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Heaven or Hell



Mindy Rushing

20 September 2006





We are a generation of overachievers.  College students today are among the most competitive and scholastically talented generation that the world has ever known.  Each successive class of entering college freshmen face a greater intensity of pressure to succeed and compete.  How do we deal with this pressure?  We work hard and party harder.  For most, partying remains limited to getting drunk and/or smoking the occasional joint, but many partygoers seek a more intense high, one in which helps them feel open and free from the burden of the future.  It’s most common name is, appropriately, ecstasy because it temporarily relieves one of their burdens and gives them a sense of euphoria.


Ecstasy is one of the most mythical substances in the illicit drug world.  It’s surrounded by various and contradicting myths, has been at the center of scandalous scientific research, demonized by the media, and separating the facts from fiction is a task that proves to be tricky indeed.  This paper will discuss what ecstasy actually is, explain how it works and what the typical effects are, look at its history, and finally examine a few of the myths that surround it.




What’s in a Name? Ecstasy by another name


Ecstasy, like most illicit drugs has many different names.  The scientific term for ecstasy is methylenedioxymethamphetamine or MDMA for short.  Throughout this paper MDMA and ecstasy will be used interchangeably.

  Some common street names include:




Pink Panther



Playboy bunnies


Green Triangles

Red devils

Blue Kisses

Happy pill

Rolls Royce

Care Bears

Herbal bliss



Hug drug




Tweety Birds


Jerry Garcias

White Diamonds


Love pill

White Doves


Lover’s speed



For a complete list of street names click on the following link Ecstasy Street Names








What is Ecstasy and what does it do?


Ecstasy, or in more professional terms MDMA, is a synthetic entactogen.  Entactogens are a class of psychoactive drugs that allows the user to feel extremely in touch with their emotions.  It is alternatively referred to as an empathogen.  Its chemical structure is similar to that of methamphetamine, a stimulant, and mescaline, a hallucinogen. (  Currently, ecstasy is the most popular “club drug” on the market.  Club drugs are typically used by adolescents and young adults who partake in all-night “raves” or dance parties.




Ecstasy is most commonly used in tablet form, but is available in a powder form that can be snorted or smoked.  The normal dosage of ecstasy is approximately 100-123 mg. (    Sometimes powder ecstasy is referred to as “madman”.  Ecstasy can also be injected, but this is very rarely done.                                                                                  (  The pills are often very colorful and have logos stamped on them to designate their “brand”.  To view pictures of some of the different stamped tablets click on the following link Brands of Ecstasy






Pharmacological content


One major concern of ecstasy users is the purity of the tablets.  The purity of the tablet is the amount of MDMA it contains.  Often tablets purchased on the street contain other substances that range from relatively harmless stimulants such as caffeine to potentially fatal drugs such as phencyclidine (PCP).  There have been several empirical studies done that test the purity of large samples of tablets, which are generally obtained through police seizures and anonymous submissions to laboratories.  Emily E. Tanner-Smith reported the results of one such study, which analyzed anonymously submitted tablets between 1999 and 2005.  The overall results were as follows:



The most common substances that were found in the “impure” or “contaminated” tablets were:



Also found less commonly, but present nonetheless were:



The study also found that the purity of the tablets decreased over time, with the purity peaking in 2001 before sharply declining, reaching a low in 2004, and beginning to increase slightly in 2005 (Tanner-Smith, 2005).








How does it work?


Ecstasy is a mood elevator that induces a sense of openness, emotional closeness, and euphoria.  Ecstasy is not a hallucinogenic drug and produces hallucinations when used in conjunction with other psychedelic drugs such as “magical” mushrooms or LSD. (


Ecstasy is believed to work by stimulating production and inhibiting re-uptake of large amounts of the neurotransmitter serotonin, as well as the neurotransmitters dopamine and norepinephrine.  These neurotransmitters are all believed to play a role in mood and pleasure perception.  Typically, ecstasy reaches it’s maximum blood concentration anywhere from an hour and a half to three hours after ingestion.  This is when the user will typically “peak”.  (  


Short-term effects of Ecstasy


The effects of ecstasy can be broken up into two categories:  short-term and long-term.  Of course, people take ecstasy because it produces desired effects. (   


 The desired effects include:









The acute physiological effects include:





As with any other drug there are acute adverse effects associated with the use of ecstasy.  An article in the “Journal of American College Health” gives the adverse effects reported by users.


