Originally appearing at http://dailyfreepress.com/2011/02/28/evacuate-the-dance-floor/. MDMA. E. XTC. X. Ecstasy is a drug with many names and a colorful reputation, especially on the dance floor. “I really have only heard good things about ecstasy from those that have used it,” said Boston University College of Arts and Sciences freshman Lindsay Rapkin. “It usually makes people more sensual and sensitive to touch and in combination with the music provides an overall feeling of relaxation.” But is Ecstasy just for club-goers anymore? Based on studies that could bring new applications for the drug to light, coupled with findings that could contradict certain conventionally presumed negative effects, some think not. Others, however, remain unconvinced. UPS AND DOWNS Harvard University’s John Halpern recently published a study in the medical journal “Addiction” that examined the effects of Ecstasy on cognitive ability. Halpern and his colleagues compared 52 long-term Ecstasy users, aged 18 to 45, with 59 non-users, all of whom were drug-tested prior to their participation in the study to ensure accurate results. The study found no cognitive changes in the control group of non-users during their Ecstasy experience. There was a small spike in impulsivity in the users, but the researchers attributed this to the personality of the subjects rather than to the drug. The subjects wanted to try Ecstasy because of their impulsive nature – it was not the Ecstasy that caused their impulsivity. This is not the first time science has explored the medical uses of Ecstasy. But some previous studies, such as Science magazine’s 2002 article about Ecstasy’s potentially healing effect on Parkinson’s disease in monkeys, were debunked after researched found the monkeys had taken methamphetamines and not Ecstasy. According to Time magazine, more recent research does suggest that Ecstasy or similar drugs could, in fact, help treat Parkinson’s after all. Ultimately, the drug’s effects are objectively neurological. “MDMA does two things: it increases the neuronal release of dopamine and has an even greater effect on increasing the neuronal release of serotonin,” said BU neuroscience professor Kathleen Kantak in an email. So what are the origins of the claims against Ecstasy? “By releasing dopamine, MDMA activates the reward system, which underlies its abuse potential,” she said. “By releasing serotonin, it initially enhances sensory awareness, but because it releases so much serotonin, there is a relative depletion of this neurotransmitter after the drug wears off and therefore it induces depression.” If the drug is abused, she said, this reaction is not solely a short-term issue. “Body temperature rises and toxicity to serotonin neurons can develop. The serotonin nerve ending die [sic] and this can result in long term depression and cognitive deficits, particularly those associated with the prefrontal cortex,” she said. She said these include “executive functions” such as decision-making and judgment, control over inhibitions and the strength of working memory. BITTER WITH THE BETTER Those interested in using Ecstasy as a therapeutic drug seem to be more intrigued by the upsides during the experience rather than the potential long-term downsides. Mary-Catherine Youmell, a third-year philosophy Ph.D. student in the Graduate School of Arts and Sciences, recalled cases where Ecstasy has been used to treat post-traumatic stress syndrome. “I’ve heard that it can be enormously helpful in PTSD cases because it temporarily shuts down the fear center in your brain, which enables the patient to face the trauma without the body having a panic response,” she said. “I imagine this would be helpful for all sorts of anxiety disorders.” But distinguishing which patients would benefit from Ecstasy use could be challenging. “I’ve heard that coming down from the high is really rough, and I think this may make the drug not ideal for many patients,” Youmell said. Carrie Abend, a junior in the College of Communication, said she would also be interested in Ecstasy being used as a form of treatment for such disorders. “I think it’s great that the medical world is trying new things to help these people, because mental illness is so stigmatized,” said Abend. Abend said she finds it acceptable to lump Ecstasy in with many other medicines. “Like with most drugs, I’ve heard horror stories and also success stories about E, but I think that E as a medicinal drug would be better controlled,” she said. “It’s a drug, and, at the end of the day, not that different from the prescriptions that doctors already give patients.” Youmell also saw no reason not to safely incorporate Ecstasy into the world of medicine. “Seems perfectly obvious to me that we need to start having controlled trials here,” she said. “I think we have a responsibility to be really open to alternate therapies, especially when they seem to be more successful and much faster.” A WAYS OFF But members of the medical community, such as Prof. Kantak, were still skeptical. “Supposedly, MDMA brings subconscious thoughts to the foreground, which helps the individual to deal with his or her problems,” she said. “It has been administered only a few times under very carefully controlled conditions.” And Kantak is not the only member of the BU community who is wary of the effects of Ecstasy on patients. Despite the good things Lindsay Rapkin said she heard from her peers, she said she would not trust Ecstasy as a medical treatment. “I’m sure that Ecstasy cannot be great for one’s body, because it can alter cognition and is possibly addictive,” she said. But Rapkin need not fear. Although there are published studies regarding the medicinal uses of Ecstasy, they are few and far between, and Kantak noted that the drug remains, at least for now, in the same class as most other illegal substances. “Because MDMA is a schedule 1 controlled substance, getting approval to do this type of study is extremely difficult,” she said. “Don’t expect to see this as a mainstream treatment any time soon.” Boston University’s student newspaper reports on Dr. John Halpern’s latest study of the cognitive risks of Ecstasy, which found no association between heavy recreational use of the drug and damage to learning, memory, or strategic thinking. The author rightly points out that the results challenge decades of prior research, which have exaggerated the risks of the drug, and correctly identifies MDMA’s growing acceptance as a treatment for PTSD. However, she and her interviewees also make a number of glaring mistakes in their characterization of the drug and its effects, including: (1) Dr. Halpern’s study was not intended to explore the “medical uses” of Ecstasy; (2) the principle (and possibly erroneous) claims against Ecstasy have been linked to its potential cognitive, rather than neurological, damage; (3) MDMA, the ingredient commonly presumed to be the main component of illegally purchased Ecstasy, is actually quite different from existing prescription medicines both in its mechanism of action and in its mode of administration; and (4) there is actually very little scientific evidence for Ecstasy being an addictive drug. With new research on the risks and medical benefits of Ecstasy and MDMA emerging, it’s important that journalists get the science right, and that they take non-experts’ claims about the drug with several grains of salt.