Zusammenfassung
Ecstasy ist ein Sammelbegriff für verschiedene Methylendioxyamphetamine mit antriebssteigernder und halluzinogener Wirkung, die darüber hinaus eine sogenannte „entaktogene“ Wirkung aufweisen. Der Begriff „entaktogen“ wird als „im Inneren ein Gefühl erzeugen“oder „Herstellen einer inneren Ber“hrung“ übersetzt und charakterisiert die Wirkung psychoaktiver Stoffe, die unbewußte Gefühle und Erfahrungen wieder zugänglich machen und die Selbstreflexion fördern. Bei 3,4 Methylendioxymethamphetamin (MDMA) als Hauptvertreter dieser Gruppe steht diese entaktogene Wirkung im Vordergrund des erstrebten Rausches. Darüber hinaus erzeugt MDMA neben den auch vorhandenen antriebssteigernden und euphorisierenden Wirkungen ein Gefühl der großen Nähe zu anderen Menschen. Negative psychotrope Wirkungen können den akuten Rausch überdauern und werden vor allem in Form von depressiver Verstimmung und Angst erlebt.
Ecstasy ist keine neue Substanz. Neu ist jedoch das Ausmaß und die Geschwindigkeit, mit der sich Ecstasy — gekoppelt an die Verbreitung der Techno-Party-Szene — weltweit durchgesetzt hat.
Epidemiologische Untersuchungen der letzten zwei Jahre vermitteln Einblicke, die über die eindrücklichen Steigerungsraten der Bundeskriminalstatistiken (Sicherstellungsmengen; Anteil an den erstauffälligen Konsumenten) hinausgehen. Die aus Repräsentativerhebungen und Erhebungen in der Technoszene ermittelte Lebenszeitprävalenz für Ecstasy bestätigen den intensiven Gebrauch vor allem in dieser Szene als sog.
„Freizeitdroge“. Darüber hinaus zeichnet sich jedoch die Existenz einer Konsumentengruppe mit exzessiven Gebrauchsmustern und psychischer Abhängigkeit ab. Für diese Gruppe wird ein erhebliches Risiko hinsichtlich medizinischer oder psychiatrischer Komplikationen angenommen. Diese Komplikationen lassen sich auf zentrale und periphere serotonerge Wirkungen von Ecstasy zurückführen bzw.durch die neurotoxischen Wirkungen von Ecstasy erklären. Die Quote psychisch abhängiger Ecstasy-Konsumenten ist überraschend hoch. Die möglichen neurotoxischen Wirkungen sind eventuell irreversibel. Die Risiken und die Ausbreitungsgeschwindigkeit von Ecstasy zeigen die Notwendigkeit geeigneter primär- und sekundärpräventiver Maßnahmen, die durch das herkömmliche Drogenhelfersystem bislang nur unzureichend geleistet werden konnten.
Summary
The term „Ecstasy“ includes a group of different methylenedioxyamphetamines which produce hallucinogenic activity, stimulation and the so-called ëentactogenic’effects.—„ntactogen“ is usually translated as „produ-cing a touching within“ or „creating an internal contact“ and refers to the special psychotropic effect of this substances. Entactogens have been reported to make users aware of previously unconscious feelings and experiences. The „entactogenic“ effect is the most typical of the psychedelic effects n 3,4-methylenedioxyamphetamine (MDMA). MDMA induces euphoria and acts stimulating, but the most common effect of MDMA is a heightened sense of „closeness“ with other people. The negative effects, especially depression and a general sense of anxiety, may endure after the acute phase of ecstasy. Ecstasy is not a novel substance. However, the rapid spread connected with the arising technoscene and the increasing prevalence of ecstasy-use world-wide is unprecedented.
Epidemiological research of the last two years provides insights going further than just showing increasing numbers in the criminal statistics (e.g. ecstasy seizures; number of ecstasy users who became conspicuous the first time). According to surveys the lifetime prevalence of ecstasy is highest in the context of the techno culture, where ecstasy is mainly taken as a recreational drug. However, there seems to be a consumer group who exhibit extreme patterns of use and a high degree of psychic dependency. These consumers may be jeopardised by medical and psychiatric complications. The complications are due to the central and peripheral serotonergic effects of ecstasy. There are also neurotoxic side effects of ecstasy clearly proven in animal models and recently, for the first time, also shown in humans.
The rate of psychic dependency is surprisingly high. Possible neurotoxic effects may be irreversible. In the face of the risks and the rapid spread of ecstasy suitable primary and secondary prevention is needed. Until now this has not been accomplished by the established structures.
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Poethko-Müller, C. (1999). Ecstasy. In: Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-38283-7_36
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