PMA and PMMA

What Kind of Drug Is It?

PMA and PMMA are strong and dangerous drugs that have been linked to a number of deaths in North America, Australia, and Europe. PMA and PMMA are nearly identical in chemical makeup, and their effects on the body are essentially the same. For the purpose of this entry, PMA and PMMA will be discussed as one.

PMA is a synthetic hallucinogen, meaning that it is made in a laboratory and is a mind-altering drug. Derived from the Latin word allucinari, which means "to wander in the mind," hallucinogenic drugs alter the user's perception of reality, thought, or emotion, and can result in alternate states of consciousness or hallucinations. PMA was known to have been used for a short time in the early 1970s in the United States and Canada and saw a comeback in the 1990s.

Deadly Deception

PMA is often sold as another synthetic hallucinogen called ecstasy (MDMA). Illegal drug makers often pass off PMA for ecstasy for several reasons: 1) Ecstasy is a popular party drug among teenagers and young adults; 2) PMA is cheaper to produce than ecstasy; and 3) PMA is similar in appearance, cost, and effect. (An entry on ecstasy is available in this encyclopedia.) However, PMA is far more dangerous than ecstasy. Its initial slow effect on the body sometimes causes users to take more of the drug because they think they have taken weak ecstasy. More drug can lead to overdose.

Official Drug Name: Paramethoxyamphetamine (PAH-ruh-meth-AHK-see-am-FETT-uh-meen) p-methoxyamphetamine, 4-methoxyamphetamine (all names for PMA); paramethoxymethamphetamine (PAH-ruh-meth-AHK-see-METH-am-fett-uh-meen; PMMA)

Also Known As: Chicken powder, chicken yellow, death, double-stacked, killer, mitsubishi, mitsubishi double-stack, red death, red mitsubishi, white mitsubishi

Drug Classifications: Schedule I, hallucinogen

Combining PMA with other drugs, alcohol, or caffeine increases the risk of overdose. (Entries on alcohol and caffeine are available in this encyclopedia.) Those who have ingested PMA have reported breathing difficulties, nausea, vomiting, muscle spasms, and increased blood pressure and temperature. Those suffering from PMA overdose experience high body temperatures, sometimes resulting in convulsions, coma, and a complete shutdown of the organs of the body. This fact has led to the drug's street name "death." Since PMA is sometimes sold as ecstasy, unsuspecting users are unprepared for the potential side effects of the more deadly drug.

Overview

Paramethoxyamphetamine (PMA) was first produced by a Canadian laboratory in 1973. In that year alone, the drug was associated with nearly a dozen deaths in both Canada and the United States. Then the drug all but disappeared until the mid- 1990s. At that time, six people in Australia died after taking what they thought was ecstasy. A later investigation found that the victims had various amounts of PMA in their systems, sometimes combined with ecstasy, amphetamines, or prescription drugs. (An entry on amphetamines is available in this encyclopedia.) In the early 2000s PMA made its way back into Canada and the United States. It also showed up in Europe, mainly in Austria, Denmark, and Germany. Additional PMA-related deaths occurred in these countries, the victims dying after taking what they believed was ecstasy.

Is It Ecstasy or PMA/PMMA?

Because PMA is cheaper to produce than ecstasy, manufacturers sometimes mix the two drugs, or they may sell PMA as a substitute for ecstasy. The pills are sold as ecstasy to drug dealers, who may not know of the PMA content. Because PMA and ecstasy have similar effects on the user and the pill size and color may be the same, PMA can easily be passed off as ecstasy. Many pills have a logo stamped on them that acts as a brand name for a particular illegal, underground drug laboratory. Those passing off PMA as ecstasy may use an established lab's logo, like the three-diamond symbol of the mitsubishi "brand" of ecstasy.

It has been found, in fact, that most of the pills that caused death in the United States carried the mitsubishi logo (but PMA has been found in pills with other logos as well). Using a known source of ecstasy is not a safeguard against PMA poisoning, since the drug dealers themselves are often unaware of PMA in their supplies.

