Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational drugs. Ecstasy was ranked 18th in dependence, physical harm, and social harm.
Ritalin: 20 mg sustained-release (SR) tablets
MDMA induced transporter reversal on human serotonin transporters (SERT), which leads to serotonin release.
A chart comparing the chemical structures of different amphetamine derivatives
In the serotonergic neurons of humans, extracellular MDMA releases serotonin via serotonin transporters (SERT). Intracellular MDMA inhibits VMAT2 and, to a much lesser extent, MAO-A.
Roasted coffee beans, a common source of caffeine.
Main metabolic pathways of MDMA in humans.
Tablets containing MDMA
Alexander and Ann Shulgin in December 2011
Lines of illicit cocaine, used as a recreational stimulant
A 1995 Vibe Tribe rave in Erskineville, New South Wales, Australia being broken up by police. MDMA use spread globally along with rave culture.
Catha edulis
UNODC map showing the use of ecstasy by country in 2014 for the global population aged 15–64

For the category "amphetamines and prescription stimulants" (with "amphetamines" including amphetamine and methamphetamine) the value was 0.7%, and for MDMA 0.4%.

- Stimulant

It belongs to the substituted amphetamine classes of drugs and has stimulant and hallucinogenic effects.

- MDMA
Addiction experts in psychiatry, chemistry, pharmacology, forensic science, epidemiology, and the police and legal services engaged in delphic analysis regarding 20 popular recreational drugs. Ecstasy was ranked 18th in dependence, physical harm, and social harm.

12 related topics

Alpha

Amphetamine

Amphetamine (contracted from a lpha- m ethyl ph en et hyl amine ) is a central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity.

It is also the parent compound of its own structural class, the substituted amphetamines, which includes prominent substances such as bupropion, cathinone, MDMA, and methamphetamine.

Cocaine

Cocaine hydrochloride
Lines of cocaine prepared for snorting
A 2010 study ranking various illegal and legal drugs based on statements by drug-harm experts. Crack cocaine and cocaine was found to be the third and fifth overall most dangerous drugs respectively.
Side effects of chronic cocaine use
A pile of cocaine hydrochloride
A piece of compressed cocaine powder
A woman smoking crack cocaine
"Rocks" of crack cocaine
Biological source of cocaine molecule in the context of the tropane class of molecules. The biological source of each tropane alkaloid is indicated by species, and below that a phylogenetic map is provided.
Biosynthesis of N-methyl-pyrrolinium cation
Biosynthesis of cocaine
Robinson biosynthesis of tropane
Reduction of tropinone
Coca leaf in Bolivia
"Cocaine toothache drops", 1885 advertisement of cocaine for dental pain in children
Advertisement in the January 1896 issue of McClure's Magazine for Burnett's Cocaine "for the hair".
Pope Leo XIII purportedly carried a hip flask of the coca-treated Vin Mariani with him, and awarded a Vatican gold medal to Angelo Mariani.
In this 1904 advice column from the Tacoma Times, "Madame Falloppe" recommended that cold sores be treated with a solution of borax, cocaine, and morphine.
Women purchase cocaine capsules in Berlin, 1929
D.C. Mayor Marion Barry captured on a surveillance camera smoking crack cocaine during a sting operation by the FBI and D.C. Police.
Drug overdoses killed more than 70,200 Americans in 2017, with cocaine overdoses making up 13,942 of those deaths.
United States CBP police inspect a seized shipment of cocaine
The U.S. Coast Guard in Miami offloading confiscated cocaine
Cocaine smuggled in a charango, 2008
Cocaine adulterated with fruit flavoring
Opioid involvement in cocaine overdose deaths. The green line is cocaine and any opioid (top line in 2017). The gray line is cocaine without any opioids (bottom line in 2017). The yellow line is cocaine and other (middle line in 2017).<ref name=NIDA-deaths>{{cite web | url = https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates | title = Overdose Death Rates | archive-url = https://web.archive.org/web/20151128091723/https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates| archive-date=28 November 2015 | work =  By National Institute on Drug Abuse (NIDA) }}</ref>
Delphic analysis regarding 20 popular recreational drugs based on expert opinion. Cocaine was ranked the 2nd in dependence and physical harm and 3rd in social harm.<ref name="Lancet">{{cite journal|vauthors = Nutt D, King LA, Saulsbury W, Blakemore C|title = Development of a rational scale to assess the harm of drugs of potential misuse|journal = Lancet|volume = 369|issue = 9566|pages = 1047–53|date = March 2007|pmid = 17382831|doi = 10.1016/S0140-6736(07)60464-4|s2cid = 5903121|author-link4 = Colin Blakemore|author-link1 = David Nutt }}</ref>

Cocaine (from cocaïne, from coca, ultimately from Quechua: kúka) is a tropane alkaloid and stimulant drug obtained primarily from the leaves of two coca species native to South America, Erythroxylum coca and Erythroxylum novogranatense.

