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Ecstasy Addiction Drug
Rehab
ANIDA-supported study has provided the first
direct evidence that chronic use of MDMA, popularly known as "ecstasy," causes
brain damage in people. Using advanced brain imaging techniques, the study
found that MDMA harms neurons that release serotonin, a brain chemical thought
to play an important role in regulating memory and other functions. In a
related study, researchers found that heavy MDMA users have memory problems
that persist for at least two weeks after they have stopped using the drug.
Both studies suggest that the extent of damage is directly correlated with the
amount of MDMA use.
"The message from these studies is that MDMA does
change the brain and it looks like there are functional consequences to these
changes," says Dr. Joseph Frascella of NIDA's Division of Treatment Research
and Development. That message is particularly significant for young people who
participate in large, all-night dance parties known as "raves," which are
popular in many cities around the Nation. NIDA's epidemiologic studies indicate
that MDMA (3,4-methylenedioxymethamphetamine) use has escalated in recent years
among college students and young adults who attend these social gatherings.
In the brain imaging study, researchers used positron emission
tomography (PET) to take brain scans of 14 MDMA users who had not used any
psychoactive drug, including MDMA, for at least three weeks. Brain images also
were taken of 15 people who had never used MDMA. Both groups were similar in
age and level of education and had comparable numbers of men and women.
In people who had used MDMA, the PET images showed significant
reductions in the number of serotonin transporters, the sites on neuron
surfaces that reabsorb serotonin from the space between cells after it has
completed its work. The lasting reduction of serotonin transporters occurred
throughout the brain, and people who had used MDMA more often lost more
serotonin transporters than those who had used the drug less.
Previous
PET studies with baboons also produced images indicating MDMA had induced
long-term reductions in the number of serotonin transporters. Examinations of
brain tissue from the animals provided further confirmation that the decrease
in serotonin transporters seen in the PET images corresponded to actual loss of
serotonin nerve endings containing transporters in the baboons' brains. "Based
on what we found with our animal studies, we maintain that the changes revealed
by PET imaging are probably related to damage of serotonin nerve endings in
humans who had used MDMA," says Dr. George Ricaurte of The Johns Hopkins
Medical Institutions in Baltimore. Dr. Ricaurte is the principal investigator
for both studies, which are part of a clinical research project that is
assessing the long-term effects of MDMA.
"The real question in all
imaging studies is what these changes mean when it comes to functional
consequences," says NIDA's Dr. Frascella. To help answer that question, a team
of researchers, which included scientists from Johns Hopkins and the National
Institute of Mental Health who had worked on the imaging study, attempted to
assess the effects of chronic MDMA use on memory. In this study, researchers
administered several standardized memory tests to 24 MDMA users who had not
used the drug for at least two weeks and 24 people who had never used the drug.
Both groups were matched for age, gender, education, and vocabulary scores.
The study found that, compared to the nonusers, heavy MDMA users had
significant impairments in visual and verbal memory. As had been found in the
brain imaging study, MDMA's harmful effects were dose related, the more MDMA
people used, the greater difficulty they had in recalling what they had seen
and heard during testing.
The memory impairments found in MDMA users
are among the first functional consequences of MDMA-induced damage of serotonin
neurons to emerge. Recent studies conducted in the United Kingdom also have
reported memory problems in MDMA users assessed within a few days of their last
drug use. "Our study extends the MDMA-induced memory impairment to at least two
weeks since last drug use and thus shows that MDMA's effects on memory cannot
be attributed to withdrawal or residual drug effects," says Dr. Karen Bolla of
Johns Hopkins, who helped conduct the study.
The Johns Hopkins/NIMH
researchers also were able to link poorer memory performance by MDMA users to
loss of brain serotonin function by measuring the levels of a serotonin
metabolite in study participants' spinal fluid. These measurements showed that
MDMA users had lower levels of the metabolite than people who had not used the
drug; that the more MDMA they reported using, the lower the level of the
metabolite; and, that the people with the lowest levels of the metabolite had
the poorest memory performance. Taken together, these findings support the
conclusion that MDMA induced brain serotonin neurotoxicity may account for the
persistent memory impairment found in MDMA users, according to Dr Bolla.
Research on the functional consequences of MDMA-induced damage of
serotonin-producing neurons in humans is at an early stage, and the scientists
who conducted the studies cannot say definitively that the harm to brain
serotonin neurons shown in the imaging study accounts for the memory
impairments found among chronic users of the drug. However, "that's the
concern, and it's certainly the most obvious basis for the memory problems that
some MDMA users have developed," Dr. Ricaurte says.
Findings from
another Johns Hopkins/NIMH study now suggest that MDMA use may lead to
impairments in other cognitive functions besides memory, such as the ability to
reason verbally or sustain attention. Researchers are continuing to examine the
effects of chronic MDMA use on memory and other functions in which serotonin
has been implicated, such as mood, impulse control, and sleep cycles.
How long MDMA-induced brain damage persists and the long-term
consequences of that damage are other questions researchers are trying to
answer. Animal studies, which first documented the neurotoxic effects of the
drug, suggest that the loss of serotonin neurons in humans may last for many
years and possibly be permanent. "We now know that brain damage is still
present in monkeys seven years after discontinuing the drug," Dr. Ricaurte
says. "We don't know just yet if we're dealing with such a long-lasting effect
in people." |
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