MDMA: The Dark Side of Euphoria
MDMA: The Basics
MDMA (3,4-Methylenedioxymethamphetamine) is a stimulant drug that is popular in the rave scene, due to its energising, euphoric high that is conducive to dancing and socialising for several hours. While under the influence, MDMA users feel unbelievably happy, alert and connected to those around them. The empathy results in guards being lowered; people are often compelled to share deep secrets on the drug, giving rise to its reputation as a "truth serum". However, control of speech and the mind isn't lost, resulting in a drug experience that is both intensely enjoyable and very lucid. For this reason, MDMA has an extremely high potential for psychological addiction and is undoubtedly one of the most harmful drugs around.
NB: ecstasy is a street drug that contains varying concentrations (or none at all) of MDMA, the active ingredient that users seek. Throughout this article, I will instead be referring to the effects obtained when MDMA is taken in pure form.
The MDMA High: A Euphoric Regression Back To Childhood
Before delving into any neurobiology, it's necessary to understand exactly how people feel and behave on the drug. Unlike cocaine, which affects dopamine and is associated with grandiose, goal-oriented euphoria, the serotonin-driven MDMA high is comprised of rising excitement and feelings of delight. Senses are heightened, so tactile sensations (e.g. your clothes brushing against your skin) feel intense and stimulating.
MDMA is universally classed as an empathogen, the main feature of the high being an almost uncontrollable desire to befriend new people, ask others about their emotions and share anecdotes and advice. Those who are not normally so empathetic are often thrown off guard by this effect; first-time users can find themselves over-sharing and telling their deepest, darkest secrets.
This is not because their motor skills and speech control are affected at all; if anything, they feel more in control of motion on the drug due to the CNS stimulatory effects. MDMA can seem like a "truth serum" because the flood of serotonin into the brain results in an enchanting high, within which talking and empathising seems fluid, natural and interesting.
MDMA is the most fun a human being can experience. This is why it is an illicit drug with such valid negative connotations; the high seems magical and meaningful, especially for vulnerable young people who are shy, have a lot of secrets or otherwise feel disconnected from their peers. It allows you to regress back to the carefree feelings of childhood that you subconsciously yearn for, and it multiplies their intensity by about 100. In this way, a drug that is an enjoyable novelty experience for one person can easily become a ridiculously enticing escape for another.
Overview: The Neuroscience Behind the MDMA High
MDMA's effects on cognition, mood and memory are largely down to its action on the serotonin pathway. Upon exposure to the drug, the concentration of serotonin in different parts of the brain increases, because these various brain regions are innervated by neurons that synthesise and release the neurotransmitter.
The cell bodies of the serotonergic neurons are located in a part of the brain stem called the Ralphe nucleus; the axons of these same neurons project to different parts of the brain. Another pathway for serotonin-releasing neurons exists running down the spinal cord; at the end of this pathway, motor neurons synapse with the neuromuscular junction and cause movement in muscles.
The brain regions that MDMA acts on include:
- the neocortex (memory, sense of altered reality and cognitive skills)
- the hypothalamus (part of the limbic system - mood changes and anxiety-generation)
- the hippocampus (memory)
- the amygdala (part of the limbic system -fear/panic response)
- the basal lamina
So, How Does MDMA Act To Increase Serotonin Levels?
We have clarified that serotonin is the major driver of the blissful, empathetic, warm MDMA high. Serotonin (5-hydroxytryptamine) is a monoamine neurotransmitter implicated in mood, perception, cognition and various mental health disorders.
In order to understand how MDMA alters the body's serotonergic neurons (that feed into various parts of the brain responsible for different functions), we need to cover normal, non-MDMA serotonin metabolism.
In short, while neurotransmitters are natural, endogenous substances, they must be cleared from the synapse rapidly in order to avoid constant overstimulation of the post-synaptic (second) neuron. It would be extremely harmful if serotonin were just left "ratting around" in the synapse between two neurons. Therefore, in a healthy, sober person, serotonin that is not bound to receptors in the post-synaptic neuron is transported back to the pre-synaptic (first) neuron, where it is metabolised by enzymes.
