Ecstasy Use Among College Students

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Ecstasy Use Among College Students

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Ecstasy:

Ecstasy Brian Wells University of Florida October 8th, 2003

What is Ecstasy?:

What is Ecstasy? Stimulant and mild hallucinogen 3,4 – metheylenedioxymethamphetamine (aka MDMA, Ecstasy, Hug Drug, Feel Good Drug, Adam, XTC, etc.) Source: http://www.usdoj.gov/dea/concern/mdma/mdma020700.htm

Types of Ecstasy:

Types of Ecstasy

History of Ecstasy:

History of Ecstasy Discovered in Germany in 1913 and patented by Merck in 1914. Myth that is was intended as an anorectic drug – never marketed due to side-effects 1950s - U.S. Army studied it as a potential chemical warfare agent that would temporarily disable enemy troops. Found an interest among psychiatrists in 1970s

History of Ecstasy:

History of Ecstasy Early 1980s - MDMA got a new nickname, Ecstasy (also XTC, E, the Hug Drug, others) Production of MDMA in clandestine laboratories, increasing use among adolescents prompted emergency scheduling of MDMA into C1 of the CSA in 1985.

The Ecstasy Problem:

The Ecstasy Problem MDMA has no approved use in the U.S. Despite the Schedule 1 classification, MDMA continues to be used illegally. MDMA is now being used increasingly in both urban and suburban populations Many young people believe Ecstasy is safe and offers nothing more than a pleasant high Source: MDMA/Ecstasy Research: Advances, Challenges, Future Directions A Scientific Conference - http://www.drugabuse.gov/NIDA_Notes/NNVol16N5/Conference.html

The Ecstasy Problem:

The Ecstasy Problem Most MDMA manufactured in Western Europe (Netherlands and Belgium => 80%) Majority of MDMA produced in other countries is trafficked to US by Israeli and Russian organized crime All major airports in Europe act as shipping points for MDMA destined for US Major US Influx Gateways are Los Angeles, Miami, and New York USCS seized 3.5M tablets in 1999 and 9.3M in 2000 Source: MDMA. http://www.whitehousedrugpolicy.gov/publications/factsht/mdma/

The Ecstasy Problem:

The Ecstasy Problem Is it really Ecstasy? A November 2000 study appearing in JAMA found that: 63% contained MDMA or analogue 29% contained identifiable drugs but no MDMA or analogue Most common drug found (other than MDMA) was DXM – 21% Other drugs found were caffeine, ephedrine, pseudoephedrine, and salicylates. 8% contained no identifiable drug. Source: Jones, Reese T. et al. Chemical Analysis of Ecstasy Pills. JAMA, November 1, 2000; Vol 284, No. 17.

The Ecstasy Problem:

The Ecstasy Problem News story from Florida Pills being sold in central Florida were PMA and PMMA PMA causes user to overheat, become confused, hallucinate, and finally collapse (body temperature as high as 108 degrees F). Six people in Florida died from using counterfeit pills PMA easier and cheaper to make “It’s like Russian roulette…If you get these PMA pills and take them, there is a chance you will die.” – Bruce Goldberger, forensic toxicologist at UF. Source: Killer Club Drug. http://abcnews.go.com/sections/us/DailyNews/ecstasy000929.html

The Ecstasy Problem:

The Ecstasy Problem

Ecstasy: Chemistry, Symptoms, and Other Fun Topics:

Ecstasy: Chemistry, Symptoms, and Other Fun Topics

How does it work?:

How does it work? Chemistry Structurally similar to amphetamine, methamphetamine, and mescaline Two stereoisomers Most activity associated with (S)-(+)-MDMA Source: Fallon, J.K. et al. Stereospecific Analysis and Enantiomeric Disposition of 3,4-Methlyenedioxymethamphetamine in Humans. Clinical Chemistry, 1999. 45, 1058 – 1069.

How does it work?:

How does it work? Chemistry Metabolism of MDMA results in formation of MDA by N-demethylation and HHMA (major) by O-demethylation Metabolites generate free radicals (oxidative stress and membrane damage) MDMA inhibits tryptophan hydroxylase (rate-limiting enzyme in the pathway of 5-HT synthesis) – irreversible reaction Source: Lyles, Johnalyn, et al. MDMA neurotoxicity: cellular and molecular mechanisms. Brain Research Reviews, 2003. 42, pg 155 – 168. Bogen, Inger L., et al. Short and long-term effects of MDMA (“ecstasy”) on synaptosomal and vesicular uptake of neurotransmitters in vitro and ex vivo. Neurochemistry International, 2003. 43, pg 393 – 400. Sprague, Jon E., et al. Hippocampal serotenergic damage induced by MDMA (ecstasy): effects on spatial learning. Physiology and Behavior, 2003. 79, pg 281 – 287.

How does it work?:

How does it work? MDMA increases the activity of three neurotransmitters Serotonin (5-HT) Dopamine (DA) Norepinepherine (NE) High affinity for 5-HT receptor Binds with less affinity to DA and NE receptors Source: Lyles, Johnalyn, et al. MDMA neurotoxicity: cellular and molecular mechanisms. Brain Research Reviews, 2003. 42, pg 155 – 168.

What are the symptoms associated with its use?:

What are the symptoms associated with its use?

