The usage of MDMA, commonly known as ecstasy is becoming a health concern of increasing importance today. MDMA has been classified as a hallucinogen in the United State of America, and comprises of lysergic acid diethylamide, phencyclidine which is commonly known as angel dust, psilocybin, peyote and mescaline. MDMA usage has been known to cause mortality and morbidity, especially during the past decade, whereby the number of cases being rushed to hospital emergencies has increased dramatically.
Hallucinogens like MDMA are potent neurotoxins and have long lasting neurotoxic effects on humans. Repeated use of the substances can make a person susceptible to neuronal damage and can also cause conditions like mood disorders, depression, memory disturbances and impulsiveness. This happens because of the depletion of serotonin caused by these substances, which is an important mood regulating hormone in the body.
Ecstasy or MDMA is most commonly used by teens and young adults in parties or in group settings. The drug is very popular among the younger generation despite the known risks associated with its usage.
If a person uses hallucinogens, he or she may experience anxiety, increased impulsiveness, depression and memory problems. These symptoms can also continue after the substance has been stopped. Most people who indulge in the usage of hallucinogens are cigarette smokers, alcohol users and usually indulge in other risky behaviors. This combination can be deemed very dangerous.
Hallucinogen usage causes the following symptoms:
- An immediate sense of well being and relaxation
- An increase in the breathing rate
- Blurred vision
- Impaired coordination
- Distorted senses of perception
- Disorganized thought process
- Anxiety and agitation
- Feelings of panic
- Nausea and vomiting
- Cold chills alternated with sweating
- Paranoid thoughts.
The criteria for the diagnosis of Hallucinogen Use Disorder are the following according to the Diagnostic and Statistical manual of mental disorders (Proposed 5th Revision):
A pattern of the use of hallucinogens that can lead to the development of distress or clinically significant impairment, confirmed by 2 or more of the following manifestations which occurs over a duration of 12 months:
- The hallucinogen is consumed in larger quantities over a longer duration of time than before.
- There is a continuous desire, combined with various efforts in vain to give up or cut down on the use of the hallucinogen.
- A considerable amount of time is wasted over activities that are essential to acquire the hallucinogen, the recovery from its effects or the use of the hallucinogen in general.
- The excessive use of the hallucinogen results on the ability to perform with satisfactory results as work/school, or to take care of important obligations at home. This may lead to recurrent absences, and unsatisfactory performance. These tendencies are associated with the use of hallucinogens, absences caused by the excessive usage of hallucinogens, expulsions or suspensions from work or school and the ignorance of household or children.
- Even though the patient is aware of the various interpersonal and social disturbances and problems being caused by the hallucinogen, the patient tends to continue the use of the hallucinogen. Some of the problems experienced as a result of excessive hallucinogen use include spousal arguments regarding the consequences of hallucinogen intoxication. In some cases, this may also lead to physical fights.
- Some normal, important and regular activities (which may include both recreational and occupational) or habits are given up owing to the use and effects of the hallucinogens.
- Repeated use of the hallucinogen during situations and activities that may pose a threat to the life and health of the person. These may include driving vehicles or operating machines while under the influence of a hallucinogen.
- The usage or consumption of the hallucinogen is continued despite the awareness of the different psychological and physical problems that are associated with the persistent and repeated use of the hallucinogen.
Another prominent manifestation is tolerance, which can be described as one of the following:
- A constant need for gradually increasing quantities of the hallucinogen in order to acquire the desired effects, or the intoxication.
- Gradually decreasing effects with the persistent or continuous use of the same quantity of hallucinogen. (It is important to note that tolerance may not occur in case of majority of the hallucinogen effects).
- Having a strong urge, desire or craving to use a particular hallucinogen.
There are no established signs and symptoms of withdrawal in case of hallucinogens and hence this criterion does not apply.
Ecstasy or MDMA is a potentially life threatening drug and it is always very dangerous to use. It causes mental addiction therefore in most cases rehabilitation is necessary for the patient to get over the addiction.
Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences- Kaplan, Harold I. M.D., and Benjamin J. Sadock, M.D. Clinical Psychiatry