The popularity of recreational drugs such as ecstasy was seen among young people who frequent the nightclub or rave scene. Such drug use has increased the risk of mistakenly taking toxic, or poisonous, substances such as PMA. A rave is a dance party, sometimes lasting all night, where DJs play electronic music and colorful lights flash to the pulsating beat. Raves are sometimes promoted as alcohol-free events, giving parents a false sense of security that their children will be safe attending these parties. In reality, raves may be havens for the illegal sale and abuse of club drugs such as ecstasy. The dangerous substitution of PMA in ecstasy tablets is an added risk, and it is causing alarm around the world.

What Is It Made Of?

PMA and PMMA are produced from amphetamines, drugs that stimulate the body's central nervous system. Often called "uppers" or "speed," amphetamines increase energy and decrease appetite. PMA is said to be twenty times more powerful than amphetamines. One of the substances found in PMA is anethole (ANN-uh-tholl), a component of the aromatic herbs anise (AN-iss) or fennel.

Chemically speaking, PMMA and PMA are very similar, and their effects on the human body are virtually identical. Of the two, PMA is the one most often found in the blood samples of overdose victims. PMA has been found in pill and powder form, and it is sold in pills mixed with other drugs such as ecstasy. PMA is extremely toxic to the human body. Although some of the PMA pills that caused death contained no ecstasy, they have been made to look identical to ecstasy in size, color, and logos. Pure PMA is beige, white, yellow, or pink. The color of the pills being sold on the street varies; most commonly they are beige, white, or red and may have the three-diamond mitsubishi logo stamped on them. In 2004 a small amount of light purple pills with no logo on them were found to contain PMMA.

How Is It Taken?

PMA is most frequently found in pill form, masked as ecstasy, and is taken orally. However, in parts of the United States, an increasing number of users have been snorting or injecting a powdered form of the drug. In some areas it is used in mixed beverages. The drugs can also be inserted rectally.

Are There Any Medical Reasons for Taking This Substance?

There are no known medical uses for PMA.

Usage Trends

PMA was first manufactured in Canadian drug labs in the 1970s and resulted in a number of deaths in both Canada and the United States. There was no sign of the drug again until the mid-1990s, when it popped up on the Australian nightclub scene. Since then PMA distributors have targeted "club drug" dealers—those who sell to teenagers or young adults attending raves. Reports from the Office of National Drug Control Policy (ONDCP) show that club drugs have been increasingly available, and the most widely available club drug is ecstasy. The substance is thought to enhance the rave experience by allowing partygoers to dance longer, while feeling dreamy and entranced by the music and lights. Other frequent places of use are college campuses, private parties, shopping malls, schools, and concerts.

Ecstasy and PMA Tracked Together

Because PMA is disguised as ecstasy—and is mistakenly used by people who think they are taking ecstasy—the trends of PMA abuse mirror the trends of ecstasy abuse. Ecstasy users tend to be between thirteen and thirty years of age. Because the drug is fairly easy to get, younger and younger people are starting to use ecstasy. In fact, in Honolulu, Hawaii, an emerging group of ecstasy users in treatment

are pre-adolescent (approximately nine to twelve years old). Users tend to be male and female middle-class whites living in both central cities and suburbs.

In the twenty-first century, ecstasy use began expanding to nonwhite and Hispanic populations across the United States. The use of ecstasy by those of African American descent has dramatically increased in the Southeast United States. And in places like Houston, Texas, the drug is becoming common among a subculture of young gay men.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), overall levels of availability and abuse of ecstasy are beginning to decrease in the United States after peaking in 2001. The 2005 National Drug Threat Assessment shows that the estimated number of people twelve or older who used ecstasy decreased from 3.2 million in 2002 to 2.1 million in 2003. Young people have begun to understand the risks associated with the drug, likely a result of prevention programs and antidrug campaigns.

