History, effects and mechanisms of action of ecstasy (3,4-methylenedioxyamphetamine): review of the literature

Abstract

This review focuses on 3,4-methylenedioxymethamphetamine, an illegal drug known as "ecstasy." Ecstasy was introduced in Brazil in 1994. Data are lacking on the epidemiology and usage pattern of the drug in Brazil. However, there is evidence that until now the use of ecstasy has been limited to middle-class or upper-middle-class youth, so that most people, including health care professionals, are unfamiliar with the drug. However, ecstasy may be becoming more popular in Brazil, following a pattern seen in North America and Europe. Possible contributing to the drug's popularity is the fact that ecstasy is sold as a pill and is thus extremely easy to use. Ecstasy has a reputation for not being physically dangerous; however, there are many reports of adverse reactions associated with the drug. In addition, it is known that not all pills sold as ecstasy actually contain methylenedioxymethamphetamine. Since there is no quality control for the pills' contents, users never know exactly what they are taking. Thus, although users may perceive the effects of the drug as mostly positive, ecstasy is potentially dangerous. Primary and secondary interventions are needed to prevent the use of ecstasy and the occurrence of adverse reactions. To be effective, these measures must take into consideration the characteristics of the user population and the usage patterns. It is also essential to prepare health professionals for emergency medical interventions in cases of intoxication and complications resulting from the use of ecstasy.