Ecstasy (MDMA) is a stimulant drug widely used recreationally that is also being tested in clinical trials for the treatment of post-traumatic stress disorder.
Led by Dr. Stephen Kish at CAMH, this study provides confirmation of a previous finding from Johns Hopkins University that levels of the serotonin transporter (SERT) are low in cerebral cortex of chronic ecstasy users. The subjects were “typical” ecstasy users who used about two tablets of the drug twice a month.

SERT is a protein responsible for regulating levels of serotonin, a neurotransmitter important for mood and impulse control. Ecstasy interacts with SERT to cause the release of serotonin, an action that probably explains some of the behavioral effects of the drug such as increased sociability.

Scientists have long suspected that ecstasy might harm brain cells that use serotonin, but 12 years of brain scan studies have produced contradictory results, even within the same laboratory.
The CAMH study used a large subject size (49 drug users, 50 control subjects), confirmed by hair analysis that ecstasy users actually used the drug, and used an imaging probe that could measure SERT throughout the brain.
“We were surprised to discover that SERT was decreased only in the cerebral cortex and not throughout the brain, perhaps because serotonin nerves to the cortex are longer and more susceptible to changes. This finding is almost identical to newer data from Johns Hopkins and is the first time that one laboratory has actually been able to replicate results of another independent laboratory in a SERT study of ecstasy users.” said Dr. Kish.

Drug hair analysis indicated that many ecstasy users, probably unknowingly, also used methamphetamine, which might itself damage serotonin cells; however, low SERT was found both in ecstasy users who used and who did not use methamphetamine. Dr. Jason Lerch at SickKids showed that those ecstasy users who also used methamphetamine had a slightly thinner cerebral cortex.

Does low SERT equal “structural brain damage”? “Not necessarily” said co-author Dr. Isabelle Boileau of CAMH. “There is no way to prove whether low SERT is explained by physical loss of the entire serotonin nerve cell, or by a loss of SERT protein within an intact nerve cell.”
Dr. Kish suggests that low SERT might explain why many ecstasy users need to keep increasing the dose to experience the same effects, since SERT is necessary for the action of ecstasy. “Most of the ecstasy users of our study complained that the first dose is always the best, but then the effects begin to decline and higher doses are needed. The need for higher doses, possibly caused by low SERT, could well increase the risk of harm caused by this stimulant drug,” said Dr. Kish.

Media Contact: Michael Torres, Media Relations, CAMH ; 416 595 6015 or email media@camh.net

Source: www.camh.net 18th May 2010

Florentia Hadjiefthyvoulou, John Fisk, and Nikola Bridges from the University of Central Lancashire and Catharine Montgomery from Liverpool John Moores University wanted to delve deeper into the link between deficits in prospective memory (remembering to remember, or remembering to perform an intended action) and drug use.

The new research into prospective memory expands on previous studies, which have shown that ecstasy or polydrug users are impaired in performing a number of cognitive tasks, including verbal and spatial exercises. A team led by Fisk also published evidence in 2005 that those using ecstasy perform worse in deductive reasoning, too. Prospective memory tasks can be either time or event based, which means that the external trigger to remember could be in response to an event, or because it is time to do something. The distinction is important because these memory tasks use somewhat different brain processes.

The researchers recruited 42 ecstasy/polydrug users (14 males, 28 females) and 31 non-users (5 males, 26 females) for the study – all were students. The students were quizzed about their drug habits (including tobacco, cannabis and alcohol), and given questionnaires to assess their everyday memory, cognitive failures and prospective and retrospective memory. They were then given a number of lab-based memory tests, including some that required students to remember something several weeks later. The results showed that recreational drugs such as ecstasy, or the regular use of several drugs, affect users’ memory functions, even when tests are controlled for cannabis, tobacco or alcohol use. According to Fisk, memory deficits were evident in both lab-based and self-reported measurements of subjects’ prospective memory.

The results also suggested that ecstasy/polydrug users “possess some self awareness of their memory lapses.”
The authors say that although ecstasy/polydrug users as a whole are aware of their memory problems they may be uncertain as to which illicit drug is behind the defects they perceive. “The present results suggest that these deficits are likely to be real rather than imagined and are evident in both time- and event-based prospective memory contexts,” Fisk says.

Source: www.cadca.org l8 March 2010

According to the annual survey, teen ecstasy use dropped from 12 percent in 2001 to 9 percent in 2003. 

Despite the decline, Steve Pasierb, president and CEO of the PDFA, said the drug is still a problem. 

“The ecstasy threat remains: Last year, 2 million teenagers in America had tried this drug,” Pasierb said. “We can and we must kick ecstasy while it’s down, and kick it down further.” 

The study also found a reduction in overall drug use by teens. Declines were seen in marijuana, LSD, and methamphetamine use. 

However, the study indicated areas of concern, including a growing use of inhalants and misuse of prescription drugs. 

The study was based on data collected from questionnaires completed anonymously by 7,270 adolescents nationwide between April and June 2003 

These results add to a growing body of research that has demonstrated  the harmful effects of Ecstasy: the drug is known to affect cognition  and mood regulation, and recent evidence suggests it is a neurotoxin  at certain doses.  The study participants were tested on a series of CANTAB tasks  normally used to identify cognitive problems in patients with  dementia or neurological damage. The two groups performed equally  in a number of tasks, but Ecstasy users significant impairment  on several others. Most of these involved memory use, the research  team says.

 One of the study’s researchers at the University of East London, Dr Andy Parrot, has said about Ecstasy: ‘the more you use, the  more you suffer memory problems. One in five novice users suffer memory loss, while almost three-quarters of heavy users do. Depression  is another big problem; it is increased even in former moderate  users, he said.  According to a survey of 1000 clubbers undertaken by Britain’s  dance culture magazine Mixmag, regular Ecstasy users are 25% more likely to suffer a mental health disorder than the rest  of the population.  One in four regular Ecstasy users had potentially serious psychiatric  disorders, compared to the national average of less than one in five the survey reportedly showed. Published in January, the  survey was based on readers filling out questionnaires. Respondents  were also twice as likely to have seen a doctor about mental  health issues, with half of them concerned about depression.

