Historical Background
MDMA was developed before WWI with a patent issued to a German company in 1914. In the late 1930s, Smith Kline and French studied it as a possible appetite suppressant, but nixed it because of its nausea side-effect.

Briefly, in the early 50s, it was a study drug in a U.S. Army funded study.

In the mid-60s, MDA, the parent drug of Ecstasy, surfaced in the underground drug market. It belonged to a group of psychedelic mind-altering substances chemically related to spices such as nutmeg and mace. An alternative to LSD, it was referred to as the "Love Drug."

In 1970, MDA was placed on the FDA's schedule 1 (high potential for abuse; no current legal medical use in the U.S.) joining the company of heroin, LSD, and marijuana.

The search for a legal analog led to MDMA (Ecstasy), which remained legal until 1985.

General Information
A designer drug is a synthetic or lab-produced analog of an FDA-controlled prescription drug, closely resembling the structure of the parent drug, differing in some instances by just a few atoms. MDMA is such a drug, the product of the chemical combination of MDA and methamphetamine. Considered a "designer hallucinogen," it produces less stimulation than cocaine or amphetamines. It is taken for its hallucinogenic effects and is considered a "domesticated" version of some of the stronger psychedelic drugs, producing a "trip" shorter than either MDA or LSD.

Until 1986, it was legal to produce and sell chemical analogs of illegal or controlled drugs, as long as the 'derivative drugs' were only similar, but not identical to the parent drug. It significantly contributed to a burgeoning of the "basement" pharmaceutical industry.

In the 80s, American drugs dealers supplied the needs of small niches of users. Its increasing popularity has attracted organized crime into this e-trade. Supply-and-demand has also necessitated tapping foreign supply lines. Today, Europe is believed to supply 80% of U.S. ecstasy.

Although it remains a "niche" drug, used by 1.3% of the U.S. population (versus: marijuana, 5% of those older than 12; cocaine 1.8%), its increasing popularity and ease of use (popping a pill instead of injection, snorting or smoking as in heroin, cocaine or marijuana) raise concerns that e might become a drug of epidemic use. Recent studies have been disturbing: ecstasy use among the youth continues to rise, and by 12th grade, 11% have had an ecstasy experience.

According to a UNODC report, Ecstasy users have increased to 8 million; Ireland and Australia are the biggest E users with 3.4% of their population, 15 to 64 years old. In the Philippines, E is used by only 0.91 percent (shabu or methamphetamine, the drug of choice).

How MDMA is taken
MDMA comes in the form of a white, crystalline powder which can be buffered and pressed into pills. The usual dose is 1 to 2 mg/kg body weight (125 to 180 mg). A 100 mg tablet usually costs around $20. It may be ingested orally, placed under the tongue, added to juice or a carbonated beverage, or snorted intranasally.

"Candyflipping" is the combined use of ecstasy and LSD.
"Stacking" means taking three or more ecstasy tablets at once, mixing it with LSD, alcohol, methadone, amphetamine, cocaine, heroin, fentanyl, ketamine, GHB, or marijuana, taking the drugs in different phases of the evening in order to modify and modulate the high. Stacking, with its mixed effects of stimulation and sedation, increases the risk of overdose. Alcohol though diuresis, increases the risk of dehydration from the marathon rave dancing.

Mechanism of Action
In the brain, Ecstasy causes the release of serotonin, one of the chemicals that transmit signals from one nerve to the next. The release of serotonin, believed to be responsible for its effects, occurs unimpeded and causes a flooding of the synapses, overwhelming the serotonin receptors and, at the same time, preventing its reabsorption. This serotonin glut is suspected to cause axonal damage that leads to axonal death (or at best, defective regeneration) and irreversible brain damage.

Effects
Increasingly popular , it is perceived as a fun drug with few side effects. Fast becoming an accompaniment to generic social encounters, it is the drug of choice at raves,  all-night marathon dance parties to the sound of techno-music. It is said to facilitate insight, heighten sensory perception, peace, self-awareness, empathy, clarity and energy. It may also cause logorrhea (verbal diarrhea) and other side effects similar to its parent compounds: loss of appetite, nausea, insomnia, and general restlessness.

Adverse Effects
The worst short-term effect is hyperthermia which has been reported to go up as high as 110, causing death. Increased heart rates are common. Long term dangers relate to possible irreversible serotonin receptor damage and depletion. It may have unpredictable psychological effects and 'bad trips' and the waning of drug levels may be marked by depression. It may also cause memory loss and learning difficulties.

As in any street drug, adulteration and/or substitution can be a problem. In about 20%, no MDMA was found, substituted by usually benign ingredients like aspirin and caffeine. Some substitutions may have fatal consequences, like DXM and PMA. DXM (detromethorphan), a common over-the-counter medication, has been found to cause hallucinations in 13 times its cough suppressant dose. PMA (paramethoxyamphetamine), a more dangerous adulterant, is significantly more hallucinogenic and hyperthermic than ecstasy.

On-going studies show that ecstasy causes impairment of memory and damages the brain mechanisms that regulate sleep and mood. A single use can cause brain changes and the effects may persist for years; the studies suggest these changes could be permanent.

The memory impairment may last 2 and 1/2 years after discontinuing use of the drug. The degree of memory impairment and difficulty in concentration appear to be more than that noted in marijuana and alcohol users. A brain scan study showed decreased blood flow to the brain two weeks after a low dose of Ecstasy.

A UK Study by Jacqui Rodgers, MD and colleagues (March 2004-Internal Medicine Report) from Web-based questionnaires of 763 participants reported that ecstasy users are at risk for long-term memory loss and impairment in performance of simple tasks. Those who used ecstasy more than 10 times were 23% more likely to have long-term memory loss than those who have never taken recreational drugs and 14% more likely to have long-term memory problems thant users of other recreational drugs. Also, ecstasy-cannabis users have both long- and short-term memory problems.

With continued use, side effects become more likely. Besides its highly addictive nature, it may cause confusion, insomnia, anxiety, nausea, teeth clenching, blurred vision, acneiform rash, erratic mood swings, paranoia, depression and aggressive behavior.

COST
Production cost: pennies per pill.
Street cost: $20 to $40