ECTASY: Is it really dangerous?

I am grateful to the authors in Wickipedia who wrote a most informative article on MDMA and ecstasy in which I was able to provide the technical information to my readers about my views on the consequences of overdosing on ecstasy.

Please note that those comments that appear with a white background are an anomaly in the printing only and not meant to apply special meaning to the text.

In popular culture, the drug, MDMA (3,4-methylenedioxy-N-methylamphetamine) has become widely known as ‘Ecstasy’ and it is usually taken in the form of a pill. It can induce euphoria, a sense of intimact with others, and diminished  anxiety and more often than not, it is taken by young people in raves (large group parties). 

 Ecstasy is  criminalized  in most countries (though some important civil society initiatives—such as the Global Commission on Drug Policy—are not concerned with putting a stop to it, but rather with educating the public about the drug and its oossession, manufacture, or sale and the even fact that possession of one pill could  lead to criminal prosecution.

 For a long time, there have been suggestions that Ecstasy might be useful in psychotherapy, facilitating self-examination with reduced fear. George Greer synthesized MDMA in the lab of Alexander Shulgin and administered it to about 80 of his clients over the course of the remaining years preceding 1985. In a published summary of the effects, the authors reported patients felt improved in various, mild psychiatric disprders and experienced other personal benefits, especially improved intimate communication with others. In a subsequent publication on the treatment method, the authors reported that one patient with severe pain from terminal cancer experienced lasting pain relief  and improved quality of life.  I suppose one question that would come to the fore is whether or not Ecstasy would be a better alternative to using marihuana to serve the same purpose. 

 The first phase-II double-blind randomized controlled clinical trial into the potential therapeutic benefits of using the drug as an augment to psychotherapy showed that most patients in the trial given psychotherapy treatment along with doses of MDMA experienced statistically significant reductions in the severity of their condition after two months, compared with a control group receiving only psychotherapy and a placebo.

 Ecstasy used recreationally is used in a Canada, the United States, the United Kingdom, Australia and New Zealand, the Netherlands and other parts of Europe and Asia.

 The primary effects attributable to Ecstasy consumption are predictable and fairly consistent among users. In general, users report feeling effects within 45 minutes to an hour of consumption, hitting a peak at approximately 2 1/2 to 3 hours, reaching a plateau that lasts about 2–3 hours, followed by a comedown of a few hours. After the drug has run its course, many users report feeling fatigue: other, more long-lasting effects such as diminished mental capacity, permanent sensitivity to light, paranoia, and impaired cognitive ability have also been reported.

 The question that must be answered is: “Does ecstasy have harmful effects on its users?”

 Compared to ingesting alcohol, ecstasy is not as addictive as alcohol. Further, I haven’t heard or read about motorists having car accidents as a result of having taken ecstasy. Mind you if you take many pills of ecstasy over a short period of time, it will definitely have an effect on your driving ability just as ingesting alcohol will.

An overdose of ecstasy has a potentially serious consequence to its user such as serotonin syndrone,  (interferes with serotonin normally found in the intestines and the brain to make them function properly) stimulant psychosis, , and/or hypertensive crisis, , among other dangerous adverse reactions, may come to prominence, the symptoms of which can include the following:

Psychological

Distortion and confusion, anxiety, paranoia, and/or panic attacks, hypervigilance or increased sensitivity to perceptual stimuli,  accompanied by significantly increased threat detection, hypomania or full-blown mania, derealization and/or depersonalization, hallucinations and/or delusions, thought disorder or deororganization thinking, cognitive and memory impairment potentially to the point of retyrorade or anterogade amnesia and acute delirium. 

The hippocampus in our brain plays an essential role in long-term memory. Recent studies are of particular interest in view of the previous various studies showing that ecstasy users display significant memory impairments, whereas their performance on other cognitive tests is generally normal. Acute swelling and atrophy of hippocampal tissue in long-term ecstasy users is still recognized of having an effect on the brain after long-time use of MDMA.

Physiological

Myoclonus  or involuntary and intense muscle twitching, nystagmus or involuntary eye movements (twitch), hypereflexia or overresponsive or overreactive reflexes, tackypnoea  or rapid breathing and/or dyspnea or shortness of breath, palpitations  or abnormal awareness of the beating of the heart, angina pectoris, or severe chest pain as well as pulmonary hypertension, cardiac arrhythmia or abnormal electrical activity of the heart, circulatory shock or cardiotoxity or damage to the heart, cardiac dysfunction, arrest, myocardial infartion, and/or heart failure, hemorrage and/or stroke, severehyperthemia,   potentially resulting in organ failure, syncope or fainting or loss of consciousness, and possible brain damage.

We have to keep in mind that the cells of our body consists of many chemicals and as we all know, when some chemicals are mixed with others, the result can be disastrous so it follows that when you mix MDMA with the chemicals in our bodies, what I have described above will definitely have a chemical reaction in our bodies.

