Social behavior effects of ecstasy

Ecstasy is a social club drug that enhances open interactions with others. A new study by Michael Wunderli and Prof. Boris Quednow of the Psychiatric University Hospital shows that individuals with superior social skills are likely more prone to using the drug, but that long-term use of ecstasy has just the opposite effect: it negatively affects social functioning.

With an estimated 19.4 million users in 2016, 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) remains one of the most-used illegal drugs worldwide. The effects of taking MDMA are well known, it makes people feel more social, more interested in interacting with other people, and more connected. But chronic use can also have downsides: Previous research by Quednow and colleagues showed that chronic use of MDMA is associated with considerable memory impairments.

Superior cognitive empathy in ecstasy users
Now the researchers wanted to understand the effect of long-term MDMA use on social cognition. For the study, they recruited long-term MDMA users, who abstained from using the drug during the study, and MDMA-naïve healthy controls. All were subjected to well-established social cognition tasks. Hair samples were analyzed from all participants to objectively quantify the severity of their drug use during the past months.
MDMA users showed superior cognitive empathy compared to the individuals in the control group, meaning that the users had a better capacity to understand another person’s perspective or mental state. The emotional empathy, the ability to show emotional concern for others, however, did not differ between the two groups.

Socially high performing drug users
The authors next asked if this better performance in cognitive empathy was a result of ecstasy use, i.e. if the drug did induce more social behavior even if in abstinent users. To answer this question the researchers analyzed the severity of drug use in the hair samples within the chronic user group. They saw that the individuals with the more severe drug use scored lower on the cognitive empathy tests, meaning that long-term high-dose ecstasy use might have a negative effect on social functioning.
So how was it possible that the user group scored better than the non-users? The authors suggest that the superior cognitive empathy of MDMA users is not a consequence of MDMA use, but rather a predisposition for it. People who value close social contact are more likely to start using ecstasy.

In comparison, for cocaine it has been suggested that a lack of prosocial behavior might be one of the triggers to start using the drug. Chronic use of cocaine is associated with broad cognitive impairment, and users score lower on both cognitive and emotional empathy tests.

Social cognition and interaction in chronic users of 3,4-methylenedioxymethamphetamine (MDMA, “Ecstasy”). Wunderli MD, Vonmoos M, Treichler L, Zeller C, Dziobek I, Kraemer T, Baumgartner MR, Seifritz E, Quednow BB. Int J Neuropsychopharmacol. 2017 Oct 26. Link to paper

See also:
Preller KH, Hulka LM, Vonmoos M, Jenni D, Baumgartner MR, Seifritz E, Dziobek I, Quednow BB (2014) Impaired emotional empathy and related social network deficits in cocaine users. Addict Biol 19:452-466. Link to pdf

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