Cheap, long-lasting, easy to make, easy to take and perceived as relatively safe, this stimulant is widely used by young women because it elevates mood, boosts energy, suppresses appetite and helps with weight loss. Researchers have long known that methamphetamine has multiple side effects. It damages neurons that use the neurotransmitter dopamine to relay signals. Women who abuse the drug during pregnancy have increased risk of premature delivery. Their newborns are often unusually irritable. But because the drug has only recently become so popular, there is limited information about its long-term effects on users’ offspring. Last spring, recognition of  methamphetamine’s blossoming popularity among young women, and the uncertainty about its effects on an exposed fetus, provoked NIDA to call for research on how the drug affects brain development for those exposed in utero.

Heller’s group at the University of Chicago had already developed a mouse model of prenatal methamphetamine exposure. They determined the dose that exposed the mouse fetal brain to similar concentrations of methamphetamine as in human infants and then studied its effects on the exposed mice and their offspring. The key finding was that male mice who were exposed to the drug before birth and then exposed again as adults (at 11 weeks old), were significantly more vulnerable to methamphetamine’s neurotoxic effects. These males suffered damage to the dopamine-using neurons, particularly in areas of the brain known as the substantia nigra and the striatum, the system that is damaged in Parkinson’s disease. Why the effect was so much greater in males than females is unclear. It may be connected with the rise in body temperature associated with use of the drug. The amount of brain damage was closely associated with this increase in body temperature in exposed mice. Methamphetamine increases core temperatures more in males than in females.

The researchers also suggest that a likely mechanism for the increase in brain damage is that fetal exposure to methamphetamine increases the release of dopamine from adult brain cells by methamphetamine. When stimulated later in life by this drug, these preconditioned nerve cells release abnormal amounts of dopamine, which accumulates outside the cells, where it can be chemically altered or oxidized. Heat exacerbates this dopamine secretion, When the altered neurotransmitters are taken back up into these nerve cells, they can be toxic. In fact, drugs that block re-uptake can prevent this toxicity. The enhanced neurotoxicity in response to methamphetamine in male animals exposed in utero “may be an additional risk factor in the development of parkinsonism,” note the authors. “With age, the persistent damage to the dopaminergic system may predispose these individuals to brain disorders.” Although Parkinson’s disease doesn’t immediately appear in these animals, or in most human drug users, the drug may be setting the stage for early disease onset. People begin to exhibit symptoms, such as slowed movements, rigidity and tremors, only after losing more than 80 percent of the dopamine-producing cells in the substantia nigra. “Regular methamphetamine users, or those at increased risk because of prenatal exposure, may have a head start on this process,” suggests Heller.

Young women taking the synthetic drug ecstasy are much more likely to die than any other group, according to new research. The drug is more dangerous for women of reproductive age because of high levels of the female hormone estrogen in their bodies, said researchers at Kings College, London. ‘The way that young women, in particular, respond to ecstasy places them at risk, though these effects can apply to anyone who takes the drug,” neuroendocrinology professor Mary Forsling told the paper. “Ecstasy is especially dangerous because of the circumstances in which people take it,” Forsling was quoted as saying. “Dancing raises the body temperature, you drink a lot, your hormones tell your body to retain water,.you drink more. It is something of a vicious cycle,” she added. Known as MDMA, ecstasy is an illegal amphetamine-based drug that causes euphoric and mildly hallucinatory effects. As ecstasy is broken down within the body it produces another chemical, known as HMMA which causes the release of a hormone encouraging the body to drink. The resulting imbalance of sodium levels in the body can be fatal.

Findings from another Johns Hopkins/ NIMH study now suggest that MDMA use may lead to impairments in other cognitive functions besides memory, such as the ability to reason verbally or sustain attention. Researchers are continuing to examine the effects of chronic MDMA use on memory and other functions in which serotonin has been implicated, such as mood, impulse control, and sleep cycles. How long MDMA-induced brain damage persists and the long-term consequences of that damage are other questions researchers are trying to answer. Animal studies, which first documented the neurotoxic effects of the drug, suggest that the loss of serotonin neurons in humans may last for many years and possibly be permanent. “We now know that brain damage is still present in monkeys 7 years after discontinuing the drug,” Dr. Ricuarte says. “We don’t know just yet if we’re dealing with such a long lasting effect in people.

“We identified that MDMA [Ecstasy] use is associated not only with short-term consequences [on memory] but with long-term consequences as well,” Reneman wrote in the October issue of the medical journal Archives of General Psychiatry. Study participants, who ranged in age from 18 to 45, agreed not to use psychoactive drugs for three  weeks before the testing. The study noted that Ecstasy users were more likely to smoke marijuana than the control group, which might have influenced the memory test results. Previous research has shown Ecstasy, sometimes known as MDMA or by its chemical name 3,4-methylenedioxymetharrphetamine, can cause dramatic changes in heart rate and blood pressure. It can also lead to dehydration and has been shown to cause lasting changes in the brain’s chemical systems that control mood and memory. Animal studies have shown damage to brain cells connected to memory function.

New research indicates that use of the drug ecstasy during pregnancy can cause long-term learning and memory problems in children, the Associated Press reported April 30.  A research team led by Charles V. Vorhees of  Children’s Hospital Research Foundation and the University of Cincinnati College of Medicine in Cincinnati, Ohio, found that rats given ecstasy on days 11-20 of their life suffered from impaired learning and memory in maze tests. During the first 11 to 20 days, a rat’s still developing brain is used to approximate exposing a woman to the drug in her third trimester of pregnancy. The researchers found that the damage suffered early in life continued when the rats
reached adulthood. “These findings suggest that ecstasy may pose a previously unrecognized risk to the developing brain,”said Vorhees.

MDMA is a ring substituted amphetamine derivative chemically related to both hallucinogens and stimulants.