An ecstasy overdose can occur when a user ingests more of the drug than the body can process. Ecstasy users commonly flirt with the risk of a drug overdose, as the difference between the high that they are seeking and serious injury or even death, is often quite small. Some young people don’t realize the risk they take when they ingest more of the drug at one time just so that they will get a high sooner than just taking one pill of ecstasy. Chronic users of ecstasy have been reported to be at a higher risk for a potentially fatal ecstasy overdose.

 Studies indicate that with long-term ecstasy usage, there is the potential for permanent damage to neurons in the brain that are responsible for creating serotonin (which is critical for learning, sleep, and positive moods) Toxic doses of ecstasy can also cause an individual to have seizures, a breakdown of muscle tissue, and failure to some of the major organs of the body, such as the liver and the kidney.

 In the United States in 2001, there were as many as 5,542 persons who took ecstasy that required emergency room treatment in a hospital.  Mind you, there were as many as 193,043 persons who took cocaine who needed emergency room treatment and more people who ingested an overdose of aspirin needed such treatment than those who ingested ecstasy but still, the number of persons who ingested ecstasy who needed emergency room treatment is still very high.

 During the five-year period between 2003 and 2005, as many as 69 users of ecstasy in the US died from overdosing on the drug. In the past year, 16 people in the province of Alberta and Saskatchewan have died from an overdose of ecstasy. It would appear that nobody has died directly from the toxic effects of the drug i.e. been poisoned or suffered an 'allergic reaction'. Instead, deaths have fallen into three categories. They are as follows:

 Use of ecstasy by itself in a hot environment such as a club will increase body temperature. Ecstasy also causes a certain amount of hyperactivity in users. Combined with vigorous dancing in a humid and possibly overcrowded venue for hours on end can cause body temperature to rise over the danger limit of 40 degrees celsius with symptoms that include convulsions, dilated pupils, very low blood pressure, and accelerated heart rate. Death is caused by respiratory collapse resulting from disseminated intravascular coagulation (DIC). What seems to happen is that MDMA somehow reacts with the chemicals that control blood coagulation meaning that blood coagulates where it shouldn't, such as in the lungs; air cannot get through and the person dies. Also if all the blood clotting agent has been used up at inappropriate sites, then the blood might not coagulate where it should and there is a risk of haemorrhaging from all the internal lesions that the human body normally sustains without problems.

There have been a number of recorded deaths of excess water intake, possibly due to a mistaken belief that simply drinking lots of water will offset any side effects of the drug, although not in all cases could the water intake be said to have been excessive. The condition is known as dilutional hyponaetremia.

In dilutional hyponatremia. ecstasy appears to affect the workings of the kidneys by inappropriately secreting an anti-diuretic hormone which prevents the excretion of fluids. Water is retained in the body, especially in the highly water-absorbent brain cells and eventually the pressure shuts down primary bodily functions such as breathing and heart beat. Symptoms include dizziness and disorientation leading to collapse into coma. Not all of those affected die; there are a number of young people who have been admitted to hospital in this condition, and who survived. Inexperienced users however who are worried about the overheating of their bodies and dehydration, may over-compensate by drinking huge amounts of water and then suffer from 'water-poisoning' or hypernatremia which will bring about their deaths.

However, if you are going to take ecstasy, drinking water is vital. You should drink about a pint of water every hour. Sip water slowly rather than drinking a lot all at once, as this can be dangerous. Eat something salty and drink juice or Gatorade. This will replenish electrolytes and prevent hyponaetremia (water toxicity). Take breaks, allow your body to cool down, wear loose-fitting clothes and don't wear a hat, which keeps the heat in.

If someone collapses on ecstasy, call 911 immediately! Get them to a cool place. Drench them with water (as cold as possible). Fan them. Once the person's temperature is down, wrap them in a blanket or give them dry clothes. Be careful that the person's temperature should not fall below 102 degrees or serious consequences could develop. When help comes tell them what drug the person took and that you think the person is suffering from heat stroke. Be sure to get this person to a hospital as soon as possible! Alcohol is absolutely useless and dangerous for someone on ecstasy. Alcohol will dehydrate them even more!

Ecstasy also causes significant rises in blood pressure and heart rate which a fit young person can normally sustain. However, a few young people have succumbed to these stimulant effects, sometimes as a result of an undiagnosed heart condition.

Many questions remain about ecstasy fatalities. For example, blood levels appear to correlate poorly with toxicity. The American literature cites cases where users with high levels of MDMA in their blood have survived 'overdoses', but where a normal dose of around 100-150 mg has caused death. Yet American psychiatrists have reported using 100mg of (presumably pure) MDMA with patients in therapy with no ill-effects.

