Extasy

In short

XTC is a drug sold in the form of pills, powders or capsules. These can have different colours and shapes. They also sometimes have an image on them. The active compound in XTC is called MDMA. Pills are often sold as XTC when they are actually not. They do not contain MDMD but, rather, some other substance which resembles XTC. The pills can contain a totally different substance compound - that is, a substance which operates differently than XTC and thus unpredictably or not at all.

• Addictive? Not physically, psychological dependence occurs sporadically. 
• Increasingly more needed for the same effect? Yes, for the stimulant effects: one will need more and more to experience these effects. For the euphoric, typical ecstasy effects this is more complicated; they will decrease when ecstasy is used again in a short period of time.  But they will not return or increase again by taking larger quantities.
• Short-term effects: Stimulating/mind altering. Surroundings are perceived differently; feelings of intimacy with others are intensified.
• Long-term effects: It is suspected that XTC causes changes in the brain; memory can be impaired; the drug can influence concentration and mood (depression). 
• Important: When large doses are used, the ‘speed’ effect predominates; XTC is dangerous in cases of cardiovascular disease, diabetes and epilepsy.

What is it?

XTC is a drug. Pronunciation of the abbreviation in English sounds like the pronunciation of the word ‘ecstasy’ which means ‘rapture.’ XTC is sold in the form of pills, powders or capsules. The pills have different colours and shapes and often have an image on them. The name of the pill is frequently related to the form of the pill or details of the image on the pill: the ‘crown,’ ‘euro’ or ‘smiley,’ for example.

Where does it come from?

MDMA was first synthesized in the laboratory around 1900. In the USA in the 1970s, it was occasionally used for experimental psychotherapeutic purposes, namely to help patients become more open and talkative. The substance showed up on the black market thereafter and became popular in discos under the name of XTC. In the 1980s, it showed up in Europe. Despite being legally prohibited (in the USA in 1985 and in the Netherlands in 1988, in Bulgaria in 1988), the distribution of XTC has only increased. XTC is produced in illegal laboratories. Via networks of dealers and subdealers, it reaches the users. The price per pill or capsule varies from 10 to 20 leva.

What’s in it?

The active compound in XTC is MDMA (methylenedioxymetamphetamine). MDMA has a double effect.

On the one hand, MDMD is a stimulant. On the other hand, it is a hallucinogen (mind altering): Perceptions are intensified along with feelings of connectedness with others.

The question of ‘What’s in it?’ raises one of the major problems with XTC: Pills are sometimes sold as XTC when they are actually not. MDMA is not in the pill but, rather, a substance which resembles it or perhaps a completely different substance — a substance which operates differently than XTC and therefore unpredictably or perhaps not at all.

How dangerous is it?

• Research has been conducted on the harmfulness of XTC. XTC can lead to changes in the brain with damage to the user’s memory, concentration and mood (depression) as a result. The danger increases as the frequency of use and quantity of use increase. It cannot be ruled out that even one-time use may lead to such changes in the brain. Just how drastic and permanent the effects are is simply not yet known. The effects of XTC in combination with other substances are also not known.
• Analyses of XTC pills show that what is sold as XTC may not be XTC at times. The pills do not contain MDMA but, for example, MDEA, speed (amphetamine), MDA or other substances which may or may not have their own risks. Sometimes the composition simply cannot be traced. Apart from the contents, the dosages can also vary tremendously per pill. There may also be more than one active compound in a single pill. Both MDEA and MDA are related to MDMA. With MDEA the stimulating effect is stronger than the hallucinogenic effect. The duration of the effect is also relatively short: 3 to 5 hours. MDEA thus resembles speed, which has only a stimulating effect (see elsewhere in this website). However, the user who is looking for a hallucinogenic effect can be quickly seduced into taking a second or third pill with all the risks which the taking of an additional stimulant entails. With MDA the hallucinogenic effects predominate. MDA works 6 to 8 hours, which is longer than real XTC.
• The person who uses XTC or some other stimulant does not feel fatigue and can dance for hours on end, for instance. If the surroundings are also warm and humid and the person does not consume enough (non-alcoholic) liquids, the risks of the body literally overheating and dehydration are quite great. Muscles and organs, such as the kidneys, may no longer function as a result. Overheating is life-threatening and difficult to treat. The risk is smaller when the disco or party location has sufficient ventilation and cooling.
• In circles which have used XTC for longer periods of time, a greater susceptibility to infection is reported. Depression, anxiety, panic reactions and sleep disorders also occur in cases of long-term use. It is also not uncommon for existing problems to return but then more intensely.
• People with asthma, a weak heart, high blood pressure, diabetes or epilepsy should definitely not use XTC. XTC can also intensify depression, anxiety attacks and psychosis. Finally, the use of XTC during pregnancy and while breast feeding is strongly discouraged.
• The combination of XTC with other substances, such as alcohol or medication, is risky. There is an increased probability of unpleasant or dangerous complications. Recall that the pill contents and exact amounts of XTC in the pills can vary greatly. As far as is known, XTC does not hinder the functioning of birth control pills. Users under the influence, however, make easier sexual contact. If a condom is not used, the risk of aids and other sexually transmitted diseases thus presents itself.
• XTC makes one reckless and can impair coordination. XTC in traffic is thus dangerous.
• XTC deaths have already occurred. In other cases, the use of XTC — or what was passed off as this — led to such liver damage that transplantation was necessary. The cause of these severe cases can plausibly be sought in overheating, a combination of substances which has gone wrong, a physical defect of the user, hypersensitivity or a combination of such factors. Not every case can be explained in such a manner, however.

