INFOFACTS RESOURCES The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention Campuses and the Club Drug Ecstasy by Amy Powell Although alcohol is the drug that college students use most frequently and in greatest quantity, thedesigner drug ecstasy has generated both curiosityand concern in recent years. This Fact Sheet offersan overview of ecstasy, possible effects of its use, and implications for institutions of higher education. What Is Ecstasy? Ecstasy is one of the names used to refer to the chemical structure 3-4 methylenedioxymeth-amphetamine. This synthetic, psychoactive substance is also known as methaline dioximeth-amphetamine (MDMA); other shorthand terms for the drug are "adam," "XTC," "bean," "essence," "roll," "E," "lover's speed," "M," "eve," "X," "feel good drug," "doves," "rave energy," "cloud nine," and "the hug drug." Its chemical composition is similar to mescaline and methamphetamine, two synthetic drugs known to cause brain damage.1 The drug was created in 1912 by a German company; it was patented, but never studied or marketed for human consumption. In the 1970s and 1980s, some therapists used ecstasy to facilitate psychotherapy. The drug was declared illegal in the United States in 1985, when it was made a Schedule 1 substance. Ecstasy is usually taken in the form of pills or capsules, although it is occasionally used in powder form. Most varieties are stamped with a distinguishing logo, such as a green triangle2 or a brand name.3 The purchase price of ecstasy in the United States is generally between $20 and $30 per pill.4 Along with gamma hydroxybutyrate (GHB) and rohypnol, ecstasy is frequently called a "club drug." This categorization comes from its widespread use at clubs, concerts, and raves (large, all-night dance parties). Young people use ecstasy in these settings to experience the euphoria and energetic feeling that the drug can provide, seeming to enhance their ability to dance, socialize, and stay awake for extended periods of time. A 2005 study revealed that students also use the drug because of its positive effects on mood, broad availability, to self-medicate, or to "escape" or achieve an altered state of mind.5 How Prevalent Is Ecstasy Use? The actual number of students using ecstasy and other club drugs remains relatively low. The 2006 Monitoring the Future study indicates that while 30-day prevalence for ecstasy among college students rose to 2.5 percent in 2000, that rate dropped to 0.6 percent in 2006. Further, lifetime prevalence reached a high of 14.47 percent in 2001, but dropped to only 6.9 percent in 2006.6 Campuses face the possibility that incoming students will have already experimented with ecstasy. According to the 2006 Monitoring the Future Survey, 1.4 percent of 8th graders report using ecstasy in the past year, with 4.1 percent of 12th graders reporting past-year use. A 2006 study also suggests that college students who use ecstasy are likely to be polydrug users: ecstasy users, compared with marijuana users, are signifi cantly more likely to have used inhalants, LSD, cocaine, and heroin in the past year.7 As with the current findings regarding ecstasy use among college students, the percentage of youth using this drug is relatively low, but may be higher on individual campuses. As is the case with all alcohol and other drugs, prevention professionals are encouraged to collect prevalence data specific to their own campus before designing a comprehensive prevention program. Along with reported increases in use, ecstasy's availability appears to be increasing. From 1993 to 1999, seizures of ecstasy tablets submitted to the Drug Enforcement Administration (DEA) by various law enforcement agencies rose from 196 to 143,600.8 According to the DEA, this increase suggests that a greater quantity of the drug is now coming into the United States, making it easier for potential users to obtain. This influx poses new challenges to law enforcement. Unlike some other popular drugs, ecstasy and its derivatives are not easily manufactured in makeshift labs. The DEA estimates that 80 percent of the drug comes from sophisticated, clandestine labs in the Netherlands.9 U.S. enforcement agencies at the national, state, and local levels are working to expand their operations to take into account this relatively new source. Possible Short-Term Effects of Ecstasy Use People who have taken ecstasy and professionals encountering those under its influence (e.g., medical personnel, law enforcement agents, counselors) report an array of possible effects from the drug:10, 11, 12, 13 * temporary feeling of enhanced selfconfidence * "energy burst" * feeling less inhibited * confusion * depression * sleep problems * hallucinations * drug craving * severe anxiety * paranoia * muscle tension * increased heart rate * increased blood pressure * increased body temperature * dehydration * involuntary teeth clenching * nausea * blurred vision * rapid eye movement * faintness * chills * sweating A small number of deaths has been reported among ecstasy users.14 Ecstasy is often used in conjunction with alcohol or other drugs while dancing in overheated venues; it is, therefore, unclear whether these deaths were the direct result of ingesting ecstasy or attributable to other factors.15 Potential Long-Term Effects of Ecstasy Use Research continues to focus on the potential long-term consequences of ecstasy use. One recent study found that exposure to MDMA in laboratory animals caused brain damage that was present six to seven years after testing; the parts of the brain affected were those critical to thought and memory.16 Another preliminary study suggests that human use of ecstasy as a recreational drug may be related to elevated impulsivity. 