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MDMA and E

Question
Hi there,

I wondered if you could please tell me about the effects of MDMA and E from a systems perspective on a person that has cystic fibrosis or if there were any links to literature/information handouts anywhere?

I am a health professional that has recently been asked this by an adolescent child who has been using them and we are trying to support them to NOT be using them by providing up to date scientific information but have found it difficult to find this information anywhere.

Thank you.



Answer
Dear questioner,
MDMA stands for 3,4-Methylendioxy-N-methylamphetamin and belongs to the structural group of amphetamins. MDMA was until the 1980s synonoumos with the drug Ecstasy or “E”. Now, the name “Ecstasy“ comprises also drugs, that are not confined to MDMA as an ingredient, but can contain further ingredients or even no MDMA at all. Some of the side effects and risks that MDMA bears for healthy people can conceivably be especially dangerous for patients with CF:
Effects on the body (here I do not mention all, only the ones potentially important for CF patients) are tachypnea, tachycardia, arterial hypertension, hyperthermia with an increased body temperature up to 42°C and dehydration. Dancing fiercly aggravates the overheating and the consumer does not realize the warning signals of his body properly. The body temperature can increase up to 42°C that can lead in the worst case to organ dysfunction, coma and death. MDMA can cause a blood hyponatremia which could cause nausea, confusion or a seizure.
CF patients lose more salt via the sweat when dancing or exercising, furthermore they have a reduced thirst feeling leading to reduced and insufficient fluid intake. Therefore, they are especially at risk to decompensate due to the mentioned side effects.
Especially when taken an overdose or regularly, further consequences might occur: muscle cramps, vomiting, depression, severe impairment of the circulation. People with heart problems, hypertension, diabetes i.a. are especially at risk. Even in otherwise healthy people, an overdose of MDMA or when taken together with other drugs can lead in very rare cases to acute heart failure, as it is a blocker of calcium channels.
CF patients have a chronic lung disease, that leads in the long run also to right heart strain and an impaired oxygen supply of the body– therefore the risk of circulatory decompensation is for sure increased.
Furthermore, MDMA and E have a certain psychic dependence potential, sometimes it paves the way for the consumption of strongly addictive drugs, such as heroin. It has to be taken into account, that in case a CF patient needs lung transplantation in the future, drug addiction is an absolute contraindication.
I did a literature research on the topic cystic fibrosis and consumption of MDMA or Ecstasy, unfortunately I did not find a single publication or any studies that have been conducted on that issue.
Hope it helps a bit nevertheless,
Best regards,
Dr. Daniela d’Alquen (Coordinator of the Central English Archive of ECORN-CF)
01.04.2014
The answer is edited by: Prof Judy Bradley