Kathy Watt presentation for the LA County HIV Drug & Alcohol Task Force October 6, 2010

WHAT ARE THE EFFECTS?  MDMA takes effect 20 to 40 minutes after taking tablet, with little rushes of exhilaration which can be accompanied by nausea  60 to 90 minutes after taking the drug the user feels the peak effects.

EFFECTS (cont.)  Sensations are enhanced and the user experiences hightened feelings of empathy, emotional warmth, and self-acceptance.  The “effects” of real ecstasy sbside after about 3-5 hours.  Users report that the experience is very pleasant and highly controlled.

EFFECTS (cont.)  The effect that makes MDMA different from other drugs is empathy, the sensation of understanding and accepting others.

WHAT IS THE DOSAGE?  Ecstasy “E” is almost always swallowed as a tablet or capsule. A normal does is around mg.  Black market ecstasy “E” tablets vary widely in strength, and often contain other drugs in their mix.  Ecstasy call also be labeled in a variety of ways to make it seemingly more trendy (different labels on the pill coating)

IS ECSTASY ADDICTIVE?  Ecstasy is not physically addictive. However, the drug can often take on great importance in people’s lives, and some people become rather compulsive in their use. Taken too frequently, however, MDMA loses its special effect.  MDMA releases the brain chemical serotonin, elevating mood and acting as a short term antidepressant. Some users may be using the drug to self-medicate for depression.

ECSTASY and DEPRESSION  Many people report feeling depressed after taking ecstasy. More often than not the depression is mild and lasts only a day or two.  Regular users sometimes report feeling depressed for much longer periods of time (especially if taking larger doses)  The vast majority of ecstasy users do not report symptoms of depression

WHAT CAUSES SOME USERS TO FEEL DEPRESSED AND OTHERS NOT?  A Possible Physiological Explanation  MDMA “Ecstasy” works by releasing from certain brain cells large amounts of the brain chemical, serotonin. This release of serotonin is what causes Ecstasy’s mood elevation effect, as well as the feelings of empathy, self- acceptance, and emotional closeness with others that so many people find valuable and rewarding about the drug.

WHAT CAUSES SOME USERS TO FEEL DEPRESSED AND OTHERS NOT? (cont.)  But in releasing large amounts of serotonin, MDMA also depletes the brain’s supply. It then takes some time for the brain to replenish what was released. How long does it take for serotonin levels to be fully restored after someone takes Ecstasy? This depends on the persons diet, general health, genetic make-up, how much ecstasy the person took and other random factors. Scientists say anywhere from 48 hours to a week.

WHAT CAUSES SOME USERS TO FEEL DEPRESSED AND OTHERS NOT? (cont.)  A Possible Physiological Explanation (cont.) The release of serotonin, however, also causes serotonin receptors in the brain to down-regulate, meaning they turn themselves off for awhile. The effect of turning the receptors on and off can cause the “balance” of the brain to be off until the serotonin can once again find the balance.

IT COULD BE A PREEXISTING DEPRESSION  Some ecstasy users who experience depression might have been depressed before they started ecstasy. Depression is a common illness that often goes undiagnosed and untreated. This is especially true of teenagers an young adults where we see higher rates of ecstasy use.