These serotonin transporters are MDMA's primary target. By binding to them, MDMA causes more serotonin to be left hanging around in the synapse through two mechanisms: 1). through the fact that the occupied serotonin transporters can't bind to serotonin (to transport it to be broken down) and 2). because MDMA's affinity for the serotonin transporters actually causes them to work in reverse mode, bringing even more serotonin into the synapse.
The result is that more serotonin is present in the synapses within the serotonergic system, and more serotonin receptors are activated. If you don't have any knowledge of pharmacology, I recommend that you do some entry-level reading on receptor activation and the way that ligands binding to a specific receptor induces an effect.
Why Do People Become Psychologically Addicted To MDMA?
Due to the action of serotonin on the limbic system, MDMA's euphoric effects are of an intensity beyond what non-users can imagine. The experience is a coalescence of different moods and sensations, all of which contribute to a high that is like a heightened version of waking up on your birthday at age 8. In fact, many people who take MDMA for the first time are shocked that it is nothing like what they imagined. Instead of feeling "sped-up" and a bit crazy for a few hours, they find that a calm, beautiful, godly wave of familiar childlike satisfaction washes over them.
Most of the MDMA literature available actually concerns ecstasy pills, which contain very little of the chemical and are padded out with generic stimulant fillers. The real drug, while taken at raves, is also used by shamans and some psychotherapists (albeit illegally), and is a world away from a cheap amphetamine buzz. Unfortunately, the general anti-drug messages employ scare tactics, grouping all stimulant highs together when MDMA is nothing like cocaine, methamphetamine or amphetamine.
However, this does not mean that MDMA is not addictive, albeit not to the same level as dopamine-affecting methamphetamine. MDMA is known to cause a "reinforcing" high, meaning that people don't just enjoy the pleasant effects, but that they will want to experience them over and over again. Drugs of this nature all have a high potential for abuse and addiction, regardless of whether dopamine plays a large part in the effects or not.
The fact that caged monkeys easily fall into addiction-loops when exposed to MDMA (repeatedly pulling a lever for it while neglecting food, water and other stimuli) serves as further evidence that MDMA dependence, whether "chemical or psychological", is a real phenomenon. All you have to do is spend some time with college-aged young adults, even at academically-prestigious colleges, and you'll become aware of just how many people take it regularly and suffer cognition/mental health problems as a result.
The Problem With MDMA? It Feels Magical, Familiar and Too Enticing
All it takes is one beautiful MDMA experience to shock people into rejecting all their previous morals and their belief system regarding drug use. A lot of people claim that they'd never take a synthetic drug twice, but this often goes out the window after the first MDMA experience. Someone previously anti-narcotics may switch to thinking "wow, drugs aren't like I imagined. I thought I'd be running around madly, but I feel more calm, intelligent and loving than I have ever felt", all because of the unrealistic representation of MDMA in media/books and poor drug education tactics. They expect the high to be fun but to feel fake, and MDMA to be something that they will easily only take once. since the only video they've seen about MDMA was full of scare tactics and people running around with crazed eyes, they think "Surely someone like me won't become addicted, right?",
An extension of this is to conclude "so, if this feels so safe and lovely, everything I've been told about drugs must be fake propaganda. I won't listen to anyone -I can take MDMA often and be fine, and might even try other synthetic drugs". It's not an exaggeration to say that MDMA is massively understated with regards to being a gateway drug. I do believe that cannabis exposure is normally a prerequisite to MDMA use and is what gets people interested in/surrounded by drugs, but MDMA is very capable of pushing some of the most vulnerable people towards other synthetic, "buying a bag of white powder" drugs like amphetamine (speed) and crystal methamphetamine (meth).
People Become Emotionally-Invested In MDMA: It's Hard To Stop
Psychologists and neuroscientists know that heavy MDMA use whittles away at your mental health and cognitive functions, but it's hard to drive that message home to someone who sees the high as a childlike regression into utter peace, after years of despair and an inability to trust people. Unstable people are drawn to MDMA, as it is an instant serotonin fix and delivers a sense of amazement, joy, happiness, peace and love that you truly will never experience while sober. That is what is so cruel about psychoactive substances; they can be seen as eye-opening tools, but at the end of the day, they are showing you a sparking, confident version of yourself and then saying "hey, enjoy these 5 hours but you'll never get to be this in real life".
