Recent reports estimate that over 2 million tablets are smuggled into the U.S. each week. Current estimates suggest that within the Newark, New York, and Jersey Shore areas alone over 750,000 dosage units are being consumed each week. It is known most widely as a "party drug" among adolescents and young adults who frequent all-night "rave" or "techno" parties.

Indications are that the drug is now becoming more prevalent in the Midwest. This review of MDMA, popularly known as "Ecstasy," is culled from several government and information advocacy groups. It is advised that you consult with local law enforcement officials for specific information regarding local awareness and prevalence of this designer drug.

MDMA or 3-4 methylenedioxymethamphetamine, is commonly known as Ecstasy. MDMA has stimulant, hallucinogenic and analgesic effects in humans. Pharmacologically, MDMA is an indirect monoaminergic agonist producing a heightened sense of awareness, and often induces loquacity (a state characterized as "excessive talking"), which was once believed to be helpful in psychotherapy.

It is also referred to as "Adam," "XTC," "Clarity," "Essence," "Stacy," and "Lover’s Speed" on the street. Ecstasy is a synthetic, psychoactive (mind-altering) drug. It is a ring-substituted derivative of phenethylamine, which is a close structural analog of amphetamine, methamphetamine, and MDA, as well as 3-4 methylenedioxyethylamphetamine (MDE: "Eve"). MDA was a popular hallucinogenic in counterculture drug experimentation in the 60’s, while domestic clandestine production of methamphetamine has risen to well-publicized and unusually high levels since the mid-90s. Though similar to methamphetamine, virtually all Ecstasy is produced and illegally imported from Northern Europe (eg. Netherlands and Belgium). It was identified as a Class 1 Narcotic and categorically banned in 1985 by the U.S. government. It also has become the first psychoactive drug to be approved for human studies by the FDA (1993).

Ecstasy is considered the most commonly used designer drug. A "designer" drug is specifically deliberately chemically designed or constructed to be a very close derivative, in this case, of methamphetamine. "Designer" drugs were once popularly considered technically legal alternatives (since most banned drugs were done so on a named, chemically-specific basis and designer drugs were technically different), but since have been legislatively categorically labelled illegal. Because of manufacturing variations, some deaths attributed to Ecstasy have been caused by some other substances inadvertently created during production, such as PMA (paramethamphetamine).

MDMA was first created in 1912, with a patent received in 1913 (patent #274.350) by the German chemical/pharmaceutical company, Merck. Though no intended use was identified in the patent, many believe it was intended as an appetite suppresant. The drug was never marketed. Interest in the drug resurfaced with the work of Alexander Shulgin, a research biochemist with Dow Chemicals. Shulgin investigated several pyschoactive drugs during his tenure with Dow (as well as afterwards), describing some 179 of them in detail. He is believed to be the first human to take MDMA. Until it’s was banned in 1985, its use was advocated by some psychiatrists and psychologists for persons in certain psychotherapy sessions. At thewell-publicized hearings that took place to identify its proper scheduling as a controlled substance, the presiding judge recommended Schedule III (available by prescription only and subject to further research); the DEA overruled him and placed it as a Schedule I narcotic with no approved uses in the U.S.

MDMA is currently illegally smuggled into this country in shipments typically of 10,000 or more tablets via express mail , couriers on commercial airline flights, and air freight shipments from major European cities to cities in the United States. The drug is sold in bulk quantity at the mid-wholesale level in the United States for approximately eight dollars per dosage unit. The retail price of MDMA sold in clubs and at parties in the U.S. is around twenty to thirty dollars per dosage unit. Typically obtained as a round white or light-colored tablet or pill, traffickers use popular brand names and logos as marketing tools and to distinguish their product from that of competitors. Stamped into the surface are comercial logos (eg. "CK" Calvin KLein) or holiday-themed or special event images. Also seen frequently are images of four-leaf clovers, butterflies, lightning bolts and geometric shapes. It also found as a powder and in capsule form. It is usually taken orally, though it has been reported to have been injected, as well.

Ecstasy has been reportedly combined with methadone, LSD, opiates such as heroin and Fentanyl, and anesthetics such as Ketamine.

Ecstasy is illegal in all countries in the world under a UN agreement. Most countries have placed it in the same category as heroin although both the Netherlands and Spain have appointed govenrment advisory committees and they both have advocated moving it to a lower category (such as cannabis).

