Ecstasy's long-term effects revealed / NewScientist

[vampire]

• 11 February 2009 by Graham Lawton
• Magazine issue 2695.
• For similar stories, visit the Drugs and Alcohol Topic Guide

THEY called it the second summer of love. Twenty years ago, young people all over the world donned T-shirts emblazoned with smiley faces and danced all night, fuelled by a molecule called MDMA. Most of these clubbers have since given up ecstasy and are sliding into middle age. The question is, has ecstasy given up on them?
Enough time has finally elapsed to start asking if ecstasy damages health in the long term. According to the biggest review ever undertaken, it causes slight memory difficulties and mild depression, but these rarely translate into problems in the real world. While smaller studies show that some individuals have bigger problems, including weakened immunity and larger memory deficits, so far, for most people, ecstasy seems to be nowhere near as harmful over time as you may have been led to believe.
The review was carried out by the UK Advisory Council on the Misuse of Drugs (ACMD), an independent body that advises the UK government on drug policy. Its headline recommendation is that, based on its harmfulness to individuals and society, MDMA should be downgraded from a class A drug - on a par with heroin and cocaine - to class B, alongside cannabis.
Read the full report
Nobody is arguing that taking ecstasy is risk-free: its short-term effects are fairly uncontroversial. MDMA is toxic, though not powerfully so - an average person would need to take around 20 or 30 tablets to reach a lethal dose. And for a small fraction of people, even small amounts of ecstasy can kill. For example, around half a million people take ecstasy every year in England and Wales, and 30 die from the acute effects, mostly overheating or water intoxication.
What has been unclear, however, is whether ecstasy use causes long-term health problems and if so, how much you would need to take to be at risk.
In animal studies the drug has been shown to inflict lasting damage to the brain's serotonin system, which is involved in mood and cognition. Imaging studies have found signs of similar damage in human users, but there are debates over whether this is caused by ecstasy use and whether the damage has any real-life consequences.
The ACMD based their review largely on a study they commissioned from Gabriel Rogers and Ruth Garside of the Peninsula Medical School in Exeter, UK. They pulled together all the research from around the world that attempted to assess the health of people who have taken ecstasy, and reanalysed the data from the 110 studies that dealt with long-term effects.
They found that compared with non-users, people who took even a small amount of ecstasy at some point consistently performed worse on psychometric tests, which measure mental performance, especially memory, attention, and executive function, which includes decision-making and planning.
The most pronounced effects are on memory, mainly verbal and working memory. While the ability to plan is somewhat affected, other aspects of executive function are not. Focused attention - the ability to zoom in quickly on a new task - suffers too, though sustained attention does not.
It is a similar story with depression. "There's a small but measurable effect," says Rogers.
These effects appear not just in current users but also in ex-users who haven't touched the drug for at least six months, suggesting that the problems are long-lasting. Strangely, there seems to be no link between the quantity taken and the severity of cognitive problems, suggesting that even a few doses can lead to these deficits.
Superficially, this adds up to a pretty depressing outlook for the e-generation, especially those who dabbled years ago but have since quit. Not so, says Rogers. Subtle differences in lab tests do not necessarily translate into real-life problems: "They're statistically significant, but whether they are clinically significant is another matter."
Subtle differences on lab tests do not necessarily translate into problems in real life



