Dec 9, 2002: What are Designer Drugs? What is MDMA (Ecstasy)?

 To discuss Designer Drugs, it is worthwhile to first review the history of Designer Drugs.  A California pharmacist first used this term in 1980 to describe the private synthesis of drugs different from the parent compound. This rendered the drugs immune from the DEA.  The loophole was that until a drug was isolated, studied, and scheduled, no laws could apply to it. Using well-known drugs such as fentanyl, mescaline, amphetamine, and meperidine, designer drugs such as MDMA, MPTP, and fentanyl derivatives were made.  This is no longer possible due to the Controlled Substance Analogue (CSA) Enforcement Act of 1985 which placed analogs of controlled substances (that had chemical structure similar to those in Schedule 1 and II) into schedule I. 
MDMA (Adam, Ecstasy) was marketed as an appetite suppressor in 1914.  It was used as an adjunct to psychotherapy in the 70s and 80s.  It was said to help people gain insight without psychotic or visual disturbances.  Therapists felt that the drug helped gain insight that was equivalent to over a year of therapy.  However, before controlled studies on MDMA were funded, the DEA ruled it could not be used for medicinal use.  The decision was influenced by media reports sensationalizing the drug and lab studies reporting serotonergic neurotoxicity.  
 In the mid 80s, it was a recreational drug in college.  In a survey in 1987, up to 40% of Stanford students said they used this drug.
Due to the increased recreational use, in 1985, the drug was made Schedule I on an emergent basis under the Comprehensive Crime Control Act.  It was removed from Schedule I in 1986 when professors from Harvard contested the classification in the Federal Court of Appeals due to the lack of scientific evidence.  
MDMA has recently gained renewed popularity.  
Next week "What is Ecstasy?"
As always, if there are any questions, call the MTPC.

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Donna Seger, M.D.
Medical Director, Middle Tennessee Poison Center