MDMA ( 3,4-Methylenedioxymethamphetamine or Ecstasy ) is a psychoactive amphetamine drug with entactogenic, psychedelic, and stimulant effects.
MDMA is considered unusual for its tendency to induce a sense of intimacy with others and diminished feelings of fear and anxiety. These effects have led some to suggest it might have therapeutic benefits in certain individuals. Before it was made a controlled substance, MDMA was used as an augmentation to psychotherapy, often couples therapy, and to help treat clinical depression as well as anxiety disorders. Clinical trials are now testing the therapeutic potential of MDMA for post-traumatic stress disorder (PTSD) and anxiety associated with terminal cancer.
MDMA is criminalized in most countries in the world under a United Nations (U.N.) agreement, and its possession, manufacture, or sale may result in criminal prosecution, although some limited exceptions exist for scientific and medical research. MDMA is one of the most widely used recreational drugs in the world and is taken in a variety of contexts far removed from its roots in psychotherapeutic settings. It is commonly associated with dance parties (or "raves") and "electronic dance music."
There have been debates within scientific, health care, and drug policy circles about the risks of MDMA, specifically the possibility of neurotoxic damage to the central nervous system (CNS). Regulatory authorities in several locations around the world have approved scientific studies administering MDMA to humans to examine its therapeutic potential and its effects.
Terminology
MDMA was first introduced clinically under the names " Adam " and " Empathy " when it was used in psychotherapy in the late 1970s and early to mid 1980s. Later on, upon making it into the recreational drug use scene, it came to be widely known as " Ecstasy ", often abbreviated as " E ", " X ", or " XTC ". MDMA in its pure, powder, crystalline, or capsule form, is commonly referred to as " Molly ". A widespread term used in the United States to describe coming under the influence of MDMA is to " Roll " or to be " Rolling ", in reference to the involuntary eye movements experienced by those under the influence. Another term used to describe someone under its influence who is acting strange or out-of-hand under the influence of MDMA is to be an " E-Tard "..
History
MDMA was first synthesized in 1912 by Merck chemist Anton Köllisch. At the time, Merck was interested in developing substances that stopped abnormal bleeding. Merck wanted to evade an existing patent, held by Bayer, for one such compound: hydrastinine. At the behest of his superiors Walther Beckh and Otto Wolfes, Köllisch developed a preparation of a hydrastinine analogue, methylhydrastinine. MDMA was an intermediate compound in the synthesis of methylhydrastinine, and Merck was not interested in its properties at the time. On December 24, 1912 Merck filed two patent applications that described the synthesis of MDMA and its subsequent conversion to methylhydrastinine.
Over the following 65 years, MDMA was largely forgotten. Merck records indicate that its researchers returned to the compound sporadically. In 1927, Max Oberlin studied the pharmacology of MDMA and observed that its effects on blood sugar and smooth muscles were similar to ephedrine's, but that, in contrast, MDMA did not appear to produce pupil dilation. Researchers at Merck conducted experiments with MDMA in 1952 and 1959. In 1953 and 1954, the United States Army commissioned a study of toxicity and behavioral effects in animals of injected mescaline and several analogues, including MDMA. These originally classified investigations were declassified and published in 1973. The first scientific paper on MDMA appeared in 1958 in Yakugaku Zasshi, the Journal of the Pharmaceutical Society of Japan . In this paper, Yutaka Kasuya described the synthesis of MDMA, a part of his research on antispasmodics.
MDMA first appeared as a street drug in the early 1970s after its counterculture analogue, MDA, became criminalized in the United States in 1970. In the mid-1970s, Alexander Shulgin, then at University of California, heard from his students about unusual effects of MDMA; among others, the drug had helped one of them to overcome his stutter. Intrigued, Shulgin synthesized MDMA and tried it himself in 1976. Two years later, he and David Nichols published the first report on the drug's psychotropic effect in humans. They described "altered state of consciousness with emotional and sensual overtones" that can be compared "to marijuana, to psilocybin devoid of the hallucinatory component".