Analysis of the correlation between the use of 18 various psychoactive substances shows that cocaine use correlates with other "party drugs" (such as ecstasy or amphetamines), as well as with heroin and benzodiazepines use, and can be considered as a bridge between the use of different groups of drugs.

U.S. Food and Drug Administration agents inspect packages for illegal drug shipments at an international mail facility in New York

Controlled Substances Act

Statute establishing federal U.S. drug policy under which the manufacture, importation, possession, use, and distribution of certain substances is regulated.

Statute establishing federal U.S. drug policy under which the manufacture, importation, possession, use, and distribution of certain substances is regulated.

U.S. Food and Drug Administration agents inspect packages for illegal drug shipments at an international mail facility in New York

αMT (alpha-methyltryptamine), a psychedelic, stimulant, and entactogen drug of the tryptamine class that was originally developed as an antidepressant by workers at Upjohn in the 1960s.

MDMA ("ecstasy" or "molly"), a stimulant, psychedelic, and entactogenic drug which initially garnered attention in psychedelic therapy as a treatment for post-traumatic stress disorder (PTSD). The medical community originally agreed upon placing it as a Schedule III substance, but the government denied this suggestion, despite two court rulings by the DEA's administrative law judge that placing MDMA in Schedule I was illegal. It was temporarily unscheduled after the first administrative hearing from December 22, 1987 – July 1, 1988.

Adriaen Brouwer, TheSmokers (1636)

Recreational drug use

Use of a psychoactive drug to induce an altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions, feelings, and emotions of the user.

Use of a psychoactive drug to induce an altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions, feelings, and emotions of the user.

Adriaen Brouwer, TheSmokers (1636)
Edgar Degas, L'Absinthe (1876)
Bhang eaters from India c. 1790. Bhang is an edible preparation of cannabis native to the Indian subcontinent. It has been used in food and drink as early as 1000 BCE by Hindus in ancient India.
A man smoking cannabis in Kolkata, India
A rational harm assessment of drugs<ref>{{Cite journal|last1=Blakemore|first1=Colin|last2=Saulsbury|first2=William|last3=King|first3=Leslie A.|last4=Nutt|first4=David|date=2007-03-24|title=Development of a rational scale to assess the harm of drugs of potential misuse|url=https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60464-4/abstract|journal=The Lancet|language=en|volume=369|issue=9566|pages=1047–1053|doi=10.1016/S0140-6736(07)60464-4|issn=0140-6736|pmid=17382831|s2cid=5903121}}</ref>
This 1914 photo shows intoxicated men at a sobering-up room
alt=A chart showing dependence potential versus safety ratio.|An analysis of the dangers of drugs<ref>{{Cite book|url=https://books.google.com/books?id=xpZhjBuDkuwC&pg=PA149|title=Drugs and Society: U.S. Public Policy|last=Fish|first=Jefferson M.|date=2006|publisher=Rowman & Littlefield|isbn=9780742542457|language=en}}</ref>
Total recorded alcohol per capita consumption (15+), in liters of pure alcohol
Caffeinated alcoholic beverages, such as Vodka Red Bull, are widespread and legal routes of administration for multiple drugs.
Insufflation of powdered drug
Injection of heroin
Cocaine is a commonly used stimulant
alt=A chart showing relative drug harm.|A chart showing relative drug harm.

Generally, recreational drugs are divided into three categories: depressants (drugs that induce a feeling of relaxation and calmness); stimulants (drugs that induce a sense of energy and alertness); and hallucinogens (drugs that induce perceptual distortions such as hallucination).

What controlled substances are considered generally unlawful to possess varies by country, but usually includes methamphetamine, heroin, cocaine, LSD, psilocybin mushrooms, MDMA, Lean, and club drugs.

A selection of MDMA pills, which are often nicknamed "Ecstasy" or "E".

