Aetiology
MDMA or related drug dependence is caused by the use of a substance known as 3,4-methylenedioxy-N-methylamphetamine (MDMA). MDMA is a synthetic, psychoactive drug with stimulant and hallucinogenic effects. MDMA is most commonly taken in tablet or capsule form, although it can also be snorted or injected. MDMA is often referred to as Ecstasy, X, or Molly, and is often used in social settings such as parties and clubs. MDMA can cause dependence on the drug, as well as physical and psychological health problems.
Diagnosis
MDMA or related drug dependence can be diagnosed based on a patient’s reported use of the drug and its associated symptoms. Symptoms include cravings for the drug, impaired control over use, increased tolerance, withdrawal symptoms, and a persistent desire to use the drug despite negative consequences. Diagnosis can also be made based on laboratory testing of urine or blood samples, which can detect the presence of MDMA and its metabolites.
Differential diagnosis
MDMA or related drug dependence should be differentiated from other substance use disorders and other medical conditions that can produce similar symptoms. A differential diagnosis should be made to exclude medical conditions such as depression and anxiety, as well as other substance use disorders, including alcohol and opioid use disorders.
Treatment
Treatment for MDMA or related drug dependence may include a combination of behavioral therapies, such as cognitive-behavioral therapy, and medications, such as buprenorphine or naltrexone. Treatment should also include lifestyle modifications, such as avoiding triggers, managing stress, and engaging in physical activity.
Prognosis
The prognosis for MDMA or related drug dependence is generally good, with the majority of people achieving sustained partial remission or abstinent syndrome. However, relapse is possible and treatment should be continued to reduce the risk of relapse. Long-term follow-up and support are also recommended to ensure continued abstinence.