A recent article in Forbes magazine noted that the drug ecstasy is at the forefront of a movement to use certain psychedelic drugs as treatments for mental health conditions.
However, this comes with a caveat — much remains unknown about the full range of effects of hallucinogens, especially in the brains of young people. The effects or damage of ecstasy on a developing brain is of particular concern for doctors, public health experts, and parents.
Ecstasy and MDMA
In 1912, scientists formulated a drug called 3,4-methylenedioxymethamphetamine, or MDMA for short. MDMA was initially designed with the intention of controlling bleeding, but researchers came to notice that the drug had psychoactive effects as well.
In 1978, a report described that patients who received MDMA were put into an “easily controlled, altered state of consciousness,” with greater emotional and sensual awareness. These effects remained in place for several hours, inducing patients to drop their anxieties and psychological defenses. Scientists wondered if this would help people open up more to their therapists.
As soon as interest rose in the idea of using MDMA as a proper prescription drug for mental health treatment, the U.S. government banned all forms of use of psychedelic substances out of concern that they had no established medical reasons behind their use, and the risk of physical and psychological dependence in users was prohibitively high. Even as formal research was halted, the idea of MDMA being a safer alternative to antidepressants and other medications did not go unnoticed.
Whether it was illicit drug manufacturers or legitimate scientists looking for a breakthrough, it was noticed that the amphetamine in MDMA induced physical stimulation in users, and the empathogenic effects (a feeling of emotional closeness to others and oneself) made patients feel greater empathy and connection with those around them. While this was useful to researchers, it was also useful to criminal drug manufacturers who continued to design MDMA to make ecstasy, a drug that found its home in the nightclub scene.
What makes MDMA so appealing? When a person consumes the drug, it causes the release of key neurotransmitters in the brain. The three most significant ones are dopamine, serotonin, and norepinephrine. As neurotransmitters, they send signals between the nerve cells of the central nervous system (CNS).
Serotonin is responsible for regulating mood and emotional functions; it is also released to manage sleep cycles, control pain, and facilitate digestion. Dopamine drives feelings of pleasure, reward, and anticipation of pleasure; it also plays a role in many other activities of the CNS. Norepinephrine controls mood, energy, sleep, anxiety, and focus. It is released as part of the fight-or-flight response.
MDMA causes significant elevation of mood due to the excessive amounts of serotonin that are released. This is a naturally pleasurable experience, but the brain cannot replenish its reserves once they are expended, and many users struggle with uncomfortable aftereffects when the effects of MDMA wear off. It takes time for the brain to produce more serotonin, a professor of neurology and biochemistry at Georgetown University Medical Center told Vice’s Tonic, and the low amounts of serotonin to go around cause depression, lethargy, and fatigue.
Long-Term Effects of MDMA
Tests on lab animals have shown that MDMA’s effect on the neurons that produce serotonin can be long-lasting. While there are no comparative clinical studies on such effects on human subjects, the little-established research into the topic has found that people who frequently use MDMA experience:
- Persistent mental disorientation
- Chronic depression
- Disruptions to short-term memory
- Difficulty concentrating and paying attention
Other imaging studies have found that people who use ecstasy regularly also struggle with cognitive, emotional, and motor functioning. While the drug induces users to be more emotionally open to themselves and those around them in the short term, long-term exposure might adversely affect their emotional reasoning and control.
The International Journal of Sexual Health confirms that much of ecstasy’s popularity and use are derived from its effect of “heightening senses, feelings of intimacy, and communication.” For many people, this makes it a desirable substance to increase their sexual pleasure and experience. However, the change to serotonin levels as the result of MDMA consumption might have future implications for reliable sexual arousal, and researchers stress that the changes to cognition can affect how a person perceives romantic relationships, both with and without ecstasy use.
There also are concerns that, as with many other chemical substances, ecstasy adversely works on the regions of the brain regulating impulse control. In 1998, the Neuropsychopharmacology journal noted that recreational MDMA use is associated with “elevated impulsivity,” which has been connected with risky behavior, such as unprotected sex or other drug use.
Ecstasy and the Developing Brain
For all the therapeutic theories of MDMA, recreational use still poses a significant risk, and this risk is exacerbated when the drug comes into contact with the developing brain.
