Controversy Over Ecstasy and Brain Damage

Ecstasy, the common name for MDMA (3,4 methylenedioxymethamphetamine), is an illegal, mind-altering drug that produces some of the effects commonly associated with both hallucinogens and stimulants like amphetamines.

The drug first shot to popularity in the 1990s among teens and young adults participating in all-night dance parties known as “raves.”

While use of ecstasy dropped after the start of the 2000s, hundreds of thousands of people in the U.S. still take the drug every year.

There is considerable disagreement among reputable researchers regarding ecstasy’s ability to produce brain damage.

Ecstasy Basics

Ecstasy users typically take the drug in order to experience effects that include a reduction in normal inhibitions, a feeling of euphoria and good will, increased energy and physical stamina, a heightened sense of personal well-being, altered time perception, and unusually heightened or focused perceptions of visual, auditory (sound-related) and tactile (touch-related) information.

Most of these effects stem from ecstasy-related increases in a chemical messenger (neurotransmitter) inside the brain and spinal cord called serotonin; you rely on stable levels of this chemical for maintenance of such everyday things as the stability of your overall mood, establishment of a normal sleeping pattern, regulation of your basic susceptibility to pain, and regulation of the urges that form the core of human sexuality.

In addition to alterations in serotonin levels, some of ecstasy’s pleasurable effects are the result of increased levels of a second neurotransmitting chemical called dopamine, which activates pleasure pathways inside the brain. Secondary effects of the drug-including increases in both heart rate and blood pressure-stem from its effects on normal levels of another neurotransmitting chemical called norepinephrine or noradrenaline.

Specific Effects on Serotonin Production

Inside the brain, neurotransmitters maintain communication between individual nerve cells (neurons) by moving between these cells and attaching themselves to sites called receptors, which sit on the surfaces of each neuron.

Every nerve cell has a variety of different receptors; essentially, they act as locks that safeguard the neuron and only open in the presence of the proper chemical key.

The receptors that respond to the presence of serotonin are known as 5-HT receptors. After serotonin molecules relay their chemical message, they get cleared from the targeted receptors by substances called serotonin transporters, and are then recycled for reuse at a later time.

When ecstasy enters the brain, it binds itself to the serotonin transporters that normally remove serotonin molecules from active use. This binding process essentially stops the serotonin transporters from doing their job and leaves serotonin in active contact with its target receptors. At the same time, ecstasy also increases the normal level of serotonin output inside the brain. It is the combination of these serotonin-related changes that triggers the drug’s strong effects on normal brain function.

Eventual Brain Damage

In people who use ecstasy repeatedly, the presence of excessive serotonin levels inside the brain will eventually lead to a decrease in normal serotonin production. This decrease is meant to help the brain adapt and maintain normal system regulation, but if it goes too far or lasts too long, it can result in symptoms of chronic serotonin reduction such as sleep disturbances, emotional volatility, loss of normal sexual urges, stomach pain and headaches.

According to a Vanderbilt University study published in 2011 in the Archives of General Psychiatry, regular use of ecstasy produces clear evidence of the brain changes associated with lowered serotonin output.

What’s more, these damaging changes remain even when Ecstasy users stop taking the drug for a period of several months. In a separate study, also released in 2011, the same group of Vanderbilt University researchers reported that regular Ecstasy users also appear to develop a significant loss of normal efficiency in parts of the brain responsible for processing visual information. These researchers were supported financially by grants from the National Institute on Drug Abuse and the National Institute of Mental Health.

Contradictory Information

In a second study, also completed in 2011 with the help of grants from the National Institute on Drug Abuse, researchers from Harvard Medical School reported a different outcome.

Essentially, they concluded that the vast majority of brain-related issues associated with habitual ecstasy use actually stem from other problems commonly found in ecstasy users.

These problems include prior abuse of other drugs or alcohol; pre-existing damage to normal brain function; and the cumulative effects of dehydration and poor sleeping habits, both of which are common in the subculture that supports ecstasy use. Still, the Harvard Medical School researchers noted, ecstasy use is dangerous for reasons that include lack of guidance from medical professionals and the potential for cross-contamination with toxic substances during ecstasy production.

These sorts of conflicting findings often lead to confusion or disinterest on the part of the general public. However, they typically mean that problems exist in current methods used to study a particular health issue.

Alternatively, there’s simply not enough available evidence to support a scientific or medical consensus. Researchers deal with these situations all the time by reassessing their findings and pushing forward until they can reach firmer conclusions.

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