Is ecstasy a drug of dependence?
Louisa Degenhardt, R. Bruno, Libby Topp
Drug and Alcohol Dependence February 1, 2010 DOI: 10.1016/j.drugalcdep.2009.09.009 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Addiction MDMA |
| Key findings | Argues that MDMA has dependence potential but likely less than other drugs, with psychological features more salient than physical ones. Proposes that ecstasy dependence may have a two-factor structure (compulsive and escalating use) and that a minority of users seek treatment. |
Abstract
This paper examines the evidence for an MDMA or "ecstasy" dependence syndrome. Animal evidence suggests that MDMA may be a less potent reinforcer than other drugs, but that it does have dependence potential. This suggests that (a) ecstasy dependence might be less likely than dependence upon other drugs; and (b) factors related to the behavioural and psychological aspects of reward and dependence may make a relatively greater contribution for ecstasy than for other drugs, where physically centred (and better understood) features of dependence may be more salient. Human evidence supports this proposition. Some people report problems with their use, but the literature suggests that physical features play a more limited role than psychological ones. Tolerance is apparent, and withdrawal is self-reported, but it is unclear whether these reports distinguish sub-acute effects of ecstasy intoxication from symptoms reflective of neuroadaptive processes underlying a "true" withdrawal syndrome. Studies examining the structure of dependence upon ecstasy suggest it may be different from drugs such as alcohol, methamphetamine and opioids. Consistent with studies of hallucinogens, a two-factor structure has been identified with factors suggestive of "compulsive use" and "escalating use". Regardless of the nature of any dependence syndrome, however, there is evidence to suggest that a minority of ecstasy users become concerned about their use and seek treatment. Further controlled studies are required to investigate this phenomenon.
Comparable studies
Other narrative reviews on MDMA for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Neuropharmacology of New Psychoactive Substances (NPS): Focus on the Rewarding and Reinforcing Properties of Cannabimimetics and Amphetamine-Like Stimulants | 2016 | Review | |
| Methamphetamine and MDMA (Ecstasy) Neurotoxicity: 'of Mice and Men' | 2004 | Review | |
| Use and abuse of dissociative and psychedelic drugs in adolescence Adolescent humans and preclinical animal models | 2021 | Review | |
| Can MDMA Play a Role in the Treatment of Substance Abuse? | 2013 | Review | |
| Neuroimaging in Human MDMA (Ecstasy) Users | 2008 | Review |
Citations in the library
Cited by 56
- The Prosocial Effects of 3,4-methylenedioxymethamphetamine (MDMA): Controlled Studies in Humans and Laboratory Animals Neuroscience & Biobehavioral Reviews September 25, 2015
- The ugly side of amphetamines: short- and long-term toxicity of 3,4-methylenedioxymethamphetamine (MDMA, ‘Ecstasy’), methamphetamine and d-amphetamine Biological Chemistry January 2, 2011
- Current Perspective on MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder. Journal of Contemporary Psychotherapy January 6, 2018
- Acquisition of MDMA self‐administration: pharmacokinetic factors and MDMA‐induced serotonin release Addiction Biology June 14, 2013
- Emerging psychoactive substance use among regular ecstasy users in Australia. Drug and Alcohol Dependence July 1, 2012
and 51 more in the library
Cites 19
- Ecstasy (MDMA) dependence Drug and Alcohol Dependence January 7, 1999
- MDMA self‐administration in rats: acquisition, progressive ratio responding and serotonin transporter binding European Journal of Neuroscience November 16, 2007
- Reinforcing Effects of MDMA (‘Ecstasy’) in Drug-Naive and Cocaine-Trained Rats Pharmacology 2001
- Serotonin–GABA interactions modulate MDMA‐induced mesolimbic dopamine release Journal of Neurochemistry October 27, 2004
- Neurocognitive function in users of MDMA: the importance of clinically significant patterns of use Psychological Medicine January 28, 2004
and 14 more in the library