3. The Complete Picture – Amphetamine/Methamphetamine including MDMA/Ecstasy

Amphetamine and/or methamphetamine, the main ingredient in ‘uppers’, is a carefully regulated class of illegal drugs. MDMA (3,4-Methylenedioxymethamphetamine), commonly known as ecstasy, often abbreviated “E” or “X”, is an entactogenic drug of the phenethylamine and amphetamine families. Those terms mean that X has a form of amphetamine at its core, and a tendency to induce euphoria, a sense of intimacy and bonding with others, along with diminished anxiety and depression. Although the effects of X are often characteristic of major categories of halluci-nogens and stimulants, X is really not exactly either although it can also be very dangerous and life threatening. The street name for MDMA changed from Adam to Ecstasy, and today the drug is one of the most popular first-time initiated substances, and there-after continually abused drugs, in our society. The drug can be purchased as a crystalline powder or capsule, but most commonly in pill form. Safrole, colorless or slightly black oil, extracted from the fruit or root bark of the sassafras plants, was the precursor for all manufacture of MDMA. The drug and its variations - MDMA, MDA, and MDEA, were added to the Schedule I controlled substances list in the U.S. in May of 1985.

Today, powdered meth, often referred to as “speed”, “ meth”, “crank” or “chalk”, is a white, odorless, bitter tasting chemical that can easily be dissolved in water or alcohol or can be snorted, injected or swallowed. In the 1980s, “ice,” a smokable form of methamphetamine, entered the scene. “Ice” looks like a small chip of frozen water/ice and it is usually clear, just like

the frozen water from which it takes its name. It is of such a high purity that “ice” can be heated and its smoke/vapors can be inhaled, using a glass pipe, without significant loss of effect. The smoke is odorless, leaves a residue that can be re-smoked, and in its purest form, can produce a high that may last for 12 hours or more.

Because smokable methamphetamine can be made with a wide variety of chemicals, there is great variation in the processes and chemicals used. This means that the final product that is sold as “methamphetamine” may not be methamphetamine at all, but a highly altered chemical mixture with some stimulant-like effects. It is absolutely correct to say that when you purchase “speed” on the street, it is impossible to know what combination of chemicals you are about to put in your body. Equally danger-ous is the fact that methamphetamine is also often ingested in combination with other substances, including cocaine/crack, marijuana, heroin, and alcohol.

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Cup of coffee

Methamphetamine crystals–“Ice”

Powder methamphetamine

MDMA

How Amphetamine/Methamphetamine/Ecstasy Act in the BodyMeth, amp, and their family member, Ecstasy (X), release large amounts of a neurotransmitter

we have written about earlier named Dopamine. Once on the brain, Ecstasy also acts as a release agent for serotonin and norepinephrine. Our serotonin system plays an important role in regulat-ing mood, aggression, sexual activity, sleep, and sensitivity to pain. Users report that X produces intensely pleasurable effects – including an enhanced sense of self-confidence and energy.

MDMA, a synthetic, psychoactive drug, has effects that are said to be similar to the combined use of methamphetamine and the hallucinogen mescaline. Street names for MDMA include “ecstasy,” “XTC,” “hug drug,” “X,” “Adam,” and “Eve.” While the effects may make one feel good, the drug is highly dangerous. Effects, when swallowed in pill form, begin to be felt within 30 to 45 minutes, peak at 60 to 90 minutes and last for 4 to 6 hours.

Users of MDMA face many of the same risks as users of cocaine and amphetamines. These include increases in heart rate and blood pressure, muscle tension, nausea, blurred vision, faintness, and chills or sweating. It can also produce nerve cell damage and long-term brain impairment. In high doses, MDMA interferes with the body’s ability to regulate temperature, which can lead to a sharp increase in body temperature which can result in liver, kidney, and heart failure. Psychological effects can include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during and sometimes days after taking MDMA.

Research links MDMA exposure to long-term damage to the neurons, mentioned earlier, that are involved in mood, thinking, and judgment. One study showed that exposure to MDMA for only 4 days caused damage to serotonin nerve terminals that was evident 6 to 7 years later.

Short and Long Term ImpactUnlike other stimulants such as methamphetamine and amphetamine, Ecstasy is not often

used as a ‘binge and crash’ drug. Unlike meth and amp, which wear off and become tolerated in the human body’s system very quickly, Ecstasy’s ‘high’ lasts 4-6 hours. That gives it a different ‘feel’ inside the user. As with similar stimulants, methamphetamine most often is used in a “binge and crash” pattern. Because tolerance for methamphetamine occurs within minutes — meaning that the pleasurable effects disappear even before the drug concentration in the blood falls significantly — users try to maintain the high by binging on the drug. Researchers have reported that as many as 50 percent of the dopamine-producing cells in the brain can be damaged after prolonged exposure to relatively low levels of methamphetamine. They have also found that other nerve cells may be damaged even more extensively. Obviously, the damage can be irreparable.

• Short-term, or immediate effects of amphetamine/methamphetamine include:

• “Rush” or high,

• Increased activity level,

• Decreased appetite,

• Heightened sense of well-being,

• Increased respiration,

• Increased body temperature,

• Insomnia.

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Long-term methamphetamine abuse results in many damaging effects, including addiction. Addiction is a chronic, relapsing disease, characterized by:

• Compulsive drug-seeking and drug use,

• Functional and molecular changes in the brain,

• Violent behavior,

• Anxiety,

• Confusion,

• Insomnia,

• Paranoia,

• Auditory hallucinations,

• Mood disturbances and delusions,

• Homicidal and/or suicidal thoughts.

Impact on the WorkplaceUnlike amp and meth,

Ecstasy has not been generally used as an ‘upper’, i.e. some-thing to help one get through the day, although its presence at work seems to be changing as “last night’s X” finds its way into factories and offices.

Generally smuggled rather than made in the U.S., MDMA, like meth and amp is a powerfully addictive stimu-lant whose intense initial feel-ings require higher doses with continued use. It has been said that the original ‘high’ can never be captured again, although higher doses chase that feeling. In earlier research, young adults aged 18-25 were more likely to be past year’s users of Ecstasy as well as LSD and Salvia divinorum.

On the other branch of the tree, individuals in occupations that demand long hours, mental alertness, and physical endurance, have long been associated with the use of amp and meth. Now those drugs, particularly meth, have branched out and are made and used recreationally, outside of the workday, all over the country.

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Methamphetamine “ice”

Symptoms and SignsThe following signs and symptoms may be noted by a supervisor:

• Agitation/Irritation,

• Excited speech,

• Little appetite for lunch,

• Increased physical activity levels,

• Dilated pupils,

• Mood swings,

• Shortness of breath,

• Nausea and vomiting,

• Occasional episodes of sudden and violent behavior,

• Intense paranoia,

• Visual and auditory hallucinations,

• Inability to rest,

• Compulsive cleaning and grooming,

• Tendency to repetitively sort and disassemble objects.

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