Ecstasy Use by Adolescents in Miami Dade County FL

Ecstasy Use by Adolescents in Miami-Dade County, FL

Ecstasy, also known as MDMA, Methylenedioxymethamphetamine, has become popular as a club drug and at techno dance events, such as raves, trance scenes and private parties. Many who attend raves and trances do not use drugs, but those who do, may be attracted to their generally low cost and to the intoxicating highs that are said to deepen the rave or trance experience ("NIDA," 2004). It has gained the reputation as a "hug drug" promoting empathy, relaxation, and sexuality. Studies indicate an increase in abuse of this drug, especially among adolescents and/or teenagers. It is a human-made drug that acts as both a stimulant and a hallucinogen. It is taken orally, in the form of a capsule or a tablet. It has short-term effects including feelings of mental stimulation, emotional warmth, enhanced sensory perception, and increased physical energy.

Health effects can include, but not limited to, nausea, chills, sweating, teeth clenching, muscle cramping, and blurred vision. Other names and/or street terms for ecstasy are those such as Adam, beans, clarity, dex, disco, biscuit, blue lips, blue kisses, E, essence, iboga, morning shot, pollutants, Scooby snacks, speed for lovers, sweeties, wheels, XTC, X, hug, beans, love drug, and white dove. In general, according to the 2003 Monitoring the Future survey, 4.5% of 12th graders, 3.0% of 10th graders, 2.1% of 8th graders had used ecstasy in the past year.

Ecstasy is synthetic. It does not come from a plant as marijuana does. Ecstasy is a chemically made drug, made in secret labs hidden around the country. Other chemicals or substances are often added to or substituted for MDMA in ecstasy tablets, such as caffeine, dextromethorphan (cough syrup), amphetamines, and even cocaine. Makers of ecstasy can add anything they want to the drug. So the purity of ecstasy is always in question. More recently, a new liquid form of ecstasy is of concern because its purity ranges wildly; it is cut with many different drugs, and user are, in turn, uncertain of what their getting ("Director's report," 1999).

Cognitive and physical effects of ecstasy can include, but is not limited to, the following: chronic users of ecstasy perform more poorly than nonusers on certain types of cognitive or memory tasks. Some of these effects may be due to the use of other drugs in combination with ecstasy, among other factors. In high doses, ecstasy can interfere with the body's ability to regulate body temperature. This can lead to a sharp increase in body temperature, which could result in liver, kidney, and cardiovascular system failure. Because ecstasy can interfere with its own metabolism, potentially harmful levels can be reached by repeated drug use. Users of ecstasy face many of the same risks as users of other drug stimulants, such as cocaine and amphetamines. These include increases in heart rate and blood pressure, a risk for people with circulatory problems or heart disease, and other symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating.

Physiological effects can include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during and sometimes days or weeks after taking ecstasy. A neurotoxicity can occur with ecstasy. Research in animals links ecstasy exposure to long-term damage to neurons that are involved in mood, thinking, and judgment. A study done in nonhuman primates showed that exposure to ecstasy for only 4 days caused damage to serotonin nerve terminals that was evident 6 to 7 years later. While similar neurotoxicity has not been definitively shown in humans, the wealth of animal research indicating ecstasy's damaging properties suggests that ecstasy is not a safe drug for human consumption.

In general, research shows that use of any club drugs can cause serious health problems and, in rare instances, even death. Many drug users take combinations of drugs, including alcohol, which may further increase their danger. For most users, a "hit" of ecstasy lasts for 3 to 6 hours. Once the pill is swallowed, it only takes about 15 minutes for ecstasy to get into the bloodstream and reach the brain. About 45 minutes later, a user experiences ecstasy's peak level or high. It's downhill from there, unless the user takes more ecstasy. But even if the user only takes one pill the after-effects of ecstasy can last for several days to a week (or longer in regular ecstasy users). These include feelings of sadness, anxiety, depression, and memory difficulties. Users might feel very alert or hyper at first. They can keep on dancing for hours at a time while at a rave. Users also experience distortions in time, and other changes in perception, such as an enhanced sense of touch. Some will become anxious and agitated. Sweating or chills may occur, and the ecstasy user may feel like fainting or dizziness. Users can also become dehydrated through vigorous activity in a hot environment.

Ecstasy can interfere with the body's ability to regulate its temperature, which can cause dangerous overheating or hyperthermia. This, in turn, can lead to serious heart, kidney, and liver problems, and rarely, death. Ecstasy can be extremely dangerous in high doses, or when multiple small doses are taken within a short time period to maintain the ecstasy high. Blood levels of the drug can reach very high levels, increasing the risk of hyperthermia and other negative health consequences of MDMA.