Shulgin took to occasionally using MDMA for relaxation, referring to it as "my low-calorie martini", and giving the drug to his friends, researchers, and other people whom he thought could benefit from it. One such person was psychotherapist Leo Zeff, who had been known to use psychedelics in his practice. Zeff was so impressed with the action of MDMA that he came out of his semi-retirement to proselytize for it. Over the following years, Zeff traveled around the U.S. and occasionally to Europe training other psychotherapists in the use of MDMA. Among underground psychotherapists, MDMA developed a reputation for enhancing communication during clinical sessions, reducing patients' psychological defenses, and increasing capacity for therapeutic introspection.
Due to the wording of the United Kingdom's existing Misuse of Drugs Act of 1971, MDMA was automatically classified in the UK as a Class A drug in 1977.
In the early 1980s in the U.S., MDMA rose to prominence as "Adam" in trendy nightclubs and gay dance clubs in the Dallas area. From there, use spread to raves in major cities around the country, and then to mainstream society. The drug was first proposed for scheduling by the Drug Enforcement Administration (DEA) in July 1984 and was classified as a Schedule I controlled substance in the U.S. on May 31, 1985.
In the late 1980s MDMA, as "ecstasy", began to be widely used in the UK and other parts of Europe, becoming an integral element of rave culture and other psychedelic- and dance-floor-influenced music scenes, particularly house music, with sub-genres such as trance, techno, Madchester and Acid House being most popular. Spreading along with rave culture, illicit MDMA use became increasingly widespread among young adults in universities and later in high schools. MDMA became one of the four most widely used illicit drugs in the U.S., along with cocaine, heroin, and marijuana. According to some estimates as of 2004, only marijuana attracts more first time users in the U.S..
After MDMA was criminalized, most medical use stopped, although some therapists continued to prescribe the drug illegally. Later Charles Grob initiated an ascending-dose safety study in healthy volunteers. Subsequent legally-approved MDMA studies in humans have taken place in the U.S. in Detroit (Wayne State University), Chicago (University of Chicago), San Francisco (UCSF and California Pacific Medical Center), Baltimore (NIDA-NIH Intramural Program), and South Carolina, as well as in Switzerland (University Hospital of Psychiatry, Zürich), the Netherlands (Maastricht University), and Spain (Universitat Autònoma de Barcelona).
Therapeutic use
There have long been suggestions that MDMA might be useful in psychotherapy, facilitating self-examination with reduced fear. Indeed, some therapists, including Leo Zeff, Claudio Naranjo, George Greer, Joseph Downing, and Philip Wolfson, used MDMA in their practices until it was made illegal. George Greer synthesized MDMA in the lab of Alexander Shulgin and administered it to about 80 of his clients over the course of the remaining years preceding MDMA's Schedule I placement in 1985. In a published summary of the effects, the authors reported patients felt improved in various, mild psychiatric disorders and other personal benefits, especially improved intimate communication with their significant others. In a subsequent publication on the treatment method, the authors reported that one patient with severe pain from terminal cancer experienced lasting pain relief and improved quality of life. However, few of the results in this early MDMA psychotherapy were measured using methods considered reliable or convincing in scientific practice. For example, the questionnaires used might not have been sensitive to negative changes and it is not known to what extent similar patients might improve from chance or from psychotherapy.
The therapeutic potential of MDMA is currently being tested in several ongoing studies, some sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS). Studies in the U.S., Switzerland, and Israel are evaluating the efficacy of MDMA-assisted psychotherapy for treating those diagnosed with post-traumatic stress disorder (PTSD) or anxiety related to cancer. In interviews, patients and researchers from the South Carolina PTSD pilot study report tendencies for some participants to have reduced disease severity after MDMA psychotherapy. MAPS reported statistically significant results.
Recreational use
The European Monitoring Centre for Drugs and Drug Ad
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