MDMA
Also known As:
MDMA, Ecstasy, XTC, E, X, Beans, and Adams.
What is it?
The chemical name for ecstasy is 3,4-methylenedioxymethamphetamine, or MDMA. The chemical structure and the effects of MDMA are similar to amphetamine (a stimulant) and to mescaline (a hallucinogen) (CAMH, 2011).
Ecstasy is the end product of pressing MDMA (and usually other drugs/fillers ex. Amphetamines, caffeine, ephedrine, etc.) into pill form. Rarely will a pill of ecstasy be pure MDMA, and some pills may contain no MDMA at all.
How does it work?
MDMA works by blocking the re-uptake and releasing the neurotransmitter serotonin within the brain and central nervous system. It floods your nervous system with serotonin, which is the neurotransmitter that is primarily associated with regulating a person’s mood (many anti-depressants, like selective serotonin re-uptake inhibitors [SSRI’s], interact with the same neurotransmitter but to a lesser degree). The serotonergic receptors in the brain will be stimulated by MDMA, eliciting feelings of both elevated mood, and hallucinations/euphoria
What does it look like?
In powder/crystallized form, MDMA has a white/yellowish colouring with a very bitter taste and will leave a hot, burning sensation if it is consumed nasally. It has the same look if it is within a capsule without the bitter taste. If MDMA is in pill form, it can be pressed into small circular pills, that may have a variety of colours and symbols pressed into them. The colour and symbol (animals, letters, etc.) are a way to denote a certain batch/label by dealers (if the pill contains a certain amount of MDMA or other drugs). However, shape, colour, symbol, and taste are not reliable indicators of the quality or potency of the drug.
Is there a safe dose?
Under prohibition and when taking illicit drugs, there is no safe dose because it is hard to know the contents or potency of a substance. MDMA and ecstasy are often cut with unknown and potentially dangerous adulterants—so it is important to know your source, test your drugs, and follow harm reduction tips.
A standard dose for an individual is dependent on the person’s experience and tolerance with the drug, as well as their own biology. Usually a starting dose would be 1/10th of a gram (0.1g) or 1 pill/capsule, but the potency of the pill/capsule/powder can vary drastically. The route of administration, oral, snorting and intravenous also has an impact on what a “safe dose” would be.
Effects
The desired effects of MDMA are intense feelings of pleasure and well-being, increased energy and sociability, and closeness/connection with both the environment and people as a whole. It has also been used for decades as a “party/rave drug”, because it produces sensations of heightened sensory experiences.
MENTAL Effects include:
Heightened auditory and visual sensory experiences
Hallucinations
Feelings of pleasure
Increased energy
Sociability and feelings of heightened empathy
Anxiety, feelings of panic, and depression after the drug wears off
Physical effects include:
Increased heart rate and blood pressure
Grinding of teeth and jaw pain
Blurred vision
Sweating and dehydration
Nausea and vomiting
Side effects and cautions
Ecstasy increases body temperature, blood pressure and heart rate, which can lead to kidney or heart failure, strokes and seizures. Ecstasy may cause jaundice and liver damage (CAMH, 2011). To decrease the likelihood of harm, follow harm reduction tips, take breaks from physical activity, and drink plenty of water if taking ecstasy.
Note that some people cannot metabolize MDMA in their liver, because they have liver disease, or lack a specific enzyme that breaks-down MDMA. For these people, taking a “regular” dose MDMA may overdose, dangerous over-heating, and death. It is important for users to be aware of their liver health, and take a very small dose if it is their first time (DanceSafe, 2014).
OVERDOSE
Excessive use or large doses of MDMA can cause overdose. However, in instances of fatal overdose, more than one drug is typically involved. Signs and symptoms of MDMA overdose include:
Mental confusion
Seizures and convulsions
Loss of consciousness
Panic attacks
Hyperpyrexia: Life-threatening elevation of body temperature
After-Effects
After the initial effects of the drug have worn off, users may also experience after-effects such as confusion, irritability, anxiety, paranoia, depression, memory impairment, or sleep problems (CAMH, 2011).
It is common for users to report feeling sad or depressed in the days following the consumption of MDMA. Taking excessive amounts of MDMA may also result in ‘midweek blues’ as a result of depleted serotonin levels (Mary Anne Dunkin, 2010).
Therapeutic Uses?
Over recent years, studies have been approved to use MDMA in therapeutic settings for research. Of particular interest is the potential of MDMA-assisted psychotherapy for treating Post-Traumatic Stress Disorder (PTSD). Preliminary results have been very promising, and future considerations for therapeutic uses of MDMA are just beginning.
Harm Reduction Tips
to reduce the possible harms of MDMA, the following is suggested:
Start low, go slow, and never use alone. Start with a quarter dose, stagger your use with others, and let a trusted friend know to check up on you.
Test your batch: MDMA, either in pill, capsule or powder/crystallized form, is likely cut with other drugs/fillers. Be sure to test your batch to ensure that other drugs (such as fentanyl) have not been added/mixed with the MDMA.
If you are dancing, take breaks and cool off. A major factor in many ecstasy-related harms and deaths is the dehydration and overheating that can result when ecstasy is taken in conjunction with all-night dancing.
Stay hydrated. To avoid dehydration, drink lots of water and consume electrolytes (salty snacks, fruit juice, and sports drinks).
Don’t mix with alcohol, MAOIs (prescription antidepressants), DXM, codeine and other opiates or Ritonivar (a medication used in HIV treatment).
Take breaks from ecstasy so that your body has a chance to recuperate.
Legal Status: Use, Possession, & Distribution
Currently, MDMA is classified under the “Controlled Drugs and Substances Act” as a Schedule I narcotic, meaning that it is illegal to possess, produce, export and sell MDMA. If you are arrested with a small amount in your possession, you can face up to 7 years in imprisonment (Controlled Drugs and Substance Act, 2019). With the breakthroughs in MDMA-assisted psychotherapy, the laws governing this drug may change in the near future.
References
DanceSafe. (2014). MDMA And Your Liver: Knowing This Could Save Your Life. Retrieved from https://dancesafe.org/mdma-and-your-liver-knowing-this-could-save-your-life/
CAMH. (2011). Ecstasy. Retrieved from www.camh.ca/en/health-info/mental-illness-and-addiction-index/ecstasy.
Dunkin, M. A. (2010). What Is Serotonin Syndrome? Retrieved from https://www.webmd.com/depression/guide/serotonin-syndrome-causes-symptoms-treatments#1https://www.webmd.com/depression/guide/serotonin-syndrome-causes-symptoms-treatments#1
Government of Canada (2019). Controlled Drugs and Substances Act. Retrieved from laws-lois.justice.gc.ca/eng/acts/c-38.8/.
Image sources:
Banner: MDMA pills. (2015). Inverse. Retrieved from https://www.inverse.com/article/7041-european-molly-looks-cooler-than-american-mdma-because-superman-is-a-brand
MDMA Pills. (2017). Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/297064.php