A few of the minor adverse effects that users report include:



Also, during the days following use some side effects include:



(Walters, Foy, & Castro, 2002)


The most dangerous risk currently associated with MDMA is impurity. Putting the risks associated with impurity to the side, the risks posed by MDMA mimic the risks linked to amphetamines.  The vast majority of instances in which MDMA users require medical care involve hyperthermic syndromes.  MDMA appears to decrease heat loss by constricting the blood vessels near the skin, this coupled with the physical exertion that most users experience can cause the body’s temperature to raise substantially.  MDMA is also thought to mask the body’s normal thirst response, which can lead to dehydration.  On the other end of the spectrum, there have also been cases involving “water intoxication” and associated hyponatremia, which causes a dilution of the blood and swelling of the brain.  Symptoms of hyponatremia include nausea, confusion, headache, and loss of consciousness.  Hyponatremia is thought to be caused when MDMA induces the release of the antiduretic vasopressin by the pituitary gland, which causes the person to retain water.  Most deaths associated with MDMA are the result of hyponatremia.  Medical treatment should be sought immediately for users experiencing symptoms of hyponatremia.


Long-term effects of Ecstasy


The long-term effects of ecstasy are still largely unknown and are the source of heated debates among scientists.  One source of the problems is that there are so many myths involving ecstasy, which will be dealt with in a later section.  Another problem is that there have been some highly publicized scandals involving scientific studies of ecstasy.  The most famous scandal involved a paper written by Dr. George Ricaurte et al., which discussed the effects of MDMA on primates.  The report claimed that monkeys, which were administered MDMA, suffered severe brain damage, which lead to death in two of the monkeys.  This article appeared in “Science”, a widely respected peer review journal, in 2003.  It was later retracted when it was discovered that the monkeys had not been administered MDMA at all, but a higher level methamphetamine.  This was supposedly done due to a labeling error, but the scandal was a huge blow to MDMA research. (


One long-term concern for MDMA users is that very high doses over a prolonged period of time could lead to damage of the synaptic terminals of serotonin neurons.  There has been some evidence in recent studies involving rats that suggest the metabolic breakdown of MDMA involves the formation of reactive oxygen species, which cause oxidative cell damage when they are taken up into a releasing synapse.  The hypothesis is supported further by experiments in which serotonin reuptake inhibitors were administered, which block the oxygen species from entering the serotonin cells.  This appeared to block the neuron damage in the rats.   (


There is also some question as to the effects of prolonged ecstasy use on memory, but most of the data regarding this has been inconclusive.  Impulsivity and impaired decision-making was the subject of a study conducted by Michael John Morgan, Lara Chiara Impallomeni, Alessandro Pirona, and Robert David Rogers at the University of Sussex.  This study compared recreational MDMA users to cannabis users and a drug-naïve control.  They found an elevated level of impulsivity in MDMA users and a possible link to risky behavior and attention deficits.  They also concluded that there might possibly be evidence that ecstasy users can recover these problems elicited by seratonergic deficiencies after prolonged abstinence, but further research would be required (Morgan et al, 2006).


Of course it is impossible to discuss the long-term effects of ecstasy without discussing addiction and dependence.  I was unable to find any literature that had concrete proof that MDMA is addictive.  The patterns of users do not follow the typical addictive patterns of physical dependence, drug-seeking behavior, nor withdrawl after the user discontinues use.  However, there is some evidence that suggests with prolonged use the positive effects begin to decline while the negative effects steadily increase (Walters, Foy, & Castro, 2002).



Where did Ecstasy come from?


Ecstasy, or MDMA, was developed by a German pharmaceutical company called E. Merck in the first decade of the 20th century (Walters, Foy, & Castro, 2002).  It was originally intended to be used in order to synthesize styptic, which is a drug used to control bleeding from wounds.  The first recorded ingestion of MDMA took place approximately 50 years after the original patent.  During the mid 1970s ecstasy was used along with psychotherapy to help victims of trauma, as well as couples having problems.  There have not been any formal studies to assess the claim that ecstasy was effective in treating patients.  In the early 1980s it took on the role of a trendy drug as its use became more widespread.  On May 31, 1985 its use was made illegal in the United States as it became a Schedule I drug. (



Myths regarding Ecstasy


There are a slew of myths involving ecstasy, which makes it even more fascinating for some.  In this section we will examine some of these myths and present the known facts concerning each of them.