Can you use safely?

No. Taking XTC is risky even if just once.

One never knows exactly what is in the pill or how much. In Bulgaria the regular citizens don't have a way and place to test the content of their pill. If a person does not want to run the risks, the person should not use.

Who uses it?

XTC has the reputation of being a club or dance drug for mostly young people and is indeed associated with large-scale dance parties or discos. In combination with the effects of lighting and music, XTC can induce a trance-like state which allows the user to party or dance for hours on end. It is certainly not the case that every person who goes to such a giant party or disco uses. Many persons can dance the night through in a trance-like state without the use of XTC; the atmosphere and beat of the music are already enough.

According to a survey conducted among the Bulgarian students, 8,4% of the interviewed people have tried XTC at least once in their life, 1,5% of them have done it in the last 30 days.  
 
The amount a person ingests differs, of course, from person to person. Many users occasionally take a pill in the weekend. For most, this is also limited to a particular stage of life. But there are also people who do not consider a party a party without taking a few pills.

The person who uses XTC does this on account of the effects which the substance causes or others say it causes. This means that the user does not always find what he or she is looking for. Other motives can also play a role as well. Some people think that you should ‘try everything’ at least once. Others may use to fit in, to escape from reality or simply for the excitement.

What does the user feel?

The user gets pepped up. He or she feels both more physical and mental energy. Fatigue is suppressed. (This does not mean that the fatigue has disappeared altogether. When the pill has worn off, the fatigue will return — typically in a more intense form. ) Perceptions also become more intense.

Under the influence of XTC, people can become more quickly intimate and trusted with others.

An ingested pill or capsule begins to work after 20 to 60 minutes. The effect is strongest during the hour thereafter. The effect is gone within 4 to 6 hours. Some users also feel a light post-effect the next day. This can be a pleasant but also empty, depressed feeling. A depressed or crabby mood can persist for days.

In addition, a feeling of tightness in the jaw, heart palpitations, a dry mouth and throat, nausea and a shortness of breath can occur. Once and awhile, there are also problems with the coordination of movements. These unpleasant side effects can lead to panic.

The intensity of the effects depends on the pills and the amount ingested, but also on the sensitivity, mood, expectations and condition of the user. In addition, the environment in which the substance is used can also influence what the user feels.

Is it addictive?

A distinction can be made between psychological and physical dependence. We speak of physical dependence when the body protests to stopped usage of the substance (withdrawal symptoms occur).

XTC leads to mild symptoms of withdrawal (fatigue, depression etc.), but the user can require increasingly more of the substance to attain the same effect. Only after a period of not using, however, do the mind-altering effects again appear. Taking a number of XTC pills one after another is thus of no use. Doing this simply increases the stimulating effects of the substance and the probability of complications.

Psychological dependence means that the user craves the substance to an increasingly greater extent and no longer feels good without it. This can be the case with XTC. That is, some people have difficulties going without the excitement or ‘kicks’ of using XTC.

Can you see if someone is using?

The use of XTC brings certain symptoms with it such as depression, anxiety and/or sleep disorders. These symptoms can also be a consequence of something else. They are also often imperceptible. In reality, only an open conversation can make it clear if someone is using or not. In this connection, it is important that preformed judgements regarding the use of XTC be avoided. Such judgement only reduces the chances of having an open conversation.

Handling of users

Those who visit house parties or discos will usually come into contact with XTC and its consequences at some point. When someone does not feel good after the ingestion of a pill or actually becomes unwell, make sure that the person does not panic. Try to calm the person down in a cool and quiet place.

When the person continues to be very restless and remains incoherent for some time, professional (emergency) help should be called in. A high temperature (fever) and irregular heartbeat are clear alarm signs.

In schools, youth services and families with growing children, the use of XTC should be talked about. Flatly prohibiting the use of XTC is of little avail.

The following are important.

• Adequate information about XTC. The text here provides the most important information (in so far as this is known).
• An open exchange of thoughts and opinions regarding use, without prejudice. The person who is worried about the use of another can only find out how much and why via a clearly open exchange. Frequent use can point to underlying problems which need to be addressed by the user him/herself and, if necessary, with the help of others and possibly professionals.
• Set clear boundaries for both the other and yourself. Your credibility as parent or educator is greater when you also stick to agreements which have been made.
• A stage of experimentation will not quickly derail into problematic use provided the young person is not bored, has developed sufficient independence, is capable of saying ‘no’ and can deal with setbacks. Keep the lines of communication open; panic and threats tend to be counterproductive.
• Do not hesitate, if necessary, to ask for advice and/or seek help.