The Agony and Ecstasy of MDMA
The use of the popular “club drug” ecstasy is on the rise in the
Prescription Drugs on the Web Spotlight on . . .
burnstyn # 411
United States. This presents a national health risk, as Dr. Alan I.
Leshner, Director of the National Institute on Drug Abuse (NIDA),
explains: “There is no safe way to use [MDMA]...even experi-
menting with [MDMA] is an unpredictable and dangerous thing
http://www.nida.nih.gov/drugpages/prescription.html Prescription Drugs
to do.” Chronic use of MDMA may cause long-term problems The National Institute on Drug Abuse provides research reports and prescription drug-related information on
with emotion, memory, sleep and pain. its website. A NEWSBRIEF OF THE ENTERTAINMENT INDUSTRIES COUNCIL, INC. NO. 9
Ecstasy has the potential for dangerous side effects like increased IN THIS ISSUE
heart rate and blood pressure, possible long-term damage to Take as Directed .............. 1 Prescription Drugs:
those parts of the brain critical to thought and memory, and This World Wide Web-based organization focuses on education, hope, and recovery for prescription drug abuse
birth defects (if ingested during pregnancy). Because of these
dangers, ecstasy is now illegal and in 1985 became a “Schedule
and addiction. Older Adults:
The Forgotten Risk ........... 1 Take as Directed
I” drug, meaning it has no medical value whatsoever. http://www.rxdiversion.com/workplace.htm Teens and Young Adults: As major advances are made
Ritalin—Not Just for Kids “When the writers told
Some of the additional risk involved in the use of ecstasy is This site contains information on prescription drug abuse in the workplace. in the medical field, we are
Anymore? ......................... 2 me, ‘We’re going to
related to its illegal sale. Due to an increased demand for lucky enough to have more
stab you in the back
ecstasy, drug traffickers are manufacturing more and cheaper http://www.health.org/catalog/catalog.asp?key=12&detail=false Women: Mother’s drugs than ever to heal our
by a psychotic patient,
pills. Dangerous chemical additives or adulterants are frequently Little Helper ...................... 2 aches, pains and even our
and you’re going to
mixed with — or substituted for — MDMA during production. The National Clearinghouse for Alcohol and Drug Information provides access to publications and reports on sorrows and fears. Now that
Requiem for a Dream One of the most common is DXM (dextromethorphan), a legal Uppers and Downers develop a subsequent
prescription drug addiction. drug companies are adver-
of Addiction ...................... 2 drug addiction,’ I was
cough suppressant that, when taken in high doses, can inhibit tising on television and other
The 2000 feature film Requiem for a Dream shockingly amazed. I didn’t think
one’s ability to regulate body temperature. DXM and the similar http://www.mhsource.com/pt/p950127.html Medical Marijuana ............ 3 media outlets, sometimes it
shows how the lives of four characters are torn apart by John Carter was
PMA (paramethoxyam- seems like there’s a drug for
their addictions to various drugs. Among these charac- The Psychiatric Times’ online edition features an in-depth article citing research on prescription drug abuse. Commonly Prescribed necessarily the face
phetamine) have been everything. Medical and
ters is a single mother who becomes addicted to pre- Medications ..................... 4 of drug addiction. But upon reflection, I realize there probably
known to cause severe Adulterants found in pharmaceutical companies,
scription diet pills. Ellen Burstyn’s (photo above) brave isn’t one face of drug addiction.”
dehydration and heat- “ecstasy” can range from Agony and Ecstasy however, have clear guide-
performance accurately depicts the horrors that can come
Encouraging the Art
stroke in users. Adulter- aspirin or caffeine to “speed” of MDMA .......................... 5 lines for developing, market- Noah Wyle, ER, recipient at the 5th Annual PRISM Awards,
from being addicted to even the most innocuous-seem- ants can also cause over- or “Special K” (ketamine), ing and prescribing these on his character’s addiction to prescription pain killers.