It is true that a small amount of MDMA in your system is not lethal but that doesn’t actually mean that it is completely safe to ingest. MDMA’s most-known side effect is teeth grinding and jaw clenching that will result in dental damage. This is why many ravers who have ingested ecstasy will suck on a pacifier during an ecstasy trip.

Dr. Perry Kendal, British Columbia’s chief provincial health officer says he is not advocating for MDMA to be legalized and sold in stores, but he stands behind his controversial comments that taking pure ecstasy can be safe. He said, “Let’s look at what works and what doesn’t work. Let’s look at what harms of various drugs are and compare them. And let’s look at the impacts of the policies on a drug use. We should be looking at a regulatory regime that is more evidence-based than the current one and decide as a society how we want to control these drugs, given that the current control is not optimal, in my opinion.”

A spokesman for Health Minister Leona Aglukkaq issued a statement in response to the story and Kendall’s clarification. “Our government is not contemplating any changes that would make ecstasy legal, so we have no further comment to make at this time,” said spokesman Steve Outhouse.

Dr., Kendal compared the substance with alcohol, which is legal, but can cause death if abused. He said; “We allow people to get intoxicated with alcohol. A bottle of vodka can kill you very easily, if you swallow the whole bottle. It’s addictive.” He admitted, that if legalized, MDMA would likely be used recreationally, but added that alcohol is arguably more dangerous.

“What is fundamentally the difference between that and a psychoactive substance that makes people feel good and gives them some energy, which as far as we know isn’t addictive, doesn’t cause cancer, doesn’t destroy the brain?” he asked. That is true however but it is the young people’s use of the drug that bothers me.

The UK Advisory Council on the Misuse of Drugs has stated that the entirely pure form of MDMA is relatively safe and a study that was published in The Lancet said that ecstasy is much safer in its purest form and it is less harmful than many other narcotics.

As far as I am concerned, no amount of the substance is safe. One of the reasons why taking an ecstasy pill is not safe is that you don’t know who manufactured it. Just as heroin is diluted with other chemicals, so can ecstasy. It’s what is mixed in the batch that you should be concerned with. Not knowing what other ingredients have been placed in the batch is what makes it even more risker to take the ecstasy pill. Often narcotics like this drug are manufactured in concealed unhygienic conditions with poor ventilation and it is possible that some of those people who are manufacturing the drug are physically ill and the kind of people you wouldn’t want to be even be washing your dishes, let alone manufacturing a drug you are going to ingest into your body.

The medical establishment widely agrees MDMA is not addictive and new research suggests some of the drug’s long-stated ill effects are exaggerated.

MDMA was criminalized in Canada in 1976 and in the U.S. 1985. It was recently boosted to the top of Canada’s drug scheduling list under the federal government’s omnibus crime bill, meaning it carries penalties similar to those for cocaine and heroin.

Other than prescribing it by medical doctors and psychiatrists for the treatment of patients who need it for medicinal purposes, I don’t think it should be available in stores or elsewhere for everyone else. I hope I am not coming across as a prude. It just seems to me that alcohol serves the purpose of making people feel good at parties and although it is a worse drug than ecstasy in terms of addiction and impairment, young people don’t have the same opportunity of getting it as easily as they do in getting ecstasy.

 It has been suggested that the sale of ecstasy should only be sold in a government regulated stores just as liquor is. That would mean that persons under 19 or more would not be permitted to purchase the drug. But consider this. Children under 19 years of age can’t purchase tobacco in any form and yet their get their hands on it anyway. That is because it is still sold. Children can’t purchase alcohol either and yet they still drink it. Picture this scenario if ecstasy could be sold at store. You attend a party at a friend’s house and instead of serving you beer, wine or stronger alcohol, he or she offers you ecstasy pills.  “Hello dear. We have three kinds of ecstasy pills for you to choose from—pink, yellow or green. Which one would you like?”

 I am not saying that MDMA shouldn’t be ingested. Recent studies have shown that it has been an effective way to treat mental diseases such as schizophrenia, depression and post-traumatic stress disorder. It has even been used to treat Parkinson’s Disease. Last year, a joint British/Australian research team discovered that an altered form of MDMA may combat blood cancers such as leukemia.

 I am simply saying that I am against anyone ingesting any form of MDMA, be it as an ecstasy pill or other form for the sole purpose of getting high. The risk is too high. Now there is a play on words is there ever was one.   

 As a general rule, one should never mix Ecstasy with other drugs, especially with alcohol. An intoxicated motorist who has ingested too much alcohol might decide to drive because the feelings of alertness caused by MDMA has clouded the impairing effects of other drugs such as alcohol, thereby creating a potentially serious risk for others on the road. Their driving will still be impaired. Further as stated earlier in this article, alcohol and MDMA (ecstasy) when taken together will dehydrate the body even more thereby causing the body temperature to rise to a dangerous level. 

In my opinion, based on the aformentioned information, MDMA (ecstasy) should never be used as a recreational drug by anyone.