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Stimulants and the Brain
Professor Daniel Fatovich
Methamphetamine is a highly addictive substance that has caused serious public health problems globally. A lot of ecstasy pills contain forms of amphetamines and methylenedioxymethylamphetamine (MDMA) or ecstasy has many similar characteristics to that of amphetamines. Most people who use ecstasy also use amphetamines, potentially without knowing they are, due to the contaminants in ecstasy pills. Of particular concern, is the emerging evidence of serious long-term effects of amphetamine use, including depression, anxiety, psychosis and memory disturbance.
Royal Perth Hospital in Western Australia experience many amphetamine related presentations to their Emergency Department. A pilot study was developed to determine if amphetamine users had brain abnormalities that neither they nor their doctors treating them suspected. People who presented to the emergency department with amphetamine-related symptoms were eligible to be recruited for the study. Brain abnormalities were detected using Magnetic Resonance Imaging (MRI), and is defined when the brain has been injured by drug use resulting in an abnormality in the brain.
The results from this pilot study showed that one in five cases had an occult brain lesion or brain scarring. Although the study recruited cases on the basis of amphetamine related presentations, all those involved in the study had also been using ecstasy alongside a variety of other drugs such as cannabis, speed, alcohol etc. Due to this, it is difficult to ascribe causation to a specific drug as many were poly-drug users, using whatever they could access. However, all the cases in which a brain abnormality was detected, they had been using ecstasy.
There was, however, a significant case in the study of a young 21 year-old female, who is described as a classic recreational ecstasy user. She reported using ecstasy once every few months. Her MRI scan showed that she had an injury in the hippocampus region of her brain which is vitally important for memory. Not surprisingly, she reported having problems with her memory.
While the significance of this study is uncertain, there has been emerging evidence that drugs that have stimulant effects such as amphetamines and ecstasy have shown similar patterns of results to this study. There is evidence emerging to suggest that these types of drugs do cause problems for brain, especially with memory, judgment, thinking and mood being affected.
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You’ve probably heard a lot of things about Ecstasy. Some good, some bad, some outrageous. Well, we’re here to set the record straight. Watch videos featuring the Ecstasy experts, read up on the facts, or chat live and confidentially with a qualified drug counsellor and ask some questions of your own.
If you require immediate help, call the Alcohol and Drug Information Service on (08) 9442 5000 or 1800 198 024 toll-free for country callers.
| What are other names used for ecstasy? | | | E, eccies, pills, bickies, love drug, disco biscuit, XTC, vitamins, MDMA |
| How soon after taking ecstasy can you expect to feel its effects? | | |
When ecstasy is swallowed, the effects become apparent within approximately 30 to 90 minutes and can last up to 6 to 8 hours.
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| How long do the effects of ecstasy usually last? | | | When ecstasy is swallowed, the effects become apparent within approximately 30 to 90 minutes and can last up to 6 to 8 hours. |
| How does ecstasy affects the ability to regulate body temperature? | | | Ecstasy affects the production of serotonin, a mechanism that regulates the body’s temperature. It appears to cause a loss of control of normal body temperature. |
| Why is it important to carefully monitor water consumption when using ecstasy? | | Ecstasy disturbs the brain’s ability to determine when a person has had enough to drink. Excessive water intake can result in a break-down of cell structure which causes cells to swell up, burst and die. Many vital organs such as the liver, heart, lungs and brain are particularly susceptible to this breakdown in cell structure. When the brain is affected, respiration, heart rate and blood pressure are affected and this can lead to death.
Additionally, lack of water consumption may cause you to feel overheated and dehydrated. |
| To avoid drinking too much water, how much water is recommended for someone to drink if they are using ecstasy? | | Some recommendations suggest that users should drink no more then 600mL of water each hour
- 250mL of water each hour if inactive
- 500mL of water each hour if active
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| I heard you have to drink water when you’re on pills, but isn't there a danger of drinking too much also though? How do I know what's safe? | | | Ecstasy affects the brain's ability to determine when a person has had enough to drink. Excessive water intake can result in a breakdown of cell structure, which causes cells to burst and die. Many vital organs such as the liver, heart, lungs and brain are particularly susceptible to this breakdown in cell structure. Ecstasy users should regularly sip water to replace lost fluids. To avoid drinking too much water, it is recommended that users should drink about 250 mL (if inactive) or 500 mL (if active) each hour. Users should also make sure they take time to cool down including taking regular breaks from dancing. |
| Can you build up tolerance to ecstasy? | | | Yes. Regular use of ecstasy can build up a person’s tolerance to the drug. This means that a person will need more of the drug in order to achieve the same effects they felt previously with smaller amounts. |
| Does ecstasy improve sexual performance? | | | There is no evidence that suggests MDMA improves sexual performance. However it has been documented that ecstasy inhibits sexual performance by decreasing the ability to reach orgasm or maintain an erection (Degenhardt, L et al, 2005). |
| Is it difficult to know how pure an ecstasy pill is? | | | Ecstasy pills are often made with no control over their manufacture, making it very difficult to know exactly what’s in them without taking them in to get analysed. Ecstasy is often mixed with a variety of different drugs including MDEA, PMA, MDA, ephedrine, LSD and other harmful ingredients such as insecticides, ketamine (horse tranquillisers) and cough suppressants. |
| How much MDMA is in ecstasy? | | Ecstasy is often made with no control over their manufacture, making it very difficult to know exactly what and how much is in them, without taking them in to get analysed. ChemCentre, who analyse ecstasy pills that Police have seized, have found that the purity of ecstasy varies significantly. In the 2009 – 2010 financial year, the purity of ecstasy pills analysed by ChemCentre ranged from 0.74% to 84%.
