An Overview of Ecstasy Use & Abuse

Molly, the love drug, XTC, X, Adam, hug beans, E, Eve, and ecstasy are all names for MDMA, which is 3,4-dimethylenemethamphetamine, a drug that has both stimulant and hallucinogenic properties. Stimulant drugs increase energy, focus, alertness, and body temperature while also raising blood pressure, heart rate, and respiration levels. Stimulants also decrease appetite and the need for sleep.

As a psychoactive drug, ecstasy heightens sexual arousal, emotional closeness, sensitivity to touch, and pleasure. It also distorts time and the senses, and lowers inhibitions. Ecstasy is generally synthesized in underground labs and considered an illegal drug in the United States by the Drug Enforcement Administration, or DEA. It is usually sold as a tablet that is swallowed, and these tablets may be brightly colored and resemble candy. The National Survey on Drug Use and Health (NSDUH) reports that over 600,000 people had abused ecstasy within 30 days leading up to the 2014 survey.

Ecstasy is often considered a “club drug“ because of the tendency for adolescents and young adults to use it at raves, or all-night dance parties. Individuals between the ages of 18 and 25 abuse ecstasy more than any other age group, NSUDH publishes. The Monitoring the Future (MTF) Survey published by the National Institute on Drug Abuse (NIDA) found that in 2015, more than 3.5 percent of high school seniors had abused ecstasy in the past year.

Particularly concerning may be the rise of Molly, the supposedly “pure” form of ecstasy. Individuals may purchase and use Molly under false pretenses, as Molly pills seized in New York in recent years were found to only contain a small percentage (13 percent) of actual MDMA and instead contained a variety of other toxins and chemicals, CNN reports. Molly is a synthetic, “designer” drug and can be especially dangerous, as individuals may not know what is actually in the drug they are taking.

Ecstasy and Molly are often also mixed with alcohol or other drugs, which can increase all of the risk factors and possible negative consequences. An estimated 11 million Americans have abused a form of the “party drug” ecstasy at least once in their lives, according to statistics published by NBC News. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that emergency department (ED) visits jumped 128 percent, in those younger than age 21 from 2005 to 2011, for negative interactions with ecstasy. Around 33 percent of these ED visits each year also include alcohol as a contributing factor.

How Ecstasy Affects the Mind and Body

Ecstasy, when ingested, typically starts working in the body in about a half-hour or so, and the effects generally last about 4-6 hours, the DEA estimates. Of course, if alcohol or other drugs are also taken, the duration of action and potential side effects may be increased and intensified. MDMA interferes with movement and transmission of the mood-regulating neurotransmitter serotonin in the brain. This is partially what causes the changes in emotions and moods, and the feelings of empathy, strong emotional attachment, and pleasure when a person is under the influence of ecstasy. It also disrupts the natural production and activity of dopamine and norepinephrine in the brain. Dopamine can create a surge of happiness and good feelings while norepinephrine is related to adrenaline and increases activity levels, blood pressure, and heart rate.

Ecstasy can have several negative side effects and possible ramifications when abused, which can include:

• Nausea
• Confusion
• Depression
• Muscle cramps
• Blurred or double vision
• Chills
• Sweating
• Racing heart rate
• Hypertension
• Decreased appetite
• Memory issues
• Difficulties sleeping
• Dehydration
• Anxiety
• Restlessness
• Impulsivity
• Paranoia
• Clenching of teeth or jaw
• Inability to regulate body temperature
• Regrettable sexual interactions
• Distortion of perception of time and surroundings

Ecstasy abuse can cause a toxic buildup in the body of hazardous chemicals that it can’t break down, especially when combined with other substances, and this can lead to a potential life-threatening overdose. MDMA may cause an individual’s body temperature to shoot up too high, leading to hyperthermia, kidney, heart, or liver failure, which can be fatal, NIDA warns. The Drug Abuse Warning Network (DAWN) publishes that in 2011, over 22,000 individuals were seen in an ED for a negative interaction to MDMA.

Ecstasy abuse may also result in poor decision-making, questionable sexual encounters, and risky behaviors that can increase negative consequences like accidents, injuries, and even the potential for unwanted pregnancy and contracting a sexually transmitted disease. Long-term ecstasy abuse may cause lasting brain damage to parts of the brain involved in helping to regulate moods, cognitive abilities, and even motor functions. NIDA warns that regular use of MDMA may cause problems with an individual’s working memory and learning functions, as well as cause mental confusion, depression, and other consequential behavioral issues.

Addiction may be a side effect of chronic ecstasy abuse. In 2014, NSDUH reported that just over 7 million Americans (aged 12 and older) suffered from an illicit drug use disorder.

