MDMA (ecstasy) is a designer drug popular among American adolescents at raves and on college campuses, with an undeserved reputation for safety. Short-term effects include sweating, tachycardia, fatigue, and muscle spasms; serious adverse effects include fatal heat injury, fluid and electrolyte depletion, and dysfunction of the central nervous system, heart, muscles, kidneys, and liver. MDMA has been implicated in at least 53 deaths in the United Kingdom and at least five in the United States, mainly from heatstroke. It is a selective serotonergic neurotoxin. Toxicology screening tests detect MDMA with about 50% reduced sensitivity. Treatment of acute toxicity involves rapid cooling, rehydration, and monitoring electrolytes and organ function.
About one in four adolescents already identified as substance abusers reported having used hallucinogenic mushrooms, often along with alcohol or marijuana. An average dose of 2-4 mushrooms cost around $8 and produced intoxication lasting 5-6 hours. Mixing different intoxicants was common, and acute adverse reactions may have resulted from drug synergy. Pediatricians should consider hallucinogenic mushroom use when evaluating a delirious or psychotic adolescent.
Psychedelics may significantly influence beliefs about paranormal experiences. In a survey of 1,200 participants, 62% reported having at least one paranormal experience after using psychedelics, compared to just 28% among non-users. Additionally, 45% of psychedelic users expressed a belief in the supernatural, versus 22% of those who abstained. These findings highlight the potential of psychedelics in shaping perceptions and beliefs, suggesting that their impact extends beyond traditional medicine into the realm of personal and spiritual experiences.