`Ecstasy' causes anything but

June 29, 2000|By Barry McCaffrey

WASHINGTON -- "Ecstasy" --- a stimulant that can cause brain damage -- is skyrocketing in popularity.

Ecstasy has the properties of amphetamines along with psychedelic effects that make users feel peaceful. Different recipes are used for ecstasy, all of which can produce serious harm.

The scientific name of the substance is long and cumbersome; its acronym is MDMA. The drug is synthetic, meaning it isn't found in nature.

Ecstasy is sometimes called "Adam," "X," "X-TC," "Stacy," "Clarity," "Essence," "Lover's Speed," "Eve," or "e." It is usually taken by mouth in tablet, capsule or powder form, but it also may be smoked, snorted or injected.

Ecstasy costs $25 to $40 per pill. Sometimes users combine MDMA with marijuana or other "club drugs" to counteract jitteriness. MDMA may remain in the body up to 24 hours although effects usually last three to six hours.

MDMA generally reduces inhibitions and creates a sense of euphoria, but it also can evoke anxiety and paranoia. Heavier doses generate depression, irrationality, and psychosis.

Side effects include hypothermia, vomiting, blurred vision, chills, faintness, sweating, tremors, loss of control over body movements, insomnia, convulsions, muscle tension, rapid eye movement and teeth clenching. Individuals with heart problems, high blood pressure or epilepsy have increased risk of adverse reac- tions.

Ecstasy destroys serotonin-producing neurons and reduces serotonin, a neurotransmitter involved in controlling mood, sleep, pain, sexual activity and violent behavior.

Unfortunately, little is known about the long-term consequences of sustained use. A study, published in the British medical journal the Lancet and supported by the National Institute on Drug Abuse and the National Institute of Mental Health in Bethesda, examined serotonin receptors to determine whether prolonged, regular use of ecstasy can produce irreversible damage to neurons.

Some of today's heavy users may be burdened with chronic depression later in life. A study at Johns Hopkins University, conducted on primates, confirmed that MDMA causes long-lasting damage to areas of the brain critical for thought and memory.

"I am very worried about ecstasy," said Dr. Jan Walburg, director of the Jellinek Clinic in the Netherlands. "We must be wary of a drug that has the potential of causing long-term brain damage, and this one does. With our tolerant attitudes, we just didn't want to see the danger here until ecstasy had spread everywhere like a virus."

NIDA Director Dr. Alan Leshner said, "At the very least, people who take MDMA -- even just a few times -- are risking long-term, perhaps permanent problems with learning and memory."

The body quickly builds up tolerance to MDMA, so the drug is said to have a "honeymoon high" -- after which users take more to recapture the initial sensation. A British study demonstrated that use during pregnancy can cause birth defects.

Between 1997 and 1998, emergency room mentions of MDMA nearly doubled. In 1999, 8 percent of 12th-graders used MDMA at least once -- up 38 percent from the previous year. Use escalated in the 1990s among college students and young adults, particularly those who participate in "raves" -- all-night dance parties held in fields or abandoned warehouses.

Raves provide open spaces for dancing amid psychedelic lights, video, smoke or fire. At such clubs, kids have died of overheating as a result of MDMA, which increases heart rate, blood pressure and body temperature.

Raves typically cost $20 per ticket, draw 6,000 to 25,000 people and bring organizers $100,000 per night. Attendees may take ecstasy -- the "hug-drug" -- to dance all night and "feel close" to friends.

Raves have become weigh stations for large purchases of ecstasy that are transported to college campuses, suburban high schools and rural areas of the country.

Most MDMA in the United States comes from the Netherlands, Luxembourg and Belgium. Dutch police estimate that the average lab there produces 80,000 tablets a day at less than the equivalent of about 50 cents each. The tablets are the size of Advil and stamped with logos like Playboy bunnies, lightning bolts or signs of the Zodiac.

U.S. Customs seized 3.5 million ecstasy tablets in fiscal year 1999, which ended Sept. 30, more than four times the amount in 1998. Much MDMA is bought by young American tourists financing summer vacations by smuggling home a few hundred tablets.

Some 150 Dutch "Smart Shops," which feature drug paraphernalia, help foreigners sneak ecstasy home by selling containers for Faberge shaving gel, deodorant sprays, Campbell's soup, or Heineken beer with secret compartments for drugs. Organized crime increasingly is becoming involved with MDMA.

Dr. Ernst Buning, formerly with the Amsterdam Municipal Health Service, argues: "There is no simple solution to the drug problem. No one nation -- not the U.S., not England -- has the answer. Together, we must warn young people about the threat ecstasy poses to their health and well-being.

Barry McCaffrey is director of the Office of National Drug Control Policy.

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