Marked tolerance occurs with an increase to 10 times the initial dose. After one ingestion, the main complications reported are hallucinations, paranoia, insomnia, tachycardia, muscle rigidity (trismus) which resolves within 48 hours. Regular users present weight loss, exhaustion, jaundice, paranoia, damage to hepatic function and spontaneous intracranial hemorrhage. Signs can develop several hours after ecstasy ingestion. These complications occur unpredictably and require immediate action with a treatment similar to that used by anesthetist to treat severe hyperthermia (dantrolene) No pharmaceutical company has ever made MDMA nor has the FDA given its approval. In 1985 the DEA classified MDMA as a Schedule I compound with a high potential of abuse and without any current medical use.
Effects of MDMA on brain and behaviour are mediated by its effect on serotoninergic nerve terminals and impairment of turnover of this neuromediator. Intrauterine growth abnormalities, complications of pregnancy and delivery including maternal death, and neurophysiologic and neurobehavioral abnormalities in neonates have been described with antenatal methamphetamine drug exposure. Intrauterine death has followed an intravenous injection of amphetamine.
Methamphetamine studies in pregnancy describe an increased incidence of intrauterine growth retardation, prematurity and perinatal complications. Body weight, length, and head circumference changes in the infant are described. At birth, withdrawal symptoms may include abnormal sleep patterns, tremors, hypertonicity, a high—pitched cry, poor feeding patterns, sneezing, and frantic sucking. During the first year, the infant may exhibit lethargy, poor feeding, poor alertness, and severe lassitude.

Dr Irvine’s research on brain damage caused by ecstasy shows that the drug seems to work mainly through its effects on one type of brain cell, and even through one molecule in those cells. It also seems likely that the way  body reacts chemically to ecstasy is important in producing adverse effects, as is the surrounding temperature, which can lead to users over heating. Adelaide’s reputation as having the highest per capita death rate from ecstasy in Australia-and perhaps even the world-forms another component of Dr Irvine’s research. Dr Irvine is looking at the shorter-term consequences of ecstasy ‘overdoses’, and has established t the high rate of death is due to a different strain of ecstasy appearing on the Adelaide market in the mid l990s.

Normal ecstasy contains the pharmacological ingredient known as MDMA as its main ingredient, but the Adelaide strain often contained no MDMA but rather a more potent chemical known as PMA. “PMA hasn’t been around since the early 1970s when it was responsible for the deaths of several people in Ontario, Canada, and now it’s reappeared here in Adelaide,” Dr Irvine says. ‘We don’t know where the PMA came from, but we do know that it has been prevalent in Adelaide since the mid 1990s.”

Konstantine Zakzanis of the University of Toronto, a co-author of the report, warns that the study relied on self-reporting by patients, which can yield misleading results. He further notes that the makeup of street drugs is variable. Still, “for those who use ecstasy repeatedly, there is preliminary evidence to suggest memory processes can be impaired with continued use of the drug,” he remarks, “For those that use ecstasy once or twice in a lifetime, to date, there is no evidence suggesting impairment of memory function that is progressive or permanent in nature, although the jury of ecstasy researchers are still deliberating the matter.

Ecstasy hangover

Additionally, the “Ecstasy hangover” – feelings of excessive tiredness and irritability, alongside an inability to think clearly – is thought to be caused by an over-depletion of the chemical as the drug ceases to have an effect. The man whose brain was the subject of the study started using Ecstasy once a month at the age of 17. In the last few years of his life, he used it four or five nights a week at nightclubs, usually including a three-day weekend “binge” during which he took six to eight tablets. It is still uncertain whether a low level of serotonin in those who take Ecstasy is due to the action of the drug, or whether naturally occurring deficits in the chemical make you more likely to take it. Studies on animals given the drug suggest the former is more likely. Dr Philip Robson, a senior research fellow in psychiatry at Oxford University, said: ‘We simply don’t know what the long term effects of losing these nerve cells is.”

Widespread drug use

The extent of drug use amongst clubbers is graphically illustrated by the fact 97% of 1,000 people surveyed said they had tried both E and cannabis at least once. Eleven per cent have tried heroin.
Mixmag estimates 1.5m people take ecstasy every weekend. But it says consumption has dropped by 13% among regular users. Ecstasy use had resulted in unplanned sex for one in three, one in 100 of which resulted in pregnancies. Half said their performance at work had been affected
because of the drug. But the survey also found clubbers had developed a novel way of ensuring Ecstasy got into their bloodstream as quickly as possible – by taking it as a suppository. One in 15 surveyed by Mixmag admitted they had taken the drug in this way, a 200% increase compared to last year. Inserting it into the rectum allows the body to absorb it more quickly because of the large number of blood vessels in the anus.

Cocaine

Cocaine use fell 4%, though 45% of those surveyed said they still took the drug on a regular basis. Almost a third of cocaine users reported suffering a nosebleed after snorting the drug. Drug use appeared to be linked closely with high levels of alcohol use. More than a third of men who responded to the survey spent more than four nights a week in the pub. All respondents were three-and-a-half times more likely to injure themselves on alcohol than on ecstasy. They were also two-and-a-half times more likely to end up in the local casualty department. The survey also showed one in three said they had been violent on alcohol, compared with one in l0 on ecstasy. Twice as many had driven on ecstasy than on alcohol but drink drivers had a higher accident rate.

Ecstasy users who also take cannabis were facing a “myriad of memory afflictions,” the report said, which could represent “a time bomb” of cognitive problems for later life.

The report, led by the University of Newcastle upon Tyne, said short-term memory was affected by cannabis. Despite some high-profile deaths caused by ecstasy, there has been a widespread perception among young users that the drug is safe.

Users say it heightens awareness, intensifies their emotions and makes them feel good. But in extreme cases, ecstasy can cause spikes in body temperatures severe enough to be fatal. “Users may think that ecstasy is fun and that it feels fairly harmless at the time,” said lead researcher Dr. Jacqui Rodgers of Newcastle University in Britain. “However, our results show slight but measurable impairments to memory as a result of use, which is worrying.”

The survey team based their findings on responses from 763 participants but they also looked closely at a sub-group of 81 “typical” ecstasy users who had taken the drug at least 10 times.

The typical users showed their long-term memory to be 14% worse than the 480 people who had never taken ecstasy and 23% worse than the 242 who had never taken drugs at all.

Additionally, the typical users made 29% more mistakes on the questionnaire form than the people who did not take drugs at all.

“The findings also suggest that ecstasy users who take cannabis are suffering from a ‘double whammy’ where both their long-term and short-term memory is being impaired,” Rodgers said.

Source: London Reuters; Jan 2004.

According to the British Crime Survey, ecstasy use among 16- to 24-year-olds in England and Wales dropped 21 percent last year. Use of amphetamines, also popular among young people attending all-night parties and dance events, also is on the decline.

The drugs have been replaced to some extent with amyl nitrate, or “poppers,” a legal prescription drug used to treat angina, officials said.