The National Institute on Drug Abuse has reported that 43 percent of teenagers and young adults who used ecstasy met the diagnostic criteria for being psychologically dependent on the drug; that is, they struggled to experience any sense of energy, happiness and emotional connection without the ecstasy. Additionally, if they experienced any discomfort because of their use of MDMA, they persisted with continuing to use the drug.
The long-term psychological implications of teenage ecstasy use suggest that the regions of the brain critical to thought and memory are at the greatest risk of being damaged. Because MDMA is a Schedule I drug in the United States (meaning that it is completely illegal and unavailable for scientific study), what little research exists suggests that the ecstasy disrupts neurons that use serotonin to send messages to and from other neurons.
As a side effect of MDMA being chemically similar to amphetamine, the effect of long-term consumption of ecstasy is that these neurons will eventually degrade over time. Without therapy and treatment, it may be impossible for the neurons to communicate at all, resulting in lifelong cognitive and developmental problems.
This is troubling enough for any brain; for a young and developing brain, it is even more concerning. The American Academy of Child and Adolescent Psychiatry explains that the human brain is in a delicate state of development well into the early 20s, and the life experiences (both good and bad) a child, adolescent, teenager, and young adult undergo during this time drastically impact how the brain settles into its long-term future.
This is why, for example, teenagers do impulsive things, even if they “know better.” The lateral prefrontal cortex, which is responsible for self-regulation, develops only gradually over the adolescent years. As a partial result of this slow construction, “adolescents and young adults take more risks than any other age groups,” says Psychology Today, quoting the Developmental Science journal.
Introducing drugs and alcohol to this delicate stitching of critical brain regions can set the stage for lifelong hampering of decision-making, judgment, impulse control, and even self-preservation.
The motor system can also be thrown off course by the early use of ecstasy. Sustained damage to the neurons that release dopamine and norepinephrine causes a trembling and a lack of coordination, eventually leading to paralysis (not unlike the development of Parkinson’s disease).
What To Do If Your Teenager Is Using Ecstasy
If you are concerned that your teenager may be using ecstasy, researchers writing in the Western Journal of Medicine caution parents to not “overstate the case.” We know there are long-term problems that are associated with MDMA use, but the young people who are most likely at risk for developing these problems are unlikely to change their behavior in response to “scare stories.”
Part of the reason is that adolescent substance abuse and the problem of denial is a widely known battleground for many researchers and parents.
As with any intervention, talking to a person about their suspected drug use is never an easy conversation to have, especially when the person is your own child. On the topic of “what to do if your student son or daughter is taking drugs,” a recovery worker advised in The Guardian that it is important to acknowledge that drug use is common among students and your child may be taking ecstasy as the result of peer pressure. Nonetheless, there are concrete steps to encourage your teenager toward recovery. The key is not to panic and to do your own research before you have the conversation.
Reiterating that you will always be available sets the scene for a calm and nonconfrontational conversation about the danger of ecstasy and your own concerns.
Teenagers and adolescents often try to impose their own burgeoning adulthood, and it is important to respect that.
Children who are away at college have a high likelihood of partaking in some form of drug and alcohol use, and they may resent any parental involvement in that part of their lives. In The Guardian, the recovery worker suggests that talking about safe and responsible ecstasy use might be one way to guide a teenager toward moderating their consumption or a way to open up the possibility of seeking treatment for dependent use.
Recovering From Ecstasy Use
In severe cases, it might be necessary for your teenager to undergo medical detox for their ecstasy use. This allows the body to safely break down the MDMA while giving the patient medications to cope with the stress of depriving the body of the ecstasy upon which it has become dependent.
For example, patients might be given antidepressants to help them manage the mood swings that come from the neurotransmitter imbalances or anti-anxiety medications to help with reducing stress and insomnia.
Medical detox usually lasts for up to a week, but this can vary depending on the nature of the ecstasy abuse as well as any genetic or individual factors that might hamper the body processing the last of the MDMA. It is vital that people receive emotional support during this time, which is why they should undergo detox at a licensed treatment center or hospital.
When the person has completed detox, and their vital signs are stable, they can begin therapy to help them address the psychological elements of their ecstasy use. This stage will help them relearn how to form emotional connections without the use of MDMA, and it will teach them how they can think clearly and make better decisions to avoid relapse to ecstasy use.