Monitoring the Future

In the 2004 Monitoring the Future (MTF) survey, high school students reported a 3-percent increase in perceived harmfulness of occasional ecstasy use from 2003 to 2004. The number of ecstasy tablets seized arriving from foreign sources also decreased, from 6.9 millions tablets in 2001 to fewer than a million tablets in 2003. And the number of ecstasy arrests made by the U.S. Drug Enforcement Administration (DEA) dropped from 2,105 in 2001 to 1,124 in 2003. It is thought that, overall, there is a decrease in the availability of the drug. This may be due to the discovery and dismantling of several large ecstasy distributors, namely Israeli and Asian groups that were distributing the drug throughout the United States.

Ecstasy in Europe

Europe is one of the world's most important areas for the manufacture of ecstasy. Belgium and the Netherlands are the countries producing the most. For many years there, amphetamines were the second most commonly used drug behind marijuana. The "Annual Report 2004: The State of the Drugs Problem in the European Union and Norway," however, indicates that the use of ecstasy may be exceeding that of amphetamines. About two-thirds of European Union (EU) countries reported recent ecstasy use to be more common than that of amphetamines among young people age fifteen to thirty-four years.

Overall, the increase in use of ecstasy that occurred during the 1990s now appears to have leveled off a bit in Europe, with only a few countries still reporting increasing numbers. At first, like in the United States, the drug was connected to the rave scene. However, in the twenty-first century, it has been increasingly spreading across a broader section of society.

Effects on the Body

PMA and ecstasy have a similar effect on the body. Taking fewer than 50 milligrams of PMA without other drugs, alcohol, or caffeine brings on mild symptoms similar to those of ecstasy. These include heightened visual stimulation and rapid and irregular eye movements, an increase in heart rate and blood pressure, motion sickness, muscle spasms, difficulty breathing, and an increase in body temperature.

This dose may also provide extra energy and a general feeling of well-being by blocking the neurotransmitter serotonin in nerve endings. serotonin plays an important role in regulating mood, sleep, and sensitivity to pain. A person taking this same dose of PMA along with other drugs, alcohol, or caffeine may experience a more intense effect, and the danger of the drug increases. The dose of PMA by itself may not be deadly, but it could become lethal when taken along with other drugs.

PMA History: Decades of "Death"

PMA use can be deadly. In fact, one of the drug's street names is "death." The following chronicles various problems associated with the drug since the 1970s.

1970s

In 1972 and 1973, nearly a dozen deaths are attributed to ecstasy use in the United States and Canada. Some appeared to have been caused by PMA sold as ecstasy. PMA itself is sold as a recreational psychoactive drug under the names "chicken yellow" and "chicken powder." (Psychoactive drugs alter the user's mental state or change the person's behavior.) PMA is placed in Schedule I of the Controlled Substances Act (CSA), making it illegal to buy, sell, or possess the drug in the United States.

1980s

PMA is no longer found on the street market. There are few, if any, reported cases of PMA-related deaths during the decade.

1990s

The rave phenomenon begins feeding the demand for and supply of club drugs such as ecstasy. In Australia, a twenty-six-year-old woman dies after taking what she thought was ecstasy. A search of historical files at the country's coroners' offices brings up cases of similar deaths. In total, six deaths in Australia originally reported as ecstasy-related deaths are determined to have been caused by PMA sold as ecstasy.

2000s

By 2005, the drug is associated with more than twenty deaths internationally. Three PMA-related deaths in Chicago and seven in Florida are reported after the drug is again sold as ecstasy. White mitsubishi pills that contain PMA cause deaths in Europe: one in Norway, one in Austria, and at least four in Denmark. Another four people are reported to have died from PMA tablets in Belgium.

Small amounts of PMA are found in Canada, and at least one drug-related death in the Toronto area is linked to PMA use. In June 2005, twelve people in Australia overdose on what they think is ecstasy. Some of those taking the drug suffer strokes after taking the pills. One nineteen-yearold girl dies after taking only half of a tablet. Later tests reveal that the pills contained PMA.

Nicknamed "Death" for a Reason

PMA doses of 50 milligrams or more are potentially deadly, especially when taken with other drugs. High doses may cause vomiting, heart failure, kidney failure, brain seizures, hallucinations, sudden collapse, and an extreme rise in body temperature—up to

115°F (46°C). This increase in temperature sometimes results in convulsions, coma, and a complete shutdown of the organs of the body, leading to death.

