Ecstasy is of the one street names for the drug 3, 4-methylenedioxymethamphetamine or MDMA. Other street names include Molly and XTC. The drug was initially developed and used in the treatment of certain types of mental health disorders. Research has continued to suggest that it may have significant medical utility in the treatment of some of these disorders; however, the drug is listed as a Schedule I controlled substance by the United States Drug Enforcement Administration. This indicates that the federal government considers MDMA to have no useful medical applications and that it is too dangerous to be used even if one is under the supervision of a physician.
MDMA became a popular drug with younger individuals because of its ability to enhance a person’s feelings of empathy and social interactions, and produce hallucinations and significant euphoria. Its illicit use peaked in the early part of the 2000s and has since declined, although it is still considered to be a significant drug of abuse.
Long-Term Effects of MDMA Use
MDMA affects numerous neurotransmitters but exerts its primary effect on three neurotransmitters in the brain. These effects result in the actions of the drug and lead to the long-term effects of its use.
- MDMA increases the availability of the neurotransmitter serotonin, resulting in feelings of euphoria, sociability, and empathy. It may also enhance sexual arousal.
- MDMA increases levels of dopamine in the central nervous system, which contributes to its ability to produce feelings of pleasure and stimulation.
- MDMA increases levels of norepinephrine in the system, which results in significant stimulation of the central and peripheral nervous systems.
The potency of MDMA that occurs in various forms of the drug sold on the street can be quite variable, and the actual contents of drugs sold as ecstasy, Molly, etc., may also be variable. For instance, these drugs may contain significant amounts of other drugs, including ketamine, cocaine, and even methamphetamine.
The effects of taking MDMA may be complicated by its potency. There are various long-term effects of using MDMA.
Significant alterations to different pathways in the brain can result from the massive neurotransmitter release and subsequent neurotransmitter depletion when the drug is discontinued.
Changes in neuropathways in the brain can lead to numerous cognitive and emotional issues that can include:
- Issues with attention and concentration
- Problems forming new memories
- Difficulty with judgment and problem-solving
- Trouble experiencing pleasure without the drug
- A vulnerability to be more reactive to stressful situations
- The development of significant psychiatric/psychological problems, such as depression, anxiety, and even psychosis
The cycle of massive neurotransmitter release followed by a depletion of these neurotransmitters can lead to vulnerability for pessimism, apathy, and potential suicidality.
Individuals who chronically abuse MDMA are at a significant risk to develop cardiovascular problems, particularly issues with hypertension and irregular heartbeat that can increase the risk to develop a heart attack or stroke.
Long-term use of ecstasy can result in liver damage.
Chronic use of ecstasy is associated with potential renal problems.
Continuing to use ecstasy increases the risk for individuals to become overheated and dehydrated, which can lead to seizures.
The stimulant effects of MDMA often results in individuals clenching and grinding their teeth. Over time, this can lead to significant issues with dentition.
There is a potential to develop physical dependence on ecstasy (issues with tolerance and withdrawal).
The development of a formally diagnosable substance use disorder is certainly a strong possibility for an individual who frequently abuses MDMA.
The term substance use disorder is the current clinical designation that encompasses both the older notions of substance abuse and addiction. The alteration of pathways in the brain as a result of the continued cycle of massive neurotransmitter release followed by depletion of neurotransmitters is not fully resolved in any individual even after long-term abstinence. Although long-term abstinence and positive physical changes can result in new alterations in the brain pathways that may lead to a remittance of some of the negative effects that have occurred as a result of chronic abuse of the drug, the potential for an individual to reactivate older structural changes when they begin using the drug is a real possibility.
Some of the effects of long-term abuse of MDMA may never fully resolve, such as problems with attention, issues forming new memories, and vulnerability to emotional problems and issues with emotional control. While these issues may lessen in someone with treatment and therapy, they may never fully be resolved after chronic abuse of MDMA.
At the time of this writing, there is no specific drug that can be used to correct the types of structural alterations in the brain that occur with chronic drug abuse, although some drugs may assist in treating some of the symptoms that have developed as a result of the chronic abuse of MDMA. Initiation of a comprehensive treatment program for a person in recovery from any form of substance abuse is an extremely important factor in helping individuals reach their full potential following recovery from a substance use disorder.
Long-term effects of the abuse of MDMA are not just limited to issues with health; they extend into all areas of functioning. The consequences of abusing the drug can be far-reaching. They can include:
- Failure to reach personal goals
- Long-term issues with valued personal relationships
- Significant issues with finances.
- Substantial issues with the legal system
- Other personal, social, and professional ramifications that change the trajectory of one’s life
Chronic abuse of any substance, including MDMA, can affect all areas of an individual’s life. The most efficient way to address the long-term ramifications of MDMA abuse is to get professional treatment immediately.
Treatment for MDMA Abuse
Younger individuals between the ages of 16 and 24 are the most at risk for abusing various forms of MDMA. Many of these individuals are still experiencing common developmental changes to the brain that occur in the anterior cortex of the brain, and chronic use of MDMA can alter the normal developmental process. However, the good news is that younger individuals are more likely to experience maximum effects of treatment interventions. Thus, it is extremely important that younger individuals who have been abusing MDMA become involved in a comprehensive treatment program that can help to resolve many of the issues that occur as a result of chronic abuse of the drug.
Because many individuals who suffer from substance use disorders have co-occurring mental health disorders, it is imperative that the person be fully assessed to determine all areas that need to be addressed during recovery. If a person who is in recovery is not receiving treatment for a co-occurring psychological disorder, their recovery will not be fully successful. Treatment should address all of these issues simultaneously.
The treatment program should include:
- A full physical, psychological, and social assessment as mentioned above
- A treatment plan that is designed to address the areas of concern identified in the assessment
- The option for initial inpatient or residential treatment when deemed necessary
- Medical detox (withdrawal management) when needed
- Medical management of issues as needed (use of medications)
- A strong concentration on intensive substance use disorder therapy in individual sessions, group sessions, or utilizing a combination of individual sessions and group sessions
- Involvement of family members in therapy and other aspects of treatment
- The use of peer support groups, such as 12-Step groups
- Other interventions that have been identified in the assessment as being needed in the specific case, such as tutoring for school, vocational rehab for job training, housing placement, alternative therapies that may be useful such as music therapy or art therapy, and case management services
- The use of different specialists for different interventions
Even if a person initially begins treatment in an inpatient or residential setting, they will eventually need to transition into an outpatient treatment program, including outpatient medical management services if needed. This transition should be smooth and allow the individual to adjust. Because the treatment for any substance use disorder should be considered a long-term endeavor, individuals in treatment should never consider themselves “cured” even if they begin to experience successful abstinence.
The potential to relapse is always a possibility for anyone in recovery. Long-term involvement in treatment helps to reduce the risk of relapse. Over time, individuals in recovery can accept their participation in longer-term interventions, such as peer support groups, as part of an ongoing lifestyle of abstinence as opposed to an ongoing form of “treatment.” As individuals experience successful recovery, they can benefit by helping others in the early stages of recovery. This can help them maintain their own focus on ongoing recovery and allow them to give back to others.