Reply to 'MDMA can increase cortical levels by 800% in dance clubbers' Parrott et al

Basal functioning of the hypothalamic-pituitary-adrenal (HPA) axis and psychological distress in recreational ecstasy polydrug users

RATIONALE

Ecstasy (MDMA) is a psychostimulant drug which is increasingly associated with psychobiological dysfunction. While some recent studies suggest acute changes in neuroendocrine function, less is known about long-term changes in HPA functionality in recreational users.

OBJECTIVES

The current study is the first to explore the effects of ecstasy-polydrug use on psychological distress and basal functioning of the HPA axis through assessing the secretion of cortisol across the diurnal period.

METHOD

Seventy-six participants (21 nonusers, 29 light ecstasy-polydrug users, 26 heavy ecstasy-polydrug users) completed a substance use inventory and measures of psychological distress at baseline, then two consecutive days of cortisol sampling (on awakening, 30 min post awakening, between 1400 and 1600 hours and pre bedtime). On day 2, participants also attended the laboratory to complete a 20-min multitasking stressor.

RESULTS

Both user groups exhibited significantly greater levels of anxiety and depression than nonusers. On day 1, all participants exhibited a typical cortisol profile, though light users had significantly elevated levels pre-bed. On day 2, heavy users demonstrated elevated levels upon awakening and all ecstasy-polydrug users demonstrated elevated pre-bed levels compared to non-users. Significant between group differences were also observed in afternoon cortisol levels and in overall cortisol secretion across the day.

CONCLUSIONS

The increases in anxiety and depression are in line with previous observations in recreational ecstasy-polydrug users. Dysregulated diurnal cortisol may be indicative of inappropriate anticipation of forthcoming demands and hypersecretion may lead to the increased psychological and physical morbidity associated with heavy recreational use of ecstasy.

Ecstasy, legal highs and designer drug use: A Canadian perspective

Recreational drug use in Canada is not uncommon, but as with most societies, illegal drug use carries harsh penalties resulting in a criminal record when an individual is successfully prosecuted. Popular drugs of use in Canada include ecstasy, cannabis (including some synthetic cannabinoids sold as ‘Spice’ and ‘Incense’) and several emerging psychoactive ‘legal highs’. Surprisingly, Canada is a major manufacturer and exporter of the popular club drug ecstasy, with criminal gangs organising the synthesis and distribution of this club drug worldwide. Over the last 18 months, there has been much interest in and use of alternatives to ecstasy due to contamination of ecstasy during synthesis. One particular contaminant, paramethoxymethamphetamine (PMMA), has resulted in several deaths. Other alternatives include piperazines and mephedrone analogues. With regard to cannabis, some is home grown within people’s properties, but there is also large-scale cultivation in British Columbia where the climate is more temperate. With the introduction of corporate drug screening, there is increasing use of synthetic cannabinoids to avoid detection of marijuana use. This article discusses the problems and trends of synthetic drug use in Canada and reflects on the limited education available to youth in this regard.