Ecstasy Use Among Adolescents in Miami-Dade County, FL

Introduction to Ecstasy and Its Use Among Adolescents

Ecstasy, also known as MDMA (methylenedioxymethamphetamine), has become popular as a club drug at techno dance events such as raves, trance scenes, and private parties. Many who attend raves and trance events 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 experience (NIDA, 2004). Ecstasy has gained the reputation as a "hug drug" that promotes empathy, relaxation, and heightened sexuality. Studies indicate an increase in abuse of this drug, especially among adolescents and teenagers. It is a human-made drug that acts as both a stimulant and a hallucinogen, taken orally in the form of a capsule or tablet. Short-term effects include feelings of mental stimulation, emotional warmth, enhanced sensory perception, and increased physical energy.

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

Ecstasy is a synthetic drug — it does not come from a plant as marijuana does. It is manufactured in clandestine labs around the country. Other chemicals or substances are often added to or substituted for MDMA in ecstasy tablets, including caffeine, dextromethorphan (found in cough syrup), amphetamines, and even cocaine. Because manufacturers can add virtually anything to the drug, the purity of ecstasy is always in question. More recently, a liquid form of ecstasy has raised additional concern because its purity varies widely; it is cut with many different drugs, leaving users uncertain about what they are actually consuming (Director's Report, 1999).

Health Effects and Risks of MDMA

Cognitive and physical effects of ecstasy include impaired performance on certain memory and cognitive tasks among chronic users compared to non-users. Some of these effects may be attributable to the use of other drugs in combination with ecstasy. In high doses, ecstasy can interfere with the body's ability to regulate temperature, potentially leading to a sharp increase in body temperature and resulting in liver, kidney, and cardiovascular system failure. Because ecstasy can interfere with its own metabolism, potentially harmful blood levels can be reached through repeated use. Users face many of the same risks as users of other stimulants, such as cocaine and amphetamines, including elevated heart rate and blood pressure, muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating.

Physiological effects can also include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during use and sometimes persist for days or weeks afterward. Research in animals links ecstasy exposure to long-term damage to neurons involved in mood, thinking, and judgment. A study using nonhuman primates showed that four days of ecstasy exposure caused damage to serotonin nerve terminals that was still evident six to seven years later. While comparable neurotoxicity has not been definitively demonstrated in humans, the body of animal research strongly suggests that ecstasy is not safe for human consumption.

Research confirms that use of club drugs generally can cause serious health problems and, in rare cases, death. Many users take combinations of drugs including alcohol, which may further increase risk. A single "hit" of ecstasy typically lasts three to six hours. Once swallowed, the drug reaches the bloodstream and brain in approximately fifteen minutes, with peak effects occurring around forty-five minutes after ingestion. Even when a user takes only one pill, after-effects can persist for several days to a week — or longer in regular users — and include sadness, anxiety, depression, and memory difficulties.

Users may initially feel very alert or hyperactive and can dance for hours at a rave. They may experience distortions in time and enhanced sensory perception, including an amplified sense of touch. Some users become anxious and agitated; others experience sweating, chills, dizziness, or near-fainting. Dehydration is a serious risk for those engaging in vigorous activity in hot environments. Ecstasy's interference with the body's temperature regulation can cause dangerous overheating (hyperthermia), which in turn can lead to heart, kidney, and liver damage, and rarely, death. The risk is particularly elevated when multiple small doses are taken within a short period to sustain the high, since blood levels of the drug can rise to dangerous concentrations.

Hidden toxicity risks also arise from the fact that other chemically similar drugs — such as MDA (methylenedioxyamphetamine) and PMA (paramethoxyamphetamine, associated with fatalities in the United States and Australia) — are sometimes sold as ecstasy. Ecstasy tablets may also contain ephedrine, dextromethorphan (DXM), ketamine, caffeine, cocaine, or methamphetamine (NIDA, 2005). Users who combine ecstasy with any of these substances, or with marijuana and alcohol, place themselves at additional physical risk.

Neurological Damage and Addiction Potential

Brain imaging research in humans indicates that ecstasy may damage neurons that rely on serotonin to communicate. The serotonin system plays a direct role in regulating mood, aggression, sexual activity, sleep, and pain sensitivity. Evidence also suggests that users who develop acne-like rashes after using ecstasy may be at risk for severe side effects, including liver damage, if use continues. Research links ecstasy use to long-term damage in brain regions critical to thought and memory; in one primate study, four days of exposure caused brain damage evident six to seven years later.