Addiction to Ecstasy

Addiction occurs when a person is not able to control their drug use. This means that they likely have tried, at least once, to stop taking a drug like ecstasy to no avail. They may continue to take it even when they realize that doing so is going to have negative consequences. They just can’t help it. They may take more and higher doses than originally intended and take the drug for longer periods of time. In doing so, a tolerance to ecstasy levels may be formed, and higher doses become necessary to keep feeling its effects.

A person who suffers from an ecstasy addiction may not be as diligent at work or school, may have a lot of unexplained absences, and therefore production (and grades) can suffer. Physical health may decline, as changes in appetite and sleep patterns take a toll on the body. Weight loss may be drastic and unhealthy, and sleep problems can lead to sallow skin, sunken eyes, and cognitive difficulties. Individuals battling addiction may not take care of their appearance, and they may appear unkempt and disheveled.

Behavior may be erratic and out-of-character for someone struggling with addiction, and mood swings may be commonplace. Interpersonal relationships may suffer, and social circles may change to center mainly around others involved in “partying” or using ecstasy. An individual may be disinterested in things they used to care about before and become secretive and withdrawn from family and loved ones. Family, work, and school obligations may be consistently overlooked, and the main focus of the person’s life may turn to figuring out where and how to get ecstasy, using it, and recovering from the drug’s effects. Drug dependence and withdrawal symptoms are also signs of addiction.

Ecstasy Dependence and Withdrawal

Physically, changes in the brain occur when a person abuses ecstasy. Some of the chemical pathways that are involved in emotional regulation, impulse control, short-term memory, pain sensations, reward, and decision-making are altered when the drug is introduced. When the drug wears off, it can take a little bit of time for the brain to return to normal. This is often called a “crash,” and in the case of stimulant drugs, it includes feelings of fatigue, low energy, hunger, and depression – often the opposite of the drug’s effects.

As individuals continue to reintroduce ecstasy, going through the high and crash periods more frequently, it can take more time for the brain to regulate itself each time.

A kind of shortcut in the brain’s circuitry may be created to accommodate the drug. In so doing, a physical dependence may be formed, as the brain expects ecstasy to be there and makes changes in its chemical makeup. When ecstasy leaves the brain then, it struggles to regain natural balance, and withdrawal symptoms are often the result.

In the case of ecstasy, withdrawal symptoms generally include difficulties concentrating, fatigue and trouble sleeping, changes in appetite levels, and depression, NIDA reports.

Withdrawal symptoms generally start after ecstasy stops being active in the bloodstream and peak in the first day or two, lasting about a week. Some of the emotional and cognitive symptoms may last longer and may be directly related to the level of dependence on the drug.

Withdrawal can be uncomfortable, and it is ideally managed through medical detox. Professional detox is performed in a specialized facility that can help individuals safely process drugs and other toxins from the body. Medical detox provides the highest level of care, as medical and mental health professionals are available to ensure that individuals stay safe and comfortable. Withdrawal symptoms may be medically managed with the aid of pharmaceutical tools and supportive care during medical detox. On average, detox generally lasts 5-7 days, although sometimes a few extra days are beneficial.

Treatment Options for Ecstasy Abuse

After detox, enrollment in a substance abuse treatment program is important in order to prevent relapse, or a return to drug use. An evaluation is often performed prior to admission in order to help families and individuals to decide on the best level of care. Any co-occurring disorders or polydrug abuse can be addressed, and care can be specifically tailored for maximum benefit.

SAMHSA estimated that almost 8 million adults in America suffered from concurrent substance abuse and mental health disorders in 2014. Treatment standards dictate that integrated care is ideal in the case of co-occurring disorders. When mental health, substance abuse, and medical providers all work together, care and recovery can be optimized for both disorders.

Outpatient programs can be flexible with a person’s existing life obligations and schedule, while inpatient treatment models are generally considered the most comprehensive as they provide around-the-clock care and support. Behavioral therapies and counseling sessions are integral parts of any substance abuse treatment program, as both group and individual sessions can help individuals to better understand themselves and learn new life skills and coping mechanisms. Individuals learn what may serve as personal triggers for them and how to avoid or manage them in the future. Stress management tools as well as helpful ways to naturally regulate moods and emotions are taught as well.

Relapse prevention tools often include support groups, wherein individuals can connect with peers in an encouraging forum where they are understood and empathized with. These support groups may last well into ongoing recovery to provide continued support and encouragement. Ecstasy abuse and addiction treatment that is multifaceted and specific to the individual provides optimal care for a healthy and sustained recovery.