For example, there is little evidence that people are actually affected by the memory and attention deficits picked up in the lab tests. "They don't seem to be very big and it is not clear that they have much effect on day-to-day functioning," he says.
Meanwhile, people who have taken ecstasy are, on average, still within the normal bounds on standard depression tests. Although they score worse than people who haven't taken ecstasy, the scores aren't bad enough to warrant a diagnosis from a doctor. "There's no indication that they are drifting out of normal functioning," says Rogers.
He also warns that his results need to be taken with a pinch of salt because most studies are based on self-reports of ecstasy use, often combined with other drugs and alcohol, from people who have volunteered to take part. These confounding factors make it impossible to determine whether you have a representative sample of users, whether people's reported use correlates with how much they actually took and what effects can be blamed on MDMA.
Psychopharmacologist Val Curran of University College London says Roger's analysis "is about the best you can make of the overall mishmash". She agrees with his conclusion that on average there seems to be no evidence of any meaningful effects on daily life.
Others have a different take on it. Andrew Parrot of the University of Swansea, UK, who has been studying the health of ecstasy users since the mid-1990s says: "We see users who have taken bucket-loads and they have very severe problems." These include memory deficits, sleep disturbances, depression, weakened immunity and sexual dysfunction, he says.
Based on his own studies, he believes that almost everyone who has taken 20 tablets in total, or more, reports niggling problems in daily life. "All fairly minor on their own, but you're ending up with someone who is not as healthy as they ought to be," he says.
Rogers admits that because he took averages of such large numbers of users, his analysis may have "ironed out" some of the effects Parrot describes.
Parrot also calls ecstasy a "gateway" drug. "Former users are often heavy users of alcohol, tobacco and cannabis. When you move off ecstasy, you look for other drugs. Ecstasy use leads to other, more problematic drugs."
Despite this, however, results from the first "prospective" studies are more encouraging. These studies follow a group of people over many years and watch the effects of ecstasy unfold over time. Crucially, they are more reliable than "retrospective" studies because they don't rely on people remembering what they did in the past.
In 2002 a group in the Netherlands recruited 188 young people who had never taken ecstasy but were likely to in the future. When they retested them on a battery of psychometric tests three years later, 58 said they had taken ecstasy at least once, giving the researchers an opportunity to compare cognitive performance before and after ecstasy.
They found that on all the tests except for verbal memory, ecstasy users performed just as well as before, and on a par with abstainers (Archives of General Psychiatry, vol 64, p 728). The results chime with Rogers's conclusions: because the effect was so small - a difference of a quarter of a word on average from a list of 15 - the real world implications are questionable. Brain imaging revealed no changes to the serotonin system, although there were signs of damage to white matter and blood vessels. The practical significance of this is not yet known (Brain, DOI: 10.1093/brain/awn255).
On all the tests except those for verbal memory, ecstasy users performed on a par with abstainers



Rogers cautions that it is too soon to give ecstasy the all-clear in the long term, not least because some effects on health might simply kick in even later. "It's possible that ecstasy has horrific consequences later in life. Only time will tell."
The low-down on ecstasy

• Ecstasy usually refers to a compound called MDMA or 3,4-methylenedioxymethamphetamine.
• MDMA was first synthesised by German firm Merck in the early 20th century but only started to be used as a recreational drug in the 1980s.
• There are around 450,000 regular users in the US; half a million people take it each year in the UK. A seriously heavy user might take up to 40,000 tablets in a lifetime.
• Drug dealers originally wanted to call MDMA "empathy" because of the powerful feelings of "loved up" warmth it induces. MDMA is also a stimulant and a mild psychedelic.
• Recent research suggests that most ecstasy pills on the market contain MDMA as their only active ingredient. Toxic impurities are often said to be common, but there is very little evidence that this is the case.
• Most of the ecstasy on the market is in pill form, with each pill containing around 40 milligrams of MDMA. But very pure MDMA powder accounts for around 30 per cent of drugs seized, which is worrying because of the potential for taking very large doses.
• A single ecstasy tablet used to cost £15. Now they cost just £2.30.

http://www.newscientist.com/article/...html?full=true


DO NOT DISCUSS!

[Nightbrother]

Thanks for sharing, Vamp. :) I love articles that can shed light on something, and remove some of the bullshit covering it.

[vampire]

Aye, were still stuck in a world with 70's views on most drugs, where they aren't looked at with new insights, more than half is less dangerous to peoples health than alcohol when properly used and precautions taken... (strangely people drink water cause they know they'll need to when on xtc, but they will drink so much they will get water poisoning, basically the largest part of drug related deaths, can be prevented by good information about the risks, over here we had test stands at big events where you could test your pills for content free of charge and anonymously, they also gave advice obviously to drink, and there was a campaign to tell people to drink like 3 or 4 glasses an hour, not more. Greatly helped prevent incidents, until some politician saw it as encouraging use and got it ended.

It's basically people not understanding stuff properly and being ignorant about it.

[giga]

That sounds horrible

[Nightbrother]

My parents-in-law did crazy amounts of drugs in the 60's and 70's, and they're both pristine human beings, to say the least.

[giga]

Under the long term health effects they have a measurable increase in depression. Not going to touch that :)

Originally Posted by Nightbrother

My parents-in-law did crazy amounts of drugs in the 60's and 70's, and they're both pristine human beings, to say the least.

My mum (danish) used to be a hippy too :D

I'm not sure how much she used to do it, but she did some hash.

[vampire]

It also causes this:

[Nightbrother]

Originally Posted by giga191

Under the long term health effects they have a measurable increase in depression. Not going to touch that :)


My mum (danish) used to be a hippy too :D

I'm not sure how much she used to do it, but she did some hash.

Hehe me neither, giga. I'm fine as I am.

Where did your mother live when she was young? People from Jylland were less inclined to hippieness I think. My parents are from Jylland, and they never did anything, the boring gits.

