hyponatremia, has been reported as a consequence of use. Sometimes more dangerous chemicals such as PMA or methamphetamine alone or in combination with MDMA are added to ecstasy tablets. Long-term effects in humans are largely unknown and the subject of much controversy - particularly with regard to the risks of severe long-term depression as a result of a reduction in the natural production of serotonin.

History
A patent for MDMA was originally filed on Christmas Eve 1912 by the German pharmaceutical company Merck, after being first synthesised for them by German chemist Anton Köllisch at Darmstadt earlier that year [1][2]. The patent was granted two years later, though in 1916, after two more additional years Köllisch died with no idea of the impact his synthesis would have. At the time, MDMA was not known to be a drug in its own right; rather, it was patented as an intermediate chemical used in the synthesis of a styptic (a drug intended to control bleeding from wounds.) Over half a century would pass before the first recorded ingestion of MDMA by humans.

The U.S. Army did, however, carry out lethal dose studies on MDMA and several other compounds in the mid-1950s. It was given the name EA-1475, with the EA standing for Edgewood Arsenal. The results of these studies were not declassified until 1969.

MDMA was legal in the United States until May 31, 1985 [2]. Before then, it was used both as an adjunct to psychotherapy and as a recreational drug. MDMA began to be used therapeutically in the mid-1970s after the chemist Alexander Shulgin introduced it to psychotherapist Leo Zeff. As Zeff and others spread word about MDMA, it developed a reputation for enhancing communication, reducing psychological defenses, and increasing capacity for introspection. However, no formal measures of these putative effects were made and blinded or placebo-controlled trials were not conducted. A small number of therapists–including George Greer, Joseph Downing, and Philip Wolfson–used it in their practices until it was made illegal.

MDMA appeared sporadically as a street drug in the early 1970s, but it came into prominence in the early 1980s in certain trendy yuppie bars in the Dallas area, then in gay dance clubs. From there use spread to rave clubs, and then to mainstream society. During the 1990s, along with the growing popularity of the rave subculture, MDMA use became increasingly widespread among young adults in universities and later in high schools. It rapidly became one of the four most widely used illegal drugs in the U.S., along with cocaine, heroin and marijuana.

In the late 1980s and early 1990s, ecstasy was widely used in the United Kingdom and other parts of Europe, becoming an integral element of rave culture. It has also been associated with other psychedelic/dancefloor-influenced music scenes, such as Madchester and Acid House.

Recreational use
The primary effects of MDMA include feelings of openness, euphoria, empathy, love, and heightened self-awareness. Its initial adoption by the dance club sub-culture is possibly due to the enhancement of the overall social and musical experience. Taking MDMA or ecstasy is commonly referred to as popping, rolling, pilling, boshing or dropping in the United Kingdom, "pinging" or "peaking" in Australia, "murfing" in Canada or "thizzing" in Northern California. Some term the rushing feeling of the drug as blowing up or coming up.

MDMA use has increased markedly since the late 1980s, and spread beyond its original sub-cultures to mainstream use. Prices have also fallen since the 1980s. In countries where distribution is more extensive, such as in the Netherlands and other places in Europe, prices can sometimes be as low as €1 per tablet. In countries where distribution is more difficult, such as the US and Australia, prices are accordingly higher at up to US$10-20 and AUD$35-50 respectively per tablet. In the United Kingdom it is common to pay around £2 to £3 for a tablet on average. Prices are also usually higher when the drug is purchased in a club or at a rave.

Supply
MDMA is usually ingested in pill form, although use of powder or crystal is increasing in popularity (sometimes known as "Mud," "Molly," "M.D." or "Madman"). Pills come in a variety of "brands", usually identified by the icons stamped on the pills. However the brands do not consistently designate the actual active compound within the pill, as it is possible for "copycat" manufacturers to make their own pills which replicate the features of a well-known brand.

Although full and proper characterization of ecstasy pills requires advanced lab techniques such as gas chromatography-mass spectrometry and gas chromatography-infrared spectroscopy, it is also possible to use a less accurate presumptive alkaloid test known as the Marquis reagent. Many organizations sell testing kits containing this reagent. DanceSafe is one such company, and it includes an extensive database of photographs of different pills, along with the results of a laboratory analysis of their contents. EcstasyData.org [3] is a non-profit site that tests the purity of street pills and compiles results. PillReports.com allows users to post reports of pills they've purchased and share the experience, pictures, and testing results. Other users can then post what they think about the pill in question or even rate the report on the pill.

Short Term
Serotonin is a neurotransmitter believed to play a role in the regulation of mood and pleasure. MDMA causes serotonin vesicles in the neurons to release quantities of serotonin into the synapses. Although popular press accounts focus on the role of serotonin release, the mechanism by which MDMA causes its unusual psychoactivity is largely unknown. In vitro and nonhuman animal studies have established that MDMA also induces dopamine, norepinephrine, and acetylcholine release and can act directly on a number of receptors, including a2-adrenergic (adrenaline) and 5HT2A (serotonin) receptors. MDMA promotes the release of several hormones including prolactin and the antidiuretic hormone vasopressin, which may be important in its occasional production of water intoxication or hyponatremia.

Other
Effects desired by users include:

increased positive emotion and decreased negative emotion increased sense of well-being increased sociability and feelings of closeness or connection with other people reduced defensiveness and fear of emotional injury a sense of increased insightfulness and introspective ability MDMA, particularly with larger doses, is sometimes reported to cause visual distortions. In a review of studies in which 1.5 to 1.7 mg/kg oral MDMA was administered in their laboratory to 74 people, Vollenweider et al. reported that scenic hallucinations were reported only once, while simple patterns, distorted objects, and flashes of light were commonly reported.

Acute physiological effects include:

Pupil dilation with attendant photosensitivity and color perception Nystagmus General restlessness Loss of appetite Increased heart rate and blood pressure Loss of sleep Dehydration

Legal Status
Use, supply and trafficking of ecstasy are currently illegal in most countries. In the United States, MDMA was legal and unregulated until May 31st 1985, at which time it was added to DEA Schedule I, for drugs deemed to have no medical uses and a high potential for abuse. During DEA hearings to criminalize MDMA, most experts recommended DEA Schedule III prescription status for the drug, due to its beneficial usage in psychotherapy. The judge overseeing the hearings, Francis Young, also made this recommendation. Nonetheless, the DEA classified it as Schedule I[10].

That same year, the World Health Organization's Expert Committee on Drug Dependence recommended that MDMA be placed in Schedule I of the Convention on Psychotropic Substances. Unlike the Controlled Substances Act, the Convention has a provision (in Article 7(a)) that allows use of Schedule I drugs for "scientific and very limited medical purposes". The Committee's report stated:

The Expert Committee held extensive discussions concerning therapeutic usefulness of 3,4 Methylenedioxymethamphetamine. While the Expert Committee found the reports intriguing, it felt that the studies lacked the appropriate methodological design necessary to ascertain the reliability of the observations. There was, however, sufficient interest expressed to recommend that investigations be encouraged to follow up these preliminary findings. To that end, the Expert Committee urged countries to use the provisions of article 7 of the Convention on Psychotropic Substances to facilitate research on this interesting substance. In the United Kingdom, MDMA is Schedule I/Class A, making it illegal to sell, buy, or possess without a license. Penalties include a maximum of seven years and/or unlimited fine for possession; life and/or unlimited fine for production or trafficking. A mandatory seven year sentence is now the penalty for a third conviction for trafficking.