ing drugs, including prescribed diet pills and mass quan- dose in users who think an animal tranquilizer. Some Editor-in-Chief medications. Often drugs
tities of caffeine. they’ve taken “weak ecstasy pills even show Brian Dyak that help one person achieve perfect health Although prescription drug abuse is similar to any
Requiem for a Dream earned a PRISM Commendation
for its accurate depiction of drug abuse and addiction.
ecstasy” and take more
pills resulting in a lethal
dose of the adulterant.
traces of arsenic, heroin,
and other deadly toxins. of Making a Difference Editors
Marie Gallo Dyak
may cause serious or fatal side effects in kind of substance abuse, prescription drugs are
another. One pill may make you feel better, legal medications, often prescribed by a trusted
but two could make you feel a lot worse. physician. In this way, addiction can sometimes
This film is a highly recommended, brilliant example of Larry Deutchman
how a good script, excellent direction and acting, and For these reasons it is important to take develop in populations not commonly thought of
Possible medical uses for
accuracy of depiction can attain critical success while medications as directed. as “typical drug users.” Thus, when looking at char-
MDMA are currently being studied in Switzerland, Israel and Spain, Spotlight on...
maintaining high standards of filmmaking. acters in relation to prescription drug abuse and
as well as in the United States. Both studies examine MDMA’s Prescription Drugs Alan I. Leshner, Ph.D., Director of the National addiction, it is valuable to understand who is at risk.
effects on post-traumatic stress disorder (PTSD). A study exam- is a publication of the Institute on Drug Abuse (NIDA), announced
ining MDMA dose response safety in cancer patients is currently TM
Entertainment Industries new efforts to address a “dangerous new
being conducted at Harbor-UCLA Medical Center in Torrance, Council, Inc. in partnership drug abuse trend” — the abuse of prescrip- Approximately 4 Million Americans Used Prescription
California. Due to the recent increase in abuse and trafficking with the National Institute on tion drugs. Several indicators suggest that Drugs for Nonmedical Purposes in 1999
however, it is difficult for researchers to obtain the drug for Drug Abuse. prescription drug abuse is on the rise.
Many Physicians Have Difficulty Discussing 3.0
scientific study. According to a 1999 study, more than a quar-
Substance Abuse with Patients http://www.eiconline.org ENHANCED CREATIVE VISION ter of the nine million people who used pre- 2.5
scriptions for non-medical purposes during
Millions of Americans
“First Draft” provides members of the entertainment 2.0
40% EIC West that year were abusing for the first time.
Percent of Physicians
500 S. Buena Vista Street industry’s creative community — scribes, directors, 1.5
Burbank, CA 91521-7283 development executives — science-based health information services
The brain scans to the left illustrate the v. (818)955-6845 for comedy, drama, talk-shows, reality-based programming, movies made for Older Adults: The Forgotten Risk
sharp difference in human brain function for f. (818)955-6870 television, feature films, and music videos. 0.5
10% an individual who has never used drugs firstname.lastname@example.org Due to compromised health caused by 0
and one who has used ecstasy many times, For free consultation on scripts and projects, please call
0% the natural effects of aging, older adults Stimulants Sedatives and Pain Relievers
Depression Alcohol Abuse Presciptive Drug Abuse
but had not used any drugs in the three 800-783-3421 use three times as many prescription drugs Tranquilizers
Over 40% of physicians report having difficulty weeks prior to the scan. as other adults. While these medications Office of Applied Studies, Substance Abuse and Mental Health Services
1760 Reston Parkway, Suite 415 Administration. National Household Survey on Drug Abuse, 1999.
discussing substance abuse, including abuse of Reston, VA 20190-3303 Free briefings with scientific experts for your staff are also available. are often necessary and beneficial to the
Source: National Institute on Drug Abuse (NIDA)
prescription drugs, with their patients. In contrast, less For more information call (888)NIH.NIDA v. (703)481-1414 To schedule a briefing or order a free copy of Spotlight on Depiction, patient, the amount of prescriptions this
than 20% have difficulty discussing depression. http://www.nida.nih.gov a resource encyclopedia for the creative community, call 818-955-6845. population uses makes them particularly take these medications according to directions.
vulnerable to prescription drug abuse. To Taking the above factors into account, it is not sur-
National Center on Addiction and Substance Abuse at Columbia University email@example.com
(CASA). Missed Opportunity: National Survey of Primary Care Physicians complicate matters further, older adults prising that misuse of prescription drugs may
and Patients on Substance Abuse. New York: CASA, 2000. may be prescribed inappropriately high be the most common form of drug abuse among
doses of medications and are less likely to the elderly.
