Risks of Illicit Recreational Use

Risks of Illicit Recreational Use of Ecstasy

Volumes of empirical studies suggest that heavy recreational use of MDMA ("ecstasy") is harmful to human health and responsible for permanent neurological changes. Less effort has been devoted to determining whether or not light infrequent use is necessarily associated with any long-term consequences of that nature. The available empirical literature provides evidence that light MDMA use may result in short-term cognitive changes but no long-term changes. It also reveals that, based on animal studies, exposure of pregnant mothers to MDMA during gestation causes significant negative consequences.

In the last few decades, recreational use of the drug known as "ecstasy" or "MDMA" (3,4-methylenedioxymethamphetamine) has grown significantly, particularly among teens and young adults. Typically, the drug is sold and consumed in conjunction with all-night dance parties known as "raves" in which participants seek the mood altering effects of high energy, euphoria, and increased appreciation of physical contact. While the drug is not physically addictive in the manner of some other illicit drugs, there is substantial evidence that regular use is detrimental to cognitive functioning and possibly a cause of permanent destruction of brain tissues. Animal studies have confirmed the destruction of neural structures as the result of ecstasy use as well as developmental changes in infants born to mothers exposed to the drug during specific phases of gestation. Human studies have documented the temporary detrimental effects of ecstasy use of light use and permanent detrimental effects linked to heavy use even long after cessation. Other human studies have been designed to determine whether or not there are potential long-term negative consequences associated with light short-term so-called "recreational" use of MDMA. Those types of studies have been limited by the inherent difficulty of isolating the specific effects of MDMA in particular because populations that choose to take MDMA typically also take other illicit recreational drugs, some of which are also known or suspected to produce cognitive changes similar in their physiological bases. A review of the available current empirical literature suggests that infrequent light use of MDMA may result in cognitive changes in the short-term but that only heavy use is necessarily associated with long-term or permanent changes in that regard. However, even light use of MDMA by pregnant mother during certain phases of gestation probably cause permanent cognitive impairment of their infants by virtue of the disruption of the development of essential neurological structures and functions. For those reasons, MDMA should be considered a dangerous drug whose recreational use should continue to be prohibited by law and discouraged as much as possible by authority figures.

Discussion -- Summary and Analysis of Empirical Research

In principle, there are four main lines of inquiry that have been the subject of extensive empirical research of the recreational use of ecstasy: specifically, (1) whether or not infrequent recreational use causes cognitive changes during the period of use; (2) whether or not infrequent use causes cognitive changes that persist beyond the short-term of actual use; (3) whether or not heavier more frequent use causes long-term or permanent cognitive changes; and (4) whether or not the use of ecstasy during pregnancy causes neurological damage, impairment, or permanent cognitive changes in infants exposed to the drug in-utero. According to the research: (1) light recreational use of ecstasy may be associated with cognitive impairment and altered neurotransmitter functioning during the period of use but not necessarily with any such changes in the longer term after cessation of use; (2) heavier or more frequent use of ecstasy may be associated with the permanent destruction of neurological tissue and long-term cognitive and impairment of mood regulation through neurotransmitter processes; and (3) the use of ecstasy by pregnant mothers likely results in permanent neurological and cognitive changes to their infants, based on empirical animal studies and anecdotal evidence collected in connection with the available clinical data.

The Short-Term and Long-Term Consequences of Light MDMA Use

More specifically, the evidence that heavy MDMA users typically exhibit permanent cognitive changes and alteration in mood regulation via neurotransmitter-modulated processes suggested the need to investigate whether or not lighter short-term recreational use of the drug presents similar or comparable dangers to users (Golding, Groome, Rycroft, et al., 2007). The results of that research indicates that light users of MDMA do exhibit mild cognitive impairment during the short-term in which they occasionally use the drug but that after six months or more of abstinence, their performance on the same cognitive tests used to identify those changes returns to being indistinguishable from the performance of those who have never been exposed to the drug (Golding, Groome, Rycroft, et al., 2007).

The Short-Term and Long-Term Consequences of Heavy MDMA Use

Animal studies have conclusively established that MDMA causes permanent destruction of neurons and synaptic processes that are essential to the physiological mechanisms of neurotransmitter secretion, response, and reuptake by virtue of the selectively neurotoxic properties of the drug on 5-HT neurons in rats (Verrico, Miller, & Madras, 2007). Those findings are consistent with anecdotal evidence collected from clinical human data in connection with the long-term cognitive, behavioral, and mood regulation functions of repeated MDMA users (Roiser, Rogers, & Sahakian, 2007). However, studies based on data from humans have been limited by the inherent difficulty of isolating the effects of (just) MDMA from that of other recreational drugs since MDMA users typically experiment with other illicit drugs, such as cannabis and cocaine, as well. Another inherent difficulty and limitation of those studies is that some of the mood differences (particularly in relation to impulsivity) may be contributing causes of drug use rather than results of drug use, much less of any specific drug. While acknowledging those complexities associated with the research, it appears that after controlling for other types of drug use, the results suggest that only heavy and long-term use of MDMA is necessarily linked to permanent changes in brain physiology of sufficient significance to produce measurable behavioral changes. Generally, the light or occasional use of MDMA does not appear to result in the same types of cognitive changes (Roiser, Rogers, & Sahakian, 2007).

The Consequences of MDMA Use by Pregnant Mothers