17 While there are no definitive findings to date, the existing research offers reason to be concerned about ecstasy's potential dangers. Other Causes for Concern While the effects of ecstasy are uncertain, known dangers involve the unregulated nature of the drug. U.S. enforcement agencies and antidrug groups report that ecstasy, laced with a variety of additives, is coming into major cities. 18 According to anecdotal evidence, common lacing agents include amphe-amines, Valium, caffeine, and dextro- methorphan (DM), an ingredient in many over-the-counter cough suppressants.19 It is also common for ketamine, ephedrine, paramethoxyamphetamine (PMA), and other substances to be peddled as ecstasy.20 Therefore, would-be ecstasy users may unknowingly ingest other potentially harmful substances. In order to determine what pills purchased by club-goers as ecstasy actually contain, groups such as DanceSafe (http://www.dancesafe. org) test pills on- site at raves and clubs to identify ingredients-including adulterants. Such groups face opposition by those who feel that such testing condones the use of illicit substances. Advocates of this practice, however, believe that testing for ecstasy reduces the risk of young people ingesting unknown substances that could prove harmful or fatal. Strategies for Institutions of Higher Education Although the number of students involved with ecstasy is relatively low, the recent increase in use challenges colleges and universities to include the drug specifi cally as they develop and implement prevention and enforcement efforts for alcohol and other drugs. Environmental strategies21 for reducing ecstasy use include the following: Promoting Alcohol- and Drug-Free Social, Recreational, and Extracurricular Options and Public Service * Use alternative events to simulate the club and rave atmospheres that appeal to some students; marketing efforts for these events must clearly outline the alcohol- and drugfree guidelines for the activities. * Incorporate rave-type activities into alcohol- and drug-free events (e.g., highenergy music, dancing, extended hours); as with any event, adequate supervision and security must be in place to ensure the alcohol- and drug-free nature of these events. In spite of marketing efforts announcing the alcohol- and drug-free nature of rave-like alternative events, informal communications among students may misrepresent these campus activities as actual raves. This misperception may lead to visitors arriving on campus to take part in these events and to the presence of ecstasy and other club drugs on campus. Creating a Social, Academic, and Residential Environment That Promotes Healthy Social Norms * Survey students to determine the prevalence of ecstasy and club drugs on campus. * Develop social norms marketing22 campaigns to address any exaggerated misperceptions of ecstasy or other club drug use. Limiting Availability and Access * Work with local law enforcement to stay current with trends related to ecstasy distribution and use in the area. * Utilize campus and community coalitions, including enforcement agencies, to identify where students are getting and using ecstasy and to address these possible sources of club drugs at the institution and in the surrounding community (e.g., arresting dealers, closing clubs that allow use on the premises). Enforcing Campus Policy and State and Local Laws * Revise campus alcohol and other drug policies as necessary to include club drugs specifically. * Communicate campus alcohol and other drug policies clearly and frequently to the community, including possible consequences for violations. * Coordinate with local law enforcement to uphold campus policies and state laws relating to the possession and use of ecstasy and related drugs. Restricting Marketing and Promotion * Prohibit on-campus advertising of rave clubs and related events. * Work with campus and community coalitions to restrict promotions in the community at large that advertise clubs and raves where ecstasy may be present and its use may be encouraged or tolerated. * Encourage all institution faculty and staff to be aware of and to report any marketing materials and rumors regarding rave clubs and similar activities where student club drug use may occur. * Work with local law enforcement to address and investigate promotions found on campus and in the surrounding community. Pursuing Further Research Efforts are under way to raise awareness and to learn more about the prevalence, effects, and potential dangers of ecstasy among youth, college and university students, and the adults working and living with them. For example, the National Youth Anti-Drug Media Campaign (funded