Substance abuse ecstasy

Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). The NHSDA Report. Accessed at http //www.samhsa.gov/oas/2k3/ecstasy/ecstasy.htm. 

The National Household Survey on Drug Abuse (NHSDA), which is conducted by the Substance Abuse and Mental Health Services Administration (SAMH-SA), provides statistical data on illegal drug use in the United States. For the purpose of the survey, hallucinogenic drugs were defined to include lysergic acid diethylamide (LSD), phencyclidine (PCP), psilocybin, peyote, and ecstasy. 

MDMA or ecstasy is generally considered the prototypical club drug, LSD remains popular as well. For example, in one recent study of clients in treatment for substance abuse (Hopfer, Mendelson, Van Leeuwen, Kelly, Hooks, 2006), LSD use was reported by nearly half (48.6%) of those under 18 years old, as compared to 32.3% reporting MDMA use. Among older clients (18-32 years) the pattern was similar, with 42.9% reporting LSD use compared with 37.0% using MDMA (Hopfer et al., 2006). So, LSD remains a significant issue in the United States today. 

Ricaurte GA, McCann UD, Szabo Z, et al Toxicodynamics and long-term toxicity of the recreational drug 3,4-methylenedioxy-methamphetamine (MDMA, Ecstasy ). Toxicol Lett 112-113 143-146, 2000 Robinson TN, Killen JD, Taylor CB, et al Perspectives on adolescent substance use a defined population study. JAMA 258 2072-2076, 1987 Rubinstein JS Abuse of antiparkinson drugs feigning of extrapyramidal symptoms to obtain trihexyphenidyl. JAMA 239 2365, 1978 Rumack BH (ed) LSD, in Poisindex, Vol 54. Denver, CO, Micromedex, 1987 Rusyniak DE, Banks ML, Mills EM, et al Dantrolene use in 3,4-methylenedioxymethamphetamine ( ecstasy )-medicated hyperthermia (letter). Anesthesiology 10 263, 2004... 

There is virtually no one who is involved in drug abuse research, or who studies the properties of recreationally used drugs, that is not by now familiar with 3,4-methylenedioxymethamphetamine (MDMA) (figure 1). Over the past 4 years this substance, usually referred to in the popular press as Ecstasy, has received widespread media attention. This chapter will relate recent findings with respect to the potential dangers attendant on the use of MDMA and explore its pharmacological properties. 

Schedule I—The drug or other substance has (1) a high potential for abuse, (2) no currently accepted medical use in treatment in the United States, and (3) a lack of accepted safety for use of the drug or other substance under medical supervision. Examples Ecstasy, heroin, marijuana, and the hallucinogens peyote, mescaline, psilocybin, and LSD. 

For this reason, the initial evaluation of a patient during an episode of mania or hypomania must include a review of all prescribed medications and illicit substance use, and collection of a urine drug screen. We must bear in mind, however, that many of the newer designer drugs such as Ecstasy are not typically detected by most commercial laboratory tests for drugs of abuse. 

This overview will therefore focus on the following substances and narrow discussion of their use primarily to the club environments where they are most used and abused. These drugs include ecstasy (MDMA), gamma hydroxybutyrate (GHB), ketamine (special K), metham-phetamine (crystal), 2C-B (nexus), and phencyclidine (PCP). 

Ketamine hydrochloride (Ketalar) is primarily used as an animal tranquilizer. When humans use the drug in a nonmedical setting, ketamine can cause hallucinations, amnesia, and dissociation. It is often used with other drugs such as ecstasy, heroin, or cocaine. Due to widespread abuse by young people, the DEA classified this drug as a Schedule III controlled substance in 1999. 

Stimulant drugs commonly abused in the USA include methamphetamine ("crank," "crystal"), methylenedioxymethamphetamine (MDMA, "ecstasy"), and cocaine ("crack") as well as legal substances such as pseudoephedrine (Sudafed) and ephedrine (as such and in the herbal agent Mar-... 

The most well-known drugs of abuse are heroin, cocaine, cannabis, LSD, amphetamines, and ecstasy. They all cause different kinds of effects and their toxic effects are also different. The first three of these are derived from or closely aUied to substances found in plants. LSD is similar to substances found in a fungus which affects crops (see pp. 244-7). h is appropriate to consider these substances here as they are drugs in the accepted sense of the word, and some of them have legitimate uses as well as being drugs of abuse. 

Abuse of volatile substances (lighter fuel, aerosols, glue) is often more common amongst schoolchildren than amphetamines and ecstasy, and is increasing in some countries. 

Another abused drug, 3,4-methylenedioxymethamphetamine (MDMA) or Ecstasy, is a synthetic drug with psychedelic and stimulant effects. In 1988, it became a schedule I substance of abuse under the Controlled Substances Act Trafficking in this drug can lead to 10 years in prison. 

High doses cause paranoia and anxiety. Abuse of MDMA and MDA has become a worldwide problem. For a list of substances to expect to find in an Ecstasy lab, see Box 7-1. 

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