There are hidden risks of toxicity with use of ecstasy. Other drugs chemically similar to ecstasy, such as MDA (methylenedioxyamphetamine, the parent drug of ecstasy) and PMA (paramethoxyamphetamine, associated with fatalities in the U.S. And Australia) are sometimes sold as the drug ecstasy. These drugs can be neurotoxic or create additional health risks to the user. Also, ecstasy tablets may contain other substances in addition to ecstasy, such as ephedrine (which is a stimulant); dextromethorphan (DXM, a cough suppressant that has PCP-like effects at high doses); ketamine (an anesthetic used mostly by veterinarians that also has PCP-like effects); caffeine; cocaine; and methamphetamine ("NIDA," 2005). While the combination of ecstasy with one or more of these drugs may be inherently dangerous, users might also combine them with substances such as marijuana and alcohol, putting themselves at further physical risk.

Brain imaging research in humans indicates that ecstasy may affect neurons that use the chemical serotonin to communicate with other neurons. The serotonin system plays a direct role in regulating mood, aggression, sexual activity, sleep, and sensitivity to pain. Also, there is evidence that people who develop a rash that looks like acne after using ecstasy may be risking severe side effects, including liver damage, if they continue to use the drug. Research links ecstasy use to long-term damage to those parts of the brain critical to thought and memory. One study, in primates, showed that exposure to ecstasy for 4 days caused brain damage that was evident 6 to 7 years later. Ecstasy, the parent drug of ecstasy, is an amphetamine-like drug that has also been abused and is similar in chemical structure to ecstasy. Research shows that ecstasy also destroys serotonin-producing neurons in the brain. Ecstasy also is related in its structure and effects to methamphetamine, which has been shown to cause degeneration of neurons containing the neurotransmitter dopamine. Damage to these neurons is the underlying cause of the motor disturbances seen in Parkinson's disease. Symptoms of this disease begin with lack of coordination and tremors and can eventually result in a form of paralysis.

Like other stimulant drugs, ecstasy appears to have the ability to cause addiction. That is, people may continue to take the drug despite experiencing unpleasant side effects, and other social, behavioral, and health consequences. No one actually knows how many times a person can use a drug before becoming addicted to it or who is most vulnerable to addiction. A person's genetic makeup, their living environment, and other factors probably play a role in their susceptibility to addiction.

Contrary to rumors, ecstasy is not an aphrodisiac and it can actually inhibit sexual performance. Ecstasy affects people differently. Depending on size, weight, health, dosage and individuals who struggle with drug addiction did not set out to destroy themselves, everyone and everything in their path; rather, these disastrous consequences are the effect of the vicious cycle of drug addiction. For many, drugs seem to be a means of averting emotional and/or physical pain by providing the user with a temporary and illusionary escape from or way to cope with life's realities. For example, an individual tries drugs or alcohol. The drugs appear to solve his problem. He or she feels better. Because he or she now seems better able to deal with life; the drugs become valuable to him or her. The person looks on drugs or alcohol as a cure for unwanted feelings. The painkilling effects of drugs or alcohol become a solution to their discomfort. Inadvertently the drug or alcohol now becomes valuable because it helped them feel better. This release is the main reason a person uses drugs or drinks a second or third time. It is just a matter of time before he or she becomes fully addicted and loses the ability to control his drug use. Drug addiction, then, results from excessive or continued use of physiologically habit-forming drugs in an attempt to resolve the underlying symptoms of discomfort or unhappiness.

Situation in Miami-Dade County, FL

Miami-Dade County has a population of nearly 2.6 million people. Miami is Dade-County's largest city, with 360,000 residents. Approximately 25 million tourists visit the area annually. South Florida's airports and seaports are among the busiest in the Nation for both cargo and international passenger traffic. For this reason, these ports of entry make this region a major port of entry for illicit drugs. Prior to September 11, 2005, ecstasy trafficking was at a record high, since then, smuggling by cruise ship has become an important trend in South Florida drug trafficking. This method has been growing since airline security increases after September 11, 2001 (Hall, 2002).

Particularly, in Miami-Dade County, there were 14 ecstasy related deaths in 2001; 5 of which were found to have been caused by the drug. In addition, 99 MDMA Emergency department (ED) mentions were reported by the Drug Abuse Warning Network (DAWN) in the first half of 2001. A total of 105 MDMA mentions were reported in all of 2001, a significant increase as compared to 2 in 1994 (Hall, 2002).

