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MDMATheEcstasy| JYITheUndergraduateResearchJournal
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MDMATheEcstasy
by:RioKevin
Institution:Physics
Date:June2007
MDMA,morecommonlyknownasecstasy,hasrapidlybecomeoneofthefourmajorillicit
drugsintheU.S.,alongwithmarijuana,cocaine,andheroin.Duringthe1990s,itsuse
spreadfromtheravesubculturetoamoregeneralhighschoolandcollegeaudience.
Despiteitsreputationasarelativelybenigndrug,datafromanimalandhumanstudies
suggestthatMDMAmaycausebraindamageafterjustafewdoses,unlike'harder'drugs
likecocaineandheroin,whichtakeyearstodamagebraintissue.
MDMABasics
MDMA(3,4methylenedioxyNmethylamphetamine)isderivedfromamphetamine,a
psychomotorstimulant.Itseffectsaresignificantlydifferentfrommoststimulantsinfact,
theyarequiteunique.Takenorallyorinsulfated(snorted),MDMAworksbycausingasurge
inthereleaseofseveralneurotransmitters,chieflyserotoninbutalsodopamineand
norepinephrine,thatregulatetheneuronalcircuitsforpleasureandemotioninthebrain.
RecreationaluserstakeMDMAforitssubjectiveeffects,whichincludeeuphoria,empathy,
andheightenedemotionandopenness.Itisnotsurprisingthatmanypsychiatristswere
onceinterestedinthedrugasasupplementtopsychotherapy,perhapsitwouldallowclients
tospeaktheirmindsmorefreely?Despitethesepotentialbenefits,thetoxiceffectsofthe
drugsmakethispracticesimplytoodangerous.
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MDMAalsocausesawidevarietyoftemporaryphysiologicalchanges,whichmostusers
wouldconsidersideeffects.Theseincludedilationofthepupils,increasedheartrateand
bloodpressure,lossofappetite,anddehydration.Thislasteffectisparticularlydangerous.
Therehavebeenseveralreportsofteenagersandyoungadultsdyingofdehydrationafter
anightspentdancingaravepartyonecstasy.
NeurotoxicityinAnimals
MDMA'seffectsinanimals,particularlyratsbut
alsomonkeysandsomeothermammals,have
beenwellstudied.Aconsistentfindingisthat
MDMAreducesoverallfunctioninginserotonin
neurons,thesameneuronsitactsuponto
produceitspleasurableeffects.Itisasifthe
drug"overloads"thebrain'scircuitrywitha
floodofneurotransmitters,whichhavetoxic
effects.Thisdamagedoesnotappeartobe
reversibleandcanhaveseriouslongterm
effects,includinganincreasedsusceptibilityto
depression.
MDMAtabletsfororalconsumption.Imagecourtesy:
erow id.org
AswithmostMDMAresearch,eventhesewellestablishedconclusionsarequestioned.A
studybytheNationalInstituteonDrugAbuse(NIDA)andtheNationalInstitutesofHealth
(NIH)recentlysuggestedthatdosesthatcauseserotonindepletion"donotreliablyincrease
markersofneurotoxicdamagesuchascelldeath,silverstaining,orreactivegliosis."The
studydidnotvindicateMDMAaltogether,italsofoundthatadministrationofthedrugcould
producepersistentanxietyevenintheabsenceofmeasurablecelldamage.
NeurotoxicityinHumans
WhatMDMAdoestoratsisoflittleconcerntomostpeopleoutsidethescientificcommunity.
Whilewemaybeabletogleansomeinsightsintothedrug'saffectsfromanimalstudies,the
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MDMATheEcstasy| JYITheUndergraduateResearchJournal
publicrarelytakesnoticeuntilevidencein
humantrialscomestolight.Hundredsof
reportsoverthepastdecadeorsosuggest
thatMDMAcausesseriousandlonglasting
braindamageinhumans.
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ArecentstudyconductedatJohnHopkins
UniversityusedPETscanstoexaminespecific
nervecellsinthebrainsofhumanMDMA
users."WehadlongsuspectedMDMAwas
SERT(serotoninneuron)densitymeasuredbyPET
dangerous,basedonourearlierstudiesin
scaninbaboonbrains.Thebaboonontherightw as
primatesthatshowednervedamageatdoses
givenaneurotoxicdoseofMDMAayearbeforethe
similartothosetakenbyrecreationaldrug
scanthecontrolbaboonw asgivenaplacebo.
users,"saysneurologistGeorgeRicuarte,
Imagecourtesy:DEA
principalinvestigator."Butthisisthefirsttime
we'vebeenabletoexaminetheactual
serotoninproducingnervecellsdirectlyinthebrain."Serotonergicdamagewasgreater
amongMDMAusersthaninacontrolgroup,andtheamountofdamagewasproportionalto
thenumberoftimesusershadtakenthedrug.
