Ecstasy em debate!

por Fernando Beserra

Em 1912, na gigante farmacêutica alemã Merck, era realizava uma pesquisa na qual procurava-se uma medicação para hemorragia quando foi descoberto o Metilenodioximetanfetamina (MDMA) em um dos passos da pesquisa. O MDMA foi patenteado como medicamento intermediário no processo de síntese em 1914, tendo a patente já expirado. Mas, nesta época, o MDMA não foi comercializado. Seu primo, o Metilenodioxianfetamina (MDA), que é seu análogo e metabólico, foi testado como supressor do apetite em 1958, no entanto, o teste foi abandonado pelas suas propriedades psicoativas. Se entre 1912 e 1953 [LM1] o MDMA tenha sido citado apenas em duas ocasiões na literatura acadêmica, sem nenhuma relevância, a situação seria modificada em um período posterior. Em 1953 o MDMA foi utilizado em lavagem cerebral e espionagem pelo Centro Químico do Exército dos EUA, aplicado em estudos com animais. ecstasy-project2

O primeiro estudo clínico do MDMA veio de Alexander Shulgin e de Dave Nichols em 1978. A partir daí, Shulgin apresentou o MDMA a diversos terapeutas que eram seus conhecidos. Em março de 1985, Deborah Harlow, Rick Doblin (posteriormente criador do MAPS) e Alise Agar referiam-se a seu grupo como Earth Metabolic Design Labortories. Os terapeutas que utilizavam MDMA na época tentaram ser mais cuidadosos do que os entusiastas do uso psicoterapêutico do LSD. Pouco foi publicado na mídia até junho de 1984, quando saiu uma matéria popular no San Francisco Chronicle.

Nos EUA, a proibição do MDMA foi anunciada pelo Drug Enforcement Agency em julho de 1984. Uma resposta de psiquiatras, psicólogos e outros terapeutas foi enviada solicitando uma audiência. A solicitação foi aceita – que é típica no processo de proibição de fármacos nos EUA, de forma distinta do processo brasileiro. No entanto, a DAE resolveu proibir o MDMA antes das audiências em 1985, declarando estado de emergência. Paralelamente, a DEA não mediu esforços para inserir o MDMA em convenções internacionais de proibição de psicoativos. Mesmo com discordâncias o MDMA foi internacionalmente inserido na Schedule 1 em 11 de fevereiro de 1986, sem observância a seus potenciais terapêuticos e minando toda pesquisa científica. É verdade que o MDMA saiu da ilegalidade, nos EUA, entre dezembro de 1987 e março de 1988, no período conhecido como Janela de Grinspoon, no qual Lester Grinspoon questionou judicialmente a proibição da DEA, ganhando em primeira instância.

O famoso ecstasy é uma substância psicoativa tornada ilícita, com características estimulantes, empatógenas e, até certo ponto, psicodélicas. No entanto, o ecstasy usado nas ruas muito comumente não é a substância que, originariamente, era o ecstasy, isto é, o MDMA. Ecstasy, na verdade, foi o nome escolhido por razões comerciais por um comerciante da época. As adulterações – infelizmente – aumentam radicalmente os riscos para os usuários. Por exemplo, além de adulterantes com menor risco potencial como cafeína, já foram identificadas substâncias como o Parametoxianfetamina (PMA), que ocasionou algumas mortes quando vendido como ecstasy. O Brasil não é exceção no caso das adulterações, como mostra a matéria referindo-se a pesquisas nacionais (http://coletivodar.org/2012/08/ecstasy-consumido-em-sao-paulo-nao-e-ecstasy/). Além disso, a flutuação da pureza do MDMA leva os usuários a variações de dose que podem conduzir à overdose, sem a intenção de fazê-lo.

O MDMA é uma substância semissintética, sendo o safrole seu principal percursor natural para sua síntese (HOLLAND, S/d). O MDMA pertence ao grupo das anfeteminas que inclui o speed (metanfetamina) e o MDA (Metilenodioxianfetamina), embora sejam substâncias distintas quanto a seus efeitos e riscos.

Além disso, existem os riscos inerentes de se utilizar ecstasy – MDMA em uma festa e dançar por horas a fio. Para estes psiconautas é fundamental um consumo moderado e constante de água, permanecerem resfriados – para evitar a hipertermia e, finalmente, pararem algumas vezes.

Historicamente, o MDMA tem um uso marcado pelos usos psicoterapêuticos e medicinais. Era chamado, nas décadas de 1970 e 80 de Adam. Um grande número de psicólogos e psiquiatras que realizavam terapia com o uso de MDMA pelos seus pacientes relatava grandes benefícios, com uma aceleração dos processos terapêuticos consideráveis. O aspecto empatógeno facilitava a transferência e permitia que os traumas fossem revividos e tratados em poucas sessões. Nesta mesma linha, as pesquisas atuais com MDMA tem demonstrado sua eficácia nos casos de tratamento de transtorno de estresse pós-traumático (TEPT).

O MDMA leva a um aumento de empatia e facilita a reestruturação do campo perceptivo, levando a insights. O usuário pode ter uma melhor na auto-imagem, incluindo a sensação de auto-aceitação e amor a si e aos outros. No seu aspecto psicodélico, o MDMA pode favorecer a experiência de pico, na qual a sensação de conexão direciona-se para além do ambiente social e alcança o domínio denominado de transpessoa. [LM2]

Do ponto de vista psicofisiológico, o MDMA envolve dois neurotransmissores. Sua ação é, prioritariamente, de receptação da serotonina e do aumento da disponibilidade cerebral de dopamina e serotonina (MALBERG e BONSON, S/d). Além disso, o MDMA pode agir como um inibidor de monoaminoxidade (IMAO), o que nos leva a algumas questões quanto a mistura de substâncias e sua margem de segurança…

Referências:

HOLLAND, Julie. Ecstasy: the complete guide. A comprehensive look at the risk and benefits of MDMA.

Links úteis:

http://www.erowid.org/chemicals/mdma/mdma_faq.shtml

http://www.ecstasy.org/qanda/q78.html

http://www.tandfonline.com/doi/abs/10.1080/02791072.2002.10399952?src=recsys#.VFlwa_nF_4M

http://www.urban75.com/Drugs/e_guide.html

https://www.erowid.org/chemicals/mdma/mdma_dose.shtml


[LM1]História

[LM2]Efeitos

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