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MDMA: (Ecstacy or E - Pill)


If not that serious send me an confidential e-mail: info@thesouthafricanantidrugteam.org.za


MDMA is a semi-synthetic compound called Methylenedioxy-methamphetamine. It popularly referred to as Ecstasy and was synthesised by a German drug company around 1912 for reasons that had nothing to do with its psychological effects.


It was rediscovered by the US Military in the 1950’s and tested along with many other psycho-tropic drugs for use as ‘brainwashing’ weapons. American chemist Alexander Shulgin synthesised it again 1976 and then it became more widely known and used. It found use as an aid for psychotherapy in the 1970’s and 1980’s in the USA, where the first recreational use was also recorded. It was made illegal in 1985 there, but that didn’t stop it from spawning the phenomenon of rave culture of the late 1980’s in the UK and elsewhere via Ibiza, as the legend goes.


MDMA usually comes in the form of small pressed pills, as powder in capsules, or as loose powder. Ecstasy generally refers to MDMA in tablet form.Tablets are taken orally and one pill normally contains an active dose, which is rough 2mg per kg body weight. It’s effectiveness is related to body mass, so a small framed person should be very careful about dosage. First timers should be careful about dose and shouldn’t take more than half a pill. Many brands/labels of pills come and go but they mean little since quality can, and generally does, vary considerably between batches. Popular brand names are rapidly counterfeited. Sometimes substitutes or adulterants are used, and these can be very dangerous although these can be screened by an easy to use home testing kit. There is a whole range of drugs sold as MDMA, such as MDEA, MDA, Amphetamine, Ephedrine but sometimes more dangerous substitutes such as PMA.


MDMA is a hallucinatory amphetamine and the effects usually begin 30-60 minutes after dropping, depending on how full your stomach is. Physical effects include raised blood pressure so anyone with high blood pressure or a heart condition should not take it, with a noticeable rise in body temperature, faster heartbeat, skin tingles, sudden sweating and dilated pupils. Some people may also experience unsteadiness, nausea and possibly vomiting, though these unpleasant effects usually pass quickly. MDMA is a profound mood-changing drug that can alter the way you see the world.


It works by causing the massive release of the neurotransmitter serotonin from storage in the axons to the synapses where it acts on the next axon. It also blocks the recycling of the serotonin molecules as well as causing the neurotransmitter dopamine to be released. Once all the serotonin stored in the axons is released, it is finished and there is little point in taking more MDMA. There is reason to believe that MDMA does damage to the system that produces serotonin.


The subjective effects of MDMA vary according to whom you are with, where you are and how you are feeling. MDMA can make you feel profoundly relaxed as well as energetic, happy, calm, exhilarated, warm and loving and sensitive to other people’s vibes. It can also open up your emotions: this can be positive but sometimes can cause panic and anxiety as a result, so be sure to have friends around. If the rush is too intense find a quiet spot to sit down with a friend. Try to relax and not to panic.


The peak effects can last 2 to 4 hours, which is followed by a smooth, not unpleasant come down feeling lasting several more hours. After effects may include tiredness or feeling spaced out for up to 24 hours. This is also an effect of staying awake all night  - sleep deprivation - so chill out afterwards. Let the after effects wear off naturally. Secondary effects - afterglow or exhaustion may be felt for a few days afterwards. Users also report side effects such as the dreaded “Steak Knife Tuesday”, when a few days afterwards you feel ratty, intolerant and short tempered. Extreme lethargy can also be felt for a few days afterwards as well.


Your brain and body - especially your liver takes a lot of strain with regular use, and this can cause chronic health problems. Although it is regarded as being not physically addictive, the temptation to do it often should be resisted, since it depletes the serotonin stores and that is responsible for your mood and a whole lot of other things. If you don’t give your body time to recover, the lack of serotonin may make you feel lethargic, depressed and moody. Your body will produce more to replace the serotonin used, but it may take some time to get it back to the normal levels, during which time your will feel lethargic, even depressed. Some ‘Experts’ recommend taking serotonin precursors like 5HTP to help restore or boost levels, however professional medical opinion does not support this for a variety of reasons, so one should be cautious about this, or any other miracle remedy or antidote.


Because MDMA is illegal, there is no quality control, so you cannot be sure of what you are taking. Tablets may include impurities, sometimes harmless powders but can include other drugs such as speed. Rumours abound about E tablets containing Heroin, however many pills have been tested in laboratories, and with very few exceptions, no trace of heroin has been found. It doesn’t make any sense to use expensive heroin when other bulking agents and other stimulants like caffeine and ephedrine are common.


Staying Safe:

MDMA is thought by many to be a relatively safe drug if used in moderation, however there are serious concerns about long term health issues, and users are taking a chance with the unknown in this regard. But if you are going to take it regardless, you should keep track of what your body is telling you whilst you are on it. The euphoria that it makes you feel can make it easy to ignore bodily distress signals. Be careful about dehydration, muscle cramping, dizziness, exhaustion, injuries or overexertion. Reports from the past tell of e-ed up ravers dancing themselves into severe dehydration and heat exhaustion that required hospitalisation, and in a few cases resulted in death. When dancing for long periods of time, sip about half a litre of water every hour. It is also good to replace lost sugars and salts with an energy drink.


