DA Aquamaster once bubbled...
Ecstasy also causes the reabsorption of water by the kidneys and can cause renal failure in the long term. Short term it creates the urge to drink large amount of water than can lower serum sodium levels to a dangerous level. In the other extreme the inability to drink water combined with higher level of sweating from hyperthermia can result in dehydration.
There's a few incidences in the literature of hepatitis occurring after Ecstasy use, but there's no indication that there is any cumulative damage in healthy subjects. Another possibility is a genetic defect in the CYP450 enzyme responsible for metabolizing MDMA in some subjects.
Long term use also appears to cause a breakdown in the serotonin neuron terminals and serotonin neurotoxicity is believed to play a role in declining cognitive functioning and prospective memory (remembering what you have to do in the future).
Actually it is short-term high-dose use which appears to cause damage to serotonergic axon terminals. There still is no evidence of the presence of this neurotoxicity in humans. For example, the study be Ricaurte and McCann in the journal _Sleep_ found that MDMA users didn't have any abnormalities in REM or slow wave sleep as would be predicted by animal models of 5-HT neurotoxicity and from PCPA inhibition of 5-HT in human subjects. Similarly a study published in _Neuropsychopharmacology_ (IIRC) found that MDMA users had psychological changes which were opposite of those expected from 5-HT neurotoxicity.
In relation to diving, I suspect that reduced anxiety, lowered defensiveness and euphoria can get you into trouble much like nitrogen narcosis would. I have no idea if the effect of one would potentiate other, but it would be prudent to assume that ecstasy would aggravate the effects of narcosis.
I'd tend to agree. There's a day-after "afterglow" effect from taking MDMA and I'd be worried about mixing that with nitrogen narcosis.
Panic and psychosis are obviously also bad things to experience while diving. An altered perception of time is also bad news as it may prevent an adequate awareness of remaining air and no decompression times.
You don't really get effects like that the day after. If we're talking about actually diving while high on the substance, I definitely think that would be a bad idea. It interferes with higher congnitive function and you shouldn't be driving cars or scuba diving while on it. Really, scuba diving while high on MDMA is a pretty insane and dangerous idea and probably a good way to wind up on DAN's accident and fatality list.
The long term effects on cognitive functioning and prospective memory are perhaps most alarming as they are permanent rather than acute effects of the drug and those deficits will remain after ecstasy has stopped. As a diver I like to be able to think and problem solve underwater and I also like to be able to remember things like checking my air, remembering what psi I need to come up at and remembering that I do in fact have to come up.
Anecdotally, I know a lot of people who have consumed a lot of MDMA, and none of them exhibit any difficulties in cognitive function like that which would affect safety.
The fallacy of "controlling" the use of a drug like ecstasy is that as your use continues over time, your ability to self assess and self regulate decreases until you reach a point where you no longer have the mental faculties to be able to maintain control. That's normally when people end up dead.
You're considering the pathological case of the habituated or addicted user. There is no "fallacy" about being able to control MDMA use -- some people can and some people can't though. Lots of people can use MDMA a few times a year without any loss in ability to self-regulate, any decrease in mental facilities, and without winding up dead.
(Myself and probably at least 100 people I know have been using MDMA with various different frequencies since around 1992, and nobody is dead from MDMA yet).
With methamphetamines addiction can occur very soon with many people becoming addicted after just a few uses. Methamphetamines also produce other negative effects on cognitive use very early on - in some cases in as few as 20 uses of the drug.
MDMA is not strongly dopaminergic like cocaine or methamphetamine and is not as addictive. That is not to say that it isn't addictive, but in my direct experience "many" people do not become addicted after just a few exposures. In fact I don't know of a single one of my friends who are addicted to it, and I've got a reasonably large sample size.
My experience with persons who have taken Ecstasy is limited but my clients who have a degree of sustained use of Meth are pretty much impossible to treat through normal means. Treatment is a very long term affair and even if successful, you are still left with a person with marked cognitive limitations and often chronic depression. Relapse rates are incredibly high.
If you are diving with people who are using drugs at any time, on the water or otherwise, you need to dump them and find new dive buddies.
Yeah, whatever. I use MDMA perhaps once or twice a year on average now and I don't think I've used it at all in 2003 (and probably won't before it ends). If you think that makes me less safe underwater than someone who smokes daily, or who is 100 lbs overweight or is addicted to acohol and hungover when they dive then I guess that's your perogative.
I'd also like to mention a few other things which I think you missed as well.
MDMA causes SIADH (syndrome of inappropriate anti-diuretic hormone excretion) which causes the user to retain water. When the user comes off of the drug this effect goes away and with the hyperthermia and stimulative effects of the drug the user tends to quickly wind up dehydrated. It actually affects your body's regulation of hydration significantly enough that there have been deaths due to water intoxication. I would think that this would be very bad to mix with scuba, even the day after.
Also, MDMA is cardiotoxic, similar to methampehtamine and cocaine. This is a much more substantial risk to the user than any hypothesized neurotoxicity. The scuba docs on the board can probably comment better on how this would affect diving, but I wouldn't think it would be good. The long-term cardiotoxic effects obviously lead to general reduction in the health of the diver. I would think that the short-term effects of taking a cardiotoxic drug followed up by the rigors of diving would lead to an increase in the incidence of heart attacks and strokes under the water as well.
Anywhere that scuba medicine suggests against excersize combined with scuba also applies equally well with taking stimulants like MDMA. I would expect increased bubble formation and increased DCS risk just like from excertion.
ills or powders