While it can be immensely tempting to routinely take MDMA and chase these dreamy feelings, obviously not everyone who tries it will become an addict. Many of us are stable enough to realise that, while undeniably engaging and enjoyable, MDMA simply cannot be taken regularly because it takes a huge toll on mental health and is illegal. We experience happiness in our actual lives, albeit not to the same chemical proportions, and we have things to look forward to in the sober world such as getting a new kitten, moving house or going on holiday.
Those who have nothing to look forward to due to poor life opportunities or depression-linked anhedonia are particularly likely to fall into the trap of using MDMA regularly, suffering the consequent harrowing comedowns and limiting their progress in life.
Drugs Education: We Need To Admit That MDMA/Ecstasy Feels Good!
This disparity between the stories delivered by the media/literature and MDMA's real effects can be extremely damaging to people experimenting, as it results in an existential confusion and a mistrust of authority figures. I am in no way suggesting that MDMA should be used by anyone. What I know for sure, however, is that teachers tell pupils that "drugs are bad" without focusing on a). the reason why they are actually appealing (the biology of neurotransmitters and drug effects!) and b). the real psychological implications of using them. Information concerning both of these points would be relevant to young people, and would prevent them trying the drug and being surprised and delighted by the beautiful high.
It would make sense to explain how good the high feels, but then show them videos of people suffering chronic panic attacks or life-altering psychosis after overusing MDMA. This is likely to teach them about the terrifying, duo-faceted nature of a "fun" drug, and the fact that, by taking these drugs, you are playing with fire.
Brushing over the fact that drugs actually feel good (i.e. anyone can fall into addiction, regardless of wealth or appearance) exacerbates the MDMA-dependency problem commonly seen in late high school/college-aged individuals. If you're a broken, suicidal teenager and you've had an amazing night taking MDMA that let you lower your guard and tell your friends your problems, you're already going to defiantly feel as if you can reject all anti-drugs messages because you know best. You're far more likely to do so if you're hearing constant anti-drugs propaganda that describes MDMA like a caffeine overdose, since you'll know that this is far from the truth.
Upon taking MDMA for the first time and discovering that it is nothing like the speedy stimulant it is described as by teachers, nurses and the government, young people become entirely disillusioned and distrusting of any anti-drugs education they have previously been given. Scare-mongering, untruthful drug information is quite directly linked to teenagers becoming heavy, psychologically-damaged MDMA users, unsure of whose information to trust and thus unaware of the permanent damage that they are inflicting upon themselves.
We need to instead be honest and tell teenagers that yes, the high feels incredible and like everything you've ever lost as a child has come back to you, but that this doesn't mean it's safe in the slightest. This message will only be clear if they are taught some basic neuroscience and understand the implications of "increasing serotonin" (i.e. it's possible for a chemical to produce lovely emotions and sensations while damaging the parts of the brain that it is acting on).
MDMA and The Rave Scene
Many people are introduced to MDMA in the rave environment, typically by a friend who enjoys the subculture; unfortunately, pairing the drug's effect with the party atmosphere is a recipe for almost-definite psychological addiction.
While ravers may claim that they would still go to raves and listen to drum and bass, EDM or house music if they were sober, the truth is that the rave culture only works when everyone is intoxicated. Alcohol also doesn't cut it; music rarely stops playing until 6am, meaning that the majority of people at the events will be taking stimulants in order to stay alert and good-spirited.
This means that falling into a social circle who enjoy raving could tempt you into using MDMA long-term, affecting your mental health and your academic studies.
Thank You For Reading!
Please fill out the following polls (they are all absolutely anonymous, don't worry). Doing this would really help me with some research on MDMA's effects. Please comment and feel free to message me, asking anything!
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NIDA. (2007, January 4). The Neurobiology of Ecstasy (MDMA). Retrieved from https://www.drugabuse.gov/neurobiology-ecstasy-mdma on 2018, July 12
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