Ecstasy commonly appears in a tablet form, usually imprinted with a monogram.

The title screen to Peter Jennings - Ecstasy Rising

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MDMA

MDMA (3,4-methylenedioxymethamphetamine), most commonly known today by the street name ecstasy, is a synthetic entactogen of the phenethylamine family whose primary effect is to stimulate the secretion of and inhibit the re-uptake of large amounts of serotonin as well as dopamine and noradrenaline in the brain, causing a general sense of openness, empathy, energy, euphoria, and well-being. more...

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Tactile sensations are enhanced for some users, making general physical contact with others more pleasurable; but, contrary to popular mythology it generally does not have aphrodisiac effects. Its ability to facilitate self-examination with reduced fear has proven useful in some therapeutic settings, leading to its 2001 approval by the United States FDA for testing in patients with post-traumatic stress disorder.

Acute dehydration is a risk among users who are highly physically active and forget to drink water, as the drug may mask one's normal sense of exhaustion and thirst. Also the opposite, "water intoxication" resulting in acute hyponatremia has been reported. By far the biggest danger comes from the fact that other, more dangerous chemicals (such as PMA, or methamphetamine) are either added to ecstasy tablets, or more often simply sold as ecstasy. Long-term effects in humans are largely unknown and the subject of much controversy —particularly with regard to the risks of severe long-term depression as a result of a reduction in the natural production of serotonin.

MDMA is also known by many other street names, including Adam, Beans, Biscuits, Candy, E, Eccies, Googs, Jack and Jills, MaDMAn, Mollies, Pills, Rolls, Scoobies, Smarties, Tabs, Thizz, Vitamin E, Vitamin X, X, XTC, Yaotou (in East Asia), and Yokes.

History

A patent for MDMA was originally filed on Christmas eve 1912 by the German pharmaceutical company Merck, and granted two years later (to the day). At the time, MDMA was not known to be a drug in its own right; rather, it was patented as an intermediate chemical used in the synthesis of a styptic (a drug intended to control bleeding from wounds.) Over half a century would pass before the first known ingestion of MDMA by humans.

Contrary to many rumours, the drug was never used as an appetite suppressant or as a stimulant for armed forces during wartime. (This was in fact methamphetamine.) The U.S. Army did, however, do lethal dose studies of it and several other compounds in the mid-1950's. It was given the name EA-1475, with the EA standing for Edgewood Arsenal. The results of these studies were not declassified until 1969. MDMA was first brought to public attention through Dr. Alexander Shulgin in the 1960s who recommended it for use in certain therapy sessions, naming the drug 'window' (he discovered it while searching for compounds that might have a similar psychoactive effect as other compounds contained in nutmeg). It was widely used therapeutically by US psychotherapists because of its empathogenic effects until its criminalization in the late 1980s. The drug was hailed as a miracle by therapists and counselors who claimed couples could have six months worth of progress in one use of the drug, and soldiers returning from the Vietnam war could overcome their PTSD sometimes more effectively than talk or group therapy. A small number of therapists continue to use it in their practices today. (See below for 2001 FDA approval and DEA licensing for use in patients with post-traumatic stress disorder.)

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Journal editors criticize MDMA study as nonscientific, unethical - News and Comment - Ecstasy drug
From Skeptical Inquirer, 5/1/03

The editors of two journals that provide objective scientific investigations of controversial and largely untested medical and mental health practices have criticized proposed research using the drug MDMA (ecstasy) as a treatment for posttraumatic stress disorder. The study, "MDMA-Assisted Psychotherapy in the Treatment of Posttraumatic Stress Disorder," is awaiting final MDMA licensing approval from the Drug Enforcement Administration.

Proponents from the Multidisciplinary Association for Psychedelic Studies (MAPS) claim that it will prove that MDMA has strong potential as a psychotherapeutic drug. The president of MAPS, Rick Doblin, is a longtime proponent of recreational and spiritual use of both LSD and ecstasy. The protocol was developed in the Charleston, South Carolina, area with the assistance of MAPS. The proposed study subjects would be twenty victims of violent assault who have been given diagnoses of posttraumatic stress disorder.

MDMA has recently received national attention because of research published in the journal Science, implicating MDMA in damage to dopamine receptors in mammalian brains. Reductions in dopamine are associated with Parkinson's disease. Although the precise neurological effects of ecstasy remain controversial in the scientific community, there is a widespread consensus that this drug has the potential to do harm in at least certain cases.

Editors Scott Lilienfeld of the Scientific Review of Mental Health Practice and Wallace Sampson of the Scientific Review of Alternative Medicine (SRAM), based on derailed investigations by health advocate E. Patrick Curry, note that the research was approved by the Food and Drug Administration (FDA) in late 2001 and by the independent Western Institutional Review Board in July 2002. In light of reports of damaging effects of MDMA, the editors found the research to be potentially dangerous and possibly in violation of human subjects research ethical standards. They also note that evidence for effectiveness that would justify such research was lacking.

According to Lilienfeld, an associate professor of psychology at Emory University and president of the Society for a Science of Clinical Psychology, the study itself is scientifically questionable at best and meaningless at worst, because the treatment will nor be compared with a meaningful and properly blinded control group consisting of either no therapy or a comparison treatment of known effectiveness.

"One of the most disturbing things about this study," Sampson said, "is that it appears to be the exclusive project of believers in psychedelic mysticism, and based on work of Dr. Sranislav Grof, an early LSD self-experimenter and psychedelic psychotherapist. After LSD and ecstasy use was declared illegal, Grof developed Holotropic Breathwork, a potentially dangerous form of severe hyperventilation, as a legal method of invoking hallucinations. Grof was a long-time fellow of the Esalen Institute, widely considered to be a birthplace of the New Age movement.

Both therapists involved in the research, principal investigator Michael Mithoefer and his wife, Ann Mithoefer, a psychiatric nurse, are trained practitioners of Grof's Holotropic Breathwork. The investigators' background, although not bearing directly on the methodological quality of the study, raises troubling questions concerning their capacity to conduct the research and to evaluate the data impartially without strong a priori allegiances.

Sampson and Lilienfeld question how such an experiment was approved by the FDA and an Institutional Review Board. Efforts by MAPS and the principal investigator, Dr. Mithoeffer, to win IRB support from the Medical University of South Carolina were rebuffed earlier this year. The project was approved within weeks when submitted to the independent IRB.

Sampson and Lilienfeld concur that comments in the popular press presenting this Charleston study as a possible "tiebreaker" in the debate over the effects of MDMA are misplaced. Lilienfeld states: "It is disturbing that scientifically flawed and potentially dangerous research like this could pass muster with the FDA, an IRB, and popular journalism."

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