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Ecstasy is the street term for a range of drugs similar in structure to MDMA (methylenedioxymethamphetamine). Ecstasy is similar in structure and effect to amphetamines and other hallucinogens.
These substances are stimulants that speed up activity in the nervous system. Because of their hallucinogenic properties, they typically affect perception and can cause things to appear distorted, or things that don't exist to be seen or heard. 
Possession of Ecstasy is illegal in most countries. and its ingredients are often hard to obtain. Therefore, manufacturers often substitute a wide range of substances when making the drug. Like with other illegally manufactured drugs, there is no control over factors such as strength and hygiene of the drug, which greatly increases the chances of a person overdosing, being poisoned, or experiencing otheradverse reactions. 
Ecstasy is also known as "E", "XTC", "eccy", and " love drug" on the street.

How is it used?

Ecstasy usually comes in tablet form, in various colors, sizes, shapes and designs. Although some users crush it, snort it, or mix with various beverages, swallowing is the most common way that ecstasy is used. Also, the pills are sometimes inserted into the anus in order to get a quick effect. This maneuver is called "shafting" or "shelving”.

History of Ecstasy

The original patent for MDMA was filed on Christmas Eve 1912 by the German pharmaceutical company Merck, after being first synthesized by the German chemist Anton Köllisch. Unfortunately, this expert died without any idea of the impact this synthesis would have. The original purpose of this drug has been a styptic effect - controlling bleeding from wounds. Half a century later, it became illegal in the United States. Before then, it was used both as a supplement to psychotherapy and as a recreational drug.

When did it appear on the streets?

Ecstasy appeared sporadically as a street drug in the early 1970s, especially in trendy yuppie bars and in gay dance clubs. From there, its use spread to rave clubs, and then to mainstream society. Today ecstasy, spreading among young adults in universities and in high schools, became one of the four most widely used illegal drugs in the U.S., along with cocaine, heroin and cannabis.
Medical use and clinical studies
In 2001, the FDA granted permission for experimental administration of ecstasy to patients suffering from post-traumatic stress disorder. This researches was to build upon studies in which MDMA was given to healthy volunteers.

The most common effects of ecstasy

The biggest problem in discussing drug effects is that the effects of any drug can vary from person to person, and it could be very difficult to set any rules! Because ecstasy is commonly taken before or during dance and parties, the stimulant effects are likely to increase.  

Medical “contraindications”

People who suffer from any of the following conditions put themselves at greater risk of physical and psychological harm by taking ecstasy:
    * hypertension
    * heart disease
    * diabetes
    * liver problems
    * epilepsy
    * history of mental illness
    * history of panic attacks
The effects of ecstasy usually begin within 20 minutes of taking the drug, and may last up to 6 hours, but there are no rules and some people report symptoms persisting for 32 hours after using ecstasy. 

There are usually three phases:

  • Coming up: This phase is characterized by effects that could be described as smooth and bumpy, and users may feel a rush
  • Plateau: This is the phase where the user may feel happy and relaxed
  • Coming down: This is the last phase, during which users may feel physically exhausted, depressed, and irritable - worse then they felt before taking the drug

Immediate effects of ecstasy

Although there are no rules, a great majority of people have experienced the following effects soon after taking ecstasy:
  • dilated pupils 
  • jaw clenching, teeth grinding
  • increase in heart rate, body temperature and blood pressure
  • increase in confidence
  • feelings of well being
  • feelings of closeness to others, hence the term "love drug"
  • anxiety
  • nausea
  • loss of appetite
  • sweating
Higher quantities may cause several unwanted effects such as:
  • convulsions
  • vomiting
  • floating sensations
  • irrational or bizarre behaviour
  • hallucinations

Is death a possibility? 

Death could be caused by overdose of ecstasy, or if taken by people who suffer from any of the high risk conditions. Although it is difficult to determine the exact number of ecstasy-related deaths that have occurred, the toxic effects of ecstasy that can lead to death include:
  • heart attack
  • brain hemorrhage
  • blood clotting
  • kidney failure
  • overheating

Long-term effects

It’s difficult to talk about long-term effects of ecstasy because people tend not to use ecstasy for a long time. There is some limited evidence suggesting that ecstasy causes damage to certain parts of the brain.

Pleasurable effects

Ecstasy used for recreational purposes lowers inhibitions and relaxes the user. MDMA is also said to increase awareness and feelings of pleasure, and to give people energy. However, some people report side effects after taking MDMA such as headaches, chills, eye twitching, jaw clenching, blurred vision, and nausea. Some doses of MDMA can cause dehydration, hyperthermia, and seizures.  

Physical Effects

If taken in high doses, MDMA can interfere with the body’s ability to regulate temperature. Occasionally, this leads to a sharp increase in body temperature which then leads to liver, kidney, or cardiovascular system failure, and sometimes even death. Users of MDMA face many of the same risks as users of other stimulants such as cocaine and amphetamines, including increases in heart rate and blood pressure (a special risk for people with circulatory problems or heart disease), muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating.

Tolerance and dependence

While some people may develop tolerance to the effects of ecstasy, using larger amounts will increase the severity of undesirable effects, rather than increase the pleasurable effects. Not only that – there is also evidence of psychological dependence on ecstasy; it can be very difficult to stop or decrease use.  

Pregnancy and breastfeeding

Most of the known drugs cross the placenta, and therefore have some effect on the fetus. That’s why it is quite possible for miscarriage to result from using ecstasy.  The use of amphetamine-like substances such as ecstasy during pregnancy has also been associated with delayed development and subtle abnormalities in the newborn.

What to do in a crisis?

If someone overdoses or has an adverse reaction while using ecstasy, some quick and easy actions can save their life.
  • First thing that any eyewitness of some drug crisis should do is to call an ambulance with no delay, because seconds could be vital!
  • He or she should definitely stay with the person until the ambulance arrives because of possible need for mouth-to-mouth resuscitation or cardiopulmonary resuscitation (CPR) before the ambulance arrives
  • Ensure that the person has adequate air by keeping crowds back and opening windows.  
  • If the person is unconscious, they shouldn’t be left on their back because they could choke
  • If breathing has stopped, give mouth-to-mouth resuscitation. If there is no pulse, apply CPR.

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