Because the victims thought that what they took was actually ecstasy, it is first believed that their symptoms came from ecstasy poisoning, which is dangerous but not necessarily deadly. PMA, however, is a far more toxic drug and has a much higher rate of lethal complications than ecstasy. Whenever a user has unusually severe reactions to ecstasy, PMA is suspected. But it is only confirmed through urine tests.

In a suburb of Chicago in May of 2000, eighteen-year-old Sara Aeschlimann was partying with friends just five minutes from her house when she decided to take a form of ecstasy called mitsubishi double-stack. Within hours she went into convulsions and fell into a coma. Her body temperature reached 108°F (42°C) and with her blood cells erupting, she was bleeding internally and from her mouth. By the following day she was dead. Later testing determined that Sara had mistakenly overdosed on PMA.

Two others died of PMA overdose around Chicago that month as well, and dozens of people around the world have suffered the same fate. According to Fox News, Michael Hillebrand, of the Chicago branch of the DEA, compared PMA with ecstasy: "With PMA, taking the same dosage amount [as ecstasy], you receive a less-intensive feeling within your system. People then think that they're getting weak ecstasy and then they take two more. Now it's too late. Ecstasy is bad," he added, but "PMA is death."

Other Effects

The Australian drug and alcohol clinic Turning Point interviewed 100 regular ecstasy users age seventeen to forty-five who had taken ecstasy at least once a month during the previous six months. It was found that 84 percent suffered from confusion, 73 percent from appetite loss, and 66 percent from blurred vision.

Other effects associated with ecstasy and PMA use are: 1) recurring paranoia, or abnormal feelings of suspicion and fear; 2) hallucinations or flashbacks, which occur when someone re-experiences the effects of a drug after the user has stopped taking it; and 3) psychotic behavior, which is the dangerous loss of contact with reality, sometimes leading to violence against self or others, long after taking the drug. Regular users of PMA or ecstasy may develop a psychological dependence on these drugs.

The most dangerous effect of ecstasy, however, is related to hyperthermia, or a dangerous rise in body temperature. After taking ecstasy, some people drink a lot of water and take rests and cold showers to help keep their temperatures down. However, when hyperthermia is a result of PMA, these means are not an effective treatment.

Research on Lasting Effects

Although little research has been done on the long-term effects of PMA, it is assumed to be very similar to effects of ecstasy. In 2001 the National Institute of Mental Health (NIMH) found that ecstasy damages the brain's nerve cells, or neurons, that use the chemical serotonin to communicate with other neurons. Neuron damage may bring on depression, a mood disorder; anxiety; loss of memory; learning problems; lack of self-control; sleep disorders; and sexual problems.

When a toxin or poisonous substance such as ecstasy or PMA is taken, neuron death occurs immediately, but the effects might not be noticed until months or years later. According to the National Institute on Drug Abuse (NIDA), research in animals indicates that ecstasy causes long-term damage to neurons. Dr. Alan I. Leshner, former director of NIDA, was quoted on the Drug-Rehabs.org Web site as saying: "People who take ecstasy, even just a few times, are risking long-term, perhaps permanent, problems with learning and memory."

Fact or Fiction?

Lots of stories and myths surround the use of ecstasy and PMA. It can be hard to distinguish fact from fiction. Here are a few examples of the myths and whether there is any truth to them.

