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The Informed Parent

Ecstasy: Recreational Use and Its Consequences

by Shanna R. Cox, M.D., F.A.A.P.
Published on Sep. 20, 2004

For each generation there are certain agents that can be associated with relaxation, partying, and fitting in. For the sixties LSD or “acid” was one such drug. In the seventies marijuana use heightened, and in the eighties cocaine was en vogue. Today’s club drug is ecstasy, scientifically known as 3,4 methylene-dioxymethamphetamine. This substance has been popularized among teens as the “love drug”, as it delivers a feeling of closeness and insight within approximately fifteen minutes of ingestion. Additionally, it can quell the anxiety that teens may feel in a large social situation among older teens or a new group of people. Large numbers of teens can be targeted for ecstasy experimentation in single venues called raves. A rave is a large dance and music party that might be accompanied by a laser show. It is often hosted in a large warehouse setting, bringing many different groups of people together in one area for an intense evening of interaction. Ecstasy’s duration of action is approximately four hours. A teen may ingest ecstasy and attend a rave, while still not violating curfew. Thanks to the drug’s short duration of action this fact makes the detection of its abuse even more difficult.

Many teens are under the impression that ecstasy is a recreational drug that may be used socially without any ill effects. This is a dangerous misconception that is being detailed extensively by scientific research into ecstasy’s neurological effects. Ecstasy functions by releasing serotonin, a neurotransmitter well recognized to be associated with a sense of mental well being. Therefore, those who ingest ecstasy frequently use up their stores of this important neurotransmitter. Researchers hypothesize that this may send already at-risk teens into a spiral of depression, a disease associated with low levels of serotonin. This information has circulated to some extent and now is leading to some partygoers pre-loading their evening with a serotonin enhancing prescription drug such as Paxil, Zoloft, Prozac, or Celexa. These drugs are selective serotonin reuptake inhibitors that leave more serotonin available for use by the brain. Users hope this will balance out the effects of ecstasy on their nervous system by the end of the evening.

It’s clear from animal studies that ecstasy use leaves the nervous system with lower levels of serotonin, and shears important neurological communication units called axons. This damage seems to be long-standing, lasting for at least seven years according to current research from Columbia University in New York City. As with many aspects of life this long-term consequence may be hard for teens to grasp, as they feel immortal in their youth. Ecstasy also has serious short-term affects that may be deadly. Perhaps the two most noteworthy of these conditions are malignant hyperthermia, and hyponatremia. Malignant hyperthermia is a rapid elevation of the core body temperature that may lead to severe organ impairment and death. As a result of such, many teens now compulsively drink water during ecstasy use, which may lead to the second condition. Hyponatremia is an overall state of low body sodium, or salt. Sodium is a crucial electrolyte in all of the body’s major functions and fluid balances; rapid shifts in its concentration may lead to brain damage and death. Less serious consequences include muscle spasm and sexual dysfunction. The later often leads to ingestion of yet another prescription drug, Viagra, to combat erectile dysfunction.

Clearly, ecstasy use is serious business and may involve the abuse of several other prescription drugs that carry additional side effects. Parents and physicians are obligated to take the mystique away from this drug so that teens understand that ecstasy use is not a choice for recreation. Knowing where, when, and who is attending a teen’s social events is one way to initiate conversation about substance abuse. Just as parents must discuss choices against alcohol and nicotine abuse, so must they clearly state their views and expectations regarding ecstasy abuse. During the yearly physical physicians should include this drug on what seems to be a growing list of substances teens may consider experimenting with. It is clear that parents have the strongest influence on a teen’s decision making, as long as they choose to be an active advocate for their teen’s health rather than a passive responder to a teen’s choices. Initiate discussion with your child and let them know your concerns. You may be surprised by the information you discover. For more information, link to the National Institute on Drug Abuse.

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