Friday, September 6, 2013

Dancing with Molly and Ecstasy

"So la da di da di
we like to party
Dancing with Molly
Doing whatever we want
This is our house
This is our rules
And we can't stop"

Miley Cyrus - MetroLyrics
The deaths of a young man and woman at the Electric Zoo Festival on Randall’s Island over the 2013 Labor day weekend underscore the ease with which anyone can access and obtain dangerous drugs like Ecstasy that can quickly do serious damage, if not become fatal. Initially more popular amongst white adolescents and young adults in nightclubs or at “raves”, (emergency departments report a 3 to 1 ratio for white/black admissions) MDMA now appeals to a broader range of ethnicities.
Courtesy Alvaro: Flickr Photostream of Alvargm
MDMA is a synthetic drug that combines the effects of the amphetamine stimulant and the hallucinogenic properties of mescaline. Users on the drug feel increased energy, happiness, emotional warmth for others and even to inanimate objects (see tree hugging video), and distortions in sensory and time perception.

Molly is the purified form of MDMA (methylenedioxy methamphetamine), a stimulant with confusing pharmacology, more commonly known as ‘Ecstasy’, the impure version which is adulterated with other stimulants such as methamphetamine, caffeine, the over-the-counter cough suppressant dextromethorphan, the diet drug ephedrine, and cocaine. Such variants have the potential to make the drug more dangerous without providing desired effects. Because of the street name, and casual mentions by Madonna, and in songs by Kanye West, and Miley Cyrus (see TMZ video), it conjures up fantasies about sexual pleasures, but contrary to popular belief the
drug does not produce such effects for most people. It is not an aphrodisiac, and men on the drug cannot get an erection, prompting some gay and bisexual individuals to take it with Viagra. It does provide feelings of warmth, encourages touching, promotes innocent childish friendliness, and is associated with a lack of desire for sex while also numbing down any pleasurable effects. In the 70’s it was used for couple’s therapy to make frigid individuals more pliable and amenable to close contact and touching.

For others, including gay and bisexual females it may cause sexual arousal by triggering the release of oxytocin and vasopressin hormones, which play important roles in love, trust, sexual arousal, and other intimate social interactions and also water retention. It may also make women unable to recognize, perceive, and respond to attacks making them highly vulnerable. One such documented case in France is about a woman on MDMA who became incapacitated in a rape and was not able to fight the aggressor back, verbally or physically, watching in amazement, and remembering everything about the attack in detail. Because of this weakened, trusting state, women are prone to sexual attack and therefore also at a high risk for contracting HIV and hepatitis.

To create the happy, worry free innocent feelings Molly restricts the re-absorption of serotoninnorepinephrinedopamine neurotransmitters back into the presynaptic terminal, an otherwise normal function, instead, in absence of the re-uptake mechanism causing the synaptic cleft and extracellular space to become flooded with the ‘happy’ neurotransmitters. In the short term that may feel good but if a person has popped an antidepressant like, Zoloft, Prozac, Paxil, Lexapro or any other selective serotonin reuptake inhibitors (SSRIs) and selective serotonin/norepinephrine reuptake inhibitors (SSNRIs) resulting in too much serotonin, causing a dangerous condition known as serotonin toxicity. Symptoms can occur fairly quickly, within minutes to hours, and may include:
Agitation or restlessness
Fast heart beat and high blood pressure
Increased body temperature
Loss of coordination
Overactive reflexes
Rapid changes in blood pressure

The serotonin surge caused by Ecstasy results in depletion of this important chemical in the brain causing confusion, depression, sleep problems, drug craving, and anxiety. Some of these effects may linger on for weeks, and heavy drug use could result in long-lasting confusion, depression, sleep abnormalities, and problems with attention and memory. Expectant mothers who take MDMA can do lasting damage to their unborn fetuses causing lagging motor and mental development after birth.

On its own Molly users may experience other symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, passing out, and chills or sweating. Taking high doses of MDMA and dancing energetically as is expected at raves and music festivals leads to sharp increases in body temperature ( hyperthermia) which can result in dehydration, and liver, kidney, or cardiovascular system failure or even death. Drinking a lot of water remains a popular remedy against dehydration but it can cause other problems, including reducing sodium ion content in blood serum (hyponatremia), resulting in water flowing into cells to balance the extracellular drop in sodium. This is in addition to what the vasopressin hormone is already attempting to do, regulating water balance by sending a message to the kidneys to stop losing water through urine. This water build up can lead to a dangerous condition since brain cells have no room to expand against the rigid skull. This may cause cerebral edema, visual changes, focal neurologic changes, encephalopathy, and seizures, and brain herniation.

Pathway to the brain- Courtesy: National Institute on Drug Abuse
Still, lasting damage to the brain can occur in a short period of time after taking Ecstasy. It absorbs quickly through the small intestine into the bloodstream and makes it way to the liver, and then on to the heart, lungs, the brain and kidneys. MDMA easily crosses the brain blood barrier to get into brain matter. In the brain it fries up serotonin neurons. All this happens within 15 minutes when taken on an empty stomach. With continued use the body adapts and may regenerate brain cells to some extent but never to pre MDMA levels.

MDMA is labeled a Schedule I substance by the DEA with high abuse potential and no recognized medicinal use. Besides limited use in couples therapy in the 70’s it is being studied in clinical trials as a possible pharmacotherapy aid to treat post-traumatic stress disorder (PTSD) and to treat anxiety in terminal cancer patients.

Song Lyrics | MetroLyrics. "Miley Cyrus - We Can't Stop Lyrics | MetroLyrics." Accessed September 7, 2013.

The Substance Abuse and Mental Health Services Administration - Homepage. "Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits." Accessed September 6, 2013.

National Institute on Drug Abuse. "DrugFacts: MDMA (Ecstasy)." Accessed September 6, 2013.

National Library of Medicine - National Institutes of Health. "Serotonin syndrome: MedlinePlus Medical Encyclopedia." Accessed September 6, 2013.

Wikipedia, the free encyclopedia. Accessed September 6, 2013.

NeoReviews. "One-Year Outcomes of Prenatal Exposure to MDMA and Other Recreational Drugs." Accessed September 6, 2013.

National Center for Biotechnology Information. "A case of drug-facilitated sexu... [J Psychoactive Drugs. 2013 Jan-Mar] - PubMed - NCBI." Accessed September 6, 2013.

MDMA and Sexual Behavior: Ecstasy Users' Perceptions About Sexuality and Sexual Risk, Substance Use & Misuse, Informa Healthcare

National Institute on Drug Abuse. "What does MDMA do to the brain?" Accessed September 6, 2013.

National Library of Medicine - National Institutes of Health. "Hyponatremia: MedlinePlus Medical Encyclopedia." Accessed September 6, 2013.

Cleveland Clinic Journal of Medicine. "Management of hyponatremia: Providing treatment and avoiding harm." Accessed September 6, 2013.

MAPS: Multidisciplinary Association for Psychedelic Studies. "MDMA-Assisted Psychotherapy." Accessed September 6, 2013.





Alvaro-Alvargm Flickr Photostream
Welcome to Flickr - Photo Sharing. "All sizes | rrrOlok01 | Flickr - Photo Sharing!" Accessed September 6, 2013.

National Institute on Drug Abuse.
Tags: #molly #ecstasy #sexual #mdma #serotonin #drugabuse #labordayweekend2013 #randallsisland #electriczoofestival #psychedelic #hyponatremia #hyperthermia #mileycyrus #kanyewest #madonna

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