In 1914, when opium and cocaine were banned in the United States, a patent was issued to the Merck chemical company in Germany for a process to produce 3,4- methylenedioxymethamphetamine or MDMA (Merck 1914). Except for a series of animal studies in 1953 and 1954 (Hardman, Haavik & Seevers 1973), the compound remained relatively ignored until 1968 when nonmedical use first appeared in the western part of the U.S. (Seymour 1986). Since that time, MDMA has appeared under a variety of street names including (in descending order of popular usage): Ecstasy, XTC, Adam, MDM, M&M, The Yuppie Drug, X, A, E, Essence, MDA, Clarity, Venus, Zen, Doctor, Cocaine, and Speed.
By 1972, street use was identified in Chicago (Gaston & Rasmussen 1972) and respondents had reported widespread use in Boston by 1976. Assays performed on street samples received by PharmChem Laboratories (Renfroe 1986) were consistent with a pattern of MDMA use spreading throughout the U.S. from 1976 to 1985. According to estimates by the Drug Enforcement Administration (DEA) MDMA was available in at least 21 states and Canada by 1985, although use was concentrated in California, Texas, Florida and New York as well as New England. By 1986, clandestine laboratories were reported throughout the U.S., while European distribution was reportedly in the planning stages.
The effects of MDMA (which is similar in chemical structure to the hallucinogenic amphetamines) have been described as stimulant, analgesic, psychedelic, psychotomimetic, empathognnic and hallucinogenic (Seymour 1986; Adamson 1985; Shulgin & Nichols 1978). While most studies of MDMA in humans have focused on use in psychological or psychiatric therapy sessions (Seymour 1986), relatively little has been reported about nonmedical patterns of use. The present study was undertaken to assess the nature and extent of nonmedical MDMA use, heretofore only mentioned in the popular press (Doblin 1985). As will be presently described, the psychological intoxication resulting from MDMA is a primary reason for both nonmedical and medical use. An important caveat is that the doses, patterns of use, set and setting for nonmedical users described here differ substantially from that of medical users discussed elsewhere in this issue.