[Narcolepsy Jones]

I got about halfway through and then BOOOOOOOOOOOOOOOOOOOOOOOOOORRRRIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIINNNGGGG I have porridge so don't need that shit. If I ever have kids, perhaps then I'll start giving two flying fucks.

[giga]

Originally Posted by Nightbrother

Hehe me neither, giga. I'm fine as I am.

Where did your mother live when she was young? People from Jylland were less inclined to hippieness I think. My parents are from Jylland, and they never did anything, the boring gits.

She lived in Viborg when she was a kid, at some point in her teenage years she moved to Aarhus.

Apparently she stole a moped with her friend once too. That made me lol when she told me, because she's just a nice occupational therapist now :D

Originally Posted by Nish

I got about halfway through and then BOOOOOOOOOOOOOOOOOOOOOOOOOORRRRIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIINNNGGGG I have porridge so don't need that shit. If I ever have kids, perhaps then I'll start giving two flying fucks.

Porridge?! If you're hardcore you eat unheated oats in water :P

[Kjeldoran]

Originally Posted by GoDGiRL

Aye, were still stuck in a world with 70's views on most drugs, where they aren't looked at with new insights, more than half is less dangerous to peoples health than alcohol when properly used and precautions taken... (strangely people drink water cause they know they'll need to when on xtc, but they will drink so much they will get water poisoning, basically the largest part of drug related deaths, can be prevented by good information about the risks, over here we had test stands at big events where you could test your pills for content free of charge and anonymously, they also gave advice obviously to drink, and there was a campaign to tell people to drink like 3 or 4 glasses an hour, not more. Greatly helped prevent incidents, until some politician saw it as encouraging use and got it ended.

It's basically people not understanding stuff properly and being ignorant about it.

I'd also consider it 'encouraging' when they give you tips on what to do best when taking drugs.

That's like giving hints for what to do when you're driving at 180kph ...

Sure, I don't mind spreading out usefull information about the drugs and what not to do when you took them. But mainly for pple to try it at home and not endanger others or harass others with it. Putting a stand on a big event to test your drugs ... for me that's just abit over the top.

Having said this, I'm not claiming drug users endanger or harass other pple, I'm just saying that they should use whatever they want in private, and not on public events where the risk exists where you could endanger others (dunno, become aggressive etc). And yes, being drunk can also endanger others.

[giga]

Originally Posted by Kjeldoran

Putting a stand on a big event to test your drugs ... for me that's just abit over the top.

It would be the perfect time for a sting :D

[vampire]

lol they actually do that in belgium at dance parties, suddenly music goes off, lights go on, and about 100 police officers with sniffer dogs run in... Mad fun lol.

[ClUR]

What does all that say? In short..

[vampire]

Fuck off if your too unsophisticated to read a scientific article then comment on it.... Thats what it says... in short!

[Kjeldoran]

Originally Posted by GoDGiRL

lol they actually do that in belgium at dance parties, suddenly music goes off, lights go on, and about 100 police officers with sniffer dogs run in... Mad fun lol.

Must be at suspicious dance parties or raves, because I've not once withnessed it and hardly ever hear about it in the news :)

All in all, I think it's a good thing though.

[Kjeldoran]

Originally Posted by ClUR

What does all that say? In short..

You lazy woman.

[ClUR]

Originally Posted by GoDGiRL

Fuck off if your too unsophisticated to read a scientific article then comment on it.... Thats what it says... in short!

I'm not well, give me a break!! =(

[vampire]

ok for this time only then, it says xtc use isn't half as dangerous as previously thought, and basically only affects memory slightly.

[ClUR]

LOL! And the rest, makes you love everyone, and want to give random people hugs and kisses.
Makes you dance until you dehydrate and die. etc etc etc..
But I suppose thats down to the gort taking it. =/

[vampire]

na i mean as in long term side effects...

[ClUR]

Oh..

[Kjeldoran]

Originally Posted by GoDGiRL

na i mean as in long term side effects...

Yes, because dieing is a short term side effect

[vampire]

Originally Posted by Kjeldoran

Yes, because dieing is a short term side effect

Dude it's just the same when your pretty drunk and get in your car to crash it into a tree, people who do die from it (30 out of 500k users so 1 in 16.7k people a year) are mostly because of either NOT drinking enough or drinking too MUCH, percentage wise it's less dangerous than driving a car still. That's why good advice on taking breaks from dancing/drinking enough but not a shitload can actually save lives, isn't that what politicians should aim at rather than fighting a unwinnable battle to get everyone not to

[ClUR]

The thing is, is this something to go towards the "legalise drugs" thing.
Because if your going to say "well its the same for alcohol and cigerettes"
Then what about food? That is addictive to some people, those huge fat people that can't move its like a drug to them and its definitly killling them.
So where does it stop?