[Recent abuse of 3,4-methylenedioxymethamphetamine ("yaoto-wang", "ecstasy")]

Abstract

3,4-methylenedioxymethamphetamine ("Yaoto(head shifting)-wang", "Ecstasy"), designer drugs is popular world wide along with rave party, especially from the 1980s. Although there is a significant misconception of MDMA as "a safe drug", recent findings show its serotonin (5-HT) selective neurotoxity with memory disturbance and cognitive disorders, not only during its use but lasting for years. Hyperinnervation of 5-HT neurons has also been reported among non-human primates. Serotonin syndrome, serious dehydration and acute renal failure are reported as serious clinical symptoms and some deaths related to the use of MDMA have been reported. Unlike many stimulant users, MDMA users are likely to be socially adapted and epidemiological research suggests that, in the United States and European countries, 6-8% of students and 0.5-3% of adults have experienced MDMA use. Although criminal cases have been reported in Japan since the 1990s, there has been no empirical study of MDMA abuse, especially among youth. Based on the "Classification of Medicine and Drugs" of the Ministry of Health, Welfare and Labor. MDMA is classified as "compound narcotics: hallucinogens and stimulants" rather than individually. Another problem is that MDMA users are likely to visit emergency rooms rather than psychiatric clinics. The American Psychiatric Association has publicized the misconception of MDMA as a safe drug and informed people of its dangers. The author offers suggestions for Japanese psychiatrists to take steps to cope with this situation and recommends authorities to establish an appropriate drug policy.