Ecstasy is structurally related to methamphetamine, which has been shown to cause degeneration of dopamine-containing neurons. Damage to these neurons underlies the motor disturbances seen in Parkinson's disease, beginning with lack of coordination and tremors and potentially progressing to a form of paralysis. Ecstasy also destroys serotonin-producing neurons, compounding its neurological threat.

Like other stimulant drugs, ecstasy appears capable of causing addiction. Users may continue taking the drug despite experiencing adverse side effects and negative social, behavioral, and health consequences. The threshold for addiction — how many uses it takes, or which individuals are most vulnerable — is not yet fully understood. Genetic makeup, living environment, and other personal factors likely influence susceptibility.

Contrary to popular rumor, ecstasy is not an aphrodisiac and can actually inhibit sexual performance. Its effects vary according to the individual's size, weight, health status, and dosage. Individuals who struggle with drug addiction rarely set out to harm themselves; rather, the destructive consequences are a product of the addiction cycle. For many, drugs initially appear to be a way to cope with emotional or physical pain — a temporary escape from life's difficulties. A person tries drugs, feels better, and comes to view the substance as a solution to discomfort. Inadvertently, the drug becomes valuable to them because it provided relief. This cycle — using, feeling better, using again — is the main reason a person continues. It is only a matter of time before the individual loses control over their use. Drug addiction results from excessive or continued use of physiologically habit-forming substances in an attempt to resolve underlying discomfort or unhappiness.

Conclusion: A Personal Story of Recovery

In conclusion, the synthetic drug ecstasy is commonly found at rave parties, nightclubs, and increasingly at malls, schools, and home parties frequented by youth and adults. Its damaging effects can be long-lasting and may occur after only a small number of uses. Ecstasy trafficking is increasing at an alarming rate, particularly via cruise ships into Miami-Dade, Florida — leaving adolescents at heightened risk of exposure. Miami-Dade adolescents are especially vulnerable given the steady influx of drugs throughout the region.

The following true story illustrates the very real consequences of adolescent ecstasy use. Daniel, 17, of San Clarita Valley, California, wanted his prom to be the best night of his life. He reached into his tuxedo pocket and took out pills stamped with Tweety Bird and Buddha. Ecstasy seemed harmless enough, but Daniel quickly learned how dangerous it could be. "My heart was racing so fast," he said. A friend helped him into the venue. His legs would not stop shaking; he tingled from head to toe. At one point he felt euphoric — like a movie star. Later that night, at a friend's house, he felt confused and depressed. He then took two more pills. By taking multiple doses within a short period, ecstasy was building to dangerous levels in his bloodstream, and his body could not process it fast enough. Daniel lay down and could not lift his head. His legs rocked uncontrollably.

The following weekend, Daniel was at it again, taking ecstasy at a dance club. Before long, he began selling the drug. He would walk into rave clubs, call out "E," and people would gather around him. He felt a sense of power. With his profits he bought more ecstasy and consumed it regularly, always alongside other teens. He used drugs so he would not feel so alone. While his father worked nights, Daniel held regular parties at home. His friends came and bought ecstasy from him; they danced to trance and techno music, wore glow-in-the-dark shirts, and chewed pacifiers to keep their teeth from grinding.

Soon Daniel was taking five pills a day. Desperate to feed his habit, he began selling cocaine and methamphetamine as well. He became severely thin, his skin pale as paper, his teeth beginning to rot. He stole whatever he could. He felt he was doing nothing wrong — until he delivered drugs to a friend's mother and saw the devastation on his friend's face. On New Year's Eve, his girlfriend called him an addict and a low-life. He jumped out of her car and thought: if he kept going down this path, he would end up alone on the streets. He went to his father and said, "Dad, I need help."

Daniel entered Phoenix House, a drug treatment program in Lake View, California. After six months of sobriety, he regained weight and began caring for himself again. Yet he worries about the lasting effects of ecstasy on his brain. Sometimes he gets stuck mid-conversation, unable to find a word. Other times he walks down the hall and forgets where he is going. He believes he may have suffered a form of brain damage.

Daniel is working to rebuild his life. He says he began using drugs because he felt that no one liked him — only to find that no one wanted to be around him when he was using, which left him more isolated than ever. Today, he says he feels like a completely new person. His story is one of disappointment, heartache, and ultimately, hope. Not every story ends as Daniel's did, but recovery is possible. Those experiencing the effects of ecstasy must reach out to others for help, and in doing so may find the support they need at the most desperate moment in their lives ("'E' is for Empty," 2003).

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