LGBT Drug Treatment Blog

Ecstasy

“I change from a not-that-friendly guy to someone who looks around and just feels like hugging people, or telling them about myself, or sliding my hands all over them.”

“It breaks the boredom of the scene for me. Maybe it’s denial, but everyone seems more interesting, more sensitive, heightened.”

“Donna Summer said it. I feel love.”

Ecstasy
Actually, Empathy might be more like it. This drug makes you feel happy — friendly and open, mainly by rapidly increasing the amount of available serotonin — a chemical transmitter that controls emotions, anxiety and clearness of your thought — in your brain. The serotonin system is the same one that antidepressants like Prozac, as well as more powerful hallucinogenics like LSD, work on.

X, which is more intense than Prozac and milder than acid, usually comes in a pill or capsule, and for four to six hours it increases your ability to relate to other people and decreases fear. Which may be one reason why those boys who won’t say hello at the gym come across the dance floor to tell you how great you look later that night. Too bad your serotonin-full brain stops producing that crucial chemical for a day or so after coming under the influence of X, so you who were so friendly while Xing on Saturday often become a depressed, bitching, irritable monster on Sunday and Monday. Other common post-X symptoms, like an aching lower back, probably have more to do with the fact that when you’re Xing you’re likely to dance all night without stopping.

Not much is known about Ecstasy use over the long term. People who do a lot of it report that it takes more to get them high over time, and research has shown some damage of nerve endings and permanent reduction in serotonin levels in animals given higher or repeated doses. There has not been enough research done to determine whether a small amount of X alters your serotonin system, or whether such a change in your serotonin system would affect the way you function. Far fewer deaths and liver failures have been reported from Ecstasy than from a drug like alcohol, and most of the fatalities and complications may be caused by what the drug was combined with, or what was cut into it before it was sold. Among the things found mixed into X: caffeine, decongestants, baking soda, dog worming medicine, amphetamines, and MDA, a trippier and possibly more toxic relative.

There is not much information about the interaction of X and HIV or HIV-related medications, though in England — where an estimated half million people use X each weekend — a man on the protease inhibitor Ritonavir recently collapsed and died with the equivalent of 22 hits of X in his body. Researchers at Ritonavir’s manufacturer, Abbot, acknowledged the theoretical possibility that interactions between their drug and Ecstasy could boost X levels by “as high as five to ten fold,” though no studies have been done or are planned on interactions between Ecstasy and any of the protease inhibitors. Abbot feels that such research would appear to be “condoning” illegal drug use.

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Among the things we do know:

• X elevates heart rate and blood pressure. If you have high blood pressure, diabetes, asthma or a heart condition, X is dangerous. A small number of people have a severe allergic reaction to X similar to that caused in some people by a bee sting or penicillin. 
• X and protease inhibitors may cause potentially deadly interactions. 
• Anti-depressants known as MAO inhibitors, like Nardil, may combine with X to raise blood pressure to deadly levels. If a serotonin-based anti-depressant, like Prozac, is helping you, it would be prudent to not interfere with a good thing. MDMA may interfere with the way Prozac functions and could lead to complications from having too high a serotonin level. The bottom line is that we don’t know what the interactions are. 
• X elevates body temperature, making you sweat up to a pint an hour. In the nineties, there have been at least 15 documented deaths due to dehydration caused by dancing, hot conditions and the use of MDMA. Several others have died from guzzling gallons of water at once. If you are going to X, try to drink plenty of water and not all at once. If you’re Xing in a hot place, take frequent breaks, rest and drink some water. If your piss seems dark or like there’s not much of it, stop and drink some water. Lose the trendy cap — it keeps in heat. Don’t keep dancing without taking breaks, and get some salt — or better, a “sports” or “isotonic” drink — to help keep your body’s balance. 
• Alcohol doesn’t get you any higher on X, but it does dehydrate you faster. 
• X can make you feel sick to your stomach as it’s kicking in, or like you have to go to the bathroom. Also, a dry mouth, tense jaw and grinding teeth are common.

