Literature Review
MDMA/Ecstasy is a recreational substance that is similar to amphetamines and cause hallucinogenic effects along with feelings of euphoria, emotional warmth and increased energy. Abuse of MDMA could lead to severe genitive disabilities.
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Many researches have studied the different bases of this drug’s effects and have found correlational relationships with the drug and cognitive functions. Discussed below are researches done specifically on the drug MDMA.
Gallagher et al, 2014, have found out that Ecstasy and poly drug use have cause in substantial impairments and deficits on prospective memory tasks including event-based and time-based tasks compared to non-drug users. However, the user group was significantly older than the nonuser group and also consumed cigarettes, marijuana and alcohol each day compared to nondrug user group. Later in the study a cannabis only group was introduced and was established that the cannabis only group did much better than the MDMA user group thus concluding the memory deficits were not related to the use of cannabis, however the cannabis only group were impaired in short term memory tasks. It is important to mention that the drug users consumed at least 80% cocaine thus leaving the possibility that the effects on the prospective memory were impaired due to this drug (Gallagher et al, 2014).
On the other hand the study conducted by Montgomery et al, 2005, on Syllogistic reasoning found that MDMA users performed worst that the nonusers and considered themselves to be “evening people” whereas the nonusers considered themselves to be “morning people”; wakefulness was tested as a control to see if MDMA causes sleep disturbances among the users as it was believed that cognitive deficits would be due to less sleep, however it was found that sleep quality was not accountable in the impairment of rational thinking. In order to see the effects of MDMA alone cannabis use was controlled as it was believed to have adversative effects on executive cognitive functioning such as organization and integration. However in the study done by Gallagher et al in 2014 it was found not to have much impact on the long term prospective memory however comparing the two studies we can conclude that even though cannabis might not have a major effect on prospective memory it does have adverse effects on higher executive cognitive tasks. Both studied used self-report questionnaires to collect data (Gallagher et al, 2014).
In response to the participants in the two studies, the first part of the study conducted by Gallagher et al. used 27 females and 38 males in the MDMA users group and 54 females out of the 85 participants in the nonusers group thus having a large gender bias in the control group. However in the second half of the study this was changed for the experimental group in to an equal amount of 51 male and female participants, 38 cannabis only group and 65 non drug users out of which 48 were females having a gender bias again (Gallagher et al, 2014).
However, in the study carried out by Montgomery et al. an equal amount of male and female MDMA users were used for the experimental group and 26 for the control group having only a slight gender bias of 10 males to 16 females. Nevertheless, all participants were from the ages of 18-25 also known to be the peak of drug abuse were used, unlike the study by Gallagher et al. which used an experimental group much older than the control group. Moreover, Montgomery et al. study used all psychology and psychology-biology undergraduates from Liverpool John Moors University, which might have created demand characteristics as they would have been able to figure out what the study was about referring to the questionnaires. On the other hand Gallagher et al. also used university students from the United Kingdom which goes hand in hand with the study done by Montgomery et al. however since they did not use psychology related undergraduates demand characteristics would not have been an issue. However, study done by Gallagher et al. used few participants who have previously undergone a study done by the same group of people. Thus, it could have affected the results slightly as the participants could have been used to the questionnaires. Both studies used opportunity samples as it is not ethical to take a normal sample and inject with drugs (Montgomery et al, 2005).
Both studies obtained informed consent from the participants and were debriefed after he study, the participants were also rewarded with store vouchers along with leaflets of drug education. In my opinion both studies were concerned about the participants, it is a good measure to always educate the participant on their unhealthy behavior. Considering all participants from both studies were university students it is important to consider the fact of peer pressure. Thus the participants would have got involved in drug use not knowing the consequences and purely under peer pressure. Thus, rewarding them with the gift of information to make an informed choice is an excellent deed.
Comparing these two studies with the third study I chose which was carried out by Braida et al. in 2002 it is much more different from the first two. The study which measures the impairment of short term working memory was carried out on 3 month old Male albino Wistar rats. It was found that when given small doses as 1-2mg there was no impact on the rats memories, however when the dose was increased to 3 mg the participant rats began to make errors. However when the rats were at an amnesic state their special memory was significantly affected and the performance was worsened when the 2 hr. delay was introduced showing specific memory impairment. This study assessed the acute effects on working memory whereas the study done by Gallagher assessed the chronic effects of MDMA on prospective memory. The rats in this study were tested on their memory at 20 minutes after the researchers induced with MDMA however, the first study by Gallagher tested on participants who have been consuming MDMA for a long period of time and were on abstinence for a week. The memory task of the rats which was rested on a radial arm maze was measured through a Likert scale which was also used in the study of Creese and Iversen in 1973. Both Gallagher and Braids’s studies measured the number of errors made by participants on the memory tasks. All three studies mentioned above were tested in laboratory settings. However since the study by Braida was done on rats it is questionable as to how far it is generalizable to the human population as the body chemistry of humans and the brain is quite different from those of rats. However, just as the two earlier studied the study with rats also used a control group which was injected with a saline solution. All three studies have mentioned the biological bases that would have affected the results such as the drug metabolism of participants, cortisol levels, activity in the different parts of the brain and neurological differences (Braida et al, 2002).
If these studies were conducted in Sri- Lanka, the results would have been quiet different for several reasons. Firstly, government university student are very less likely to abuse drugs due to the traditional parenting styles and also due to the fact that drugs such as MDMA is quiet expensive. However, private university student are much likely to be abusing cannabis and only a very few students would be using MDMA. If the study was replicated here, it would have been hard to find a sample population who does only MDMA as many students who use MDMA also use drugs such as cocaine and also due to the fact that many students are not very open about it. However, it would have been easier to find a control group who does not use any drugs, alcohol or smoke cigarettes or use cannabis once again due to the cultural background these students are brought up in.
In relation to therapy methods that can be used to help these individuals who are involved in drugs, I would suggest, that they go for a total detoxification at first, and then be directed to a psychologist for further therapy. Even though the therapy used would depend solely on the condition of the patient, in my opinion the psychologist could use methods such as behavioral therapies including but not limited to aversion therapy, contingency management and covert sensitization, cognitive behavioral therapy along with an individual plan using behavioral self-control training, relapse prevention training, family therapy, group therapy or the individuals could be directed towards outpatient or residential treatment including residential treatment centers, therapeutic communities and self-help groups.
References
Gallagher, D. T., Fisk, J. E., & Hadjiefthyvoulou, F. (2014). Prospective memory deficits in illicit polydrug users are associated with the average long-term typical dose of ecstacy typically consumed in a single session .28(1), 43-54. doi: 10.1037/neu0000004
Montgomery , C., Fisk , J. E., Wareing , M., & Murphy , P. N. (2005). Syllogistic reasoning performance in mdma (ecstasy) users.13(2), 137-145. doi: 10.1037/1064-1297.13.2.137
Braida, D., Pozzi, M., Cavallini, R., & Sala, M. (2002). 3,4 methylenedioxymethamphetamine (ecstasy) impairs eight-arm radial maze performance and arm entry pattern in rats.116(2), 298-304. doi: 10.1037/0735-7044.116.2.298
Keshani Perera
