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Ecstasy Brian Wells University of Florida October 8th, 2003
What is Ecstasy? ,[object Object],[object Object],Source:  http://www.usdoj.gov/dea/concern/mdma/mdma020700.htm
Types of Ecstasy
History of Ecstasy ,[object Object],[object Object],[object Object],[object Object]
History of Ecstasy ,[object Object],[object Object]
The Ecstasy Problem ,[object Object],[object Object],[object Object],[object Object],Source:  MDMA/Ecstasy Research: Advances, Challenges, Future Directions   A Scientific Conference -  http://www.drugabuse.gov/NIDA_Notes/NNVol16N5/Conference.html
The Ecstasy Problem ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  MDMA.  http://www.whitehousedrugpolicy.gov/publications/factsht/mdma/
The Ecstasy Problem ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Jones, Reese T. et al.  Chemical Analysis of Ecstasy Pills.  JAMA, November 1,  2000;  Vol 284, No. 17.
The Ecstasy Problem ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Killer Club Drug.  http://abcnews.go.com/sections/us/DailyNews/ecstasy000929.html
The Ecstasy Problem
Ecstasy: Chemistry, Symptoms, and Other Fun Topics
How does it work? ,[object Object],[object Object],[object Object],[object Object],Source:  Fallon, J.K. et al.  Stereospecific Analysis and Enantiomeric Disposition of 3,4-Methlyenedioxymethamphetamine in Humans.  Clinical Chemistry, 1999. 45, 1058 – 1069.
How does it work? ,[object Object],[object Object],[object Object],[object Object],Source:  Lyles, Johnalyn, et al.  MDMA neurotoxicity:  cellular and molecular mechanisms.  Brain Research Reviews, 2003.  42, pg 155 – 168. Bogen, Inger L., et al.  Short and long-term effects of MDMA (“ecstasy”) on synaptosomal and vesicular uptake of neurotransmitters in vitro and ex vivo.  Neurochemistry International, 2003. 43, pg 393 – 400. Sprague, Jon E., et al.  Hippocampal serotenergic damage induced by MDMA (ecstasy):  effects on spatial learning.  Physiology and Behavior, 2003.  79, pg 281 – 287.
How does it work? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Lyles, Johnalyn, et al.  MDMA neurotoxicity:  cellular and molecular mechanisms.  Brain Research Reviews, 2003.  42, pg 155 – 168.
What are the symptoms associated with its use?
What are some of the symptoms associated with its use? ,[object Object],[object Object],[object Object],[object Object],[object Object]
What are the symptoms associated with its use? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Shannon M.  Methylenedioxymethamphetamine.  Pediatric Emerg Care  2000; 16:377-380
What are the symptoms associated with its use? ,[object Object],[object Object],[object Object],[object Object]
What are the symptoms associated with its use? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What are the symptoms associated with its use? ,[object Object],[object Object],[object Object]
What are the symptoms associated with its use?
PET Scan
Usage Trends
 
 
What about among College Students? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What about among College Students?
 
What can we do about these Trends? ,[object Object],[object Object],[object Object],[object Object],[object Object]
What can we do about these Trends? ,[object Object],[object Object],[object Object],[object Object],[object Object],Source:  MDMA.  http://www.whitehousedrugpolicy.gov/publications/factsht/mdma/
What can we do about these Trends? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Source:  Library of Congress.  http://thomas.loc.gov
What can we do about these Trends? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What can we do about these Trends? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Interesting Facts and Studies ,[object Object],[object Object],[object Object],[object Object],[object Object]
Questions?
Sources for Additional Information ,[object Object]

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Ecstasy Use Among College Students