Each pill of ecstasy usually contains 75-125 mgs of ecstasy. In the United States, the wholesale price for ecstasy, nowadays, is $8.00 per pill for 100 units; however, the pills could sell as much as $10.00-50.00. Locally, in Miami-Dade, according to local law enforcement, ecstasy prices may have started to drop in the first half of 2001, which reflects an increase in supply. In addition to this, giveaway deals are offered to new customers, so as to entice them in order to attempt to hook them in. There are labs set up over seas, in Europe, especially the Netherlands and Belgium, that make these pills in mass quantities. There are rumors that there are labs in South Florida, as well, attempting ecstasy production.

According to the National Monitoring the Future (MTF) study, ecstasy was at an all time high among 8th, 10th and 12th graders in 2001. This was higher than cocaine use among the same age group. In addition the study showed there was a slight increase in availability. In 1999, 40% of those teens surveyed said that ecstasy was fairly easy to obtain. This increase in availability has resulted in price decreases and more give-away deals, of ecstasy. More and more, ecstasy is being used at private parties now as much as raves. Ecstasy current use was reported by 2.8% of Miami-Dade 7th to 12th graders in the 2001 survey conducted by the Miami Coalition (Hall, 2002).

There is a method used by drug traffickers called body packing that is being used more and more these days. A body packer is an individual who ingests packets of illicit drugs in an effort to smuggle those drugs into this country. Many times, body packers apprehended from the Hollywood/Ft. Lauderdale International Airport are brought to Broward General Medical Center (BGMC) for treatment. During the last six months of 2001, there were 17 body-packers treated at BGMC, and 14/17 (82%) had ingested latex covered packets of cocaine (Hall, 2001).

The first report of internal body packing involving ecstasy originated in Miami in the last part of 2001. An individual flew into Miami in the last part of 2001. An individual flew into Miami from Canada after having swallowed numerous packets containing ecstasy. Apparently, the objective was to retrieve the pills from his feces for illicit distribution. This case is interesting because it was a case that happened after the September 11, 2001 event. Even though there are increased security measures, a high demand for ecstasy and a high profit potential, body packing could still become a more routine smuggling method in the future to come.

Based on information obtained from the DEA's STRIDE program, the state of Florida is the highest ecstasy trafficking area in the country, followed by New York and California. According to the U.S. customs service the quantity of ecstasy tablets seized nationally increased from 400,000 in 1997 to 750,000 in 1998, 350,000 in 1999, and 9,300,000 in 2000 (Hays, 2002). According to data from law enforcement sources, analysis of alleged ecstasy samples in 2000 showed that 12% contained amphetamine or methamphetamine but no ecstasy, 5% contained no controlled substances, and 3% were determined to be other substances (e.g. caffeine, ephedrine, dextromethorphan, and diphenhydramine) but were sold as ecstasy.

Florida is a prime area for international drug trafficking and money laundering organizations, and a principal thoroughfare for cocaine and heroin transiting to the northeastern United States and Canada. The over 8,000 miles of Florida coastline and the short distance of 45 miles between The Bahamas and Florida provide virtually unlimited opportunities for drug trafficking organizations to use maritime conveyances to smuggle drugs. Miami International Airport (MIA), which is a gateway for heroin and ecstasy trafficking in Florida, continues to be the number one airport in the U.S. For international freight and number three in the world for total freight. South Florida, specifically Miami-Dade and Broward counties, are still favorite areas of drug traffickers for the smuggling of large quantities of cocaine, heroin and marijuana into the continental United States (CONUS) from South America, Central America and the Caribbean. Smuggling occurs via various types of maritime conveyances and cargo freighters, as well as via private and commercial aircraft. Additionally, there is a continued shift to ground transportation (e.g. bus, rail and vehicle) as a means of transporting narcotics throughout the state and to northern destinations.

Miami is the primary domestic command & control center for Colombian narcotics traffickers. Colombian traffickers represent the greatest international threat to the Miami Field Division (MFD). MFD enforcement groups continue to target the transportation infrastructure of Colombian traffickers in the Eastern Pacific, the Caribbean and within Florida. Florida leads the nation in ecstasy seizures. South Florida has been identified as a primary gateway for ecstasy smuggling into the CONUS. The MFD will target specific enforcement initiatives towards the identification and dismantling of groups operating in Florida, with emphasis on South Florida. MIA is a major entry point for South American heroin into the United States. Presently the overwhelming majority of South American heroin enters the CONUS via MIA. Methamphetamine remains a large problem in the MFD and is the primary drug of concern in Central Florida.