• Ravers often wear baby pacifiers around their necks as pendants. Fact —Yes, some do. The use of ecstasy and/or PMA creates excessive jaw muscle tension, which makes users grind their teeth involuntarily. So, ravers often chew on baby pacifiers or lollipops to calm this unwanted side effect.
• Club drugs such as ecstasy and GHB have gained popularity because users think they are not as harmful as mainstream drugs such as cocaine or heroin. Fact —Some users do believe that club drugs are less harmful. However, all of these drugs are dangerous at any dose, particularly PMA. Club drugs are potentially fatal if a user takes too much and overdoses. Plus, some club drugs are associated with date rape. Psychological dependence can occur with any of these drugs. All club drugs have negative long-term effects on the brain.
• Some ecstasy (and PMA) users take breaks from physical activity and use cold showers to cool down. Ecstasy and PMA use combined with intense dancing can elevate body temperature to dangerous levels. Drug users have tried cold showers as a way to safeguard against rising temperatures caused by these drugs. Fact —A cold shower does not help a person suffering from a high body temperature due to PMA poisoning. If the brain reaches 108°F, no shower can fix that. If PMA poisoning is suspected, emergency medical help is needed immediately.
• The Marquis Reagent Testing Kit can be used to test if a pill contains ecstasy or PMA. Fact —The kit produces a dark blue-purple color if the substance is ecstasy but produces no color change if the substance is PMA. However, some pills containing PMA also contain ecstasy, so a positive result for ecstasy does not mean the pill is free of PMA.

Researchers at Johns Hopkins University studied the effects of the drug on red squirrel monkeys. They found that just four days of exposure to the drug caused damage to serotonin nerve endings that was evident up to seven years later. This supports earlier findings done by the research team that indicated that people who had taken ecstasy scored lower on memory tests.

More Long-Term Problems

A person's memory consists of all that has been experienced in one's life, including sounds, sights, smells, tastes, and emotions. Drugs like PMA and ecstasy can distort these memories and emotions, causing the user to lose touch with reality and changing his or her impression of time and space. Over time, the drugs tend to damage a person's natural ability to feel good. This results in severe depression—and a craving for more of the drug to bring back the good feelings again.

According to the Centre for Addiction and Mental Health of Canada, there are other long-term problems that may come up long after taking ecstasy. These problems may or may not also occur during ecstasy usage. They include muscle spasms in the jaw, neck, and lower back; low blood pressure; changes in blood flow to the brain; and persistent problems with involuntary teeth grinding. Researchers suspect that PMA use may cause similar effects, but long-term data are not yet available.

Reactions with Other Drugs or Substances

Because PMA is sold on the illicit, or illegal, drug market as ecstasy, it is not deliberately used recreationally in its pure form. PMA is usually found in combination with ecstasy, and ecstasy users often take others drugs at the same time. Such drugs include LSD (lysergic acid diethylamide), GHB, ketamine, and nitrous oxide. (Entries on all of these drugs are available in this encyclopedia.) Ecstasy is also used with marijuana, methamphetamine, heroin, cocaine, and the prescription drug Viagra. The risk of overdose or death is greatly increased when mixing PMA with these other drugs or with alcohol or caffeine. Small doses of PMA that are not normally lethal become deadly in the presence of these other drugs.

As with all drugs, the strength and quality of PMA pills may differ greatly from one batch to another. Different pills may contain varying amounts of the drug. Moreover, the secret labs that make these drugs are often very dirty, and the pills they produce may contain many dangerous chemicals in addition to PMA.

An example of PMA poisoning in the presence of other drugs is a victim who died in the late 1990s. She died after ingesting what she believed to be an ecstasy tablet. Testing of her blood revealed high but not deadly levels of PMA, coupled with the prescription drug Prozac. (Information on Prozac can be found in the entry on antidepressants in this encyclopedia.) Ecstasy was not detected in her blood samples at all. Drug users often abuse Prozac to enhance the energizing effects of ecstasy. This patient died from a brain hemorrhage despite the low levels of PMA she had taken.

Treatment for Habitual Users

Due to the fact that PMA is taken by mistake by those who think they are consuming ecstasy, there is no official treatment program solely for PMA abuse. There are treatment facilities for ecstasy abusers, however. These are usually located around large cities where ecstasy use is common. The Narconon organization, which is used by many types of drug addicts in the United States, is one of many groups that has a specific treatment program for those overcoming ecstasy addiction. While ecstasy users are not known to develop physical addictions, psychological addictions are common. Therefore, recovery programs for drugs like ecstasy work with the psychological nature of the addiction. In addition to organizations with recovery programs, peer support groups are available as well.