Not everything called a ‘Pill’ contains MDMA. Be sure to find out as much as possible before dropping. You might consider doing a test on a new batch: please see the Drug Testing chapter for more info on tests you can do.


Avoid drinking lots of alcohol because it dehydrates you, and on top of MDMA since this can be dangerous. Make sure you feel well rested and in good shape in the first place. MDMA puts a lot of physical strain on your heart, liver and kidneys. Make sure you rest often and use the chill out area to do just that.


If you suffer from diabetes, asthma, epilepsy, depression or psychosis, the dangers associated with the use of MDMA increase. There have been confirmed reports of just one dosage of MDMA being fatal for a first timer, so it can happen. There could be a lot of reasons for this, one is that certain people about 5-9% of the population don’t have a certain liver enzyme - CYP2D6 that breaks down the MDMA. Thus these people are at an increased toxic risk when taking MDMA. Deaths have been reported of some MDMA users who were also taking Monoamine Oxidase Inhibitors - MAOI’s, which are often prescribed as antidepressants. Therefore MDMA is not recommended to anyone taking any MAOI..


Overheating is one of the main dangers of taking Ecstasy since it causes the internal organs to fail. Sweating is essential to avoid overheating and water is essential in order to sweat. Neurotoxicity has also been linked to high body temperatures, so try keep cool in a well-ventilated spot whilst dancing the night away, or at the very least make sure you take regular rests to cool down. There is also a serious risk of renal - liver failure due to increase body heat.


Drinking too much water can be harmful, even fatal. If you drink more than you can get rid of by sweating or urinating, it gets into your blood and swells your brain. You can go into a coma ... or even worse. You shouldn’t drink more than a litre of water an hour.


What are the long term effects of MDMA?

More is slowly becoming known about the long term effects of regular use. However the research and data are still inconclusive, some studies contradict each other but, there is a lot of reason for concern about negative long term effects of regular use. Research has shown that users are altering their brain by using MDMA. It is not yet known how this ‘damage’ manifests itself, but this could be permanent or at least long lasting and this may affect you psychologically and in other ways. Research has shown that use adversely effects memory, attention and bring about depression disorders as well. Although some of this research that claimed serious brain damage has now been discredited - Ricaurte et al, there is a growing amount of research that shows negative effects in the long term, even for moderate users. The low down is that it’s a big unknown, and most research has shown some sort of negative long term impact.


What about teeth grinding?

The serotonin release can also over-stimulate muscles and dental damage from teeth grinding is something you should be careful of. Research in the UK has shown teeth damage amongst Ecstasy to be high amongst clubbers.


I am on Prozac. Can I take MDMA?

Prozac blocks out the action of MDMA, so generally one will not feel the effects of the MDMA. The action of Prozac and other similar SSRI’s is to block the re-uptake of serotonin. This normally gets recycled into the storage area after it’s done its job. This means that one won’t feel the effects of the massive serotonin release that MDMA normally causes. Because Prozac has a half-life of several weeks, you can’t just stop taking it for a few days and expect to feel the effects of E. 


But there is a more important consideration: Prozac is normally proscribed by a doctor to help address a serotonin deficiency, which is one of the causes of depression. MDMA can aggravate this, and the chances are that the post-E depression and lethargy people normally feel could be so hectic one could go into clinical depression following use.


How does MDMA effect you psychologically?

It’s generally considered that recreational dance drug experimentation or casual use is something one can dabble in without serious dangers. But this is not always the case, and we have always strived to present all the facts in an unbiased and factual way. There is a danger that use of any psycho-active drugs - like e, speed, acid can bring out a range of psychological conditions. 


For example, the activation of some serious psychological conditions that are latent. In other words, you could have a mental condition like paranoia psychosis and schizophrenia that is dormant and generally not a problem but any psychoactive drug use can activate this, and make it a real problem. This predisposition is generally genetic that is passed down through the family. The only way you can find out if there is a possibility of this is to examine your family tree to see if any of your ancestors have had any of these conditions. If you have any doubts, it’s best to see a professional psychologist. Psychoactive drug use can also cause other psychological problems as well, like self-perpetuating panic attacks for instance. Sometimes it is possible to recover from these conditions with professional psychological counselling, other times its more serious like requiring hospitalisation.


What about pre and post-loading?

Some people use widely available substances like 5-HTP to “pre-load”, that is in the belief that they are boosting the serotonin levels before taking E. Some believe this works, perhaps so, perhaps it’s the placebo effect, however professional advice given to us by doctors is that this is not recommendable and can cause other serious problems such as a serotonin syndrome. Another argument is that if one is altering the brains functioning with one agent, it’s risky to think that introducing another to compensate is completely predictable, especially when not everything is known about the serotonin system in the brain anyway. The same goes for post-loading techniques. There’s a lot of uncertainty and myths about this, one thing for sure is it does not make taken MDMA any safer.


NB:  What you reap is what you sow:

1.   Say NO to any drugs.

2.   A small pill can control your life.