Caroline Flint, the Home Office drugs minister, said the decline in ecstasy use indicates that the government’s drug strategy is working.

“Young people are getting the message that drugs are harmful and some drugs can, and do, kill. It’s encouraging to see signs that our work is having an effect,” she said. “After increases in the late 1990s in drug use, the trend overall is now steady and drug use has remained stable since 2001/02.”

Source: Guardian Dec. 2003

Self-assessment by volunteers showed that clubbers who pop the pills an estimated 2 million a week in Britain are 23% more likely to suffer memory blanks than those who do not use them.

Lapses in following TV plots and forgetting to pass on messages were frequently cited in their responses to a website questionnaire.

“Users may think that ecstasy is fun and that it feels fairly harmless at the time,” the project lead researcher Dr Jaequi Rodgers, of Newcastle University’s neurology department said. “However, our results show slight but measurable impairments to memory as a result of use, which is worrying.”

Mixing ecstasy-taking with cannabis use a very pattern, according to the data adds significantly to the damage, the report says. Such users face a double whammy; they are vulnerable to a myriad of memory afflictions which may represent a time bomb of cognitive problems for later life.’

The research, which attracted responses from the US, Australia and EU countries, is the biggest piece of self analytical material so far contributed to the ecstasy debate. Dr Rodgers said the findings conformed to most published data from actual memory tests taken by ecstasy users, although the drug’s effects needed much more study.

“We all know of cases where people have suffered acutely from the use of ecstasy such as the teenager Leah Betts, but relatively little is known about the more subtle effects on regular users: she said.

“It’s a matter for concern that we don’t really know what the long-term effects of ecstasy use will be. But our results indicate that users are potentially creating a time bomb of potential cognitive difficulties in later life?’

The research, which involved medical staff from East London, Northumbria, Tees side and Westminster Universities, had 763 participants, but looked particularly Closely at 81 respondents who had taken ecstasy more than 10 times.

The drug, scientifically known as 3,4- methylenedioxy- methaznphetamine or MDMA, has been fashionable n clubs, bin the Home Office said last month that its use in Britain had fallen last year by 21%.

Young users are thought to be shifting to legal alternatives such as amyl nitrate ‘poppers’ – partly in fear of ecstasy’s potent damage, including research indications that it may affect women more than men.

The charity Drugscope welcomed the findings as a contribution to information on ecstasy’s effects, but a
spokeswoman said: “What we really need is a long term study of the drug and government funding to pay for that.”

The memory findings are published in the new issue of the Journal of Psychopharmacology. The project plans to run website memory tests later this year.
Source:Journal of Psychopharmacology; Jan 15th 2004.

Rationale/objectives Research has revealed associative learning deficits among users of ecstasy; the present study explored the component processes underlying these deficits.

Methods: 35 ecstasy users and 62 non-ecstasy users completed a computer-based, verbal paired-associates learning task. Participants attempted to learn eight sequentially presented word pairs. After all eight had been presented, the first member of each pair was displayed and participants attempted to recall the second. Eight trials were administered. Correct responses on each trial, forgetting at various levels of learning, perseveration errors and the rate at which the associations were learned (trials to completion) were all recorded.

Results: MANOVA revealed that ecstasy users performed worse overall and subsequent ANOVAs showed that users performed significantly worse on virtually all measures. Regression analysis revealed that over half of the ecstasy-group related variance in trials to completion was attributable to group differences in initial learning and forgetting. In relation to forgetting, it appears that cannabis use may be an important determinant. In relation to rate of learning (trials to completion) and initial learning, both ecstasy and cannabis may be implicated.

Conclusions: There appears to be abundant evidence of associative learning deficits among ecstasy users. However, it appears that a range of illicit drugs including cannabis and ecstasy may contribute to these deficits

The rise in popularity of ketamine in the past year is revealed in a survey published today by DrugScope, the leading drugs information charity. The results of the survey – which involved analysing data from 40 frontline drug services operating in 15 cities – show that the drug, which was once only popular within the gay clubbing scene, has widened its appeal. Special K is now to be found on the list of major drugs on sale in eight of the 15 cities for the first time.

“The emergence of ketamine as a key substance of choice is an entirely new phenomenon since we last carried out the survey in 2004 when it didn’t figure at all,” said Harry Shapiro, editor of Druglink, the drug information charity’s magazine.

The survey quotes Nottingham drugs worker Peter Hurd, of the drug counselling service Compass: “Ketamine has now established its place alongside the usual dance scene drugs like ecstasy. It is popular in pre-club bars and has a big following in both gay and straight clubs. It is being taken with other dance drugs by middle-class people who like to party hard at the weekend and then go back to work in the week.”

Ketamine is being sold for as little as £15 a gram in London and Nottingham, half the average UK cost.

Neil Venables, a Birmingham drug treatment worker said that for some young people ketamine had replaced ecstasy: “Ecstasy pills contain less MDMA [the active ingredient] than they used and so it is more of ‘just a stimulant’ than something that alters your state of mind. People aged 18 to 25 are taking ketamine for a more trippy night out. You can spot them on the dance floor because they are not dancing, they’re sitting down in a bit of vegetative state.”

This anecdotal evidence from frontline drugs agencies is backed up by figures from the National Poisons Information Service, which reports that cases of ketamine intoxication have risen from 10 in 1995 to more than 100 in 2001.

The rise in popularity of ketamine has alarmed Home Office ministers, who have decided to outlaw it as a class C drug later this year on a par with cannabis and amphetamines.

Ketamine was invented by Parke-Davis laboratories in 1962 as a replacement for PCP or Angel Dust and is used as a horse tranquilliser. But it has also been used widely on humans after its worth as a “disassociative anaesthetic” in battlefield surgery was proved by the Americans in Vietnam. This hallucinogenic quality meant it helps to “separate” the mind from the body enabling urgent surgery to be performed to save the soldier’s life.

Talk to Frank, the government’s drug advice website, says: “Mixing it with anything else that slows down your body, like heroin, tranquillisers or alcohol, can be very dangerous. There’s a risk you’ll feel sleepy and unable to wake, and it’s more likely that if you’re sick you won’t wake up or cough, so you’ll choke on your own vomit. If it is mixed with ecstasy, it can bring back E sensations and feel quite trippy but it could also leave you with no control over your legs.”