by the Office of National Drug Control Policy [ONDCP]) offers a Web site, http://www. freevibe.com, to educate and encourage discussion about ecstasy and other club drugs. In December 1999, the National Institute on Drug Abuse (NIDA) announced an additional national initiative that would increase funding for research about club drugs, their effects, and effective strategies for curbing use; this effort brought NIDA's financial commitment to address club drugs to a total of $54 million dollars. As part of this initiative, NIDA maintains a Web site for information about ecstasy and other club drugs: http://www.clubdrugs.org. Institutions of higher education will need more data about this trend in order to address it effectively. Patterns of student use, implications for academic performance, and correlations to other social issues on campus (e.g., sexual assault, suicide) are potential areas for further study. Notes 1. National Institute on Drug Abuse, National Institutes of Health (NIDA/NIH). "Infofax- MDMA (Ecstasy) 13547." http//165.112.78.61/ Infofax/ecstasy.html. 2. A. Bollman. "Ecstasy Additives Trouble Activists," Boston Globe, 11 September 2000, sec. B, 1. 3. Partnership for a Drug-Free America Website [www document]. http:// www.drugfreeamerica.org/druginfo/ drugInfo.asp?drugID=10. 4. U.S. Department of Justice, Drug Enforcement Administration Website [www document]. http://www.usdoj.gov/dea/concern/mdma/ mdma.htm. 5. Levy, K. B.; O'Grady, K. E.; Wish, E. D.; and Arria, A. M. "An In-Depth Qualitative Examination of the Ecstasy Experience: Results of a Focus Group with Ecstasy-Using College Students." Substance Use & Misuse 40, 9-10, 2005. 6. Johnston, L. D.; O'Malley, P. M.; Bachman, J. G.; and Schulenberg, J. E. Monitoring the Future National Survey Results on Drug Use, 1975-2006. Volume II: College Students and Adults Ages 19-45 (NIH Publication No. 07-6206) (Bethesda, Md.: National Institute on Drug Abuse, 2007). 7. Wish, E. D.; Fitzelle, D. B.; O'Grady, K. E.; Hsu, M. H.; and Arria, A. M. "Evidence for Significant Polydrug Use among Ecstasy-Using College Students." Journal of American College Health 55, 2, 2006. 8. U.S. Department of Justice, Drug Enforcement Administration Website, op.cit. 9. K. DeYoung. "Alarm on Spreading Ecstasy," Washington Post,1 August 2000, sec. A, 3. 10.Partnership for a Drug-Free America Website, op.cit. 11.National Institute on Drug Abuse, op.cit. 12.K. Kaufhold. "Use of Ecstasy Explodes on Campus and in Clubs." http://www.cpnet.com/ cpres/backtoschool/docs/991210ecstasy.asp. 13.Join Together Online (June 22, 2000). "Free Water for Drinkers, Designer Drug Users." http://www.jointogether.org/sa/wire/news/ reader.jtml?Object_ID=263558. 14."Ecstasy and Raves," Developments 20, no. 5 (October-November 2000). http:// www.gov.ab.ca/aadac/addictions/Developments/v20_5.htm. 15.Ibid. 16.National Institute on Drug Abuse, op.cit. 17.M. J. Morgan. "Recreational Use of 'Ecstasy' (MDMA) Is Associated with Elevated Impulsivity," Neuropsychopharmacology 19, no. 4 (October 16, 1998): 252-64. 18.Bollman, op.cit. 19.Bollman,op.cit. 20."Party Drug, Fatal Drug." CBS News/48 Hours (November 30, 2000). http:// cbsnews.com/now/story/0,1597,253290- 412,00.shtml. 21.For more information about environmental strategies for alcohol and other drug prevention, see the Higher Education Center's publication Environmental Management: A Comprehensive Strategy for Reducing Alcohol and Other Drug Use on College Campuses. . 22.For more information about social norms marketing, see the Higher Education Center's publication Social Marketing Strategies for Campus Prevention of Alcohol and Other Drug Problems. Amy Powell is a freelance writer based in Washington, D.C Office of Safe and Drug-Free Schools (OSDFS) U.S. Department of Education http://www.ed.gov/osdfs; 202-245-7896 OSDFS supports efforts to create safe schools, respond to crises, prevent alcohol and other drug abuse, ensure the health and well-being of students, and teach students good character and citizenship. The agency provides financial assistance for drug abuse and violence prevention programs and activities that promote the health and well-being of students in elementary and secondary schools and institutions of higher education. The U.S. Department of Education's Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention http://www.higheredcenter.org; 1-800-676-1730; TDD Relay-friendly, Dial 711 The Higher Education Center offers an integrated array of services to help campuses and communities come together to identify problems; assess needs; and plan, implement, and evaluate alcohol and other drug abuse and violence prevention programs. Services include training; technical assistance; publications; support for the Network Addressing Collegiate Alcohol and Other Drug Issues; and evaluation activities. The Higher Education Center's publications are free and can be downloaded from its Web site. The Network Addressing Collegiate Alcohol and Other Drug Issues http://www.thenetwork.ws; see Web site for telephone contacts by region The Network Addressing Collegiate Alcohol and Other Drug Issues (Network) is a national consortium of colleges and universities formed to promote healthy