Abuse of MDMA( ecstasy): signs, effects, treatment of dependence

MDMA ( Methylenedioxymethamphetamine) is a semisynthetic chemical compound in the amphetamine group with psychoactive properties.As part of the tablet form it was named Ecstasy( Molly, Adam, etc.). This narcotic substance is popular and common among the youth of most countries of the world, it can be called one of the leaders among the "club" psychoactive substances.MDMA in popularity ranks third after cannabinoids and cocaine.

The world scientific community and the press are still debating about the harm caused by MDMA.The drug is classified as a group of drugs that are taken only for pleasure and are not officially used in medicine. Compared to other drugs, Ecstasy is most harmless, but has high neurotoxic properties.It is this quality that led to the fact that in most countries its production, distribution and use are criminal offenses.

Please note: MDMA poses a particular risk in combination with other narcotic substances.

Table of contents: Scientific research and distribution of MDMA From which MDMA is produced Types of MDMA abuse and dose Mechanism of action and dependence formation Manifestation of narcotic action Disposal syndromes and side effects after MDMA abuse Overdose Treatment for misuse of MDMA

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Scientific research and distribution of MDMA

The year of the appearance of MDMA is 1912. German chemist A. Kölesch synthesized a new substance when trying to find an effective drug, usingyuschiysya to improve blood clotting.Psychoactive properties of this compound were discovered only in the 50s of the XX century.Mass hobby for a drug begins in 1976, after the work of the American chemist A. Shulgin.

A number of physicians begin to use MDMA in the practice of psychotherapy to increase the suggestibility effect in patients.After 1980, this drug was used by more than 1000 doctors from different clinics of the West. The substance receives one of its names - "Adam", in connection with its properties, contributing to the emergence of a person's openness, innocence, simplicity and naivety. Doctors practicing the application of "Adam" did not make sensational statements from their works.One of the reasons for "secrecy" is the fear of repeating the ban on LSD, which became the subject of a universal "cult", going beyond clinical application.

But to keep the "secret" effects of MDMA scientists failed, and the drug in large numbers "poured" into the world of youth club subculture. America became the first victim of the new drug, it is in it that its new name "Ecstasy" appears.Then the drug penetrates into Europe, and becomes the property of the broad masses all over the world .

The fight against the drug begins in the US since 1984 on the initiative of the DEA, an American organization combating drug problems.After numerous political and scientific debates with supporters and opponents, MDMA was banned.Subsequently, the ban spread to other countries.

But the measures taken have proved ineffective.Ecstasy filled the drug market, and became the psychosymbol of the musical movement of acid house, coming from England around the world.Tens of thousands of young people turned out to be active users of the drug, driving out alcohol and smoking cigarettes.The clandestine laboratories put the process of producing Ecstasy on a line-by-line basis.The tablets acquired their "appearance" with a specific brand.

The popularity of the drug grew until 2003.There were all new "modifications" of the drug, in which the constituent ingredients were changed.After a series of scandals in the United States, the RAVE 2003 law on fighting Ecstasy was passed.But he did not bring any particular benefit.

Since the end of 2016, the US Department of Medicines Supervision( FDA) has authorized the clinical trials of MDMA involving 230 patients.According to their results, the question of the possible inclusion of this compound in the official list of permitted medications for the treatment of Parkinson's disease, autism, stress, etc. will be decided.

Note: In recent years, the number of Ecstasy users in the world has reached 18 to 28 million.

What is produced from MDMA

The raw material for obtaining the drug MDMA is oil - Safrole, which is derived from the bark of the roots of Sassafras, the bush of the family of laurel plants.To produce the drug, vanillin, piperonal, pyrocatechin are used.Synthesis of narcotic drug does not require expensive equipment and special laboratories.

Types of abuse of MDMA and dose

Produced drug is used as:

• tablets Ecstasy;
• powders "Molly" and "Mandi";
• capsules;
• solutions;
• smoking crystals with marijuana( rarely);
• injection of the substance into the nasal apertures;
• injection;
• rectal method.The average single dose is 120 mg.

.It can vary from 50 to 1000 mg.In recent years, the incidence of combined drug use has increased( with the availability of other drugs). Therefore, narcotic effects and side effects may differ significantly from the action of pure Ecstasy.

The most common way to use MDMA on weekends, 3-4 times a month.Sometimes during the week the person taking the drug complements the effective dose.

Mechanism of action and dependence formation

The action of Ecstasy begins to unfold after half an hour after receiving.The drug has a powerful effect on neurotransmitter mediators, in particular, on the release of large amounts of serotonin, dopamine, norepinephrine, acetylcholine. MDMA itself is able to bind to the receptors on which these mediators operate, and cause drug effects.

The peak of action occurs in 2 hours.After 3-7 hours after taking, against a background of a symptomatic "plateau", a gradual decrease in the manifestations of action occurs.Residual effects can be observed within 10 days after taking the dose.

