Is ecstasy MDMA? A review of the proportion of ecstasy tablets containing MDMA, their dosage levels, and the changing perceptions of purity
Not every tablet sold as “ecstasy” contains MDMA (3,4-methylenedioxymethamphetamine). The historical origins and evolution of this mismatch will be reviewed, in order to estimate the proportions of ecstasy tablets containing MDMA at different periods over the past 30 years.
Surveys into the pharmacological constituents of ecstasy tablets, dosage levels, and empirical reports of their perceived purity, provide the main data for this review.
During the 1980s and early 1990s there were few problems with the purity of ecstasy tablets, and the biochemical evidence shows that they nearly always contained MDMA. During the mid-1990s, the majority of ecstasy tablets continued to contain MDMA, while many others comprised MDA (3,4-methylenedioxyamphetamine), MDEA (3,4-methylenedioxyethylamphetamine), or amphetamine drug mixtures. However, a small proportion (4–20% according to survey, time and place), comprised non-amphetamine drugs such as caffeine, ephedrine, ketamine, paracetamol, or placebo. During the late 1990s, the proportion of ecstasy tablets containing MDMA increased to around 80–90%. The latest reports suggest that non-MDMA tablets are now very infrequent, with purity levels between 90% and 100%. Dosage levels of tablets are also highly variable, with low dose tablet often encountered during the mid-1990s, and high dose tablets now seen more frequently. The theoretical and practical implications of these findings will be debated.
The ecstasy purity problem was predominantly a phenomenon of the mid to late 1990s, when many tablets contained substances other than MDMA. Before and since then, the proportion of ecstasy tablets containing MDMA has been very high.
KeywordsMDMA Ecstasy Amphetamine Stimulant Serotonin MDMA tablet purity MDMA tablet analysis
- Beck J (1990) The public health implications of MDMA use. In: Peroutka SJ (ed) Ecstasy: the clinical pharmacology and neurotoxicological effects of MDMA. Kluwer, BostonGoogle Scholar
- Cohen RS (1998) The love drug: marching to the beat of ecstasy. Haworth Medical Press, New York StateGoogle Scholar
- Cuomo MJ, Dyment PG, Gammino VM (1990) Increasing use of “ecstasy” (MDMA) and other hallucinogens on a college campus. J Am Coll Health 42:271–274Google Scholar
- Dowling GP (1990) Human deaths and toxic reactions attributed to MDMA and MDEA. In: Peroutka SJ (ed) Ecstasy: the clinical pharmacology and neurotoxicological effects of MDMA. Kluwer, BostonGoogle Scholar
- Dye C (1982a) MDA/MDM: the chemical pursuit of ecstasy. Do it Now Publications, Phoenix, Ariz.Google Scholar
- Dye C (1982b) XTC: the chemical pursuit of pleasure. Drug Survival News 10:8–9Google Scholar
- Green AR, Mechan AO, Elliott JM, O’Shea E, Colado MI (2003) The pharmacology and clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”). Pharmacol Rev (in press)Google Scholar
- Handy C, Pates R, Barrowcliff A (1998) Drug use in South Wales: who uses ecstasy anyway? J Subst Misuse 3:82–88Google Scholar
- King LA (2000) Was it MDMA? Neuropsychobiology 42:45–46Google Scholar
- McCann UD, Eligulashvili V, Ricaurte GA (2000) (±) 3,4-methylenedioxymethamphetamine (“ecstasy”)-induced serotonin neurotoxicity: clinical studies. Neuropsychobiology 42:11–16Google Scholar
- McDowell DM, Kleber HD (1994) MDMA: its history and Pharmacology. Psychiatr Ann 24:127–130Google Scholar
- Palenicek T, Fiserova M, Kubu P (2002) Test of ecstasy tablets in Czech Republic—quantitative analysis. Adiktologie 1:70–71Google Scholar
- Parrott AC (2001) Human psychopharmacology of ecstasy/MDMA: a review of fifteen years of empirical research. Hum Psychopharmacol 16:557–578Google Scholar
- Parrott (2002b) Tolerance to recreational MDMA (3,4-methylenedioxymethamphetamine) or ecstasy. Psychobiol Newsletter (Winter):16–17Google Scholar
- Parrott AC, Fox HC, Milani RM, Soar K, Turner JJD (2002) Polydrug use amongst recreational ecstasy users. Adiktologie 1:71Google Scholar
- Peroutka SJ (1989) “Ecstasy”: a human neurotoxin? Arch Gen Psychiatry 46:191Google Scholar
- Polkis A, Mackell MA, Drake WK (1979) Fatal intoxication from 3,4-methylenedioxyamphetamine. J Forens Sci 24:70–75Google Scholar
- Ramsey JD (2003) Personal CommunicationGoogle Scholar
- Ramsey JD, Butcher MA, Murphy MF, Lee T, Johnson A, Holt DW (2001) A new method to monitor drugs at dance venues. BMJ 232:603Google Scholar
- Renfroe CL (1986) MDMA on the street: analysis anonymous. J Psychoact Drugs 18:363–369Google Scholar
- Saunders N (1995) Ecstasy and the dance culture. Neal’s Yard Desktop Publishing, LondonGoogle Scholar
- Scholey AB, Parrott AC, Buchanan T, Heffernan T, Ling J, Rodgers J (2004) Increased intensity of ecstasy and polydrug usage in the more experienced recreational ecstasy/MDMA users: a www study. Addict Behav (in press)Google Scholar
- Sherlock K, Wolff K, Hay AWM, Conner M (1999) Analysis of illicit ecstasy tablets: implications for clinical management in the accident and emergency department. J Accident Emerg Med 16:194–197Google Scholar
- Shulgin AT, Nichols DE (1978) Characteristics of three new psychotomimetics. In: Stillman RC, Willette RE (eds) The pharmacology of hallucinogens. Pergamon, New YorkGoogle Scholar
- Solowij N (1993) Ecstasy (3,4-methylenedioxymethamphetamine). Curr Opin Psychiatry 6:411–415Google Scholar
- Wijngaart van de GM, Braam R, de Bruin D, Fris M, Maalste NJM, Verbraeck HT (1999) Ecstasy use at large scale dance events in the Netherlands. J Drug Issues 29:679–702Google Scholar
- World Health Organization (1996) Amphetamine like stimulants. Report from the WHO meeting on amphetamines, MDMA and other psychostimulants. November 1996. WHO, Geneva, SwitzerlandGoogle Scholar