Ecstasy Use in Clubs and Its Direct Potential for AbuseAmong a certain demographic, nightclubs are places of fun and celebration, where music and dance channel energy and a zest for life. But under the strobe lights and deafening rhythms lurks the danger of substance abuse, especially in an environment where inhibitions are cast loosely aside. Ecstasy use in clubs, and its direct potential for abuse, has long been a concern for authorities and parents; understanding what ecstasy is, and why nightclubs are its hunting grounds, can explain some of the risk.

From MDMA to Ecstasy

In talking about ecstasy, the conversation begins with a drug known as 3,4-methylenedioxymethamphetamine, better known as MDMA. MDMA was first created in 1912, originally as a substance to control bleeding. Over time, researchers noted its psychoactive effects; Psychiatric Times writes of a 1978 report that described how MDMA induced

“an easily controlled, altered state of consciousness, with emotional and sensual overtones.”

Researchers noted that the effects of MDMA lasted for several hours; of particular note was how the drug caused users to lower their defenses and anxieties, which was noted for the possibility of being beneficial for therapists.

Stimulant Abuse
This led to the small-scale use of MDMA as a legally prescribed psychotherapeutic drug, even as the US government moved against the use of psychedelic substances for fear of unregulated (and dangerous) recreational use. Notwithstanding attempts to downplay the use of MDMA in therapeutic settings, the use of MDMA for nonmedical purposes was noted by underground chemists and drug smugglers.

They noted that the amphetamines in MDMA caused stimulant effects in users, and the empathogenic effects chemically manipulated users into feeling heightened senses of empathy and emotionally more connected and open to those around them. The perfect market for the new drug was the nightclub scene, and the name “ecstasy” fit like a glove.

Pure Ecstasy and Popping Molly

Pure Ecstasy and Popping Molly
In July 1985, the Drug Enforcement Administration labeled MDMA as a Schedule I substance, officially declaring it to be of no medical value, and causing physical and psychological addictiveness to too great a degree for public or private consumption.

Of course, classifying something as illegal sometimes makes it all the more desirable. In 2001, 15 percent of college students admitted to trying MDMA, and at least 11 million people over the age of 12 reported using ecstasy at least once.

But the DEA’s ban on MDMA did have the effect of forcing underground manufacturers to come up with a new way of creating and marketing their product. In China, chemists in the employ of drug rings started producing MDMA as a crystalline powder, cut with other chemical substances. In an attempt to entice the gullible and the hedonistic, the new concoction was presented as a healthier, molecularly “purer” form of ecstasy – one that wouldn’t cause the addiction and abuse that the government was so worried about. The idea of molecules gave rise to the new drug’s name: “Molly.”

Molly being a safer derivant of ecstasy may be how sellers attempt to pitch their product to naive or impulsive clubbers, but as Playboy warns that “What’s Inside Your MDMA” is “not what you think,” such a line is nothing but a “marketing gimmick.” A spokesman for the Drug Enforcement Administration told the magazine that from January to June 2013, DEA in Florida confiscated 43 different chemicals in 106 batches of Molly. Government scientists could not identify nineteen of those chemicals.

In other cases, the drugs sold with Molly in nightclubs are much more familiar. In April 2015, police in Jacksonville, Florida, shut down the local Pure Nightclub as part of a bust that confiscated Molly, cocaine, heroin and marijuana. The maneuver was given the name “Operation Poppin’ Molly.”

Ecstasy and Serotonin

Most ecstasy tablets have MDMA in them, says Psychiatric Times, but other substances are nowhere near the “molecular purer” form of ecstasy that Molly claims to be. Some of them include:

  • Ketamine
  • MDA
  • Amphetamine
  • Dextromethorphan
  • Phencyclidine (PCP)

Whether the MDMA goes by Molly or ecstasy, how it works is essentially the same. Once a user consumes the drug, it goes to the brain and triggers three neurotransmitters, chemicals that communicate signals across the brain. The neurotransmitters affected by MDMA are serotonin, norepinephrine, and dopamine.