Teens and Young Adults -- Ritalin: not just for kids anymore? CNS Depressants, continued from page 2. Treatment: Breaking the Cycle Some Commonly Prescribed Medications: Use and Consequences
Drug use is a common problem among youth aged 12-25. When Benzodiazepines for treatment of anxiety, acute stress, and panic Just like any other addiction, prescription drug addiction is a brain OPIOIDS CNS DEPRESSANTS STIMULANTS
thinking about drug abuse among youth, we tend to focus on Women — Mother’s Little Helper? attacks and short term treatment of sleep disorders: disease; and, like other diseases, this addiction can be treated.
illicit “street” drugs. However, research shows that dramatic But the natural diversity of individual behavioral patterns, as well Oxycodone (OxyContin) Mephobarbital (Mebaral) Dextroamphetamine (Dexedrine)
increases in numbers of new abusers of prescription drugs are Diazepam (Valium) Alprazolam (Xanax) as the many different drugs that can result in addiction, make Propoxyphene (Darvon) Pentobarbital sodium (Nembutal) Methylphenidate (Ritalin)
found within this age group. Further, psychotherapeutic drugs — While the numbers of men and women who abuse prescription Triazolam (Halcion) Estazolam (ProSom) each individual a special case. This may be taken into consider- Hydrocodone (Vicodin) Diazepam (Valium) Sibutramine hydrochloride
including painkillers and stimulants — are among the drugs most drugs are basically the same, there are some increased risks for Chlordiazepoxide HCL (Librium) ation when incorporating drug treatment into storylines and char- Hydromorphone (Dilaudid) Chlordiazepoxide hydrochloride monohydrate (Meridia)
commonly abused by teens aged 12-14. women. Women are more likely than men to be prescribed an acters, as it is easy to fall back on stereotypes of the “typical” Meperidine (Demerol) (Librium)
addictive prescription drug, particularly narcotics and anti- When first taking a depressant, the user usually feels sleepy and addicted person. Diphenoxylate (Lomotil) Alprazolam (Xanax)
anxiety drugs — in some cases 48 percent more likely. This uncoordinated. After a few days, his or her body becomes accus- Triazolam (Halcion)
Illicit Drug Use Among Youths Age 12 to 14 increases the possibility of abuse and subsequent addiction Treating any kind of drug addiction usually means treating two
tomed to these side effects. If one uses these drugs long term, Estazsolam (ProSom)
to these prescriptions. In addition, prescription drug abuse is separate aspects that contribute equally to drug addiction: be-
6% the body will develop tolerance for the drugs, and larger doses
Percent Using in Past Month
Psychotherapeutics more likely among adolescent girls aged 12-17 than boys the havioral aspects and physical components. The behavioral side
5% will be needed to achieve the same initial effects. Continued use GENERALLY PRESCRIBED FOR GENERALLY PRESCRIBED FOR GENERALLY PRESCRIBED FOR
same age. Among women and men who use either a sedative, of addiction can be treated through counseling including indi-
Hallucinogens can possibly lead to physical dependence and — when use is
4% anti-anxiety drug, or hypnotic, women are almost two times as vidual, group or family therapy, contingency management and
reduced or stopped — withdrawal. Post-surgical pain relief Anxiety Narcolepsy
3% likely to become addicted. therapies.
