How Ecstasy Affects the Brain

Drugs have a tendency to trend. Dependent on the era, there is typically one or two substances that were most abused. We had the heroin boom of the 90s, the cocaine infested America of the 80s, the hallucinogenic 70s, and now sadly we are currently in the midst of the opioid crisis of the 21st century.

But opioids are not known to be party drugs, nor are they advertised as such. Another currently trending drug is ecstasy. Once rave and festival culture skyrocketed, with nearly an event on every day of the year now, so too did the reputation of ecstasy. In essence, ecstasy is the drug that pairs perfectly with these environments. It provides energy to sustain late nights, heightens the senses which in turn adds to music experience, and grants the user a sense of euphoric happiness that lasts.

It goes by pseudonyms like X, Molly, E, Scooby Snacks, Pressies, and many more that would take up this article to name. Ecstasy itself is actually a street name for the drug 4-methylendioxymethamphetamine (MDMA). MDMA at its purest form is often coined as Molly while ecstasy is now considered to be what popular culture calls a pressed pill.

Therein lays the problem. These pills are pressed and cut with a host of additives and more often than not users do not know what they are ingesting. They are aware that the core molecular structure is that of MDMA but have no answers for the question marks save for trying to identify how it makes them feel.

In which case, being that ecstasy has become prevalent in the couple decades, it is wise to understand how ecstasy affects the brain. While we hear of cocaine, heroin, and opioid addiction—and all the pitfalls that beget it—it is rather rare to hear of someone that’s addicted to ecstasy. Still, party goers and festival frequenters can take a handful of pills each weekend. Many do.

Which poses the question: how bad is ecstasy for the brain?

Ecstasy and MDMA: Is There a Divide?

Ecstasy was first synthesized in the early 20th century but it only gained popularity towards the end of it. After the drug was tested and accepted as a medicine for mood disorder, it quickly became a party favorite. Due vastly to its ‘happiness effect,’ it was commonly cut into cocaine, ephedrine, heroin, and a whole host of other stimulants. This is when it took its name as ecstasy, following after the brand name of one of the original variations of FDA regulated MDMA.

As the drug became more and more desirable, eventually the US had to ban its use completely (this occurred in 1985). In which case, being that there no longer existed a source for the drug, its reproduction in illegal labs caused an impure product to hit the streets. Now, as previously mentioned, ecstasy can be cut with harmful and dangerous additives, and typically is.

But between ecstasy and MDMA, there is no real difference. Both are used interchangeably and both can be purer or cut with other substances. On the street, MDMA might be used to identify the ‘white powder’ that is known for its purity, while ecstasy might be used in reference to a solid pill. For the purposes of this article, however, we are simply going to call the drug ecstasy.

Ecstasy and the Brain

To understand the way in which ecstasy affects the brain is also to take a look at our neurotransmitters. Neurotransmitters are the chemicals in our brain that transmit messages from cell to cell. They tell our lungs to breathe, heart to beat, and govern our moods. In short: they are extremely important.

Three of these neurotransmitters are known as serotonin, dopamine, and norepinephrine. Serotonin helps govern our emotional stability, sleep patterns, pain tolerance, appetite, and a host of other things. Dopamine is the reward chemical, responsible for dictating our inherent happiness and drawing links between what is ‘good’ and ‘bad’ within our own perceptions. Norepinephrine, also referred to as the stress hormone, is what is released in response to, as you can deduce, stress. It is actually the chemical responsible for engaging our fight or flight defense mechanism.

When ecstasy reaches the brain, it stimulates those three neurotransmitters. Not only does it enhance their release but it also blocks their reuptake, which isolates the ‘power’ of the ecstasy. As these neurotransmitters take their steroid-like injection from ecstasy, the feelings associated with the drug are what follow.

Serotonin is the most stimulated of the neurotransmitters and once it floods the synapses, the MDMA experience is activated (empathy, heightened sociability, pure elation, enhanced sensory—most particularly touch, etcetera). Along with that comes dopamine, which adds that extra ‘euphoria’ and exuberant ‘happiness’ commonly associated with ecstasy. Last, norepinephrine is released, which is what produces that tenacious energy which makes the drug such an ‘asset’ in these late-night, ongoing party environments.

Thus with the combination of these three stimulated neurotransmitters, now the user has an enhanced sensory system, a heightened state of happiness, a surge in energy, an increase in sociability and a decrease in certain centers of the brain known for governing insecurity and identity, and all the sensations associated with popular culture’s most coveted party drug.

Serotonin Depletion

As the ecstasy puts serotonin into over drive, eventually the neurotransmitter will wane and eventually become depleted. As this occurs and the synapses begin to clear, this is what we know as the comedown period. What will often happen here is—as the user begins to feel a decrease in energy, happiness, and euphoria—they will in turn take more ecstasy to try and reclaim the earlier sensation.