Notes de l'éditeur

  1. MDMA is 3,4 methylenedioxymethamphetamine, a ring substituted derivative of phenethylamine, which is a close structural analog of amphetamine, methamphetamine and 3,4 methylenedioxyethylamphetamine (MDE: Eve). methylenedioxy (-O-CH2-O-) joining the 3,4 phenyl carbons to form a ring
  2. During the 1970s there was an interest by some psychiatrists in using MDMA as a therapeutic agent because it was reported to reduce the inhibition of their patients to speak openly during therapy sessions.
  3. CSA = Controlled Substances Act In the 1980s, MDMA got a new nickname, Ecstasy (also XTC and E), given to it by the newest group to experiment with it, our Nation’s youth. But at about the same time that MDMA first appeared as a so-called “party” or “club” drug at raves or all-night dance parties, evidence was emerging that this compound was not harmless, and indeed, could cause damaging effects on serotonergic neurons. In fact, in 1985 the U.S. Drug Enforcement Administration added MDMA to the Schedule I list of drugs with no accepted medical use.
  4. 63% - either MDMA or 3,4 – methlyenedioxy-ethyl-amphetamine
  5. PMA = paramethoxyamphetamine PMMA = paramethoxymethamphetamine Five hours after death, the body temperature was recorded at 104.
  6. R – rectus (Latin for right) - S – sinister (Latin for left) Chiral is from the Greek kheir meaning “hand” Maximum number of stereoisomers is = to 2^n where n = number of chiral carbons MDA = methylenedioxyamphetamine … HHMA = 3,4-dihydroxymethamphetamine MDMA also induces a state characterized as "excessive talking" (loquacity), which was once believed to be helpful in psychotherapy. In the 1970s, MDMA was documented to produce permanent damage to serotonin pathways in the brains of rats and monkeys. Much like other amphetamines, MDMA causes these neurotransmitters to be released from their storage sites in neurons, increasing brain activity. Compared to the potent stimulant methamphetamine, MDMA triggers a larger increase in serotonin and a smaller increase in dopamine. Serotonin is a major neurotransmitter involved in regulating mood, sleep, pain, emotion, and appetite, as well as other behaviors. By releasing large amounts of serotonin, and also interfering with its synthesis, MDMA leads to a significant depletion of this important neurotransmitter. As a result, it takes the human brain a significant amount of time to rebuild the store of serotonin needed to perform important physiological and psychological functions.
  7. This over-stimulation can selectively kill the neurons that normally release dopamine & serotonin Damage is not necessarily immediately apparent or noticeable as behavior
  8. Serotonin (5-hydroxytryptamine, 5-HT) MDMA blocks 5-HT reuptake and induces 5-HT release and causes, to a lesser extent, DA and NE release.
  9. High anti-diuretic levels stop kidneys from producing urine – can cause dangerously high water content in blood as kidneys improperly process water "Ataxia," which refers to coordination problems such as clumsy or awkward movements and unsteadiness, occurs in many different diseases and conditions. Friedreich's ataxia is an inherited disease that causes progressive damage to the nervous system resulting in symptoms ranging from muscle weakness and speech problems to heart disease. In Friedreich's ataxia, ataxia results from the degeneration of nerve tissue in the spinal cord and of nerves that control muscle movement in the arms and legs. The spinal cord becomes thinner and nerve cells lose some of their myelin sheath - the insular covering on all nerve cells that helps conduct nerve impulses. Nystagmus is an involuntary eye movement which usually results in some degree of visual loss. The degree and direction of eye movement, amount of visual loss and resulting impairment varies greatly from person to person. Role of MDMA in hyperthermia is not fully understood – might be the result of increased dopamine release through interactions with the dopamine D1 receptor
  10. Malignant hyperthermia is a sharp increase in body temperature. Role of MDMA in hyperthermia is not fully understood – might be the result of increased dopamine release through interactions with the dopamine D1 receptor
  11. Dose to cause these effects = 150 lb human taking 350 mg over 4 days
  12. This slide shows brain PET scans of an individual who has never used MDMA (seen at the top of slide marked "control") and those of an individual who used MDMA for an extended period of time up until 3 weeks prior to the images being taken. Specifically, the PET scans show the brain's ability to transport a neurotransmitter called "serotonin" from the synapse back into the releasing neuron. Serotonin is fundamental to the brain's integration of information and emotion. Brighter colors in the PET scans indicate that more serotonin is being transported than do duller colors. As seen in the slide, the brain of the MDMA user shows duller colors compared to the control, indicating a decrease in the MDMA abuser's ability to remove serotonin from the synapse. Such findings are leading researchers to conclude that MDMA may increase the risk of long-term, perhaps permanent, problems with learning and memory.
  13. From Department of Health and Human Services Monitoring the Future study for 2002
  14. Older NY gay men may use ecstasy as part of a post-traumatic stress response to having lived through the death years of AIDS Youth may be rebelling