With CNS depressants, it’s the withdrawal that can be problem- Management of acute or chronic Tension Attention-deficit hyperactivity
2% The addiction must pain Panic attacks disorder (ADHD)
atic. Because these medications are designed to slow brain activ-
1% often be remedied Contingency Management: Offers Relief of coughs or diarrhea Acute stress reactions Depression
ity, withdrawal from long-term abuse can cause brain activity to
0% by addressing the “vouchers” as a reward for staying Sleep disorders Short-term treatment of obesity
Morphine has been termed a “Schedule II” increase at a rapid rate, possibly causing seizures and other harm-
Age 12 Age 13 Age 14 body’s physical drug-free (based on a negative drug Anesthesia (at high doses) Asthma
drug by the Drug Enforcement Agency (DEA) ful consequences. Thus, if an addict wants to discontinue use of
dependence on the test) that can be used to obtain items
Office of Applied Studies, Substance Abuse and Mental Health Services Administration.
which means that: these drugs, it is recommended that he or she seek treatment
National Household Survey on Drug Abuse, 1999. drug. This some- that promote healthy living, EFFECTS OF SHORT-TERM USE EFFECTS OF SHORT-TERM USE EFFECTS OF SHORT-TERM USE
under a doctor’s supervision.
1. The drug or other substance has a times means pre-
high potential for abuse. scribing medica- Cognitive-Behavioral Therapy (CBT): Blocked pain messages A “sleepy” and uncoordinated Elevated blood pressure
tions to regulate Combines cognitive and behavioral Drowsiness feeling during the first few days, as Increased heart rate
2. The drug or other substance has a and relieve with- therapies to address the self-defeating Increased respiration
Stimulants (“Uppers”) enhance brain activity, causing an increase Constipation the body becomes accustomed --
currently accepted medical use in drawal symptoms, behaviors that contribute to addiction Suppressed appetite
in alertness, attention and energy as well as increased blood pres- Depressed respiration tolerant -- to the effects, these
The Uppers and Downers of Addiction treatment [of illness] in the United
sure, heart rate and respiration. These medications trigger the
drug cravings, or to as well as how thinking patterns (how feelings diminish Sleep deprivation
States or a currently accepted medi- treat overdose. you see yourself, your life) can trigger
Abusers’ Drug of Choice cal use within severe restrictions.
release of chemicals like dopamine in the brain and may cause a
Called pharmaco- drug use.
sense of euphoria, which may lead to stimulant abuse in order to
therapy this EFFECTS OF LONG-TERM USE EFFECTS OF LONG-TERM USE EFFECTS OF LONG-TERM USE
3. Abuse of the drug or other substance achieve that feeling. Due to their potential for abuse, stimulants
method is most
It may be safe to say that no one is strung out on her prescription may lead to severe psychological or are prescribed by doctors for the treatment of only a few health
often misconstrued as merely giving the person a new drug Potential for tolerance, physical Potential for tolerance, physical Potential for addiction
for Vaniqa, the new facial hair-removal medication. There are, how- physical dependence. conditions including narcolepsy, attention-deficit hyperactivity
(i.e., the debate over administering methadone to treat heroin dependence, withdrawal, and/or dependence, withdrawal, and/or
ever, certain kinds of drugs that affect the brain and the body in disorder (ADHD) and as a last resort for the treatment of
addiction). Use of these drugs must obviously be closely addiction addiction
ways that elicit a feeling of being “high” or altered in a way that is depression. In rare instances, stimulants are used for the tem-
regulated when dealing with someone addicted to prescription
pleasurable to the patient. While prescription meds are designed to porary treatment of morbid obesity and asthma that fails to
drugs. The medications can also be extremely effective for a POSSIBLE NEGATIVE EFFECTS POSSIBLE NEGATIVE EFFECTS POSSIBLE NEGATIVE EFFECTS
improve the health of a patient, using them to enhance mood is possibly addiction. Once addicted, the body cannot function respond to more common medications. Examples of prescrip-
actually misuse, or non-medical use. properly without the drug. When an addicted person fails to tion stimulants include dextroamphetamine (Dexedrine) and
Severe respiratory depression or Seizures following a rebound in Dangerously high body tempera-
take the opioid, he or she may experience withdrawal symp- methylphenidate (Ritalin).