The Advisory Council on the Misuse of Drugs, which recommended that Ketamine be made a class C drug, said recreational users were unlikely to come to harm but it does pose risks for people with heart and circulation disorders and for those with schizophrenia and other psychotic disorders. They advised the government that it can be addictive but dependence level was substantially below nicotine and amphetamines.

Traditionally, ketamine pills on the illegal market came from vets’ surgeries but more recently Customs and Excise say they have been brought in bulk from India, often shipped in as rosewater and massage oils. About one litre of ketamine liquid can make up to 50 grams of powder when cooked up.

“The disturbing number of teens in the Phoenix area who already are experimenting with these drugs makes this a health problem that must be addressed,’ said Dr. Peggy Stemmler, president of the AzAAP, a key partner in the new health education campaign. “Paediatricians are in a unique position to help close the gap between perception and reality about the real consequences of these drugs.”

In the Phoenix area, 14 paediatricians will serve as primary spokespeople for the media communications effort. Campaign coordinators believe the voice of the medical community will resonate with parents in particular in order to motivate them to take an active role in persuading their teens not to use these drugs. HMA Public Relations, a local public relations agency, will coordinate media efforts for paediatricians participating locally.

“More than one of every three teens in the Phoenix area has been offered Ecstasy or ‘meth,’ and teen use of both drugs is above national averages,” said Steve Pasierb, president and CEO of the Partnership, the national non profit organization best known for its media-based drug education campaigns. “Phoenix needs the facts about the real risks of using these drugs if we’re going to turn those numbers around.” The Partnership is providing the local effort with hard-hitting public service ads for television, radio, print and Internet, as well as with research to measure the impact of the effort.

Top-line findings of the Partnership for a Drug-Free America’s study include:

* 13 percent of Phoenix-area teenagers report having used methamphetamine (meth), compared to nine percent of all teens nationwide; 13 percent report having used Ecstasy, compared to 11 percent of all teens nationwide;
* 33 percent of teens report having been offered methamphetamine, and 35 percent report being offered Ecstasy;
* 61 percent of teens report knowing someone who uses Ecstasy, and half (50 percent) report knowing someone who uses methamphetamine; and
* Just one to two percent of Phoenix-area parents surveyed (one percent for Ecstasy, two percent for meth) agree that it’s possible their kids may have tried these drugs.

“Survey data also show parents and teens underestimate the specific health risks of these drugs,’ said Pasierb. “Risk-related attitudes correlate strongly with trends in drug use; for example, when teenagers see greater risks associated with a particular drug, use of that drug declines, Unfortunately, the opposite holds true as well, so the time is right for a concerted intervention to reverse the trends were seeing in Phoenix.”

Methamphetamine is an addictive stimulant. Often called ‘speed’ or ‘crystal’, meth is a crystal-like, powdered substance that sometimes comes in large rock-like chunks. Meth is usually white or slightly yellow, depending on the purity. The drug can be taken orally, injected, snorted or smoked. Once a threat largely in the American southwest, production and use of the drug, which is cheaper and longer lasting than cocaine, has moved steadily eastward in recent years, finding willing users in a generation unlikely to remember the phrase, ‘speed kills’. Long-term use and/or high doses of methamphetamine can bring on full-blown toxic psychosis, often exhibited as violent, aggressive behaviour. Ecstasy–chemically known as 3-4 methylenedioxymethamphetamine, or MDMA – is a psychoactive drug with amphetamine-like and hallucinogenic properties. It can be extremely dangerous, especially in high doses. Usually taken orally in pill form, the drug accelerates the release of serotonin in the brain and provides users with an intense high, characterized by feelings of love and acceptance, as well as a general sense of well being, decreased anxiety and enhanced sensitivity to touch. Ecstasy can cause dramatic increases in body temperature, muscle breakdown, and kidney and cardiovascular system failure, as reported in some fatalities.
Source: Press release, Partnership For Drug Free America June 200

The partnership produces most of the anti drug messages for the White House. Among them: one featuring a young man visiting the site where his brother was killed by a driver under the influence of marijuana. The difficulty is getting kids to see the ads and pay attention to them. A University of Pennsylvania study released last year found the ads are largely ignored by teens.

A spokesman for the government’s drug policy office, Tom Riley said the partnership changed the tone of the ads in the last year to make them harder hitting and punchier. The ads also play up the negative consequences of drugs more, he said.
“These ads have taught millions of teens the truth that marijuana is a harmful drug,” said Riley.

Barry McCaffrey drug czar during the Clinton administration said the anti drug ads are having a profound impact in a fundamental way, affecting not just adolescents but adults” as well including parents, pediatricians and teachers. The drop in drug use proves the ads are a key part in the battle, he said.
Source: Sunday Partnership for Drug free America 2003

While nearly 3 million teenagers in America have already tried the club drug Ecstasy, only one percent of parents believe their son or daughter is among them – and half of all parents are unclear about the effects of the so-called ‘love drug,’ according to a national survey by the Partnership for Drug-Free America (PDFA).
The 2001-2002 Partnership Attitude Tracking Study (PATS) surveyed 1,219 parents across the country from December 2001 to January 2002. (Margin of error + / -2.8 percent. Data are nationally projectable.) This is the 14th installment of parents data fielded for the PATS study since
1987. Top line findings include the following:

• Spreading the word: 92 percent of all parents have heard about Ecstasy. Parents of children in grades 7 to 12 are more likely to have heard about Ecstasy (93 percent) than parents of younger children in grades 4 to 6 (89 percent).
• Instilling the meaning: One of every two parents in America (49 percent) is unclear about Ecstasy’s effects on users. Some 60 percent of all parents are unsure of what is in the drug.
• Not acknowledging the risk to their children: With 12 percent of teenagers in the country (2.8 million teens) reporting use of Ecstasy, the study released today shows that only one percent of parents believe their teen might have tried the drug. (Teen use of Ecstasy has jumped 71 percent since 1999- and is now equal to or greater than adolescent consumption of cocaine, crack, heroin, LSD and metbampheta mine.)
• Parent & teen perceptions far apart: Parents underestimate the availability of Ecstasy to teenagers, and overestimate the degree of risk teens associate with the drug. Almost three out of four parents (72 percent) believe their teen sees great risk in using Ecstasy once or twice. (Just 42 percent of teens agree.) Some 41 percent of parents think Ecstasy would be very or fairly difficult for their teen to get. (Just 26 percent of teens agree.)
• More reminders, more talks: Exposure to anti-drug ads correlate with frequent parent-child communication about drugs. Among parents who reported seeing or hearing an anti-drug message every day or more, 55 percent talk frequently. Among parents exposed to fewer messages, 44 percent talk frequently.
• Ecstasy-specific talks: Among the drugs parents talk ‘a lot’ about with teenagers, parents were more likely to discuss inhalants (36 percent)
• cocaine/crack (48 percent); marijuana (60 percent) and alcohol (70 percent) than Ecstasy (29 percent).