But ecstasy does not create or tell the brain to create serotonin. Instead, it manipulates it. Dependent on how much ecstasy is ingested, if the serotonin levels are extremely low, then the ecstasy will no longer have an effect. While it may provide the user with a surge of energy or a quick flash of the previous ‘high,’ it simply will not have enough serotonin to manipulate.

In which case the comedown is inevitable, as it is up to the brain to rebalance its chemical structure, and not the ecstasy or any other drug to provide it (although there are certain medications that help the brain produce serotonin).

As the comedown ensues the user can feel exhausted, depressed, irritable, emotionally vacant, and anxious. The brain is not used to releasing serotonin at such levels and as it tries to create order of the entropy, the user is going to feel depleted. In fact, ecstasy comedown is also a common theme of rave and festival culture. There are companies who have developed products specifically to mitigate the depressive nature of this very comedown.

The Bad

As with all drugs of this nature, with prolonged use they can effectively rewire the brain and cause a chemical imbalance. In the case of ecstasy, this imbalance is caused by the onslaught of serotonin stimulation and then the depletion that occurs afterwards. When talking on ecstasy in its purest form—to say the type of ecstasy used is absent of additives—then what occurs is damage to serotonin production in the future.

Low serotonin can cause extreme memory problems, depression, lethargy, anxiety, and at worst psychosis (paranoia being the most common symptom of ecstasy-induced psychosis). The more the brain is depleted of serotonin, the worse these problems become. Attention and focus can wane as well as a host of other psychological impairments.

The depletion of norepinephrine, one of the other three neurotransmitters stimulated by ecstasy, can, unfortunately, cause cognitive impairment (although these cases are a bit rarer). PET scans—or brain images—that have been done on users which stopped using MDMA have identified certain changes in the brain brought about by ecstasy.

Massive decrease in brain activity can ensue well outside of depleted neurotransmitters. It can, overtime, restrict cerebral blood flow in certain regions of the brain. These regions are responsible for complex thought, governing emotional development and regulation, sensory function, motor function, and behavioral management.

Due to the nature of ecstasy, it is difficult to study users as—made apparent in NYC after their police tested the purity of all the ecstasy they’d seized—only 13% of ecstasy on the street is pure. This means there are a slew of other substances that could also be affecting the brain outside of MDMA.

What we do know is that the prolonged use of ecstasy causes depression, lethargy, and a decrease in the brain’s overall functionality. Related: How long ecstasy stays in your system.

The Misconception of Its Addictiveness

A point to touch on when it comes to ecstasy and the brain is its addictiveness. Sadly, there is an incorrect perception that ecstasy is somewhat of a risk free drug. You take it in these party environments, enjoy the experience, but you’ll never want to use the drug again. The truth is that ecstasy addiction is not as common as other drugs but to say that it is not an addictive substance is incorrect.

A user can become accustomed to the feelings brought about by ecstasy and use it to enhance their social flexibility. Overtime, they will no longer feel comfortable interacting in certain environments or upholding a social presence without the drug in question. Likewise, a user can deplete their serotonin to a point that they require the drug for their own sense of happiness within these environments, and, sometimes, for life in general.

The Dangers

Ecstasy is shellshock to the body. For someone with a predisposition to a certain medical condition, ecstasy can be the trigger for this ailment to surface. There are tons of tragic stories where a novice user took ecstasy for the first time only to learn—after death—that they had a certain heart or respiratory condition that was triggered by the drug.

Because it’s a stimulant, it excites the entire body. Heart rate climbs. Arteries constrict. Blood flow becomes abnormal in some areas. A user’s body temperature—if they are on ecstasy—can skyrocket. If a user is not in the physical condition to take the drug, it can be lethal. The unfortunate nature of this phenomenon is that rarely do people know whether or not they can actually handle the drug and figure they, like everyone else, will be just fine.

Pressed Pills

The other reality of ecstasy, as previously mentioned, is that it’s not always ecstasy. It can be cut with LSD, methamphetamines, cocaine, opioids, heroin, and a vast pool of other drugs that do not even remotely complement the stimulatory nature of the substance. In this case, drug overdoses can ensue.

It is actually a rarity that an overdose is caused solely by MDMA. In comparison to other drugs, MDMA at its purest form is actually a lot healthier for the body than say, heroin or cocaine. But being that its somewhat of a crapshoot when taking the drug, due to these additives, a user can go in blind and end up overdosing because of a certain substance cut into the drug.

Sources:

T., Buddy. “The Effects of Ecstasy or MDMA on the Brain.” Verywell Mind. 25 Nov. 2018. 14 Mar. 2019. https://www.verywellmind.com/what-does-mdma-do-to-the-brain-63096

Kelly, Paul. “Does Recreational Ecstasy Use Cause Long-Term Cognitive Problems?” NCBI. Aug. 2000. 14 Mar. 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071023/

“What Are the Mental and Physical Effects of the Drug Ecstasy?” American Addiction Centers. 14 Mar. 2019. https://americanaddictioncenters.org/ecstasy-abuse/mental-and-physical-effects