Hug drug or thug drug?

 H-A-T-E
Is that how you spell love in your dictionary
K-I-C-K
Pronounced as kind
F-U-C-K
Is that how you spell friend in your dictionary
Black on black
A guidebook for the blind

Dictionary by XTC

Ecstasy is widely known as a drug that produces feelings of emotional warmth, and empathy toward others (even total strangers, as well as a general sense of well being)

Beyond these enactogenic properties, however, a far lesser known consequence of taking E is....increased aggression

Reid et al (2007) describe data collected from 260 ecstasy users. After controlling for key predictors of aggression (that are independent of ecstasy use), a higher prevalence of lifetime ecstasy use was linked to higher levels of aggressive and violent behaviour. Particularly those who exhibit low self-control were more affected by ecstasy use than those who do not in terms of aggression.

Verheyden et al (2002) looked at the sub-acute effects of MDMA. Forty participants were examined on the night of taking the E and then 4 days later. E users rated lower levels of aggression than controls on the night of drug use, but significantly higher levels of aggression mid-week (both for men and women); and in men change in aggression correlated with the amount of MDMA taken on the weekend

Fig 1. Verheyden et al (2002)
Lower aggression when taking E and higher aggression later

In a rat study, Wallinga et al (2009) assessed (behavioural) aggression in rats 5 days before and 23 days after MDMA administration (by introducing an 'unknown' male rat into cage). They found that MDMA treatment increased aggressiveness in only low aggressive rats and not in medium and high aggressive animals. This suggests that "the vulnerability for increased aggression long after a single MDMA treatment is dependent on the individual's trait aggressiveness and not on the degree of MDMA induced serotonergic neurotoxicity."

Wan et al (2009) examined abstinent Ecstasy users, free of drugs for a minimum of 21 days. They found that aggressive behaviour history correctly identified 73% of those who had been regular ecstasy users and 78.3% of those who had not. The abstinent Ecstasy users showed moderate to large effects for aggression and anti-social behaviour (on lifetime history of aggression rating scale) compared to controls who were mostly cocaine and alcohol dependent.

Table 1. Wan et al (2009)

Curran et al (2004) found that ecstasy users show increased aggression 4 days after taking E both on self-ratings and crucially on objective measures of interpretative bias. Their ecstasy and control groups were well matched for age, education, trait aggression, and trait depression. Importantly, the two groups did not differ significantly in their reported use of drugs other than MDMA. On the interpretive bias task, Ecstasy users were faster in completing sentences that could be interpreted aggressively compared with those which had only neutral interpretations. The control group showed the exact opposite pattern of being slower to complete aggressive than neutral sentences - this suggests that ecstasy users are sensitised to aggressive material


Gerra et al (2001) examined participants with a history of MDMA use and nonuser controls were tested on a laboratory measure of aggression (receiving monetary reward for repeated button pressing and provoked by having it taken away by a fictional other). The authors found that the user group was considerably more aggressive than nonusers and that there was a significant correlation found between the extent to which participants had been exposed to MDMA and aggressive response (r=.78). They also found that aggressiveness in the MDMA-using subjects seemed to be associated more with MDMA pharmacological effects than with personality traits. Finally, they noted that the aggressive responses of Ecstasy users were higher than those seen in heroin users in the same experimental scenario.

Finally, the issue of self-harm with ecstasy...

Kim et al (2011) examined the relationship between ecstasy use and suicidal behaviour among adolescents in the United States. Data from the adolescent subsample (ages 12–17, N = 19,301) of the 2000 National Household Survey on Drug Abuse were used in the analyses. They found that the rate of past year suicide attempt among adolescents with lifetime ecstasy use was almost double that of adolescents who had used other drugs only, and nine times that of adolescents with no history of illicit drug use. After controlling for other related factors, the effect of ecstasy use remained significant.

References

Curran, H.V.; Rees, H.; Hoare, T.; Hoshi, R.; Bond, A. Empathy and aggression: Two faces of Ecstasy? A study of interpretative cognitive bias and mood change in Ecstasy users. Psychopharmacology 2004, 173, 425-433

Gerra, G., Zaimovic, A., Ampollini, R., Giusti, F., Delsignore, R., Raggi, M. A., Laviola, G., Macchia, T., & Brambilla, F. Experimentally induced aggressive behavior in subjects with 3,4-methylenedioxymethamphetamine (‘‘ecstasy’’) use history: Psychobiological correlates.
Journal of Substance Abuse, 2001, 13, 471–491.

Kim J, Fan B, Liu X, Kerner N and Wu PEcstasy use and suicidal behavior among adolescents: findings from a national survey. Suicide and Life Threatening Behaviour, 2001 41, 435-444

Reid, L.W.; Elifson, K.W.; Sterk, C.E. Hug drug or thug drug? Ecstasy use and aggressive behavior. Violence Vict. 2007, 22, 104-119

Verheyden SL, Hadfield J, Calin T, Curran HV . Sub-acute effects of MDMA (3,4-methylenedioxymethamphetamine, "ecstasy") on mood: evidence of gender differences. Psychopharmacology (Berl), 2002, 161: 23-31

Wallinga AE, ten Voorde AM, de Boer SF, Koolhaas JM, Buwalda B. MDMA-induced serotonergic neurotoxicity enhances aggressiveness in low- but not high-aggressive rats. Eur J Pharmacol 2009;618(1-3):22-27.

Wan, L.; Baldridge, R.M.; Colby, A.M.; Stanford, M.S. Enhanced intensity dependence and aggression history indicate previous regular Ecstasy use in abstinent polydrug users. Prog. Neuropsychopharmacol. Biol. Psychiatry 2009, 33, 1484-1490.