Recreational use of MDMA and the development of Ecstasy

March 13, 2017 The Noffs Team Comments

- Updated 4 February 2019.

Ecstasy began to emerge on the youth party scene in the 1980s, initially in isolated pockets of youth subculture [1]. It was previously investigated for medicinal purposes, predominantly in treating anxiety and PTSD [2] and its early use was largely clinical, amongst a closely connected group of psychiatrists and psychotherapists on the US west coast [3]. Despite efforts to keep the drug largely under wraps and maintain its legal status, MDMA’s popularity grew immeasurably, to the point where it was impossible to hide [4]. The catalyst for its publicity as a non-medical drug can be traced to an article published in 1984 in the San Francisco Chronicle, titled “The Yuppie Psychedelic” [5]. The name “ecstasy” was coined as part of a marketing strategy by an LA-based distributor, and it quickly gained popularity throughout the US, particularly in Texas, where it was openly sold in bars and nightspots [6]. In the UK, the government banned MDMA pre-emptively in the late 1970s, however it became wildly popular in the UK club and rave scene throughout the 1980s and 1990s, with use widespread despite its illegal status. [7]. Australian police first seized MDMA in Sydney in the mid-1980s, leading to the National Drugs and Poisons Committee recommending it be prohibited nationwide [8]. However, its use here increased during the 1990s, from 1% in 1990 to 3% by 1995 [9]. Since then, ecstasy has increasingly been used by those within the 20-29 age demographic [10], with around one-fifth of this demographic having experimented at least once with ecstasy [11].

Ecstasy and MDMA - crucial differences

It is important to establish the difference between MDMA and the drug marketed as “ecstasy”. MDMA is the chemical compound that produces the well-documented psychoactive effects in those who consume it. MDMA was initially viewed as a potential treatment for anxiety and trauma, due to its ability to create feelings of empathy and trust amongst users [12]. Ecstasy, on the other hand, is the street name for pills or capsules marketed as containing MDMA, but may contain a number of different substances as well as MDMA - or may not contain MDMA at all [13]. When manufacturing ecstasy, certain other chemicals may be added that mimic the effects of MDMA. This could be something as harmless as caffeine, or as dangerous as PMA, a compound more toxic than MDMA and linked to several fatalities worldwide [14].

Initial research suggested that the ease with which the body becomes tolerant to ecstasy led users to consume it infrequently, thus maximising the positive effects [15]. These early studies concluded that ecstasy was a relatively benign drug as usage was oral and intermittent, with mild, short-term side effects. However, as ecstasy usage increased, so did the ways and contexts in which it was used, leading to increased risk associated with its use. In a controlled, clinical context, pure MDMA carries a low risk when consumed, with some even describing it as “safe” [16]. MDMA interferes with blood pressure and body temperature, and when manufactured with other adulterants or in unregulated potency as “ecstasy”, it can be dangerous [17].

Patterns of use

In the United States, initial non-medical use of ecstasy was localised to nightspots, particularly in Texas [18]. However, use quickly increased, especially amongst young people. In 1991, the lifetime use of MDMA amongst young adults between the ages of 19 and 28 in the United States was 3.2% and by 2001 it has increased rapidly to 13% [19].

Between 1995 and 2007 ecstasy use in Australia had been steadily increasing, but saw a gradual decline for the first time in 2007 [20], and fell from 3% in 2010 to 2.5% in 2013 [21]. In 2010, the majority of Australians using ecstasy reported their use as once every few months or less [22]. However, as of 2013 it remains the second most commonly used drug in a person’s lifetime, behind cannabis [23]. According to the 2013 National Drug Strategy Household Survey, 2.1 million (10.9%) Australians aged 14 or older had used the drug at least once. The decrease reported between 2010 and 2013 was only significant amongst females and the 30-39 age demographic. There is also evidence suggesting small minorities of ecstasy users are increasingly consuming emerging psychoactive substances [24].

As previously mentioned, ecstasy use is highest amongst the 20-29 age group, and lowest amongst those aged 40-49 [25]. Use has remained stable or increased across all age groups except those aged 14-19 [26]. One study found significant gender-related differences in patterns of use. Whilst males reported taking larger amounts of ecstasy at any one time, they were not more frequent users when compared with females [27]. Ecstasy remains a fairly easy drug to obtain, however between 2008 and 2011 an increasing amount of users (6% to 20%) reported that it was becoming more difficult to find [28], which may have an impact on usage patterns in the future.

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[1] 'The agony and the Ecstasy'. The Economist. 5 September 2002. (Retrieved from here)

[2] Alcohol and Drug Foundation. 10 December 2018. Drug Facts - Ecstasy. (Retrieved from here

[3] Ellens, J.H and Roberts, T.B. 2015. The Psychedelic Policy Quagmire: Health, Law, Freedom and Society. (Retrieved from here)

[4] Ellens, J.H and Roberts, T.B. 2015. The Psychedelic Policy Quagmire: Health, Law, Freedom and Society. (Retrieved from here)

[5,6] Spitnale, S.J. Understanding MDMA. (Retrieved from here) **

[7] Palamar, J.J. 'The evolution of ecstasy: From Mandy to Superman, the effects of the drug MDMA'. The Independent. 6 January 2015. (Retrieved from here)

[8] Donnelly, J. 2015. The case for MDMA (ecstasy) regulation. (Retrieved from here

[9] Topp, L et al. 1998. Ecstasy Use in Australia. (Retrieved from here

[10] AIHW. 2017. National Drug Strategy Household Survey 2016. (Retrieved from here

[11] AIHW. 2011. Drugs and Young People. (Retrieved from here)

[12] Alcohol and Drug Foundation. 13 July 2018. MDMA and PTSD. (Retrieved from here)

[13] Project Know. Jagged Little Pill. (Retrieved from here

[14] Dams, R et al. 2003. 'Fatality Due To Combined Use of the Designer Drugs MDMA and PMA: A Distribution Study. Journal of Analytical Toxicology. (Retrieved from here

[15] Topp, L et al. 1998. Ecstasy Use in Australia. (Retrieved from here

[16] Ellens, J.H and Roberts, T.B. 2015. The Psychedelic Policy Quagmire: Health, Law, Freedom and Society. (Retrieved from here)

[17] Palamar, J. 'MDMA Vs. Ecstasy: How They Differ, Risks, And Benefits You Need To Know'. Medical Daily. 9 December 2016. (Retrieved from here

[18] Savlov, M. 'Countdown To Ecstasy: A New Drug for a New Millenium'. The Austin Chronicle. 9 June 2000. (Retrieved from here)

[19] Spitnale, S.J. Understanding MDMA. (Retrieved from here)

[20] Roxburgh, A et al. 2011. Trends in Drug Use and Related Harms in Australia, 2001 to 2011. (Retrieved from here

[21] AIHW. 2017. National Drug Strategy Household Survey 2016. (Retrieved from here

[22] Roxburgh, A et al. 2011. Trends in Drug Use and Related Harms in Australia, 2001 to 2011. (Retrieved from here

[23] AIHW. 2017. National Drug Strategy Household Survey 2016. (Retrieved from here

[24,25,26] Roxburgh, A et al. 2011. Trends in Drug Use and Related Harms in Australia, 2001 to 2011. (Retrieved from here

[27] Ogeil, R.P et al. 2013. 'Male and female ecstasy users: Differences in patterns of use, sleep quality, and mental health outcomes. Drug and Alcohol Dependence. (Retrieved from here

[28] Roxburgh, A et al. 2011. Trends in Drug Use and Related Harms in Australia, 2001 to 2011. (Retrieved from here

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