Ecstasy (MDMA) Seychelles
Ecstasy (MDMA) SeychellesEcstasy (MDMA) Seychelles
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Ecstasy (MDMA) Seychelles
Ecstasy (MDMA) Seychelles
A psychedelic drug may help treat PTSD. But questions remain on how best to use—and regulate—it
Ecstasy (MDMA) Seychelles
Methylenedioxymethamphetamine (MDMA) Toxicity (Ecstasy Toxicity)
Ecstasy (MDMA) Seychelles
The island paradise of Seychelles is suffering from a drug epidemic of huge proportions. Known for its coral reefs, mangroves and white sandy beaches, , tourists travel to the Indian Ocean archipelago each year for a holiday of a lifetime. But look beyond the private islands, the boutique resorts and high-end restaurants, and the small nation is battling a heroin epidemic of huge proportions. Per capita, the Seychelles suffers from the highest rate of heroin abuse in the world. Jed Lesperance was 20 years old when he first started taking drugs. He is 34 now. At first it was fun,' he said. I was smoking heroin two to three times a day, even stealing from my grandmother to pay for my habit. Within a few weeks, I had become addicted,' he said. Heroin makes the long journey from Central Asia, especially Afghanistan, before being smuggled to the islands via East Africa. Made up of islands, the Seychelles has many porous borders, which makes them hard to monitor and easy for drugs to come into the country. But rather than attempting a 'war on drugs', which would criminalise the large proportion of heroin users in the Seychelles, the head of the anti-drug agency has introduced a Portuguese-style drug policy - considering drug addiction as a chronic disease to be treated. Individuals have access to medical and psychosocial support under both programmes. Mr Lesperance is one of those people who has benefitted from joining a rehabilitation programme set up by the agency. Each morning, he visits one of the country's roaming methadone clinics - white vans that are manned by drug counsellors and qualified nurses to give the correct dose of methadone to recovering addicts. Dozens of people line up outside the open windows of the white van ready to show their ID. Their name, the date and time are logged into a spreadsheet and on receipt of the information, the correct dose of methadone is distributed to them. Mr Lesperance, who has been clean for three months, now works as a pastry chef in a five-star hotel on Mahe, the largest island in the Seychelles. Michelle Sabury, who helps recruit drug addicts on to rehabilitation programmes, agrees that 'he is a completely different person'. Now he looks a lot healthier and is able to go to work each day. We are proud of what he has achieved,' she told the BBC. After receiving methadone, many of those enrolled in the programme stay to talk with their peers or a counsellor before heading off to work or back home. Some arrive with family members in tow, illustrating how the stigma attached to treatment in the Seychelles is slowly disintegrating. One of the counsellors, Levina Mosses, is a reformed heroin addict who now comes to offer support to others hoping to get clean. My boyfriend was a dealer at the time, so I never had to pay for drugs. My only option was to get clean. Ms Mosses left her boyfriend, also the father of her children, 11 years ago - and has been clean ever since. Following the rollout of the rehabilitation programmes, the price of heroin in the Seychelles has plummeted. However, there is another threat mounting in the Seychelles as the popularity of synthetic drugs is now on the rise. Seychelles profile. Seychelles starts 'Britain-sized' reserve. Africa Today podcasts. I was smoking heroin two to three times a day, even stealing from my grandmother to pay for my habit'. Morning methadone clinics. Heroin users have two options:. To join a high-threshold MMP, which includes a period of in-patient treatment where they must commit to detoxification Or the low-threshold programme, which focuses on harm reduction. More on drugs in Africa:. How addict Jesus survived South Africa's drug epidemic Prescription drugs sold illegally in Uganda How a codeine investigation changed Nigeria. The heroin epidemic has touched so many people in my country, it's only right to be open and honest about the problems we are facing'. Five things about Seychelles:. Popular with tourists after overcoming history of coups and mutinies following independence The Duke and Duchess of Cambridge spent their honeymoon there in The archipelago has a high per capita income, good health care and education Much of the land on its islands is protected as part of nature reserves Home to the endangered Aldabra giant tortoises. Related Topics. Drug use Seychelles Drug rehabilitation. More on this story. Published 24 March. Published 22 February Around the BBC.