Empathogen–entactogen

A selection of MDMA pills, which are often nicknamed "Ecstasy" or "E".

Empathogens or entactogens are a class of psychoactive drugs that produce experiences of emotional communion, oneness, relatedness, emotional openness—that is, empathy or sympathy—as particularly observed and reported for experiences with 3,4-methylenedioxymethamphetamine (MDMA).

This class of drug is distinguished from the classes of hallucinogen or psychedelic, and amphetamine or stimulant.

MDMA (Ecstasy) pills. The Convention allows only government-approved medical and scientific uses of this and other substances.

Convention on Psychotropic Substances

United Nations treaty designed to control psychoactive drugs such as amphetamine-type stimulants, barbiturates, benzodiazepines, and psychedelics signed in Vienna, Austria on 21 February 1971.

United Nations treaty designed to control psychoactive drugs such as amphetamine-type stimulants, barbiturates, benzodiazepines, and psychedelics signed in Vienna, Austria on 21 February 1971.

MDMA (Ecstasy) pills. The Convention allows only government-approved medical and scientific uses of this and other substances.
Despite its well-known presence in the rave scene, ketamine remains uncontrolled internationally due to its importance as an anesthetic in veterinary medicine.
Article 32 makes an exception for peyote and other wild psychotropic plants, to protect use in religious rituals in case such plants themselves were in the future added to Schedule I.
Psilocybin mushrooms are not controlled by the Convention, but the drugs contained in them are.
LSD and equipment used in its manufacture are subject to seizure under Article 22.
Crystal meth has emerged as a commonly abused drug, from the American and European rave scenes to East Asia.

Circa 1969, with use of stimulants growing, ECOSOC noted with considerable consternation that the Commission "was unable to reach agreement on the applicability of the Single Convention on Narcotic Drugs, 1961 to these substances".

Schedule I includes drugs claimed to create a serious risk to public health, whose therapeutic value is not currently acknowledged by the Commission on Narcotic Drugs. It includes isomers of THC, synthetic psychedelics such as LSD, and natural psychedelics like certain substituted tryptamines. ATS such as cathinone, MDA, and MDMA (ecstasy) also fall under this category.

The bacterium Escherichia coli (E. coli), is a single-celled prokaryote

Sympathomimetic drug

Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of endogenous agonists of the sympathetic nervous system.

Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of endogenous agonists of the sympathetic nervous system.

The bacterium Escherichia coli (E. coli), is a single-celled prokaryote

Illegal drugs such as cocaine and MDMA also affect dopamine, serotonin, and norepinephrine.

Thus, all sympathomimetic amines fall into the larger group of stimulants (see psychoactive drug chart).

Racemic amphetamine skeleton

Substituted amphetamine

Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with substituents.

Substituted amphetamines are a class of compounds based upon the amphetamine structure; it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with substituents.

Racemic amphetamine skeleton
This shows phenethylamine in blue with its substitution points marked. Amphetamine and its substituted derivatives contain a CH3 group at the alpha-position (Rα).
This shows amphetamine with its substitution points marked, excluding the N-position at the NH2 group which is unmarked.
Amphetamine pills

The compounds in this class span a variety of pharmacological subclasses, including stimulants, empathogens, and hallucinogens, among others.

Examples of substituted amphetamines are amphetamine (itself), methamphetamine, ephedrine, cathinone, phentermine, mephentermine, bupropion, methoxyphenamine, selegiline, amfepramone (diethylpropion), pyrovalerone, MDMA (ecstasy), and DOM (STP).

A drawing of someone with insomnia from the 14th century

Insomnia

Sleep disorder in which people have trouble sleeping.

Sleep disorder in which people have trouble sleeping.

A drawing of someone with insomnia from the 14th century
Potential complications of insomnia.
Normison (temazepam) is a benzodiazepine commonly prescribed for insomnia and other sleep disorders.

Use of psychoactive drugs (such as stimulants), including certain medications, herbs, caffeine, nicotine, cocaine, amphetamines, methylphenidate, aripiprazole, MDMA, modafinil, or excessive alcohol intake

Both pupils are dilated (mydriasis) because of hyper-activation of the sympathetic system caused by the recreational psychedelic drug LSD

Mydriasis

Dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response.

Dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response.

Both pupils are dilated (mydriasis) because of hyper-activation of the sympathetic system caused by the recreational psychedelic drug LSD

Stimulants (typically monoaminergics) such as amphetamines, cocaine, MDMA, and mephedrone.