They also found that the average purity of ecstasy pills have been declining over the past five financial years. |
| I have heard that even though some ecstasy will look the same as others, they are actually different. Is this true? | | | In some cases yes. ChemCentre, who analyse ecstasy pills that Police have seized, have found that some pills that appeared to be visually identical (same colour, logo and shape) were found to contain different substances of cheaper quality and varying toxicity. |
| I have heard that some ecstasy pills have no MDMA in it? | | | In some cases yes. ChemCentre, who analyse ecstasy pills that Police have seized, have found that some “ecstasy” tablets contained no MDMA. Some were found to actually contain no illicit drug/s at all. These pills were found to contain substances that include – 3, 4 -methylenedioxyamphetamine (MDA), paramethoxymethylamphetamine (PMA), benzylpiperazine (BZP) and trifluromethylphenylpiperazine (TFMPP), methylamphetamine, ephedrine/pseudoephedrine, paracetamol, codeine, caffeine and methandrostenolone (dianabol). |
| Where does ecstasy come from? | | | Methylenedioxymethamphetamine (MDMA) was first synthesized by Merck Pharmaceuticals in 1912. It was originally developed as an appetite suppressant, although it was never actually used for this purpose. In 1970, MDMA was used in American therapy classes to enhance communication. Ecstasy became available in Australia in the mid-1980’s, and became and illegal drug in 1987. |
| I know ecstasy is swallowed, but can you take ecstasy another way? | | Ecstasy tablets or capsules are usually swallowed. Ecstasy may also be taken by suppository, snorting, smoking or injecting crushed tablets.
Snorting ecstasy can damage the fragile mucous membrane in the nasal passages. It produces burns and sores on the membranes that line the interior of the nose.
As ecstasy usually comes in tablet form, it is not designed to be injected. The tablets are bound by a chalky substance or bulking agent, which if injected, can cause blocked veins that can cause major damage to the body’s organs such as inflamed blood vessels and abscesses, blood poisoning (septicaemia), gangrene, bacterial infections which can damage the heart valves, vein collapse, infection at the injection site, bruising or more serious injuries if it is injected into an artery or tissue. |
| Can you get a hangover after using ecstasy? | | The hangover or after effects of ecstasy can last for up to 24 hours, sometimes longer depending on the toxicity of the drug.
Research suggests that weekend use of ecstasy may lead to a depressed mood mid-week. |
| When my friends go out they take ecstasy so that they can drink more. Is this true? | | The stimulant properties of ecstasy mask the depressant properties of alcohol making it difficult to judge how much alcohol has been consumed., but the brain is still impaired, as is motor function, making it dangerous to drive.
Using ecstasy with alcohol also dehydrates the body further, which can increase the problems associated with dehydration |
| Some of my friends use Cannabis and Ecstasy. Is this ok? | | | Ecstasy has both stimulant and hallucinogenic properties, so when combined with cannabis, which also has hallucinogenic properties, an individual can experience exaggerated visual distortions and impaired reaction times, along with an increased risk of other harms including the risk of anxiety, paranoia and psychosis. |
| Can you overdose on ecstasy? | | Overdose occurs when the level of intoxication from the drug reaches a point where it begins to produce physical and/or psychological harm. Overdose from ecstasy usually results from the body overheating and becoming dehydrated, which can cause muscle meltdown (rhabdomyolysis) and possible death from the failure of major organs such as the kidneys or liver.
Overdose may also result from excessive water consumption and retention (hyponatraemia). This may cause cells in the body to swell, which can result in brain damage and death.
The risk of overdose generally increases with a larger dose. As the strength and content of street ecstasy is unknown it can be difficult to judge the dose, increasing the risk of overdose. |
| If someone is pregnant, can they still take ecstasy occasionally? | | Most drugs cross the placenta, and therefore have some effect on the unborn child. There is limited research on the specific effects of using ecstasy during pregnancy. However, there is potential to harm the child, especially if the ecstasy is combined with other drugs. It is also possible that miscarriage can result from using ecstasy.
Injecting ecstasy also increases the risk of HIV infection and other disease for both the mother and baby.
It is recommended that women check with their doctor (or other health professional) if they are using or planning to use drugs while pregnant or breastfeeding, including prescribed and over-the-counter medicines. |
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