- The Washington Times - Tuesday, September 18, 2001

Many teen-agers go through stages where they question their self-worth. They may think they are not good-looking, sporty or smart enough to become successful or popular in school.

Along comes Ecstasy, a drug that increases self-confidence and makes the user feel more at ease around strangers — happier and even sexier.

"Teen-agers are such a vulnerable population and here comes a drug that makes you feel like everyone love you," says Dr. Una McMann, associate professor of psychiatry at Johns Hopkins University. "It's a warm and fuzzy feeling, and you feel great about everyone around you."

Ecstasy is a synthetic drug with both stimulant and hallucinogenic properties, which means it makes users highly energetic while they also may have hallucinatory experiences. The drug's medical name is 3-4 methylenedioxymethamphetamine (MDMA for short).

"Clearly, it's the younger population using it. High school and college kids primarily," says Glenn Hanson, director of the Division of Neuroscience and Behavioral Research at the National Institute on Drug Abuse, a division of the National Institutes of Health.

For some reason, Ecstasy has received the reputation of being safer than other drugs, which it isn't, and for some adolescents and young adults, it goes hand in hand with other gateway drugs, such as marijuana and alcohol, Mr. Hanson says.

"For some kids, it might be [their first drug experience]. They hear that it's relatively safe and they buy into it," he says.

Doctors and researchers have not yet determined whether Ecstasy is addictive, but many of them say there are addictive tendencies associated with the drug.

It's sold in pill form weighing between 50 and 100 milligrams.

"It costs about $20 to $25 a pill," says Sgt. John J. Brennan of the District's narcotics branch.

Most of the Ecstasy pills that the police confiscate in the District are found at concerts arenas such as RFK Stadium and clubs in the Northwest and Northeast.

But Ecstasy plays a small part in the overall drug scene in the area and it's seldom sold on the street, Sgt. Brennan says.

"Ninety-nine percent of what we confiscate is other drugs," Sgt. Brennan says.

There is some domestic production of Ecstasy, but most of it comes from Amsterdam, Holland, he says.

While the long-term effects are still being researched, studies by such researchers as Dr. McMann have shown there are both physical and mental repercussions of taking the drug.

"Certainly there are short-term memory problems," Dr. McMann says. "A lot of people have found problems in sustained attention."

Brain imaging shows that Ecstasy can damage neurons, also called nerve cells, that produce serotonin. The serotonin functions as a neurotransmitter, a group of chemical agents released by nerve cells to stimulate neighboring nerve cells. Serotonin plays an important role in regulating sleep, mood, sexual activity and aggression.

The defects shown in the brain imaging matches the complaints Ecstasy-using patients have expressed over panic attacks, anxiety disorders, mood changes and sleep disorders.

At Suburban Hospital's addiction treatment facility in Rockville, the research rings true, too.

"We've seen some kids who have tried it a few times and have started having panic attacks," says Beth Davidson, director of the Suburban Hospital Addiction Treatment Center. Of course, it's difficult to know if the drug caused it or just triggered the attacks, but it's still alarming, she says.

"A drug that causes brain damage is a dangerous drug," Dr. McMann says. "There have been cases where a person dies after using the drug once "

There are also short-term effects of Ecstasy.

"There is a hangover effect" the day after, Dr. McMann says. "People will often get depressed, down and anxious and kind of yukky."

Ecstasy also affects the body's ability to regulate its temperature. There have been cases where Ecstasy-users at raves have become overheated and experienced kidney failure, dehydration or had a seizure.

Many equate Ecstasy with the rave scene of the 1990s, but the drug was actually first introduced in 1914 as a legal appetite suppressant. It was later used by psychotherapists in the 1960s and 1970s during the course of therapy. And in the mid-1980s, it became illegal after increased unprescribed use was noticed by law enforcement, Mr. Hanson says.

In the 1990s, the drug resurfaced on the European rave scene and has been increasing in popularity ever since, making inroads in the United States as well. The Drug Enforcement Administration seized 13,342 pills nationwide in 1996. Four years later, the agency confiscated 949,257, according to the National Institute on Drug Abuse.

In the United States, there are pockets of heavier use on the West Coast, the Rocky Mountain states, Miami and Atlanta, Mr. Hanson says. The drug is usually taken orally, but users have been known to crush and snort it or inject it.

The Northeast is not considered a hot spot for Ecstasy, but it certainly exists — especially in the suburbs.

While hospitals and drug treatment centers in the District, such as Providence Hospital in Northeast, see few or no cases of Ecstasy use, it's different in communities nearby.

"It's a suburban drug," says Dr. Margaret Barron, chairwoman of the Emergency Department at Providence.

"We never see it here. It's a rich kids' drug. We're still a heroin, cocaine and alcohol environment," Dr. Barron says.

At Seton House, one of Providence's drug treatment center, the message was the same. No, the guys here are into alcohol, heroin and cocaine, says Tara Scherer, a nurse practitioner at Seton House.

The Emergency Department at Suburban Hospital in Bethesda hasn't seen any Ecstasy patients, either, but at the addiction treatment center, the picture is quite different.

Mrs. Davidson says 90 percent (or 40 adolescents) of the "kids" that came in for outpatient counseling last year reported that they had tried Ecstasy.

"Ecstasy is definitely out and about among the young kids," she says. "It's been highly promoted as a safe drug [as opposed to] drugs or alcohol."

The pill containers sometimes feature pictures of yellow butterflies, the Flintstone characters and Playboy bunnies. The innocent nature of the labeling further helps portray the drug as safe, Mrs. Davidson says. At least six new designs come out every month, she says.

"It's kind of a collector's item that the kids are into anyway. If one kid has it, they all just follow suit."

If U.S. teens take to Ecstasy the way some European teens have, it could mean that as many as 35 percent of teens will try Ecstasy at some point, Mr. Hanson says.

But Mrs. Davidson has seen a slight decrease in the number of adolescents who come in for Ecstasy counseling at Suburban. She attributes the decrease to heightened media attention, and dissemination of knowledge that Ecstasy is dangerous and that you never really know what a pill of Ecstasy contains. The "normal" recipe could be laced with heroin, for example, she says.

While the question of whether Ecstasy is addictive or not is still pending, Mrs. Davidson says her patients' description of their drug experiences indicate that the drug is indeed addictive.

"You're relying on a drug to allow you to feel good and have relationships," she says. "I think that points to a dependency."

It's difficult to determine the addiction aspect of Ecstasy since it's so often taken together with drugs like marijuana and alcohol.

" and here comes a drug that makes you feel like everyone love you."

Dr. Una McMann, psychiatist, Johns Hopkins University

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