Myth #1: “Ecstasy is an aphrodisiac”

The truth is that while many users experience pleasure from tactile sensations, many users also experience sexual dysfunctions including difficulty in arousal and achieving orgasm.  In order to combat this, many users use “sextasy”, which is a term meaning the combination of Viagra and Ecstasy. (


Myth #2 “Ecstasy drains your spinal fluid”

This is a myth that was popularized by a special episode of Oprah involving Ecstasy as the topic of the day.  This has been proven in no way.  It is believed that this myth was brought about by a misunderstanding of an experiment studying the effects of MDMA.  Serotonin is produced in the brain as well as the CSF. In order to study MDMA researchers look at the levels of serotonin so they perform a procedure that is commonly referred to as a spinal tap, in which CSF is drained.  It is the procedure that drains the spinal fluid, not the MDMA.  Another source of this myth could be the soreness that is reported by some users in the days following use.  This is more than likely do to the physical exertion they experience while under the influence (


Myth #3 “Ecstasy burns holes in your brain”

Again, this myth was popularized by Oprah, as well as an MTV special on Ecstasy.  On the MTV special, a young woman that had heavily used ecstasy in the past was given a brain scan that appeared to show large holes in her brain.  In actuality what was seen in the scan was the amount of blood flow to different areas of the brain.  The “holes” were simply areas receiving less blood flow.  Another reason for the spread of this myth is Ricaurte’s study involving the monkeys, which was discussed earlier (see long-term effects section).



Myth #4 “Ecstasy is completely harmless”

Perhaps this is the most dangerous myth out there.  The fact is that there is currently not enough information to go on in determining the risks involved with Ecstasy.  The important thing to remember is that just because most of the research is inconclusive, that does NOT mean that it is wrong.  It simply means that there needs to be further research done.  As we discussed in the short-term effects section above, there are some definite dangers entailed in using ecstasy.  Also, at its core, ecstasy is a stimulant and with any stimulant there are adverse effects on health.



          The debate over the MDMA is far from over.  Ecstasy is a drug whose effects remain largely mysterious.  Only time and further study will be able to properly inform us.  The important thing to note is that not everything you read about ecstasy is true, but not everything that is unproven is necessarily false.  Ecstasy may not be as dangerous as some of the other illicit drugs, but it does not come without its own set of potential problems.  In the future it is possible that we may know much more of the dangers presented by ecstasy, as well as if it has a place in treating some forms of trauma or psychiatric disorders.  Until we know more, however, ecstasy should be viewed through a cautious eye.




Ecstasy Street NamesOffice of National Drug Control Policy (Updated 6 April 2005).  Retrieved: 18 September 2006 from


National Institute on Drug Abuse Notes. Vol. 14 (4).  (November, 1999).  Retrieved on 23 August 2006 from Ecstasy  (unknown) Retrieved on 18 September 2006 from


Wikipedia: Free online Encyclopedia; methylenedioxymethamphetamine (Updated 19 September 2006).  Retrieved on 19 September 2006 from


Brands of Ecstasy. Toronto Rave Information Project. (Date Unknown) Retrieved on 19 September 2006 from,GWYA:2006-31,GWYA:en%26sa%3DX


E. Merck (Date Unknown). Retrieved on 18 September 2006 from


MDMA: Essential Guide (April, 2003).  Retrieved on 19 September 2006 from


Tanner-Smith, Emily E. (2005). Pharmacological content of tablets sold as “ecstasy”: Results from an online service.  Drug and Alcohol Dependence, 83, 247-254.


Morgan, J.M., Impallomeni, L.C., Pirona, A., & Rogers, R. D.. (2006). Elevated impulsivity and impaired decision-making in abstinent ecstasy (mdma) users compared to polydrug and drug-naïve controls. Neuropsychopharmacology, 31, 1562-1573.

Walters, S. T., Foy, B. D., & Castro, R. J. (2002). The agony of ecstasy: Responding to growing MDMA use among college students. Journal of American College Health, 51, 139-141.



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