‘Kids who learn a lot about the risks of drugs at home are less likely to try drugs’ Pasierb said. “Yet millions of parents sincerely don’t believe that their kids are the ones experimenting with drugs like Ecstasy. It’s these assumptions that enable drug use to go undetected. rf you’re a parent hearing this, the question we beg you to consider is ‘Could this be me?”
Ecstasy–chemically known as 3,4 methylenedioxymethamphetamine, or MDMA – is a synthetic, psychoactive drug with amphetamine-like and hallucinogenic properties. Taken orally in pill form, Ecstasy can be extremely dangerous, especially in high doses. Ecstasy accelerates the release of serotonin in the brain, producing an intense high, often characterized by extreme feelings of love and acceptance – ‘the very emotions teens crave the most,” Pasierb said. Ecstasy can cause dramatic increases in body temperature and can lead to muscle breakdown, as well as kidney and cardiovascular system failure, as reported in some fatalities. A growing body of research has found Ecstasy to be neurotoxic. According to the National Institute on Drug Abuse, MDMA can damage the neurons that use the chemical serotonin to communicate with other neurons.
As reported by the Partnership’s research and other studies, Ecstasy use has increased significantly across the country. Partnership research indicates that older teens (16-17) are more likely to experiment with Ecstasy than are younger teens (13-15); most users are boys, but by a slim margin. Unlike methamphetamine and other drugs that are more regional in nature, Ecstasy is a drug that has been found in major cities and small towns throughout America, with noteworthy emergence in locations as diverse as Baltimore, Maryland and Billings, Montana. (See “Pulse Check” findings.) Emergency room mentions related to Ecstasy increased nearly 13-fold from 421 in 1995 to 5,542 in 2000.

Crack cocaine has replaced ecstasy and heroin as the drug of choice among many young adults in the United Kingdom. In particular the use of crack cocaine has increased among ravers and prostitutes, the Observer reported Dec. 29.
“Tackling Crack’ a new report from Britain’s Home Office, shows that the use of crack cocaine has grown more than 200 percent over the past three years. The biggest increase has been within the sex industry.
In addition, DrugScope, an anti-drug group, reports that many club goers have switched to crack over fears of the effects of ecstasy use.
“There is growing evidence that clubbers are under the mistaken belief that cocaine is a safer option,” said a spokesman for the charity. “Because they haven’t seen scare stories about cocaine or crack, they believe that it is a better option than ecstasy.”
In Scotland, police said that crack cocaine is the drug of choice for middle class club-going teenagers. According to Tom Wood, deputy chief constable of Lothian and Borders Police, there has been a 200% increase in the use of the drug.
Crack cocaine is an emerging threat,” said Wood. He added that dealers sell young people smaller ‘clubbing rocks.’
U.K. drug officials said the spread of crack cocaine is a result of Jamaican dealers who have introduced the drug in London and other major cities.

Adding to an already hefty body of evidence a new study finds ecstasy users suffer from long-term memory problems while marijuana smokers struggle with short-term memory lapses. The study found those who regularly took the popular club drug ecstasy were 23% more likely to report problems with remembering things than people who are drug-free. And marijuana smokers reported up to 20% more memory problems than non-users.

“There is a lot of evidence that ecstasy users are likely to use other drugs, including cannabis. Users of both substances may therefore be vulnerable to a myriad of memory afflictions, which may represent a time bomb of cognitive problems for later life,” says lead researcher Jacqui Rodgers Rodgers is with the School of Neurology, Neurobiology and Psychiatry at the University of Newcastle in England. The findings appear in the January issue of the Journal of Psychopharmacology.

Collecting data through a Web site, Rodgers and colleagues used a standard questionnaire to assess drug use among the 763 individuals who responded. They also looked closely at a subgroup of 81 ‘typical’ ecstasy users who had taken the drug at least 10 times.

The people were asked about their short-term and long-term memory. They were also asked to rank the probability of scenarios such as finding a television story difficult to follow or forgetting to pass a message on to someone.

The group of ‘typical’ ecstasy users reported their long-term memory to be 14% worse than the 483 people who had never taken ecstasy, and 23% worse than the 242 non-drug users.

“We found that people who regularly take ecstasy report experiencing long-term memory difficulties, and are 23% more likely to report problems with remembering things than nonusers,” she says.

“We also found that people who use cannabis regularly report up to 20% more memory problems than non-users, in terms of short-term memory performance,” Rodgers adds.

Rodgers team also noted the number of mistakes the people made when titling out the questionnaire.

Users of ecstasy – also known as MDMA –made 21% more mistakes on the questionnaire compared with non-ecstasy users and 29% more mistakes than people who did not take drugs at all.

These differences were the same for men and women.

“Our findings may help drug services in the U.K. and elsewhere explain the potential consequences of use, so that people can make an informed decision as to whether to take ecstasy or not,” Rodgers says.

“Users may think that ecstasy is fun and that it feels fairly harmless at the time. However, our results show slight but measurable impairments to memory as a result of use, which is worrying,” she notes. “It’s equally concerning that we don’t realy know what the long-term effects of ecstasy use will be, as it is still a poorly understood drug,” Rodgers adds. “The findings also suggest that ecstasy users who take cannabis are suffering from a double whammy, where both their long-term and short-term memory is being impaired.

“Rodgers team is planning to launch a Web site within the next two months that will include memory tests that may determine whether self-reported memory impairment is actually detectable by objective measurement.

Dr Stephen Koesters, a clinical assistant professor at the College of Medicine and Public Health at Ohio State University, says, “The study has a number of limitations, but does seem to support other studies that have been released in the past.”

“While the specific effects of MDMA are difficult to pinpoint in light of multiple drug use by many patients, self- reporting of the amount and the frequency of drug use, there is certainly a trend in the available literature that suggests memory impairment is a real side effect of MDMA use” he adds.

