Ecstasy Overdose

What is Ectasy?

The designer drug concept is incorporated in the preparation of the ecstasy, as the structural design of the drug is similar as the amphetamines. The chemical name of the ecstasy is 3, 4-methylenedioxymethamphetamine and in short form it is called as MDMA.

The available dosage forms of ecstasy are powder and pill and strengths as 80 to 160 mg. Ecstasy and amphetamines both are CNS stimulants and psychoactive drugs, but in addition, ecstasy can produce hallucination effect.

At the initial stage, the usage of the ecstasy provides pleasurable feeling of the users, but in long term use, it has dangerous effects and it may be fatal for overdose.(1,3)

Why ecstasy provides pleasurable effects?

Central nervous system organizes the physiological alterations, which require to manage the increased stress level under stressed condition. CNS stimulates the release of the adrenaline and other stress hormones, which encourages to increase heart rate, blood pressure and transmit the circulation towards muscle and left behind the small intestinal flow.

All the stress hormones activate sympathetic nervous system, which kick off the ‘fight or flight’ responses and increased energy level. The use of ecstasy helps to distort from the reality and users feel peace and love at their surroundings due to the hallucinogenic effect of the ecstasy. The hallucinations trigger both the vision and audibility in providing peace.

The provided pleasant effect of ecstasy is due to an increase level of the neurotransmitters, like serotonin and dopamine. But after peaking concentration of the ecstasy in the CNS, it becomes gradually come down and all the pleasant effects are flattened.

The usual onset of effect starts within 20 minutes of the drug intake and lasts for 3 to 6 hours. Then coming down by the ecstasy reaction is not same for all the individuals, but unpleasant experiences are obtained, which includes depression, muscles ache and fatigue.(2)

Short term effect of ecstasy

Ecstasy triggering the effect of the dopamine, serotonin and nor-epinephrine activation after it reaches to the systemic circulation. The increased level of these neurotransmitters provides impact in the CNS and provide short term effects, which may stay for 3 to 6 hours after onset of the effects begins.

  • Euphoria
  • Peaceful mind
  • Increased self confidence
  • Feeling of happiness and compassionate
  • Increase sexual urge
  • Hallucinations
  • Increased blood pressure
  • Jaw clenching
  • Teeth grinding
  • Eye wiggling
  • Profuse sweating leads to dehydration
  • Anorexia
  • Insomnia

The provided effects are very desirable for rave parties and but after the competition of pleasant effects users should keep in mind the list of undesirable effects. (2,3)

The Long- term effect

The long term use of the effects of the ecstasy can cause serious impairments and affects cognition and sleep. In long term use, depression, memory impairment and anxiety are common symptoms complaining users. Ecstasy has addicting effect and according to the report published in the National Institute on Drug Abuse 43% of ecstasy users becomes addicts. Therefore, the manufacturing of ecstasy become illegal and generally made in illegal laboratories. (3)

Ecstasy Overdose

The manufacturing of the ecstasy is usually performed under illegal laboratories without following the proper manufacturing SOP. Therefore, no standard methods are followed and the batch of the prepared sample is not matched and dose variation is common.

The chances of overdose are high and fatal outcome is common.  In addition, the different available dosage form of the ecstasy is not pure and adulterated with other toxic chemicals and that cannot usually measurable.

Therefore, users unknowingly taking ecstasy. The possibility of the overdose is increased due to combinations of other adjuvant drugs including alcohol. No evidence available for proper dosing of the ecstasy or stating that use of ecstasy is safe. Furthermore, the pure form of ecstasy rarely available, so it is always advisable that avoid ecstasy intake.

Ecstasy increases the sexual urge and can influence to perform unprotected sex, which increases the possibility of the incidence of the AIDS and other sexually transmitting diseases. In addition, sharing of the same syringe for injecting the powder form of ecstasy can cause AIDS and other form of systemic infection. (2)

Sign and symptoms of ecstasy overdosing

The following are the sign and symptoms of the overdosing of ecstasy:

  • Convulsive attack
  • Extensive vomiting
  • Spiky raising of the body temperature
  • High blood pressure
  • Vertigo
  • Muscle cramps
  • Increased cardiac rate
  • Palpitation
  • Diabetes
  • Renal disease
  • Mood or psychiatric disorders

Fatal symptoms

Overdose of ecstasy often cause death due to the following aggravated conditions:

  1. Cardiac failure
  2. Heart stroke
  3. Renal failure
  4. Hyperthermia (overheating)
  5. Dehydration
  6. Dilutional hyponatremia due to excessive water intake. (1,2,3,4)

Treatment of an Ecstasy Overdose

Arising of any sign or symptoms related to overdose of the ecstasy need immediate medical attention, otherwise it may cause death of the affected person. In emergency medical care, following therapeutic measures are applied for avoiding fatal condition.

  • Lower down body temperature by providing ice compression
  • Anti-emetic medication is provided via intravenous route to control nausea and vomiting
  • Sedatives drugs are also injected to calm down the patient, and when the patient becomes stable, then medicine may be given via oral route for a few days to control the withdrawal symptoms.
  • Ensuring patient and consultation with psychologist helps to boost morale and emotional power and encourage to avoid addiction. (3)

Dependence, tolerance and withdrawal

Yet now no evidence is available bout the physical dependence of the ecstasy, but chronic users often reported that it is hard to restrict oneself to avoid of ecstasy administration, it is assumed that it may due to psychological dependency.

Ecstasy also creates tolerance symptoms, as other addictive drugs. Tolerance can be illustrated as rising of dose with every usability to maintain the desirable effect.  This means with increasing dose, ecstasy does not cause increase patient response., But in alternatives, ecstasy increases the power of the unpleasant side effects. (2)

References

  1. Dangers of Ecstasy Overdose, Retrieve from: https://www.futuresofpalmbeach.com/addictions/ecstasy-abuse/overdose/
  2. Ecstasy (2015); Retrieve from: https://www.betterhealth.vic.gov.au/health/healthyliving/ecstasy#lp-h-0
  3. Ecstasy and MDMA Overdose; Retrieve from: http://www.allaboutcounseling.com/library/ecstasy-and-mdma-overdose/
  4. Ecstasy Overdose; Retrieve from: http://www.ecstasy.ws/e-overdose.htm

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