Does recreational ecstasy use cause long-term cognitive problems?

Abstract

The recreational drug ecstasy, also known as “XTC” or“E,” Adam, Clarity, or Essence, is widely used by young people throughout the United States and Western Europe. The drug is an amphetamine derivative, with the pharmacologic name 3,4-methylenedioxymeth-amphetamine(MDMA). Its popularity has been enhanced by its close association with particular forms of music and dance venues and, despite well-publicized casesof MDMA-associated death, by the widely held belief that it is a“safe” drug. Indeed, many users and social commentators believe that with better management, the negative consequences of MDMA use can be avoided.1 This belief is based on the false premise that the danger associated with MDMA lies exclusively with poor control of environmental temperature and“bad” or adulterated drug. The latter risk, it is believed, would be eliminated by better quality control as a result of legalizing the drug. A review of the scientific literature, however, paints a very different picture of this drug, which is far from benign.