Recreational use of MDMA and the development of Ecstasy

March 13, 2017 The Noffs Team Comments

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 20% of Australians within 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 intimacy and euphoria 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.

[1] http://www.druginfo.adf.org.au/attachments/353_ResearchbookletDec05.pdf

[2] http://www.druginfo.adf.org.au/attachments/353_ResearchbookletDec05.pdf

[3] https://books.google.com.au/books?isbn=1440839719

[4] https://books.google.com.au/books?isbn=1440839719

[5] https://www.onu.edu/files/spitnale-understanding_mdma_article.pdf

[6] https://www.onu.edu/files/spitnale-understanding_mdma_article.pdf

[7] http://www.independent.co.uk/life-style/health-and-families/features/the-evolution-of-ecstasy-from-mandy-to-superman-the-effects-of-the-drug-mdma-9959732.html

[8] http://s3-us-west-1.amazonaws.com/mapscontent/research-archive/Donolley_2015_Case+for+ecstasy+regulation.pdf

[9] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Mono.39.PDF

[10] http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848

[11] http://www.druginfo.adf.org.au/attachments/353_ResearchbookletDec05.pdf

[12] http://www.druginfo.adf.org.au/attachments/353_ResearchbookletDec05.pdf

[13] http://www.projectknow.com/discover/jagged-little-pill/

[14] http://jat.oxfordjournals.org/content/27/5/318.full.pdf+html

[15] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Mono.39.PDF

[16] https://books.google.com.au/books?isbn=1440839719

[17] http://www.medicaldaily.com/mdma-vs-ecstasy-how-they-differ-risks-and-benefits-you-need-know-406164

[18] http://www.druginfo.adf.org.au/attachments/353_ResearchbookletDec05.pdf

[19] https://www.onu.edu/files/spitnale-understanding_mdma_article.pdf

[20] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Australian%20Drug%20Trends%20Final%202.pdf

[21] http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848

[22] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Australian%20Drug%20Trends%20Final%202.pdf

[23] http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848

[24] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Australian%20Drug%20Trends%20Final%202.pdf

[25] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Australian%20Drug%20Trends%20Final%202.pdf

[26] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Australian%20Drug%20Trends%20Final%202.pdf

[27] https://www.deepdyve.com/lp/elsevier/male-and-female-ecstasy-users-differences-in-patterns-of-use-sleep-OFNj1fARmV?key=elsevier

[28] https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Australian%20Drug%20Trends%20Final%202.pdf

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