Illicit Drug (ecstasy Mdma) Essay - 1,581 words

Illicit Drug (Ecstasy MDMA) Ecstasy, scientifically known as 3, 4-methylenedioxy-methamphetamine (MDMA), represents a known street illicit drug and simultaneously entirely synthetic substances, which does not exist in nature. From the chemical perspective, MDMA is a derivative of a derivative of methamphetamine and its parent compound amphetamine. Practically, it differs from the mentioned chemicals in a single but important aspect: due to the specific location of its methylenedioxy (-O-CH^sub 2^-O-) group it resembles the structure of the hallucinogenic material mescaline. The drug was patented in 1914 as an appetite suppressant, and has been investigated as a mood-modifying drug. Its clinical use was banned in the USA in 1985 because of its neurotoxicity and its potential for misuse. In the UK, MDMA has been listed since 1977 as a class A drug under the Misuse of Drugs Act, 1971. Although misuse of MDMA in the USA has caused deaths, mainly from cardiac arrhythmias (Dowling & McDonough, 1987), there have been several cases of severe toxicity in the UK with a different clinical pattern. There were few enquiries to the hospitals until the second half of 1995 when a striking increase in calls was noted.


Laboratory detection of MDMA and 3,4-methylenedioxyamphetamine (MDA) increased similarly, but MDMA was more commonly found. Although what was being sold as "ecstasy" usually contained MDMA, other substances, such as MDA or amphetamine, were also identified; mixtures were uncommon. Since MDA is a metabolite of MDMA, coingestion of MDA with MDMA could not be excluded by analysis of biological samples. Although the doses involved were difficult to establish with certainty, it seems that in most cases only a few tablets or capsules were consumed; the pattern of toxicity did not seem to be a result of overdose. One analytically documented overdose of a large amount of MDMA (allegedly 42 tablets taken at home; plasma MDMA 7-72 mg/1) was accompanied by no symptoms other than a "hangover", with tachycardia and hypertension (Suarez & Reimersma, 1995). Ecstasy practically attains its peak concentration in the plasma in 2 hours after oral ingestion (21). Concentrations of 50mg, 75mg, and 125mg resulted in blood concentration of 106 ng/mL, 131 ng/mL and 236 ng/mL respectively, were administered to research volunteers and subsequently were considered to be low, however helpful in comparison with the levels indicated in patients, experienced significant and fatal effects from MDMA overdose. In organism, MDMA is broken down in the liver metabolically with the help of enzyme CYP2D6 (Maurer et al, 2000). Drug elimination is characterized with slow pace 20% drug elimination exceeds 8 hour period. Practically, it takes up to 45-50 hours for over 95% of MDMA to be cleared from organism; however, some troublesome effects can last 2 days of primary ingestion.


Contemporary medicine possesses a considerable amount of evidence, both research and clinical, that MDMA acts by increasing the net release of the monoamine neurotransmitters, namely serotonin, noradrenaline and dopamine (Green et al, 1995). MDMA does not work by directly releasing serotonin. Practically, it binds and therefore blocks, the transporter used in its reuptake. During experiments using rats, animals, specifically trained to differentiate between the effects of saline and those of serotonin, respond to MDMA as if it were serotonin (Glennon et al, 2000). A similar action was also noted on the reuptake of dopamine. The physiological effects of MDMA in mice were characterized as similar to those of amphetamine, acting like a releaser of dopamine and noradrenaline.


Simultaneously, researchers possess a small amount of experimental evidence that the total release of acetylcholine is increased by MDMA, however, the importance of the trend in humans is unknown. But it is evident that the increase in the total release of serotonin along with dopamine explains the distinctive mental effects of ecstasy. The ability of MDMA to intensify the concentration of serotonin in the synapse underlies its functioning in improving mood and effect on sensory alterations. Being examined with high doses, researchers indicated that the massive release of serotonin not only produce increase of acute psychotic symptoms but causes significant chemical damage to the cells that released it. During studies of long-term MDMA users, it has been revealed that being free of drug, patients have abnormally low levels of serotonin and its metabolites in the cerebrospinal fluid, reduced numbers of serotonin transporter molecules, increased numbers of glial cells, and altered patterns of glucose metabolism and blood flow in certain parts of the brain (Ricaurte et al, 2000). Reports on MDMA from the USA suggest that the drug is only mildly toxic despite widespread recreational misuse. The main cause of severe toxicity and death is cardiac arrhythmias; rhabdomyolysis and disseminated intravascular coagulation (DIC) may also take place, with 2 such fatalities reported in the UK.


Most cases about which scientists were consulted had mild symptoms, and the general pattern on presentation ...................................................................................................................................................................................................................................................................................................................................................................

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Essay Tags: mdma, drug, ecstasy, illicit drug, toxicity

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