campus environments by addressing issues related to alcohol and other drugs. Developed in 1987 by the U.S. Department of Education, the Network comprises member institutions that voluntarily agree to work toward a set of standards aimed at reducing AOD problems at colleges and universities. It has more than 1,600 members nationwide. Other Organizations Community Anti-Drug Coalitions of America (CADCA) http://www.cadca.org; 1-800-54-CADCA CADCA's mission is to create and strengthen the capacity of new and existing coalitions to build safe, healthy, and drug-free communities. The organization supports its members with technical assistance and training, public policy, media strategies and marketing programs, and conferences and special events. The Core Institute http://www.siu.edu/~coreinst; 618-453-4420 The federally funded Core Institute assists colleges and universities in AOD prevention efforts. The Core Alcohol and Drug Survey includes questions on academic performance as well as substance use, campus climate, campus violence, beliefs about the effects of alcohol, participation in campus activities, perceptions of group norms, risks involved in using alcohol and other drugs, and secondary effects of drinking. The institute provides technical assistance on survey administration and data analysis and interpretation. Join Together http://www.jointogether.org; info@jointogether.org 617-437-1500 Join Together, a project of the Boston University School of Public Health, is a national resource for communities working to reduce substance abuse and gun violence. Monitoring the Future Study http://monitoringthefuture.org; 734-764-8354 Since 1975, Monitoring the Future has surveyed a nationwide sample of high school seniors. Since 1991, the project has also included nationwide samples of 8th and 10th grade students. Annual follow- up surveys are mailed to a sample of each graduating class for a number of years after their initial participation. This survey assesses the beliefs, attitudes, and behaviors of young people in the United States. Follow-up survey results are reported for undergraduate students attending college. National Clearinghouse on Alcohol and Drug Information (NCADI) http://www.ncadi.samhsa.gov; 1-800-729-6686; 301-468-2600 NCADI is the information service of the Center for Substance Abuse Prevention of the Substance Abuse and Mental Health Services Administration in the U.S. Department of Health and Human Services. NCADI is a major resource for current information and materials concerning substance abuse. The organization responds to public inquiries regarding alcohol and other drug use; distributes free or low- cost informational, culturally appropriate materials on prevention, intervention, and treatment; and provides access to several alcohol and other drug prevention databases. National Institute on Drug Abuse (NIDA) http://www.nida.nih.gov; 301-443-1124 NIDA's mission is to lead the Nation in bringing the power of science to bear on drug abuse and addiction. This charge has two critical components: The fi rst is the strategic support and conduct of research across a broad range of disciplines. The second is to ensure the rapid and effective dissemination and use of the results of that research to signifi cantly improve drug abuse and addiction prevention, treatment, and policy. Office of National Drug Control Policy (ONDCP) http://www.whitehousedrugpolicy.gov ONDCP establishes policies, priorities, and objectives for the Nation's drug control program, the goals of which are to reduce illicit drug use, manufacturing, and trafficking; drug- related crime and violence; and drug-related health consequences. ONDCP's Pulse Check: Trends in Drug Abuse Mid-Year 2000 has a section on ecstasy and other club drugs (see www. whitehousedrugpolicy.gov/drugfact/pulsechk/midyear2000/midyear2000. For additional information The Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention Education Development Center, Inc. 55 Chapel Street Newton, Massachusetts 02458-1060 http://www.higheredcenter.org 1-800-676-1730; TDD Relay-friendly, Dial 711 Fax: 617-928-1537 Funded by the U.S. Department of Education August 2008 This publication was funded by the Office of Safe and Drug-Free Schools at the U.S. Department of Education under contracts number ED-99-CO-0094 and ED-04-CO- 0137 with Education Development Center, Inc. The contracting officer's representative was Richard Lucey, Jr. The content of this publication does not necessarily reflect the views or policies of the U.S. Department of Education, nor does the mention of trade names, commercial products, or organizations imply endorsement by the U.S. government. This publication also contains hyperlinks and URLs for information created and maintained by private organizations. This information is provided for the reader's convenience. The U.S. Department of Education is not responsible for controlling or guaranteeing the accuracy, relevance, timeliness, or completeness of this outside information. Further, the inclusion of information or a hyperlink or URL does not reflect the importance of the organization, nor is it intended to endorse any views expressed, or products or services offered. Published