Street Drugs Today Featuring: MDMA

Hunter Skelton, Student Pharmacist

What is MDMA?

3,4-methylenedioxymethamphetamine, MDMA, or “ecstasy” is a synthetic (manmade) drug that affects mood and perception of reality. It has stimulant and psychedelic effects on the body, which can create senses of euphoria, energy, and distortions of time and place.1

MDMA is derived from methamphetamine and amphetamine, and therefore produces similar effects on the mind and body. MDMA has been tested clinically in patients with PTSD and other mental disorders with some efficacy, but it was not approved by the FDA and was deemed illegal in 1985 by the DEA.2

It is not usually known to cause physical dependence, but it can cause psychological dependence due to its strong euphoric effects. Those who consistently use MDMA and wish to quit should seek out behavioral therapy to help with any emotional stress they may experience during the process.3

Often called a “party drug”, MDMA gained its popularity at raves and parties for making people feel social, empathetic, and energized. However, it has now made its way out of just the nightclub venue.1

What does MDMA do to the body?

MDMA affects brain chemicals associated with energy and mood changes.

Increased dopamine in the brain results in increased energy and activation of the reward system. This causes the user of MDMA to feel good and continue using the drug. However, this feeling will fade over time and cause damage to the reward system.

Increased serotonin in the brain results in emotions like trust, empathy, and sexual arousal (the high levels of serotonin are thought to be mostly responsible for the psychedelic effects of MDMA). The user may also experience mood, appetite, and sleep changes.1,2,4

Unfortunately, MDMA will also produce unwanted effects in the body.

Physical effects: muscle tension and cramps, tremors, teeth clenching, chills, sweating (due to increased body temperature), nausea, or blurry vision.

Increased norepinephrine results in increased heart rate and blood pressure. Therefore, MDMA should be avoided in people who have heart issues.

Psychological effects: confusion, depression, anxiety, sleep issues, paranoia, and cravings.1

Common Street Names

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Colorful tablets are the most common, but MDMA can also come in capsules, powder, and liquid form.

Drug Interactions and Toxicology

“Ecstasy” tablets may come as MDMA mixed with other substances such as methamphetamine, cocaine, ketamine, heroin, and others. Unless the substance is tested for purity before ingesting, there is no way to really know its contents. MDMA and alcohol interact together to enhance and increase the euphoric effects of both substances.

Amphetamine-like substances (such as MDMA) can interact with opioids and cocaine to produce too much serotonin, resulting in serotonin syndrome. If it is too severe, the user may need to seek medical attention.

Opioids, cannabinoids, ketamine, and alcohol can produce central nervous system depression when taken together.5,6

Monitoring MDMA

Effects of MDMA can occur within 30-45 minutes of ingesting the drug, and they usually last 4-6 hours, but they may stick around for days or weeks. Taking another dose of MDMA while the first dose is still in the body will prolong its presence in the body and increase the risk of unwanted side effects.

MDMA is detectable in blood and saliva tests for 3 days after last use, up to 5 days after for urine tests, and for months in strands of hair.3

Laws and Regulations

MDMA has a high abuse potential, no accepted medical use in the U.S., and lacks safety information. This makes it a Schedule I substance (under government discretion) and is therefore considered illegal to use or posess.1

MDMA is heavily metabolized by CYP2D6 enzymes in the liver. Some of the metabolites are reactive and can cause damage to the liver, causing jaundice, hepatitis, bleeding, and even liver failure if not taken care of.

As mentioned earlier, the increase in norepinephrine can lead to increased heart rate and blood pressure, leading to cardiovascular issues like heart failure. Since MDMA can affect the body’s ability to regulate temperature, it can lead to high fevers and dehydration. The body may also experience irregular water retention in the body from alterations in hormones. Changes in temperature and water retention can lead to seizures or compression of the brain. High body temperatures can also lead to other tragic events such as muscle degradation, kidney failure, and serotonin toxicity.2

Monitoring MDMA

Effects of MDMA can occur within 30-45 minutes of ingesting the drug, and they usually last 4-6 hours, but they may stick around for days or weeks. Taking another dose of MDMA while the first dose is still in the body will prolong its presence in the body and increase the risk of unwanted side effects.

MDMA is detectable in blood and saliva tests for 3 days after last use, up to 5 days after for urine tests, and for months in strands of hair.3

References

1.DEA. Ecstasy/MDMA. DEA.gov. Home. DEA.gov.

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