Physical dependence does not cause MDMA, but psychic - is well known.

Manifestation of narcotic action

The person taking Ecstasy falls into the power of mental changes.This drug combines the action of a hallucinogen, empathogen, psychostimulant and psychedelic.

The following manifestations are explicitly noted:

• relaxed and easy to establish relationships.Under the influence of the drug, the person who took it easily comes into contact with everyone.Friendliness and openness come to the fore, although there is some disruption in the functions of speech;
• , the existing complexes that cause closed communication leave, are "unclenched".He who accepts Ecstasy does not feel any internal barriers;
• there is a growing need for human communication and attention;
• events and other people's problems become the object of a strong personal experience( empathy);
• a feeling of inner harmony grows in the soul, the surrounding world seems perfect and devoid of shortcomings;
• perception acquires brightness, color;
• is dominated by emotions of joy, heightened mood.

Note: In some cases, negative manifestations may develop instead of euphoria.

Psychotic effects are accompanied by some physiological characteristics.

Often arise:

• visual impairment of perception( bifurcation and fuzziness);
• dryness of mucous membranes of mouth, nose;
• arrhythmia caused by increased cardiac activity, accelerated breathing, increased blood pressure figures;
• loss of appetite with nausea;
• sweating and loss of body fluids;
• sensations of a pricking of a skin, "murashki";
• strabismus, dilated pupils;
• problems with urination;
• discoordination of motor ability;
• spasm of chewing musculature and gnashing of teeth;
• marked increase in body temperature.

Discharge Syndromes and Side Effects after MDMA Abuse

MDMA cancellation after long-term administration is accompanied by a number of pathological changes in the body.

The most typical are the following:

• apparent weight loss, physical and mental exhaustion;
• apathy, depressive condition, anger and irritability;
• expressed concern;
• obsessive fears and thoughts;
• inability to concentrate, reduce memory;
• development of hallucinatory experiences.

Prolonged abuse of MDMA can provoke liver disease, bleeding in the retina, hypertension, which is complicated by strokes and infarctions of .Influences on the blood are characterized by the development of problems of clotting.

Against the background of misuse of MDMA, hyponatremia occurs( loss of sodium ions).This condition leads to a constant thirst and increased need for water. The patient may develop "water poisoning".The developed state provokes the development of renal failure, problems of the cardiovascular system, metabolic disorders.

Note: Among the causes of mortality of persons who abused Ecstasy - hyponatremia is in the first place.The increase in body temperature can reach critical numbers.

Hyperpyrexia( a rise in temperature above 42 ° C) leads to failure of the main organs, leading to the lethal outcome of .This cause is the second among the deaths of MDMA.

Overdose of Ecstasy

Overdose of Ecstasy is another cause of death following hyponatremia and hyperthermia.The usual single dose can not cause serious complications.A specific value that can cause death from an overdose does not exist.This dose is very variable.It is generally accepted that such a drug intake is considered to be in the range of 50 to 100 mg per 1 kg of a person's weight .

Some people have a hereditary hypersensitivity to MDMA, which can lead to complications.

Rarely, against a background of large doses, an allergic reaction may occur, proceeding with the edema of Quincke, anaphylactic shock.

Treatment for abuse of MDMA

Elimination of dependence on Ecstasy is carried out in specialized narcological hospitals.The main emphasis is on psychotherapeutic forms of healing.

Important: In acute forms of overdose, patients need specialized detoxification therapy, which is carried out in toxicological units, intensive care units, or intensive care units.

Emergency measures for hyperthermic syndrome are aimed at lowering the temperature.

Water poisoning is removed by intravenous administration of saline solutions.

In psychotherapy, narcologists, psychiatrists, psychologists take part.

Treatment is carried out according to the plan, which includes:

• motivational conversations, the purpose of which is to explain to patients the essence of the disease, their condition, which developed as a result of prolonged narcotization.Motivation stimulates the desire to live a healthy life;
• suggestion and persuasion.Rational therapy is carried out individually, by group methods and with the involvement of relatives;
• application of hypnotherapy, allowing to remove subconscious pathological foci of the disease, replace them with the formation of new, active centers in the brain that will dominate the human mind;
• coding techniques, which are based on suppression of a possible mental craving for drugs.Encoding includes the formation of an installation that, when attempted to use MDMA, will cause a sharp rejection of the drug at the physical level.

After passing the main course of treatment in a drug clinic, the best option for the patient will be continued recovery at the recommended rehabilitation center.

The prognosis for well-conducted treatment should be expected to be favorable.It is important not to allow the relapse of MDMA abuse and the substitution of this type of dependence for another.With the prophylactic goal of convalescent patients, periodic visits to a narcologist and a psychologist, as well as psychological exercises and trainings are recommended.

Alexander Lotin, medical reviewer