What is ecstasy?

Ecstasy is a synthetic chemical with the scientific name 3,4-methylenedioxy-n-methylamphetamine (MDMA). Ecstasy tablets also frequently contain two similar chemicals, MDEA and MDA, which tend to have slightly different effects, in particular lacking the sociable qualities of MDMA. 

Pills sold as ecstasy may also contain other psychoactive chemicals, such as amphetamine (speed), LSD (acid), caffeine and a number of synthetic chemicals. 

Ecstasy acts as a stimulant and increases brain activity. It causes nerve cells in the brain to release a neurotransmitter (signalling chemical) called serotonin, which is involved in the control of mood, emotions, pain perception, appetite and sleep. 

Ecstasy became particularly popular in the 1990s when it was associated with the development of rave culture. 

It's often taken by clubbers, who say it induces a sense of euphoria, followed by a feeling of calm. They claim it makes them feel more sociable and increases their awareness of their surroundings, and are able to stay awake and dance for hours. 

Slang names for ecstasy include E, XTC, pills, hugs, the love drug, dolphins, disco biscuits. 

Ecstasy is a Class A illegal substance, with severe penalties for possession or supply. 

Effects of ecstasy

Effects from ecstasy include:

• An energy buzz
• Feelings of being very alert or 'alive'
• Heightened sense of surroundings, such as colour and music
• Increased sociability or positive feelings towards those around you
• Increased talkativeness, although this may be incomprehensible to others 

Risks of ecstasy

Immediate or short-term effects include an increased heart rate and raised blood pressure. It may also cause a dry mouth and raised body temperature, which when dancing in a hot club for long periods may make you dangerously dehydrated, so it's important to take regular breaks to cool down. However, ecstasy also interferes with the body's fluid control mechanisms and salt balance, and it's easy to drink too much fluid and overhydrate, causing the brain to swell dangerously. 

As MDMA or ecstasy is known to cause massive release of serotonin from the brain cells (which may then die off), it is perhaps not surprising that evidence is growing about links between its use and psychological problems. Large doses of the drug can cause anxiety, panic and confusion, and many people feel some degree of depression as the drug wears off. 

In the past few years there have been a significant number of deaths related to ecstasy use, including a number as a result of these short-term effects. 

Evidence is also mounting that regular use of the drug may cause long-term brain changes, including depletion of serotonin, which may be linked to an increased risk of mental health problems, including chronic depression and personality changes. 

Research from University College London has also shown that that former ecstasy users may suffer from serotonin loss and memory impairment (even a year or more after giving up the drug). Other research on long-time users suggests ecstasy may also increase the risk of liver and kidney problems in later life. 

People with problems such as epilepsy, high blood pressure and depression are thought to be more likely to suffer side effects from ecstasy use. The drug may also interact with certain medications or other street drugs to cause problems.

Although ecstasy is not generally thought to lead to addiction, and there are no specific withdrawal symptoms, it's possible to build up tolerance to the drug and need more over time to get the same buzz. Some people also become psychologically dependent, feeling that they need to keep taking it even when they recognise that it can do harm. 

A further risk comes from the other chemicals which may be mixed with MDMA in the tablet, or included instead of MDMA, and which may cause their own side effects. 

Managing ecstasy use

Although it's clear that the drug has the potential to kill, most ecstasy-related deaths have been caused by dehydration. The medical profession is still unclear as to the exact danger that the drug poses to health. Part of the problem is that many tablets sold as ecstasy are not what purchasers think they are. The amount of ecstasy in a tablet can vary greatly. Tablets have been analysed and up to 50 per cent contain no ecstasy while others contain drugs such as amphetamine or ketamine. Some tablets have even been found to be fish tank cleaners or dog worming tablets.

 

If you are going to take ecstasy, remember that it is illegal. Be alert to the health risks, follow advice about keeping cool and adequately hydrated with isotonic drinks, take frequent breaks from a hot dancefloor or bright sunshine if you're at a festival, and look after your friends.