3,4-Methylenedioxymethamphetamine
(MDMA, XTC, X, Ecstasy, Adam)

Introduction

3,4-Methylenedioxymethamphetamine (MDMA) is a popular drug of abuse. Its subjective effects have contributed to its popularity as a "party drug" among adolescents and young adults who frequent "rave" or "techno" parties. There is no accepted medical use for MDMA in the U.S. The majority of the drug is being smuggled into the U.S. but it is also produced in illicit laboratories domestically. MDMA produces significant long-term neurochemical changes after a single administration and selective and permanent brain damage during repetitive use. Recent reports estimate that over 2 million tablets are smuggled into the U.S. each week. Current estimates suggest that within the Newark, New York, and Jersey Shore corridor over 750,000 dosage units are being consumed each week.

Licit Uses

MDMA has no approved medical use in the U.S. MDMA was discovered in Germany in 1913 and patented by a pharmaceutical company in 1914. It was intended as a weight-loss (anorectic) drug, but because of its side-effects MDMA was never marketed. MDMA was re-discovered in the mid 1960s, began to be reported in growing numbers in the scientific literature but remained outside of the control mechanisms for many more years. 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. The subjective effects of MDMA in humans include a heightened sense of awareness as well as a feeling of increased empathy or emotional closeness to others. The production of MDMA in clandestine laboratories, its increasing abuse among young people and evidence of adverse health effects, including brain damage, led to the emergency scheduling of MDMA into C1 of the CSA in 1985.

Chemistry/Pharmacology

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). MDMA has both stimulant and hallucinogenic effects in humans. MDMA has analgesic and central stimulating effects; it produces hyperthermia, memory loss, cognitive impairment, and long-term neurochemical and brain cell damage. Pharmacologically, MDMA is an indirect monoaminergic agonist producing a heightened sense of awareness. 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. Short-term high dose use of MDMA has produced incidences of an amphetamine-like psychosis and, in some cases, severe hyperthermia which was unresponsive to medical intervention leading to death. In the mid 1990s it was clearly demonstrated that similar neurotoxicity was produced in humans self-ingesting MDMA as a recreational drug. The results of extensive laboratory testing of humans with a history of MDMA use has shown cognitive and memory loss which have been attributed to a unique interaction between serotonin and midbrain dopamine systems resulting in the progressive degeneration of nerve terminals.

Illicit Uses

MDMA is used as a drug of abuse for its combination of stimulant and hallucinogenic effects. There is no accepted medical use for MDMA in the U.S.

User Population

Similar to gamma-hydroxy-butyrate (GHB), MDMA is abused by young adults who frequent the "rave" or "techno" parties which have become popular in large urban communities. While these urban rave clubs may be the usual venue for the acquisition of MDMA, many suburban communities are experiencing an increased use of MDMA within smaller party environments. It has become increasingly available through high school drug networks through purchases made in rave clubs. MDMA is usually taken orally in doses ranging from 50 to 150 mg. Doses of MDMA are often "piggy-backed" on each other in a series over just a few hours leading to severe over-heating and cardiac emergencies which require medical intervention.

Illicit Distribution

All seized MDMA is produced from clandestine or foreign manufacturing facilities. The Netherlands, Israel, and Belgium traffic large quantities of the drug throughout Europe and England. The packaging and pill characteristics of MDMA are as varied as the sources of the product.

Control Status

The control action on MDMA was prepared in 1984. After formal hearings it was emergency controlled on July 1, 1985. Permanent control into CI of the CSA was completed in 1986. After a protracted appeal process the final permanent control into C1 of the CSA occurred in 1988.