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Leave It to Science: Should We Do E?

Leave It to Science: Should We Do E?

Ecstasy, Adam, Disco Biscuits– many names have been given to this crazy little thing called MDMA. Using this party drug might get you arrested, but does it also destroy your life –and brain?

 

PSYCHIATRY

Once upon a time, MDMA was widely available. In fact,  it wasn’t even considered an illegal substance. It was during the early seventies in California, when MDMA found its way into the therapeutic clinics. After a few decades of absence, MDMA is now being rediscovered by many psychiatrists.

From medicine to party drug
Although MDMA -or Ecstasy, its street name that would emerge later- had already been discovered in a German laboratory 1912, it was American scientist Alexander Shulgin who rescued it from obscurity in the late sixties.  Years later, therapists in Shulgin’s circle began experimenting with the drug in couples counselling and psychotherapy.  For these  therapists MDMA offered the possibility to dig deep into their patients’ psyche, without them feeling any fear or pain. Unfortunately for them,  word got out of this magical drug, and MDMA spread beyond  psychiatric clinics. Alarmed by its growing use among teenagers, the US government classified it as a controlled substance in 1985. A little too late, as it turned out. While a whole new generation was discovering its benefits on the dance floor, thousands of practitioners kept risking their licenses to use MDMA in underground clinical settings.

MDMA and Post Traumatic Stress Disorder
So what does it do exactly? During a MDMA trip, both the level of serotonin and dopamine (neurochemicals associated with sensations of happiness and pleasure) and oxytocin (which causes feelings of trust and bonding) increase significantly. In addition, MDMA tames the brain’s fear center, the amygdala, and suppresses the fight-or-flight reaction which occurs when the level of adrenaline rises. Because of this, any apprehension a trauma patient might ordinarily suffer in therapy—about revisiting trigger memories or confronting painful emotions—is muted.

The use of MDMA has proven especially helpful for patients with PTSD, Post Traumatic Stress Disorder. Dr. Michael Mithoefer, a psychiatrist, therapist and researcher, is one of the leading experts in that field. His study, published in 2010, involved 20 patients with treatment resistant PTSD, who were assigned to psychotherapy. The study was double-blind and placebo controlled, meaning that neither the therapist nor the subject know whether the subject is receiving MDMA or a placebo.  The outcome:  83% of the subjects in the MDMA-aided treatment group no longer met the diagnostic criteria for PTSD, versus 25 % in the placebo group.

Lift the fog
Donna Kilgore, a rape victim, was one of the patients who received MDMA.  Before she started the clinical trial,  she wasn’t able to grasp what had happened to her. “Imagine standing on a mountain top and looking down in a valley that’s covered with fog,” she explains. “You know that you have to go through that valley to get to the other side. You don’t know what’s in that fog, but you know you’re going to die if you go there.  What MDMA did for me, was lift the fog.”

The results are promising, but what about the risk of addiction? According to Mithoefer, none of the patients felt the need to use MDMA again in a  recreational setting. The reason for this, he explains, is that the experience of using MDMA during therapy is very different from doing it at a rave. “At least two people said things like: ‘I don’t know why they call this ecstasy,’ Mithoefer recalls. “The MDMA helped them not to become overwhelmed by anxiety or fear and made them connect with their emotions. As a result, many of them had some very frightful and difficult experiences during the sessions. So it wasn’t just a day of ecstasy. It was hard work.”

 

NEUROLOGY

So MDMA can be helpful in trauma therapy, but what about its long term neurological effects? Does it really turn your brain into Swiss cheese, as is often claimed by worried parents?  Or cause Parkinson’s disease? Recent evidence suggests the opposite.

