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Body fluids and electrolytes
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
MDMA (ecstasy) is taken as a recreational drug by some, due its mood-enhancing properties. Unfortunately, whereas many people can take MDMA with few side effects, there are potentially life-threatening consequences due to a number of effects, one of those being hyponatraemia. It is thought that the hyperpyrexia, which may occur in response to MDMA, triggers thirst and excessive water intake. The introduction of ‘chill out’ rooms in clubs, where there are often ‘sports’ drinks and water readily available, were designed to counteract hyperthermia but may have contributed to an increased fluid intake among drug users. MDMA users may also take other amphetamine-type drugs, with a common side effect being a sensation of thirst and dry mouth, exacerbating excessive fluid consumption.
Hallucinogenic Agents
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
Unlike other hallucinogens, long-term use of MDMA has been associated with potential for addiction.* Treatment of acute ecstasy toxicity is symptomatic and is managed as with the intoxication associated with amphetamine and/or LSD crisis. The most effective therapy for long-term abuse and addiction is similar to that for other drugs of abuse—that is, cognitive behavioral psychological interventions with the objective of modifying addictive behavior patterns and psychosocial activity.
Pharmacotherapies for PTSD and Substance Use Disorders
Published in Anka A. Vujanovic, Sudie E. Back, Posttraumatic Stress and Substance Use Disorders, 2019
Lorig K. Kachadourian, Kevin P. Jensen, Mehmet Sofuoglu, Ismene Petrakis
MDMA is a psychoactive drug whose subjective effects include reduced anxiety and acute depression, as well as increased insight, euphoria, visual and auditory perception, and prosocial behaviors, including a sense of trust and bonding (Amoroso & Workman, 2016). Although early uses included an adjunct to psychotherapy (Greer & Tolbert, 1986), MDMA was subsequently banned from medicinal use in the mid-1980s due to its increased recreational use and categorized as a Schedule 1 controlled substance by the FDA. However, recently MDMA has been gaining attention in the mental health field once again for the treatment of various psychiatric disorders, including PTSD. Research suggests that MDMA may help reduce the fear response in individuals who have been exposed to trauma by allowing them to revisit traumatic memories without feeling overwhelmed (Greer & Tolbert, 1998; Mithoefer et al., 2011). For example, Carhart-Harris and colleagues (2014) examined the effect of MDMA on autobiographical memories with 19 healthy participants. These individuals were given a one-time dose of 100 mg MDMA and then participated in an autobiographical memory task approximately 80 minutes later. For this task, participants were asked to recall several of their very best and very worst memories in a randomized order. Findings showed that individuals’ negative autobiographical memories were rated as less negative (and favorite memories were rated as more positive) after taking MDMA compared to a placebo.
A primer on sleeping, dreaming, and psychoactive agents
Published in Journal of Social Work Practice in the Addictions, 2023
Unlike indolylalkylamines, which only produce hallucinogenic effects, the phenylethylamines also have secondary stimulant effects, not only altering serotonin but also norepinephrine and dopamine, through to a lesser degree than drugs such as amphetamines. DOM (2,5-Dimethoxy-4-methylamphetamine) also known as the ”STP” (serenity, tranquility, and peace) can include sleeplessness, dry mouth, nausea, blurred vision, sweating, flushed skin, and shaking, along with exhaustion, confusion, excitement, delirium, and convulsions, which also impact sleep. MDMA can cause the acute depletion of presynaptic serotonin, which plays a direct role in regulating aggression, mood, sexual activity, sensitivity to pain, and sleep. MDMA users typically experience restless, disturbed sleep for up to 48 hours following drug use. Total sleep time has been found to be reduced, with increased time spent in transition, stage one sleep and less time in stage two. While there was no reported change in REM sleep, there was an increased risk of sleep apnea with continued use of MDMA (McCann et al., 2009; Schierenbeck et al., 2008).
Description of Adverse Events in a Cohort of Dance Festival Attendees with Stimulant-Induced Severe Agitation Treated with Dissociative-Dose Ketamine
Published in Prehospital Emergency Care, 2021
Matt S. Friedman, David Saloum, Astrid Haaland, Jefferson Drapkin, Antonios Likourezos, Reuben J. Strayer
Common drugs of abuse utilized at festivals tend to be entactogens–psychostimulants that produce experiences of emotional communion and openness such as 3,4-methylenedioxymethamphetamine (MDMA) as well as hallucinogens like lysergic acid diethylamide (LSD). MDMA, known colloquially as Molly or Ecstasy, causes euphoria and mental stimulation but is well known to cause serious adverse effects including hyperthermia, seizures, hyponatremia, rhabdomyolysis, and multiorgan failure (10). LSD, often referred to as acid, causes intense visual hallucinations as well as altering the user’s emotional valence and relationship to their surroundings. Dangerous effects of LSD primarily arise from distortion of reality leading to impulsive actions such as believing one can fly, but LSD may also cause hypertension, tachycardia, and hyperthermia (11).
Illicit drug use and fertility treatment: should we be developing a standard operating procedure?
Published in Human Fertility, 2021
Toxicology itself would need to be sensitive to the presence of the drug for medium and possibly longer-term periods in order to support a SOP requirement for a drug-free period, so, relying on urinalysis or oral fluid alone might be insufficient. In all cases, hair is arguably the most effective screening as, in the case of cannabis, cocaine and ecstasy, the detection period can be as long as 90 days. However, in the case of cannabis, urine detection can be limited to 2–3 days for the casual user and up to 14 days for persistent users. For oral fluid samples, detection can range from 24 h and up to 10 days for heavy users. For cocaine, the picture is similar, in that detection in urine can range from 2–10 days and of oral fluid samples, up to 3 days. In the case of ecstasy (or MDMA), a urine sample can yield a detection period of between 3–5 days and a similar detection period for oral fluid samples (Dolan, Rouen, & Kimber, 2004; Hadland & Levy, 2016). These detection periods will, of course, be subject to a range of physiological and behavioural factors, such as duration and frequency of use, dose, concentrate and multiple substance use and age. Hair toxicology, then, offers the broadest detection window, however, it is also the most expensive of the toxicology procedures discussed here and for that reason alone, is likely to be prohibitive.