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Sex, X, and HIV.X is often described as more sensual than sexual: in other words, more about overall sensation and less about your dick, ass and getting off. Research suggests that X actually decreases men’s ability to get hard or reach orgasm. Still, people take Ecstasy because it helps them get over their shyness and feel more connected to others. Bring condoms and lube along with you to the party, before you find yourself on the way home with a goofy grin and a fine man who seems like he can see into your soul.

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Sex, K and HIVDon’t get K-razy in the bedroom. If you can’t walk straight, do you really think you can fuck safe? If you feel like your body is one place and your mind is somewhere else, it’s going to be hard to bring the two back together to cope with telling him to wear a condom.

GHB

(In England, GBH), usually sold as a clear liquid or a powder you dissolve into liquid, is also called liquid E or liquid X. Since its effects are different from X (it actually works, like K, on the GABA system), the name seems wrong. The English nickname for the drug — Grievous Bodily Harm — may be more like it. Not that GHB is always harmful. The right dose may make your sense of touch electric, make you feel like sex, and give you a hangover-free feeling like being drunk. Take a little more, however, and you slip into a deep sleep, often one so deep you can’t be awakened. Just a little more GHB can lead to a coma, and possibly death.

Sleep — including the deep, restorative sleep known as slow-wave sleep, when the body releases immune-boosting growth hormones — is what GHB is intended to produce, and why it sold briskly over gym and health-food store counters throughout the ’80s. If GHB is not mixed with any other drug, those slipping into GHB sleep will usually twitch slightly and awaken some hours later feeling refreshed. But add any other kind of drug that slows down your central nervous system — like alcohol or even allergy medications — and you run the risk of seizures, breathing failure, and even coma and death. Nearly a dozen people at a Los Angeles concert had to be carried into ambulances after doing GHB and who knows what else. A man at GMHC’s 1996 Morning Party had to be airlifted to a hospital after he mixed GHB and alcohol and collapsed. A model in New York took a swig of GHB from an Evian bottle, and woke up a day late for her photo shoot. Two men on Fire Island overdosed on GHB and alcohol, and died.

The issue is what psychopharmacologists call the therapeutic index — the difference between how much of a drug makes you feel good and the dose that makes you sick. You could take a dozen Prozacs, for example, and probably not do yourself lasting damage. Do an extra dose or two of GHB, and you may find yourself unconscious on top of your sex partner (really unconscious) or waking up long after the rest of the world has gone on ahead. And since all the GHB you get is manufactured in do-it-yourself labs, you really don’t know how much is in that teaspoon or water bottle you’re raising to your mouth. If you have HIV, you should know that not much is known about how GHB affects the immune system. Growth hormones similiar to the one GHB helps to release have proved useful in treating AIDS-related wasting. Respiratory failure and comas, on the other hand, are definitely not recommended.

• If you have any history of seizures, convulsions or slowed heart beat or low blood pressure, GHB is especially dangerous. 
• Mixing GHB with alcohol, tranquilizers (Valium, Xanax), painkillers or even over-the-counter sleep or allergy medications that slow down your nervous system puts you at risk for coma, breathing failure or death. 

   

• Don’t use GHB in a place where sudden, unexpected unconsciousness is going to be a problem. Yes, that includes clubs and parties (no matter how attractive an alternative coma may seem compared to the late end of a slow Saturday night). If you do GHB, use it in very small amounts to determine when you get high, and then stop. Don’t eat beforehand, since a full stomach may make the effects harder to gauge. 

   

• Make sure a friend knows what you’re doing and can get you to safety if you do go unconscious.

Sex, GHB and HIVFeeling dreamy and electric is what most of us want from sex. What you don’t want is to dream yourself into believing that feeling good means you don’t have to protect yourself or someone else with condoms. You also don’t want to find yourself so out of it that you don’t know where you’ve been, or what or who’s been up your ass.