MDMA: a review of epidemiologic data.

This article reviews recent surveys and reports that provide insight regarding prevalence, frequency, trends, perceptions, and seizures of methylenedioxymethamphetamine (MDMA) or "Ecstasy." An estimated 6.4 million individuals have used MDMA. Among students in the eighth, 10th, and 12th grades, MDMA use has substantially increased from mid-1990 levels to 2001, with sharp increases noted in 2000 and a more gradual increase in 2001. Exposure to MDMA among high school seniors has increased progressively and nearly quadrupled over the past decade, and a substantial proportion of young adults report having friends who use MDMA. Perceived availability has increased dramatically during the 1990s, with sharp increases in 2000 and again in 2001 among high school seniors. MDMA is now one of the most available drugs for youth. Among college students and young adults, MDMA use has increased progressively and substantially throughout the 1990s, and sharply increased in 2000. MDMA-related emergency department visits increased progressively and dramatically during the 1990s, often or nearly doubling from year to year. Most visits were attributed to patients ages 25 years or younger. The motive for their MDMA use tended to be recreation, and their reasons for the emergency department visit tended to be overdose and unexpected reactions. MDMA-related deaths are rare, but the rate is increasing, as are the number of MDMA-related calls at selected poison control centers. The quantity of MDMA seized by U.S. law enforcement has increased dramatically recently, as have the number of MDMA-related arrests. MDMA use is worldwide, and in certain European countries it is the second most frequently used drug following marijuana.