Evacuate the dance floor
Since the use of MDMA became illegal in the U.S in 1985, several – often government financed- studies have been conducted to prove its negative effects on the brain. In 1998, neurologist George Ricaurte was the first to publish a study on MDMA. Ricaurte claimed that Ecstasy causes brain damage in humans, suggesting that its users could lose up to 85% of the brain’s serotonin function. Using these results, the U.S. began its ‘Brain on Ecstasy’  campaign. By spreading post cards showing a brain scan of the ‘MDMA brain,’ which appeared to be full of holes, Ecstasy panic arose. In a follow-up study, Ricaurte added that  using the party drug –even once- could cause Parkinson’s disease.

But all claims proved to be unfounded. The Parkinson’s study, published by Science, was retracted when researchers discovered that vials of MDMA had been accidentally switched out for methamphetamine, also known as Crystal Meth, MDMA’s less forgiving nephew. In 2002, the British magazine New Scientist also started questioning Ricaurte’s body of work. Leading independent researchers were asked to look at the evidence and answer one question: Does MDMA damage brain cells? New Scientist’s conclusion was: ‘the jury is still out.’

No brain damage
As of February 2011, the jury seems to have reached a verdict. Harvard University’s John Halpern recently published a study in the medical journal Addiction that examined the effects of Ecstasy on cognitive ability. His conclusion: heavy recreational Ecstasy use does not cause cognitive damage.

Halpern and his colleagues compared 52 long-term Ecstasy users, aged 18 to 45, with 59 non-users, all of whom were drug-tested prior to their participation in the study to ensure accurate results. Unlike previous research, only ‘ravers’ were tested, to make sure that other side effects of having a party lifestyle –for example repeated sleep and fluid deprivation- would not influence the outcomes. The experiment also corrected for the possibility that any cognitive impairment shown by Ecstasy users might have been in place before they started using the drug.

Not everyone was convinced. Recently the U.K. National Health Service (NHS ) published an article in response to Halpern’s study, claiming that “without further research, it is not possible to say that there is no evidence that ecstasy causes brain damage.”An incorrect assertion, according to Halpern, “What is critical to understand here is that we don’t have these sorts of debates over the damage from alcohol. The fact is that there are 20-plus years of research in this field and it still isn’t conclusive for harm: This alone is quite telling. We don’t have this sort of debate over alcohol, so why with MDMA? I suspect that it’s quite likely that our findings have zoomed in on what has achieved the wide range of results in studies of the cognitive performance of Ecstasy users: variables were poorly controlled for in the past.”

Get Out of Jail Free card
So does this mean we can use MDMA whenever, wherever, without ever having to pay the price? Not exactly. The fact that MDMA may not cause any brain damage, doesn’t mean it’s without risks.  “Ecstasy consumption is dangerous: illegally-made pills can contain harmful contaminants,” Halpern notes. “There are no warning labels, there is no medical supervision, and in rare cases people are physically harmed and even die from overdosing. It is important for drug-abuse information to be accurate, and we hope our report will help upgrade public health messages. But while we found no ominous, concerning risks to cognitive performance, that is quite different from concluding that ecstasy use is risk-free.”

BIOLOGY

Being called ‘the hug drug,’ you would expect MDMA to boost your love- and sex life. However, new scientific evidence suggests that a hug might be all you’re getting. Using MDMA inhibits your sex drive and takes you longer to finish.

Just not that into it
This conclusion isn’t a new one. In 1991, the effect of MDMA on sexual desire was first tested on laboratory rats. The leading author, psychologist and researcher Dr. Wayne Dornan, found  “a transient disruption of male copulatory behaviour” after treatment with MDMA.  However, it wasn’t really fair to apply this results to party users, since the doses the rats received were much higher than the doses usually consumed on the dance floor.

In  2008, a team of Italian scientists repeated the study, now using lower doses. The results remained the same: male rats on MDMA are just not that into it.  Although a male rat normally penetrates the female right after they meet, the intoxicated rats needed much more time, or did not even try to approach  females. Furthermore, the ones who did get it on, took much longer to ejaculate.  Still, it’s important to note that only the acute effects were measured. After a couple of hours, the MDMA rats performed just as well as the sober ones again.