Of all the drugs commonly prescribed by physicians, three classes The Medical Marijuana Issue: death following a large single brain activity after reducing or tures or an irregular heartbeat
toms such as restlessness, muscle and bone pain, insomnia, discontinuing use after taking high doses, cardio-
appear to be the most commonly abused: opioids CNS depressants
opioids, depressants, Some abuse of stimulants may be dose
and stimulants Below are some examples of each of these drugs
diarrhea, vomiting, cold flashes with goose bumps, and invol-
misguided attempts to stay awake in Still Hazy vascular failure or lethal seizures,
untary leg spasms. As bad as withdrawal symptoms may be, possible hostility or feelings of
for more specific depiction opportunities. order to complete work or school- For years, there has been an ongoing debate
they are sometimes better than possible alternatives: for paranoia
related tasks, but for some stimu- about the potential benefits and drawbacks of
example, a large single dose of an opioid could cause severe
Opioids lants high doses taken repeatedly legalizing marijuana for medical application.
respiratory depression. Medical Marijuana, continued from page 3
within a short period of time can cause Proponents of the legalization of marijuana for
Opioids, also referred to as narcotics, are frequently used to treat hostility or paranoia. Stimulant abuse medical purposes cite the drug’s potentially ben-
CNS Depressants excruciating side effects that may be caused by chronic illnesses such as cancer and HIV/AIDS, or drugs used for treating
pain. When used as prescribed, under a doctor’s supervision opioids may also cause dangerously high body eficial side-effects of appetite stimulation, pain these conditions.
can effectively and efficiently suppress pain. In addition to relieving temperatures, irregular heartbeat relief and the suppression of nausea and vom-
CNS Depressants (“Downers”) are drugs that slow normal brain
pain, these drugs can affect regions of the brain that involve plea- and, in extreme cases, heart failure or iting, which could be helpful in alleviating the While opponents of using marijuana for medical purposes do not deny some of the benefits listed above, they note that the effects
function and reactions. When used properly, these medica-
sure and can result in feelings of euphoria. Common opioids deadly seizures. of marijuana are unreliable or the drug affects different people in different ways, and that other medications that yield the same
tions can effectively treat anxiety and sleep disorders. CNS
include: continued on page 4 results are already commonly available to patients. In addition, smoking the drug is carcinogenic and any form of smoking may have
depressants fall into two categories.
a negative effect on the patient’s immune system.
Morphine Codeine The debate over the medical use of marijuana continues, even as scientists attempt to manufacture a reliable medical-grade drug
Barbiturates for treatment of anxiety and sleep disorders:
Oxycodone (OxyContin) Propoxyphene (Darvon/Darvocet) There have been several reports of teenagers and and $30 a pill. Viagra has also been associated with ecstasy from chemical extracts of marijuana, as is now done with opium extracts. In the meantime, the use of marijuana for any purposes
Meperidine (Demerol) Hydrocodone (Vicodin) college students abusing the drug Viagra, the popu- use as a way to combat male erectile dysfunction often caused
Mephobarbital (Meberal) remains illegal in the United States.
Hydromorphone (Dilaudid) lar drug used to combat impotency. Most commonly, by MDMA, the active ingredient in ecstasy. Reports as early
Viagra is used at rave parties in conjunction with as 1998 detail Viagra abuse in London nightclubs. Called “poke” On March 28, 2001, the U.S. Supreme Court ruled against the Oakland Cannabis Buyers’ Cooperative, a California organization that
Users of opioids can build up a tolerance for the drugs, which may alcohol or other club drugs. The drug is also being by British youngsters, Viagra was often abused as a substi- wants to provide marijuana to chronically ill people. Justice Antonin Scalia stated that, while individual cases may be made for
continued on page 3.
lead them to increased use in order to achieve the same initial sold illegally on college campuses for between $25 tute for ecstasy or cocaine which were harder to obtain. medical uses of the drug, no case can be made for “someone who opens up a business to provide illegal drugs.” The Oakland
effects. Thus, long-term use can lead to physical dependence and Cannabis Cooperative sought protection from this ruling on the grounds that marijuana is a “medical necessity” but on May 14, 2001
the Supreme Court ruled that marijuana was not worthy of such an exemption.