Body fluids and electrolytes
Peate Ian, Dutton Helen in 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.
Stimulants and psychedelics
Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros in Substance Misuse and Young People, 2019
MDMA, while being an amphetamine-like derivative, has some pharmacological differences from amphetamine and methamphetamine and its structure is related to that of some hallucinogens such as mescaline. A review of the pharmacology and toxicity of MDMA suggests that the effects of use can be classed under three headings: acute (single-occasion), chronic (long-term) use and serious or fatal toxicity events (Kalant, 2001). Acute MDMA use reverses serotonin reuptake and so leads to an increase of the neurotransmitter in the synaptic cleft, this produces the mood changes which accompany acute use of the substance. Longer-term use of MDMA is reported to result in a reduction of the desired mood changes and an increase in side effects, and early studies have suggested that this has led to users discontinuing use of MDMA over time (Parrott, 2005).
Pharmacotherapies for PTSD and Substance Use Disorders
Anka A. Vujanovic, Sudie E. Back in Posttraumatic Stress and Substance Use Disorders, 2019
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.
Anxiety-related Symptoms following the Sporadic Use of Ecstasy – A Case Study
Published in Journal of Psychoactive Drugs, 2022
Tomislav Majić, Lasse Brandt, Christiane Montag
3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) is a ring-substituted phenethylamine stimulant, releasing similar amounts of serotonin (5-hydroxytryptamine, 5-HT) (Shulgin 1986) and noradrenalin, with less pronounced effects on dopamine transmission (Hysek et al. 2013; Simmler and Liechti 2018). Additionally, MDMA also exhibits strong endocrinological effects including an increase in plasma levels of oxytocin (Kirkpatrick et al. 2014) and cortisol (Seibert et al. 2014). In contrast to other amphetamine-type stimulants (ATS) like amphetamine and methamphetamine, MDMA additionally exerts pro-social effects (Hysek et al. 2014; Schmid et al. 2014), which led to the classification as an “entactogen” or “empathogen” (Nichols 1986). Notably, the term “ecstasy” usually refers to black market substances sold as MDMA and used in a non-controlled, recreational setting. However, the purity of black market MDMA pills is usually high, but of unknown concentrations, leading to the risk of overdosages (van der Gouwe et al. 2017). In some cases, the ingredients of ecstasy pills or powders are not restricted to MDMA, but include various adulterants (Saleemi et al. 2017).
Illicit drug use and fertility treatment: should we be developing a standard operating procedure?
Published in Human Fertility, 2021
Chris Bulmer, Adam Balen
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.
Making and Communicating Decisions About Sexual Consent During Drug-Involved Sex: A Thematic Synthesis
Published in The Journal of Sex Research, 2021
Lauren A. Smith, Katerina Z. Kolokotroni, Tamara Turner-Moore
It is possible that different drugs differentially impact the facets of sexual consent as a result of their wide-ranging psychoactive effects. Drugs with anesthetic properties, such as, GHB and ketamine can result in drowsiness, loss of consciousness, and dissociation (Jansen, 1993; Oliveto et al., 2010). MDMA, has been found to impair concentration and short-term memory (Britt & McCance-Katz, 2005). It is likely that these effects can impact a person’s ability to retain information pertinent to making a sexual decision, or impact how that decision is communicated. Furthermore, people have been found to hold positive sex-related expectancies for many illicit drugs, including that they enhance sexual desire, arousal and libido (Sumnall, Beynon, Conchie, Riley, & Cole, 2007). It is possible that a similar association to that of alcohol and sexual consent exists, such that individuals are perceived as having more sexual intent when they are consuming drugs.
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