Whether these effects are cumulative is difficult to determine, Koesters adds.

“Current evidence does suggest that MDMA can be dangerous, both with acute ingestion and to longer-term memory impairment,” Koesters says. “With the current rate that MDMA is being abused, it is not safe to wait 30 or 40 years to see if we have a true epidemic,” he adds.

Source: Journal of Psychopharmacology. Jan 2004 Reported on www.healthday.com

“What they are saying in this study is that ecstasy essentially breaks down that protection,” said Dr. Robert Margolis, executive director of Solutions Counseling, an adolescent addiction treatment center in Atlanta, Ga. “(It) makes that blood brain barrier more porous, the openings between those cells larger, and (it) makes your brain more vulnerable to having things that you don’t want in your brain like infections and germs and bacteria.”

And now, for all those who took ecstasy at parties or dance clubs, there is a question: Has the drug damaged the barrier that protects their brain?

“The thing that I think you will start to see is looking at long-term epidemiological studies where they start to at least try to find out if ecstasy users have more brain infections (or) have more strokes,” Margolis said.

He said there’s a chance the damage will be permanent. “You do not want to do anything that is going to damage your brain because that is one area of your body that does not regenerate,” he adds. “It does not fix itself.”

Angela was 15 when she first tried ecstasy and soon she was doing it every week. “Everyone always told me it would put holes in your brain and I just ignored them,” said Angela, who is now 21. “I was like, ‘Whatever, I’m not doing it that much.’ Angela and her mom, Peggy, are worried.

“I hope that it doesn’t pan out to be that serious because I want her to have a normal brain and be able to function in life,” Peggy said. “But you know, sometimes we don’t get second chances. If she blew this without knowing what would happen on down the line then that’s a sad thing.”

“Now I have paranoia … that I might have something wrong with me later down the road and I don’t want to have to deal with that,” Angela said. “I mean, I want to be there for my children, I want to be there for my family. I want to be able to have a regular life now, and it wasn’t worth it.”

According to the National Institute on Drug Abuse, ecstasy use is going down. More high school students say they know about ecstasy’s harmful effects.
Source: CWK Network January 2006

Symptoms of Ecstasy use alone or in combination. Most common symptoms with Ecstasy use alone:

Strange/unwell/dizzy/weak 44 %
Palpitations 37 %
Nausea or vomiting 31 %
Panic/anxiety/restlessness 31 %
Hot/cold 25 %
Abdominal pain 15 %
Most common symptoms with Ecstasy and other drugs/alcohol:
Collapsed/Loss of consciousness 31 %
Strange/unwell/dizzy/weak 25 %
Nausea or vomiting 19 %
Palpitations 19 %
Panic/anxiety/restlessness 12 %
Headache 12 %
Shaking 12 %
Source: Williams H., Drareau L, Taylor L., et al. (1998)
“Saturday night fever” Ecstasy related problems in a London accident and emergency department journal of Accident and Emergency Medicine 15: 5. 322-325

Setting: Vancouver, which introduced a needle exchange programme (NEP) in 1988, and currently exchanges over 2 million needles per year.

Design: IDU who had injected illicit drugs within the previous month were recruited through street outreach. At baseline and semi-annually, subjects underwent serology for HIV-1 and HCV, and questionnaires on demographics, behaviours and NEP attendance were completed. Logistic regression analysis was used to identify determinants of HIV prevalence.
Results: Of 1006 IDU, 65% were men, and either white (65%) or Native (27%). Prevalence rates of HIV-1 and HCV were 23 and 88%, respectively. The majority (92% had attended Vancouver’s NEP, which was the most important syringe source for 78%. Identical proportions of known HIV-positive and HV-negative IDU reported lending used syringes (40%) Of HIV negative IDU. 39% ,.. borrowed used needles within the previous 6 months. Relative to HIV-negative lDU, HIV-positive IDU were more likely to frequently inject cocaine (72 versus 62%; p <0.001). Independent predictors of HIV-positive serostatus were low education, unstable housing, commercial sex, borrowing needles, being an established IOU, injecting with others, and frequent NEP attendance. Based on 24 seroconversions among 257 follow-up visits, estimated HIV incidence was 18.6 per 100 person-years (95% confidence interval, 11.1—26.0).

Conclusions: Despite having the largest NEP in North America, Vancouver has been experiencing an ongoing HIV epidemic. Whereas NEP are crucial for sterile syringe provision, they should be considered one component of a comprehensive programme including counseling, support and education.

While the researchers, from the Centre for Addiction and Mental Health in Toronto, concede it is difficult to draw conclusions from a single case, they say the finding is significant. Dr Stephen Kish said: “This is the first study to show that this drug can deplete the level of serotonin in humans.” Serotonin is a neurotransmitter chemical, released by nerve cells in the brain, which controls mood, pain perception, sleep, appetite and emotion. A massive release of serotonin stimulated by Ecstasy is widely thought to be the principal mechanism of the drug.

Ecstasy hangover
Additionally, the “Ecstasy hangover” – feelings of excessive tiredness and irritability, alongside an inability to think clearly – is thought to be caused by an over-depletion of the chemical as the drug ceases to have an effect. The man whose brain was the subject of the study started using Ecstasy once a month at the age of 17. In the last few years of his life, he used it four or five nights a week at nightclubs, usually including a three-day weekend “binge” during which he took six to eight tablets. It is still uncertain whether a low level of serotonin in those who take Ecstasy is due to the action of the drug, or whether naturally occurring deficits in the chemical make you more likely to take it. Studies on animals given the drug suggest the former is more likely. Dr Philip Robson, a senior research fellow in psychiatry at Oxford University, said: “We simply don’t know what the long term effects of losing these nerve cells is.”

Source: Dr. Stephen Kish Centre Addiction and Mental Health, Toronto, July 2000

Widespread drug use
The extent of drug use amongst clubbers is graphically illustrated by the fact 97% of 1 000 people surveyed said they had tried both E and cannabis at least once. Eleven per cent have tried heroin.
Mixmag estimates 1.5m people take ecstasy every weekend. But it says consumption has dropped by 13% among regular users. Ecstasy use had resulted in unplanned sex for one in three, one in 100 of which resulted in pregnancies. Half said their performance at work had been affected because of the drug. But the survey also found clubbers had developed a novel way of ensuring Ecstasy got into their bloodstream as quickly as possible – by taking it as a suppository. One in 15 surveyed by Mixmag admitted they had taken the drug in this way, a 200% increase compared to last year. Inserting it into the rectum allows the body to absorb it more quickly because of the large number of blood vessels in the anus.