No global love potion
Another study, conducted by psychologist Dr. Jim Pfaus, showed similar results. Pfaus did not just stick to MDMA, but also examined how alcohol, cocaine and even caffeine can affect a rat’s sex life. Basically, none of these so-called aphrodisiacs proved  to be helpful.  “We reviewed data from more than 100 different studies,” explained Pfaus, “including original data from our own studies, to systematically examine the effects of drugs on sexual performance. In addition, we evaluated the aphrodisiac claims of some of these pharmaceuticals. In this broad-based and wide-reaching study, it appears that drugs and sex don’t mix well and there is no global love-potion.”

Although the tests again were performed on lab rats, the effects of drugs on sexual performance resemble those in human beings, Pfaus explains. “Rats are a lot like us. They’re highly social animals. Also, there’s a high degree of behavioural and environmental plasticity, which is the same for humans.  And most important, their sexual behaviour, which is often described as being polygamous, is highly opportunistic and malleable by their experience.”

Using Ecstasy is not without risks. It will increase your heart rate and blood pressure, which –especially when combined with fluid deprivation and high body temperature- can lead to hyperthermia -a dangerous increase in body temperature. In addition, Ecstasy usually contains other components besides MDMA, like speed, LSD or PMMA.  The only way to find out exactly what is in a particular pill, and in what quantity, is to have it laboratory tested; a service which is offered in some countries.  However, MDMA definitely isn’t as destructive as was often claimed, and even proved to be very beneficiary in some cases.  Its story serves as an important reminder that science isn’t always right, and therefore should never be taken for granted.

MC Mithoefer, MT Wagner, A T Mithoefer,R Doblin (2011). The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study Journal of Psychopharmacology

Recommended Reading:

‘Ecstasy: The Complete Guide’  by Julie Holland

 

 

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9 Comments

  • Rob
    March 22, 2012, 19:44

    You’ve chosen the wrong molecule. The molecule at the top of the article is for Methylone, hence the ketone group (=O). MDMA molecules shouldn’t have this. Credibility is already gone at this point. If you can’t get something as simple as the molecule right, how can we trust your knowledge of the substance throughout the article?

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  • Lima Hotel
    March 22, 2012, 21:00

    The drug in the picture is actually Methylone, a β-ketone analogue of MDMA.

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  • Tim
    March 22, 2012, 21:28

    Other than the one chemical structure at the top being methylone instead of MDMA, that was actually a pretty decent article! Oh, however, I do think anybody cutting their MDMA with LSD isn’t very wise concerning the whole profit aspect of their career.

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  • Alex
    March 22, 2012, 22:26

    Hey, this was a really amazing article that summed up a lot of the information that is currently out there on MDMA. I would just like to note one thing that I thought was a little off towards the end of the article. It’s more or less semantics but here we go: MDMA would almost never be cut with LSD. Here’s the reason:
    LSD is expensive. If you were to cut something into a drug, you would use cheaper materials, to increase your profits. Things like Methamphetamine and speed, PMMA, as well as MDA would be more likely choices for cutting, as they are inexpensive.
    Other than that, amazing article. Thank you for being unbiased, and basing any opinions on proven scientific facts.

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  • Anonymous
    March 23, 2012, 00:39

    I just wanted to point out that the molecule you have pictured at the top of this article is a methylone molecule, not a MDMA molecule.

    I haven’t read all the article yet, but something stuck out.

    >Once upon a time, MDMA was widely available. In fact, it wasn’t even considered a drug.

    That’s stupid. MDMA has been considered a drug since the earliest days of it’s use. A drug is any substance other than food which changes the way the body works, and what’s more MDMA is clearly a psychoactive drug. Similarly, alcohol, nicotine, paracetamol, heroin and oxycodone are drugs. In the UK, every one of these is legal (heroin is a prescription medicine). In the US, most of the them are. Whether something is a drug is not decided by it’s legal status.

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