Florida leads the nation in ecstasy seizures and international traffickers continue to use south Florida as a base of operations for the importation and distribution of ecstasy. Almost half of the seizures in Florida occur at MIA. Couriers on international flights originating from non-source countries (i.e. The Netherlands and Germany) attempt to smuggle ecstasy through MIA. Non-source countries include the United Kingdom, Spain, Italy, Switzerland and the Dominican Republic. Miami remains the primary source location for ecstasy trafficking in Florida. Ecstasy continues to be widely available and used in the club scene in south Florida (Miami to Fort Lauderdale). Large-scale ecstasy groups operate in the Tampa Bay area. Ecstasy, in multi-thousand dosage units, is shipped into Tampa/St. Petersburg from Germany and The Netherlands. Additionally, the international airports of Tampa and Orlando, plus the two major highway arteries to the Miami area make the acquisition of ecstasy an easy task. Ecstasy arrives in the Fort Myers area from Miami and Fort Lauderdale.

Ecstasy is popular among the club goers in Fort Myers. Central Florida's "rave scene," nightclubs and tourist atmosphere provide a constant market for ecstasy and ecstasy continues to grow in popularity with high school and college age individuals. Bulk quantities of ecstasy in the Orlando area are shipped, mailed, or smuggled via courier from Western Europe, usually Belgium, The Netherlands, Germany, Spain or the United Kingdom. A majority of the ecstasy found in Jacksonville is brought into the area from Orlando, South Florida or directly from Europe. Ecstasy is extremely popular in Jacksonville, especially among teenagers and young adults and most distributors tend to be college students. Sources of supply originate in The Netherlands and shipments are received via mail. Some ecstasy is brought into the area from sources in South and Central Florida and is delivered in personal vehicles. Additionally, "spring break" activities in the panhandle are a prime time for ecstasy sales and usage and reports indicate that users are becoming younger.

Prevention

Prevention and enforcement methods and initiatives have been put in place in order to help curb the use of ecstasy and other club drugs. In 1999, the National Institute on drug abuse (NIDA) and its partners launched a national research and education initiative, "Club Drugs: Raves, Risks, and Research," to help combat the increased use of club drugs in America. Through this initiative, the NIDA was able to increase funding for club drug research and launched a multimedia public education strategy to alert teens, young adults, parents, educators, and others about the dangers associated with ecstasy and other club drugs.

In 2002, the Partnership for a Drug free America (PDFA) launched a National ecstasy education campaign. The campaign promoted television and print advertising and an ecstasy micro site found within PDFA's web site. It includes advertising campaigns, a parent web community, web resources for parents and a parent driven campaign to recruit families that have dealt with substance abuse to spread the word to others. The campaign is designed to reach out to teenagers and their parents, with new, compelling information regarding drug abuse today. The challenge is to get parents and teenagers to look at the issue of ecstasy use today and realize the costly effects it has on people's lives and those around them.

In 2002, as well, the Drug Enforcement Administration (DEA) began Operation X-Out, which is a multi-faceted, year-long initiative that focuses on identifying and breaking up organizations that distribute ecstasy and similar drugs in the United States and around the world. Some results that have come out of Operation X-Out are an increased number of investigations involving ecstasy ad other drugs, enhancement of airport security, the creation of new task forces in big cities, such as in Miami and New York. Other results are the creation of a task force on Internet drug trafficking and an expanding cooperation with international law enforcement entities.

Research at the University of Washington has examined the long-term effects of and intervention combining teacher training, parent education, and social competence training for children during the elementary grades on health risk behaviors at age 18 years. Studies were done on 643 students in the Seattle, Washington area. The full-intervention group reported more commitment and attachment to school, better academic achievement and less school misbehavior. Finding such as these, suggest that a package of interventions with teachers, parents, and children provided throughout the elementary grades can have an enduring effect in reducing the risk of use of heavy drinking, drug use, violent behavior, and sexual intercourse at age 18 years among multiethnic urban children. Results support efforts to help reduce health-risk behaviors through universal interventions in selected communities or schools serving high-crime neighborhoods (Hawkins, 1999).

There are social influence-based prevention programs that have been developed that can delay the onset of tobacco, alcohol, and other drug use and slow the rate of increase in substance use prevalence among early adolescents. These programs can have an impact on students who are users at baseline. The advantage of such a program is that it may reach and affect a silent and not yet identified high risk population of early drug users in a non-stigmatizing and non-labeling fashion at an age when youth are easily persuaded and vulnerable (Chou, 1998).

Arizona State University did a research study of parental effects on young adult alcohol and drug abuse dependence. They tested whether adolescent symptomology and adolescent substance use mediated the effects of parental alcoholism on these diagnoses. 454 families were targeted. Results showed unique effects of parental alcoholism on young adult substance abuse and dependence. This study suggested that parental alcoholism is a specific risk factor for substance abuse or dependence. Children of alcoholics are at elevated risk for substance use disorders, partly because of their broad pattern of early adolescent anti-sociality and conduct problems (Chassin, 1999).