Cocaine
Cocaine use fell 4%, though 45% of those surveyed said they still took the drug on a regular basis. Almost a third of cocaine users reported suffering a nosebleed after snorting the drug. Drug use appeared to be linked closely with high levels of alcohol use. More than a third of men who responded to the survey spent more than four nights a week in the pub. All respondents were three-and-a-half times more likely to injure themselves on alcohol than on ecstasy. They were also two-and-a-half times more likely to end up in the local casualty department. The survey also showed one in three said they had been violent on alcohol, compared with one in 10 on ecstasy. Twice as many had driven on ecstasy than on alcohol but drink drivers had a higher accident rate.

Source: Mixmag Survey. Dr Adam Winstock, National Addiction Centre University, Kent, Jan 2002

Cognitive health
Previous studies have found that ecstasy impairs other types of memory, such as short-term retention of a list of words. Researchers suspect that ecstasy may be damaging neurons that make serotonin, a neurotransmitter involved in memory. There is a belief that soft drugs – which many consider ecstasy to be – should be legalised when in fact research, including our own, suggests that regular use can have a very damaging effect on your cognitive health, say Heffernan. Whether the memory impairments are long term is not yet clear, he says. This research was presented at the British Psychological Society’s Centenary Conference in, Glasgow, UK.

Source: Author Tom Heffernan. Published on NewScientist.com, March 2001

Ecstasy users reported similar memory lapses to those taking cannabis. Dr Andrew Scholey, a psychologist from the University of Northurabria, said: The more they had taken ecstasy in the past, the more their long term prospect of memory failed. “This was down to the amount they had used, not the frequency. “The other thing we recorded was the number of errors they made when submitting the questionnaire. “The more people had taken ecstasy, the more errors they made on the form.”

Brain damage
The research team suggest ecstasy targets the frontal lobes of the brain, which are related to memory and organising responses. People with frontal lobe damage caused by accidents often find difficulty concentrating and are More easily distracted, research shows. Psychologists are intrigued that ecstasy users continue to take the drug, despite knowing it is damaging their brain. Dr Scholey said: “It’s bizarre. People are aware of what’s happening to them in terms of deteriorating mental function and don’t seem to do anything about it.” The team recognises the weaknesses of the study. Scholey said: “We have to be cautious in interpreting these types of data. “We are relying on self reports of memory failures in groups with memory problems.

‘However, it’s difficult to see why cannabis and ecstasy users would try to exaggerate these psychological problems.” The study was devised and conducted by UK scientists from the universities of Newcastle, Northumbria, Teeside, East London and Westminster. The majority of those who took part in the questionnaire (75%) were aged between 21 and 25. About 80% came from Europe and 16% were from the USA.

Source: BBC News, 14 March 2002

Source: www.momstell.com, Oct 2003

Why am here?
Heffernan studied 40 adults in their early or mid-twenties who took ecstasy at least 10 times a month for up to five years. He found significant impairments in everyday measures of three kinds of prospective memory. The ecstasy users and a group of non-drug users completed questionnaires asking about memory lapses during the previous week and month. The questionnaires probed short-term habitual memory (such as forgetting to switch off an alarm clock in the morning) long-term episodic memory (such as forgetting to pass on messages) and internally-cued memory (such as forgetting what you have come into a room to do). Even when the team controlled for the use of other drugs known to impair memory, such as marijuana, the regular ecstasy users recorded significantly more memory lapses than the non-drug users.

Cognitive health
Previous studies have found that ecstasy impairs other types of memory, such as short-term retention of a list of words. Researchers suspect that ecstasy may be damaging neurons that make serotonin, a neurotransmitter involved in memory. There is a belief that soft drugs – which many consider ecstasy to be – should be legalised when in fact research, including our own, suggests that regular use can have a very damaging effect on your cognitive health, say Heffernan. Whether the memory impairments are long term is not yet clear, he says. This research was presented at the British Psychological Society’s Centenary Conference in, Glasgow, UK.

Source: Author Tom Heffernan. Published on New Scientist.com, March 2001.

Ecstasy users reported similar memory lapses to those taking cannabis. Dr Andrew Scholey, a psychologist from the University of Northurabria, said: The more they had taken ecstasy in the past, the more their long term prospect of memory failed. “This was down to the amount they had used, not the frequency.” The other thing we recorded was the number of errors they made when submitting the questionnaire. “The more people had taken ecstasy, the more errors they made on the form.”

Brain damage
The research team suggest ecstasy targets the frontal lobes of the brain, which are related to memory and organising responses. People with frontal lobe damage caused by accidents often find difficulty concentrating and are more easily distracted, research shows. Psychologists are intrigued that ecstasy users continue to take the drug, despite knowing it is damaging their brain. Dr Scholey said: “It’s bizarre. People are aware of what’s happening to them in terms of deteriorating mental function and don’t seem to do anything about it.” The team recognises the weaknesses of the study.
Scholey said: “We have to be cautious in interpreting these types of data… We are relying on self reports of memory failures in groups with memory problems.”

“However, it’s difficult to see why cannabis and ecstasy users would try to exaggerate these psychological problems.” The study was devised and conducted by UK scientists from the universities of Newcastle, Northumbria, Teeside, East London and Westminster. The majority of those who took part in the questionnaire (75%) were aged between 21 and 25. About 80% came from Europe and 16% were from the USA.
Source: BBC News, 14 March 2002

It was one of the largest such seizures in the nation. Foxy is so new and seizures so rare that nationwide statistics are not readily available, Ed Childress, a spokesman for the federal Drug Enforcement Administration in Washington, said yesterday. Every bit as rare, authorities said, is the manner in which they got hold of the drugs: The defendant, from Absecon, notified them and led them straight to the stash. The man is in federal custody and undergoing psychiatric evaluation.
Foxy began appearing at all-night dance parties in 1999, and municipal police departments began seize amounts in 2001 Only a handful of large seizures have followed.

Source: www.momstell.com, Oct 2003