Serotonin, explains The Huffington Post, induces feelings of happiness and wellbeing. People who are isolated and lonely often have low levels of serotonin; the sensation of belonging and acceptance that comes from being accepted by a group is, chemically speaking, the release of serotonin in the brain (which is one reason why MDMA is so popular among nightclub patrons). Similarly, serotonin in the brain is also what triggers feelings of sexual desire and love (even crossing over into sexual preference), which feeds into the environment of relaxed inhibitions and emotional and sexual openness at nightclubs.

When a person takes MDMA, the drug promotes the release of serotonin, but also prevents the brain from reabsorbing the serotonin, which is what would normally happen. This has the effect of users feeling artificially “connected” to those around them (and for an artificially lengthened period of time), in a place where such an attitude is valued and welcomed.

Dopamine and Norepinephrine

dopamine neurotransmitterMDMA has a similar effect on the dopamine neurotransmitter, which is the neurotransmitter released by the brain during periods of pleasure and the anticipation of being rewarded for engaging in desirable activity. Most people feel good after doing something they enjoy, which is the result of the brain being awash in the temporary release of dopamine. Satisfying as though that is, the feeling is designed to pass, which is explained by the brain reabsorbing dopamine. Like with serotonin, MDMA boosts dopamine production in the brain, but then prevents the brain from reabsorbing the dopamine. Scientific American explains that this leaves users with a manufactured sense of pleasure and euphoria, for an artificially boosted period of time.

This also has the effect of the user’s brain associating the powerful sensations with the consumption of MDMA. Such an association is the basis of dopamine, and why we are drawn back to activities and substances (harmless or otherwise) that give us pleasure. For someone whose brain was chemically overwhelmed by the dopamine released by MDMA (which also prevented its reabsorption), the MDMA might eventually become the only way that any form of satisfaction can be achieved.

Lastly, there is norepinephrine. This neurotransmitter is released by the brain to increase heart rate and blood pressure, and has the added result of making people feel mentally sharp and attuned to their surroundings. When a person drinks caffeine, norepinephrine is what leads to more oxygen being sent to the brain and other tissues, causing feelings of being more alert and awake. But while caffeine causes only a moderate norepinephrine release, the amphetamines in MDMA open the floodgates; users experience a superhuman level of mental and sensory acuity, which might complement the blinding lights and intense music in a nightclub.

Put the effects of MDMA on the three neurotransmitters together, and users experience an increase in their self-confidence, mood, level of extroversion, and emotional arousal when they take their first pill of ecstasy or Molly. These effects may be felt particularly strongly by people vulnerable to the lure of ecstasy’s promises and the environment of the nightclub.

Ecstasy, Nightclubs, and the LGBT Population

For example, in “Making Sense of the LGBT Community’s High Rates of Substance Abuse,” ThinkProgress pointed out the high level of discrimination and violence that LGBT people have to face on a daily basis (43 percent of gay people have been discriminated at in the workplace, and 90 percent of transgender employees have been harassed or mistreated at their jobs, according to the Center for American Progress).

As a result, many LGBT people find solace and solidarity in the bar and club scene, where alcohol is used as a bonding agent, and the feelings of empathy and loosened inhibitions induced by ecstasy are welcomed. The Independent writes that LGBT teens channel the fear, shame, and rejection they feel as a result of their sexual orientation into consuming the drugs and alcohol that are passed around at gay-themed bars and clubs, which becomes the primary way they socialize.

To that point, The Advocate writes that LGBT culture revolves around the bar and club scene “very heavily,” which, if there are pre-existing issues of discrimination and prejudice causing stress and depression, may lead to self-medication with on-hand drugs in a suggestive environment that may contribute to abuse and the development of a substance abuse problem.

The Effects of Ecstasy

When a person takes ecstasy, the effects of the drug are at their highest between 15 and 30 minutes after consumption, and typically last for 3-4 hours.

Additionally, some users report feeling a sense of derealization (feeling that their surroundings are not real) and depersonalization (a feeling that they are perceiving themselves from a distance, as though from another perspective). A study referred to this as “ecstasy-induced psychotic depersonalization syndrome.”

