E for Ecstasy by Nicholas Saunders
Appendix 1: Reference Section

37 The Phenomenology of Ecstasy Use, by Teresa O'Dwyer, Senior Registrar of Adult Psychiatry at St Thomas' Hospital, Morpeth, November 92

This paper is an account of a study of users' experiences on Ecstasy and the patterns and circumstances of their use undertaken by the Leeds Addiction Unit between January and September 1992. 33 subjects aged between 16 and 27 - mostly male - were referred by the LAU and given a questionnaire, part of which they completed themselves and part of which was filled in by researchers.

70% of respondents used Ecstasy on weekends only. Half had tried it only once. 31% had never taken more than one E at a time, but 12% had used over 7. During the onset of the drug, the apprehension felt by inexperienced users sometimes developed into panic. Many said it was essential to feel very hot to get the full effect of the drug. To this end, a group of friends once drove around in a car with the heater on.

All respondents described an increase in social interaction under MDMA, an increased ability to approach and relate to strangers, and an enhanced ability to express affection. The drug also seemed to produce an attitude of recklessness where users had little concern about the consequences of what they were doing, although only two had had accidents.

Thoughts about sex when on E were not always matched by real desire. Establishing a 'meaningful relationship' was felt to be an essential part of foreplay. Some found sex while on Ecstasy disappointing while for others it was enhanced.

The name 'Ecstasy' was regarded as appropriate by many respondents. Their comments on the mood induced by the drug included "I cried for joy", "It's the best feeling you could ever have", "Like I've just been woken from a dream to really experience life". Some felt privileged to have had the E experience, and one respondent expressed this by saying "We have a secret that no-one else has".

A depressed mood is reported by most users as the after effect of taking E and this sometimes lasted for a couple of days. Paranoia was reported by 85%. "For many, this began as an awareness of beingadmired by others. Gradually as the weeks passed, this admiring regard changed to critical scrutiny and ridicule. Increased sensitivity to comments and a tendency to interpret situations in a threatening way was described by some," O'Dwyer says. Most people experienced a hangover lasting from 12 to 24 hours, but for some this lasted for up to a week.

The thoughts most frequently reported on E relate to music, dancing and affection for companions. 60% felt E had changed the way they looked at their life. Over half 'felt that while under the influence of Ecstasy they could see a new significance in current and past events'. Over half reported losing personal interests including sport and drinking, but a third said they gained new interests, such as music and clothes. Thinking could become focused but was also sometimes distracted: "The most elaborate, complicated solutions are arrived at only to find that the initial problem is now forgotten," O'Dwyer said.

76% of respondents had lost weight averaging one stone through taking E. All frequent users reported that they became tolerant to Ecstasy. To maintain the effect, they had to increase the dose, but this also increased the side effects of nausea, cramp, depression and paranoia. Some took a break from using the drug for a few weeks for this reason. 58% of respondents said they had stopped using Ecstasy. The most common reasons given were that it was no longer providing enough pleasure; it had caused problems due to the associated lifestyle of all-night raving or it caused paranoia or concerns about health. 30% reported social problems such as losing their job or the break-up of a relationship following using E. Most felt that the quality of the drug had deteriorated.