Ecstasy (MDMA) Seychelles
Why Seychelles has world's worst heroin problem
Ecstasy (MDMA) Seychelles
It differs pharmacologically in that it has both stimulatory and mild psychedelic properties, noted to be equivalent to that of hallucinogenic mescaline, however, auditory and visual hallucinations are uncommon. MDMA elicits its neurochemical effects in much the same manner as amphetamines and methamphetamines, by stimulating catecholamine release of norepinephrine and dopamine, and blocking presynaptic reuptake of these catecholamines. Additionally, the mescaline-like ring structure enhances both serotonergic and dopaminergic release, as well as inhibition of serotonin reuptake. MDMA was classified as a Schedule I drug by the Drug Enforcement Administration DEA in , as it had been linked to neurotoxicity and potential brain damage, and therefore data from clinical studies have been very limited. It is noted to give users a sense of euphoria, empathy, and decreased inhibitions, lasting approximately 3—6 hours. It is also taken in conjunction with marijuana and alcohol. Unfortunately, for clinicians attempting to identify the agent ingested, what is being sold in the street as pure MDMA, often times had been adulterated with a wide variety of chemical and pharmaceutical substitutes: acetaminophen, ibuprofen, methamphetamine, caffeine, dextromethorphan, ephedrine, and cocaine are common. The typical amount of MDMA varies from 30— mg, or none at all. The data is then published online along with pill image and name, active contents, its sales location, and the date tested. As the drugs purity is typically in question, the clinician must always consider other variants being sold as pure MDMA. One drug which has come to the attention of researchers and clinicians is paramethoxyamphetamine PMA , which has been associated with a higher incidence of death than MDMA at relatively lower doses. In addition to stimulating the release of serotonin, it also acts as a monoamine oxidase inhibitor MAOI , which can result in serotonin syndrome and can lead to refractory hyperthermia and death. On occasion, it is pooled with data on stimulants, and in others, with hallucinogenics, although it lacks true hallucinogenic properties. The report showed a significant increase in lifetime use among individuals aged 12 years or older, from 4. Among persons aged 12—49 years, the average age at first use of MDMA was Among young adults aged 18—25 years, males were more likely to have used ecstasy during the past year than females. However, among youths aged 12—17 years, females were more likely to have used ecstasy during the past year than males. As with any ingestion, whenever possible, obtaining a detailed history is of the upmost importance. Type of drug, amount taken, last ingestion time, frequency of use, route, and coingestants can guide therapeutic interventions. It is important to remember that MDMA is manufactured clandestinely and therefore the true composition and purity are difficult to establish. However, it is not recommended to delay care while identifying the offending agent or agents. Drug toxicology can be erroneous and delaying care while awaiting the results can have negative implications on patient outcomes. The user can present with a wide variety of signs and symptoms from CNS stimulation following use, with most being mild and non-life threatening. During the acute phase minor reactions have been reported including: anxiety, nausea, euphoria, enhanced sensory perception, pupillary dilation, diaphoresis, bruxism, dry mouth, tachycardia, and hypertension. The development of serious side effects of MDMA intoxication vary individually and there is no established correlation between the amount of MDMA taken and severity of side effects. Case reports have confirmed that some individuals have died after consuming only one dose of MDMA, while others have consumed relatively lethal doses and have survived. A list is provided of the potential life-threatening complications which have been observed with MDMA toxicity and it should be kept in mind by the clinician assessing the patient:. Laboratory and radiological testing depends on the severity of the intoxicated patient and should be expanded based on the history and physical. A complete metabolic panel along with a creatine phosphokinase CPK is indicated in all patients. Additional testing should be tailored to each patient. Complete metabolic panel: to monitor for hyponatremia, hyperkalemia, acute renal failure, acute liver failure and metabolic acidosis. Urine drug testing for MDMA can be erroneous and therefore supportive care should not be delayed while awaiting the results. However, it may support the clinical diagnosis and also provide information on common drugs of abuse which may have been taken concurrently. Acutely intoxicated patients are at risk for developing a wide range of medical complications from minor symptoms, which require minimal intervention, to potentially life-threatening side effects, which require intubation, sedation, and monitoring within an intensive care unit ICU setting. Following the acronym ABC Airway, Breathing, Circulation , along with establishing good intravenous access, is essential. Clinical intervention is managed on an individual basis and is typically supportive in nature. Hyponatremia associated with MDMA use can be multi-factorial. Many users are aware of the risks of developing hyperthermia, and compensate by drinking copious amounts of water leading to delusional hyponatremia. This can be exacerbated in individuals already taking selective serotonin reuptake inhibitor SSRI or other psychotropic medications. Serious neurological complications resulting from hyponatremia include altered mental status, seizures, cerebral edema, and death. MDMA has structural similarity to serotonin, which accounts for increased serotonin release and inhibition of serotonin reuptake. Severe symptoms of serotonin syndrome consist of the triad of cognitive-behavioral, neuromuscular and autonomic derangements. This results in hyperthermia, agitation, seizures, hyperflexia and altered mental status, leading to refractory hyperthermia, multisystem organ failure, and death. In most cases hyperthermia is associated with excessive activity without adequate fluid replacement. Additional factors can be from dancing for long hours without breaks in poorly ventilated areas. Clinicians should always consider serotonin syndrome as a possible cause. Sudden cardiac death has been postulated to occur secondary to sympathomimetic stimulation, resulting in lethal dysrhythmias. Individuals with undiagnosed cardiac disease and conduction abnormalities are at greater risk. Patients with evidence of end-organ damage, focal neurological deficits, arrhythmias, delirium, or uncontrolled agitation should be admitted for observation. Substance abuse referrals should also be made prior to discharge. Nitroprusside: 0. A beta blocker may be used only if an alpha adrenergic antagonist is concomitantly administered. Use of a beta blocker without alpha blockade may result in paradoxical increase in BP as it may cause unopposed alpha-receptor stimulation. Diazepam: 5—10 mg IV push initially, may repeat every 5—10 minutes as needed; consider a second agent if seizures persist or recur after total dose of 30 mg diazepam administered. For severe cases intubation and sedation with a non-depolarizing neuromuscular blocker is indicated. Frequent monitoring of serum sodium levels, to eliminate rapid correction leading to osmotic demyelination syndrome. Cyproheptadine a 5-HT2 antagonist : 4—12 mg PO; limited research, but has shown to be effective in case reports. SMA Findings, All rights reserved. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC. Show More. Login Register. We want you to take advantage of everything Cancer Therapy Advisor has to offer. To view unlimited content, log in or register for free. Register now at no charge to access unlimited clinical news, full-length features, case studies, conference coverage, and more. Jump to Section I. Diagnostic Approach. What is the differential diagnosis for this problem? Historical information important in the diagnosis of this problem. Physical Examination maneuvers that are likely to be useful in diagnosing the cause of this problem. Laboratory, radiographic and other tests that are likely to be useful in diagnosing the cause of this problem. Management while the Diagnostic Process is Proceeding. 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Ecstasy (MDMA) Seychelles
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Seychelles' drug problem threatens the success of its blue economy
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Ecstasy (MDMA) Seychelles
Ecstasy (MDMA) Seychelles