ResearchersattheUniversityofTorontofoundthatprolongedMDMAuseledtomemory
lossinhumansubjects.Thedrugaffectsthehippocampus,aportionofthebraininvolvedin
consolidatingmemoriesfromshorttolongterm.Thisdamageresultedincognitivedecline,
particularlyinretrospectivememory,theabilitytorecallashortpassageimmediatelyand
afteradelay."Forthosewhouseecstasyrepeatedly,thereispreliminaryevidenceto
suggestmemoryprocessescanbeimpairedwithcontinueduseofthedrug,"says
KonstantineZakzanis,coauthorofthestudy.
ParticularlyfrighteningisMDMA'sabilitytocausebraindamageduringthefirstorsecond
recreationaldose.Afternumerousanimalstudies,thefirstpapertoexaminetheseeffectsin
humanswaspublishedin2006andpresentedattheannualmeetingoftheRadiological
SocietyofNorthAmerica(RSNA).Subtle,butmeasurable,differencesinbrainchemistry
wereobservedinfirstorsecondtimeusers,includingdecreasedbloodflowtocertainareas
ofthebrainandchangesincellarchitecture.Itisstillunknownwhetherthesechangesare
permanentornot.
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TheFutureofMDMA
Despitethesesomewhatgrimreports,manyremainunconvincedthatMDMAisdangerous
inhumans.TheLancet,aleadingmedicaljournal,recentlypublishedanarticlefromUK
researchersthatsuggestsMDMAisoneoftheleastdangerousillicitdrugsforhuman
consumption,rankingbelowalcohol,tobacco,andmarijuana.
Thereporthasbeencriticizedbymanyinthescientificcommunity.Inparticular,itsdefinition
of"dangerous"hasbeencalledintoquestion.Thestudy'sfindingsarebasedonsurveys
filledoutbydrug'experts,'amongthemdoctors,pharmacologists,andlawenforcement
agents.Toapoliceofficer,MDMAwouldseemrelativelyharmless,itdoesnotmakeusers
violent(likemethamphetamineorcocaine)anditisnotsoexorbitantlyexpensivethatits
usersmustresorttocrimetosupporttheiraddiction(likeheroin).SimplybecauseMDMA
doesnotposemuchrisktononusersdoesnotmeanitshouldbeconsideredsafe.
Althoughthereisnosmokingguntoprovethat
MDMAisneurotoxicatthefirstrecreational
dose,evidenceismountingtothatend.Users
shouldbeawarethatMDMA,likeanydrug,is
nottotallyharmlessandcanhaveseriousside
effects.
MaartjedeWin,aradiologistattheUniversity
ofAmsterdamintheNetherlands,sumsupthe
currentstateofMDMAresearchbysaying,
"Wedonotknowiftheseeffectsaretransient
orpermanent.Therefore,wecannotconclude
thatecstasy,eveninsmalldoses,issafefor
thebrain,andpeopleshouldbeinformedof
thisrisk."
Withhope,thisinformationwilltrickledownto
theteenagersandyoungadultscurrentlyusing
orthinkingaboutusingMDMA.Whetherornot
theychoosetotakethedrugisanindividual
decision,buttheyshouldatleastbeawareof
itspotentiallydangerousconsequences.
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Ahighlycontroversialrankingoflicitandillicitdrugs,
from"mostdangerous"ontherightto"least
dangerous"ontheleft.NotethatMDMA(ecstasy)is
amongtheleastdangerous.Imagecourtesy:The
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EA,Hedgingdllboleh
Lancet.
References:
"Hopkinsstudyshowsbraindamageevidenceinecstasyusers"fromJohnsHopkinsMedical
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8/6/2016
MDMATheEcstasy| JYITheUndergraduateResearchJournal
Institutions(http://www.eurekalert.org/pub_releases/199810/JHMIHSSB301098.php)
"Studyfindslongtermecstasyuseleadstomemoryloss"fromtheAmericanAcademyof
Neurology(http://www.eurekalert.org/pub_releases/200104/AAoNSfle0904101.php)
"Ecstasycanharmthebrainoffirsttimeusers"fromtheRadiologicalSocietyofNorth
America(http://www.eurekalert.org/pub_releases/200611/rsonech112106.php)
"Alcoholandtobaccocausemoreharmthanecstasy,studyclaims"byDavidRose,The
Times(UK).
WrittenByKevinRio.
ReviewedByAntjeHeidemann.
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19982016JournalofYoungInvestigators.Allrightsreserved.ISSN:15394026
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