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Rhapsody so blue, the downside of ecstasy

Research suggests designer drug may cause brain damage

THE past week has been an important time for both those who study the effects of the drug ecstasy and for those who take it.

A British study reported that long-term ecstasy users have poor memories. A German research group has suggested that even infrequent use of ecstasy may be enough to decrease your memory and reasoning ability. On Saturday, the respected medical journal The Lancet published a review of the scientific evidence about this drug. In it, we a group of Sydney researchers argue that ecstasy use is a much more hazardous activity than many users realise.

The real hazards of ecstasy use have little to do with the rare fatalities which we read about in newspaper headlines. Ecstasy users have largely discounted these sensationalist warnings about “death on the dance floor”.

They have good reason: in terms of the risk of death, taking an ecstasy tablet is safer than riding a horse. Indeed, among users, ecstasy has a reputation as a safe drug because it does not produce the craving caused by heroin and cocaine.

The real hazard of ecstasy use is that it is neurotoxic, which means it can damage nerve cells in the brain that contain the chemical serotonin. Evidence that ecstasy can be neurotoxic has emerged over the past decade. While there are methodological difficulties in such research, the consistency of findings raises a strong suspicion that ecstasy is damaging the brains of some users.

It is essential to point out that these results may only apply to long-term, high-dose users of the drug. Whether occasional use of low doses of ecstasy causes damage is not yet known.

We are concerned that more and more ecstasy users are using the drug in a way that increases the risk of these neurotoxic effects. The risk factors include: using two or more tablets of ecstasy at a time, using fortnightly or more often, using ecstasy for 24 hours or more at a time, overheating the body (for example, by dancing for hours at a time) and snorting or injecting ecstasy.

Almost all respondents to a survey of 329 Australian users identified one or more of these risk factors in their use, yet 94 per cent believed that their pattern of use was safe.

If ecstasy does damage serotonin nerve cells in humans, what effects should we expect? Firstly, it is important to note that neurotoxic damage can occur in the absence of symptoms: ecstasy users may damage their nerve cells without realising it. Nevertheless, symptoms are evident in some users. Research shows that a poorly functioning serotonin system is most often linked to depression and memory problems. So it is not surprising that some ecstasy users report irritability and depression that are related to how often and how much ecstasy they use. Nor is it surprising that there are now seven studies reporting memory problems in users.

Ethical reasons prevent researchers from doing definitive studies to test the effects of ecstasy on human brain function. But we should not let this blind us to the wide array of evidence which raises a strong suspicion that ecstasy can produce neurotoxic effects in some recreational users.

If we had the same type of evidence of harm from a pesticide or a pharmaceutical drug it would be withdrawn from the market.

Current and potential users of ecstasy need to be informed of these risks by peers in the dance party milieu and through the media they use, such as videos and the Internet. Sensationalism and paternalistic finger-waving by researchers and the media only serve to alienate those to whom we wish to provide information.

Thus, non-alarmist and accurate information is required that acknowledges uncertainties about the risks of occasional use of low doses of ecstasy, while emphasising the clearer risks that heavier and more frequent ecstasy users probably face.