NEWS & EVENTS

NEWS ARCHIVE | EDUCATIONAL RESOURCES

XTC

HISTORY

Methylenedioxymethamphetamine (MDMA) was originally synthesized by Merck in 1912. Although MDMA was patented in 1914 as an appetite suppressant, it was never marketed. The armed forces investigated using MDMA as a psychological warfare agent in the 1950s, and it was used to aid psychotherapy in the 1970s. In 1985 MDMA was classified as a schedule I controlled substance, and is no longer legally available. MDMA entered the rave culture in the early 1990s where it was especially popular in Europe.

PHYSICAL DESCRIPTION

MDMA is distributed in a wide variety of pill shapes and colors. Pills available at raves usually contain from 100 – 125 mg MDMA, but occasionally the concentration is 50 mg. As will all street drugs, "XTC" pills often contain other drugs such as methamphetamine (MA), caffeine, dextromethorphan, and pseudoephedrine. Some preparations also contain the very dangerous compound called paramethoxymethamphetamine (PMA, death). www.dancesafe.org displays MDMA and other rave drugs from around the US. The KC Star recently reported a bust of the first MDMA lab in the KC area.

MECHANISM OF ACTION

MDMA is a derivative of methamphetamine (MA, speed, crank) and as such retains its stimulant properties. However, unlike MA, MDMA is also an hallucinogen, an empathogen (facilitates empathy), and an entactogen (enhances touch sensation). MDMA is an indirect monoamine agonist in that it enhances serotonin (5HT) and dopamine (DA) release by the neuron terminals into the neuronal synapse. MDMA also inhibits monoamine oxidase (MAO) which metabolizes excess 5HT and DA in the neuronal synapse.

PHARMACOKINETICS

MDMA has a slow onset of 2 hours. Many believe that this contributes to over dosage in which users take more because they do not feel the drugs effects initially. MDMA’s half live is 7 to 8 hours and therefore its effects last several hours.

SIDE EFFECTS

"Ravers" are attracted to MDMA due to its effects of euphoria, the heightened sense of touch, and the feelings of warmth and empathy that the drug encourages. However, MDMA also causes nausea, dehydration, heat stroke, tooth grinding (bruxism), jaw clenching (triasmus), headache, fatigue, anxiety, blurred vision, and the midweek blues (suicide Tuesday) following weekend usage. Serious effects include cardiac arrhythmia, muscle breakdown (rhabdomyolysis), acute renal failure, disseminated intravascular coagulation (DIC), and liver damage (hepatotoxicity). While death from MDMA alone is rare it does occur.

LABORATORY DIAGNOSIS

While MDMA is an amphetamine derivative, MDMA is frequently not detected as an "amphetamine" by emergency room point of care devices unless it is a severe overdose. If you believe MDMA may be a causative agent, make sure to indicate this on the requisition. PRL's Toxicology Department offers both an MDMA screen and confirmation. Due to its expanded use in the KC area, we are currently working on adding this drug to our regular clinical drug screening profiles. We will also soon be able to offer this service to our legal clients as well.

David K. Roberts, Ph.D.
Toxicology Services Director
December 11, 2001