What are some of the symptoms associated with its use?:

What are some of the symptoms associated with its use? Effects last 4 to 6 hours and include: Euphoria Peaceful, emotional feelings Feelings of increased closeness to others Heightened sensory awareness

What are the symptoms associated with its use?:

What are the symptoms associated with its use? Physical Muscle tension Involuntary teeth clenching Nausea Blurred Vision Faintness Chills or Sweating Rash similar to acne with associated liver damage in some individuals Hypertension Hyperthermia Hyperexcitability Tachycardia Myocardia Ischemia Elevated anti-diuretic hormone levels Ataxia Nystagmus Cerebral hemorrhage Source: Shannon M. Methylenedioxymethamphetamine. Pediatric Emerg Care 2000; 16:377-380

What are the symptoms associated with its use?:

What are the symptoms associated with its use? Ecstasy is neurotoxic High doses can cause malignant hyperthermia leading to muscle breakdown kidney and cardiovascular system failure.

What are the symptoms associated with its use?:

What are the symptoms associated with its use? Psychological Euphoria and Closeness Confusion Depression Sleep Problems Drug Cravings Severe Anxiety Paranoia Can be during or sometimes weeks after taking Ecstasy

What are the symptoms associated with its use?:

What are the symptoms associated with its use? Tolerance Evidence from lab animal studies suggest tolerance with repeated use Not known as a physiologically addictive substance

What are the symptoms associated with its use?:

What are the symptoms associated with its use?

PET Scan:

PET Scan

Usage Trends:

Usage Trends

What about among College Students?:

What about among College Students? Harvard College Alcohol study showed that 1997 – 2.8% of college students used ecstasy 1999 – 4.7% used ecstasy Increase of 68% in two years Factors more common is ecstasy users than other students Binge drinking Increased number of sexual partners Smoking Rating arts and parties as more important than academic pursuits.

What about among College Students?:

What about among College Students?

What can we do about these Trends?:

What can we do about these Trends? Target specific audiences Each group of people is driven by unique motivations 2001 article in JAMA – “Ecstasy Experts Want Realistic Messages” NIDA’s prevention campaign relies on “scare tactics” Social science researchers say that “blunt prevention messages fail to reduce Ecstasy use” and advocate less extreme campaigns that users can identify with.

What can we do about these Trends?:

What can we do about these Trends? Legislation Ecstasy Anti-Proliferation Act of 2000 Effective May 1, 2001 Increased sentencing guidelines for ecstasy trafficking Mainly targets upper-middle-level distributors Source: MDMA. http://www.whitehousedrugpolicy.gov/publications/factsht/mdma/

What can we do about these Trends?:

What can we do about these Trends? Legislation Ecstasy Awareness Act of 2003 HR 2962 of 108 th Congress (1 st Session) Introduced by Rep. Pascrell, Rep. Terry, Rep. Pallone, Rep. Etheridge, and Rep. Capuano Referred to Committee on Energy and Commerce, Committee on the Judiciary, and Subcommittee on Crime, Terrorism, and Homeland Security Amends section 416 of CSA (21 U.S.C. 856) `(c) Whoever profits monetarily from a rave or similar electronic dance event, knowing or having reason to know that the unlawful use or distribution of a controlled substance occurs at the rave or similar event, shall be fined not more than $500,000 or imprisoned not more than 20 years, or both. If the defendant is an organization, the fine imposable for the offense is not more than $2,000,000.'. Source: Library of Congress. http://thomas.loc.gov

What can we do about these Trends?:

What can we do about these Trends? Legislation Reducing Americans' Vulnerability to Ecstasy Act of 2003 (RAVE Act) HR 718 of 108 th Congress (1 st Session) Introduced by Rep. Coble and Rep. Smith (TX) Companion bill to S. 226, the Illicit Drug Anti-Proliferation Act, introduced by Sen. Biden Referred to the Subcommittee on Crime, Terrorism, and Homeland Security Purpose is to prohibit an individual from knowingly opening, maintaining, managing, controlling, renting, leasing, making available for use, or profiting from any place for the purpose of manufacturing, distributing, or using any controlled substance, and for other purposes.

What can we do about these Trends?:

What can we do about these Trends? Legislation Communities Combating College Drinking and Drug Use Act S. 406 of 108 th Congress (1 st Session) Introduced by Sen. Dewine and Sen. Lieberman Referred to the Committee on Health, Education, Labor, and Pensions The purpose of this Act is to encourage States, institutions of higher education, local communities, nonprofit groups, including community anti-drug or anti-alcohol coalitions, and other substance abuse groups within the State to enhance existing or, where none exist, to establish new statewide coalitions to reduce the usage of drugs and alcohol by college students both on campus and in the surrounding community at large.

Interesting Facts and Studies:

Interesting Facts and Studies Mental Health Weekly had an article suggesting that prior Ritalin or Ecstasy use may increase sensitivity to cocaine. High doses of Ritalin were used An article in Neurotoxicology and Teratology showed that Ecstasy exposed rat pups had a 502% increase in the number of DA neuron fibers in the frontal cortex compared with control. Possible that Ecstasy may affect the fetus during pregnancy Differences seen only in male pups but why?

Questions?:

Questions?

Sources for Additional Information:

Sources for Additional Information MDMA/Ecstasy Research: Advances, Challenges, Future Directions A Scientific Conference - http://www.drugabuse.gov/Meetings/MDMA/MDMAExSummary.html

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