But while a drug user in a nightclub might want to feel the music, lights, and closeness of other attendees, Molly is not a substance that stops working on demand. The National Institute for Drug Abuse lists some of the much less desirable effects of ecstasy:

  • Involuntarily clenched teeth
  • Blurred vision
  • Insomnia
  • Uncontrollably tense muscles
  • Nausea
  • Dizziness
  • Fainting
  • Seizures
  • Dangerously high body temperature

Other effects include psychosis (such as hallucinations and delusions), anxiety, panic disorder, and depression. A study by the journal of Drug and Alcohol Abuse of 150 ecstasy users reported that 53 percent of them were diagnosed with neuropsychiatric problems. Another study discovered that high levels of ecstasy use were associated with high levels of paranoia, hostility, eating disorders, impulsiveness, and sleep disorders.

Abusing Ecstasy

risks of abuse
Can recreational ecstasy use lead to issues of long-term abuse and dependence? The evidence is unclear. Psychiatric Times writes that MDMA “has less addictive potential than psychostimulants” (such as cocaine and methamphetamine); however, MDMA may make users more susceptible to the effects of those stimulants, thereby furthering the dependency. A study in Drug and Alcohol Abuse found that compulsive ecstasy use will likely meet the standards for dependence, but in general, ecstasy use has not shown to result in traditional models of dependence or withdrawal for a majority of users. Similarly, the journal Addiction wrote in 2011 that a study of 52 ecstasy users “failed to demonstrate marked residual cognitive effects,” a finding at odds with other previous experiments, including those conducted by the same researchers.

One possible reason for this is because users develop a fast tolerance to the euphoric effects of ecstasy, so much so that increasing usage and doses can lead to unpleasant side effects. This has the unexpected result of limiting repeated use. However, people who do become chronic and high-frequency users of ecstasy (usually as a result of consuming the ecstasy with other stimulants, like cocaine or amphetamines) tend to have withdrawal symptoms similar to those caused by the other drugs they are taking at the time.

Treating Ecstasy Abuse

But even though it may not cause long-term addiction issues, ecstasy can easily be abused, especially in a nightclub setting, where the drug is liberally passed around and its effects are touted as part of the overall experience. The abuse can lead to a number of physical and psychological problems, which should be – and can be – stopped, regardless of conflicting scientific findings.

Stopping the damage done by ecstasy entails a treatment program that addresses the chemical abuse of the drug, as well as its mental effects. For example, if a person abstains from taking ecstasy, this will likely trigger withdrawal symptoms, as the body and mind are deprived of the powerful substance (or substances) upon which they had come to depend.

One very common withdrawal symptom is depression, as a result of the neurochemical changes of the lack of MDMA, and the person also craving the drug again and craving the euphoria that no longer comes. To that point, a doctor can prescribe selective serotonin reuptake inhibitors, drugs that work by regulating amounts of the serotonin neurotransmitter in the person’s nervous system. As long as serotonin levels are kept in balance, the feelings of depression and anxiety that come with withdrawal will be moderated.

Since ecstasy is often taken in conjunction with other stimulants, a treatment program should be designed to address the presence (and effects) of those other drugs.

This may complicate the withdrawal process, so a person looking to get off ecstasy should never attempt to do so at home, or without the help and resources that can be provided at a hospital or a rehabilitation facility.

When the person has successfully withdrawn from the ecstasy (and other drugs), treatment will then address psychological damage and craving for the substances. This may entail long sessions of psychotherapy, as well as group meetings and 12-Step support programs, to establish personal goals and then hold the person accountable in their development.

One challenge of accountability is enforcing lifestyle changes, so the temptation to relapse into ecstasy use can be more easily avoided. A person who is sober after drug addiction should not frequent the same bars and clubs where there are constant reminders and temptations of the ecstasy abuse. Fortunately, sober raves – where no drugs and alcohol are allowed – can serve as a way a sober individual can still engage in the fun, music, and dance of the club scene, without any of the dangers and drugs that fueled an old way of living.