Ecstasy can be detected in the urine for up to four days following use. As with other illegal drugs, because manufacturing has no known quality controls or government safety involvement, the introduction of contaminants, alternative "active ingredients," and unpredictable variations in strength of dose create additional health risks, not to mention diagnostic and treatment challenges.

According to its advocates, MDMA greatly enhances empathy, passivity, social interaction and often enhancing sensory experiences. These claims are similar to those made some forty to fifty years ago by proponents regarding LSD, a drug that is also finding a resurgence in use in recent years.

Many of the risks users face with MDMA use are similar to those found with the use of amphetamines and cocaine. They are:

• Psychological complications, including confusion, depression, sleep problems, drug craving, severe anxiety, and paranoia - during and sometimes weeks after taking MDMA (even psychotic episodes have been reported).
• Physical symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, syncope, and chills or sweating. Because of the propensity towards teeth clenching, many youth use pacifiers during MDMA use.
• Increases in heart rate and blood pressure, a special risk for people with circulatory or heart disease.
• Brain damage, perhaps even with short-term use. The drug appears to damage the neurons that use the chemical serotonin to communicate with other neurons. Serotonin is implicated in the regulation of aggression, mood, sexual activity, sleep, and sensitivity to pain. It appears it is this action that gives MDMA its mood-altering ability. Because of its closeness in chemical structure to methamphetamine, researchers speculate that it may share its tendency to cause the degeneration of neurons using dopamine, as well. Such damage may invoke symptoms mimicking Parkinson’s disease. Recent research findings also suggest MDMA use may cause immediate impairment and long-term damage to those parts of the brain critical to thought and memory. In monkeys given relatively high levels of MDMA for 4 days, evidence of damage was noted two weeks after the use, as well as 6 to 7 years later. Studies continue to investigate long term affects and damage.
• There is some evidence suggesting that people who develop a rash-like acne after using MDMA may be risk of additional side effects, including liver damage, through continued use.

Recent Trends in Use (compiled by the National Institute on Drug Abuse)

Use of MDMA by teenagers and young adults has increased significantly in recent years. Nationally, in 1999, 1 in 13 high school seniors reported having tried the drug, and 1 in 40 reported using it in the past month. Among recent studies:

Community Epidemiology Work Group (CEWG)*

MDMA use most often reported is by young adults and adolescents at clubs, raves (large, all-night dance parties), and rock concerts. Its use/abuse is increasingly reported in all 20 benchmark metropolitan areas monitored by the CEWG.

Among the recent findings:

• In Kings County, Washington, a recently completed survey of gay males showed that MDMA was among the frequently used drugs (20 percent of the sample).
• A 1996-97 survey of public high schools in Boston found that about 14 percent of male and 7 percent of female 12th graders had used MDMA during their lifetime.

In a 1998 survey by the National Household Survey on Drug Abuse (NHSDA)** an estimated 1.5 percent (3.4 million) of Americans (at least 12 years old) reportedly had used MDMA at least once during their lifetime. By age group, the heaviest use (5 percent or 1.4 million people) was reported for those between 18 and 25 years old.

Data regarding MDMA use from the Monitoring the Future Study (MTF)*** shows use remained relatively stable from 1996 to 1999 for students in the 8th grade, while usage among 10th- and 12th-graders has increased. The number of 12th-graders that had used MDMA in their lifetime increased from 5.8 percent in 1998 to 8.0 percent in 1999. Use in the past year also increased nearly 60 percent, from 3.6 percent in 1998 to 5.6 percent in 1999. In addition, 12th-graders use of MDMA in the past month also increased from 1.5 percent in 1998 to 2.5 percent in 1999.

Some regular users of Ecstasy now try taking the antidepressant Prozac, as the initial effects of the Ecstasy wear off. They look with concern to the studies reporting damage done to serotonin axon terminals and the theory that the damage is caused by the cells trying to reabsorb the flood of chemicals released by the Ectasy use. The Prozac (or other serotonin reuptake inhibitor, or SSRI) block the serotonin receptors like a "pharmaceutical cork" possibly reducing the harmful effects of the ‘toxic trash" created by the MDMA.

a higher risk for depression, anxiety and memory problems. Preliminary animal studies suggest that this may be the case, but no human research is available.