Consequences

Because PMA is found mixed with or as a replacement for ecstasy, the social consequences of PMA usage go along with those of ecstasy usage. The individual consequences of PMA contamination of ecstasy pills, however, are far more dangerous. Unknowing ecstasy or PMA users may find themselves in great danger: they could experience an uncontrollable rise in body temperature, convulsions, coma, and death. Ecstasy alone has caused accidental overdoses and deaths in the past. However, with the emergence of PMA, the death rate has increased steadily.

Ecstasy, and PMA through the disguise of ecstasy, are social drugs. They are perceived to be harmless, "feel good" drugs that are most often used by teenagers and young adults at parties and nightclubs. Studies have shown that a large number of people who use ecstasy tend to be attracted to the techno-style rave scene. Raves have become a major source of illegal ecstasy distribution and are likely one of the main sources of the ecstasy "epidemic." There is scientific proof that ecstasy is not a safe drug, however. A number of experiments in both animals and more recently in humans have confirmed that club drugs, particularly ecstasy, are not harmless, "feel good" drugs at all. They pose serious health risks and long-term effects.

Club drug users often have difficulty coping with life situations, anger, depression, or low self-esteem prior to drug usage. These problems often cause individuals to seek an escape or relief from their troubles. Drug use supplies an escape route by allowing the users to forget their worries and experience positive sensations instead. After the drug's initial high, users can be sent into extreme depression, resulting in social withdrawal and cravings for more of the drug. This could result in financial problems and drug-related crime. The use of these drugs is also associated with an increase in sexual activity. Those in a drug-induced state may engage in sexual activities they would otherwise avoid. Moreover, individuals who use ecstasy risk serious psychological and physical damage, such as panic attacks, hallucinations, paranoia, and loss of memory and sense of reality. And when PMA comes into the picture, users risk even more serious complications and possible death.

The negative effects of club drugs such as ecstasy are not limited to the user alone. Findings released in 2001 in the Journal of Neuroscience found the first evidence that prenatal (before birth) effects of ecstasy used by the mother could include memory loss and other impairments in offspring. Rodents exposed to the drug during critical stages of brain development were found to have memory and learning problems.

The Law

Making, selling, and buying PMA and ecstasy is illegal. There are tough laws and penalties tied to them. PMA and ecstasy, as well as other club drugs such as LSD and GHB, have been categorized under the U.S. Controlled Substances Act (CSA) of 1970. The CSA ruled that federally regulated drugs must be categorized into one of five schedules. The schedules are based on a substance's medicinal value, possible harmfulness, and potential for abuse and addiction.

Aussie Overdoses

In June 2005, twelve people in Australia overdosed on what they thought was ecstasy. All of the victims took a form of the drug called red mitsubishi or orange CK. Some of those taking the drug had suffered strokes after taking the pills. One nineteen-year-old girl died after taking only half of a tablet. Although the popularity of ecstasy is beginning to wane, its use is still a threat, especially because PMA is being used as a supplement to or substitution for ecstasy.

PMA has been listed as a Schedule I drug since 1973. Ecstasy has been listed as a Schedule I drug since 1985. Schedule I controlled substances are defined as having a high potential for abuse, no accepted medical use in the United States, and a lack of accepted safety for use under medical supervision. However, PMA is produced legally in the United States for limited commercial applications, and a small quantity is allocated for Schedule I drug research.

Because PMA is so similar to ecstasy, it is regulated under the Ecstasy Anti-Proliferation Act of 2000. The act gave authority for stiffer sentencing for those involved in the manufacture, import, export, and trafficking of ecstasy and ecstasy-like substances. The increase in ecstasy users, the drug's potential for causing permanent brain damage, and the deaths associated with ecstasy usage led to the passage of the Ecstasy Prevention Act of 2001. This act enhanced the Ecstasy Anti-Proliferation Act of 2000 by providing funds for the education of law enforcement officials and the public, and for medical research done by the National Institute on Drug Abuse (NIDA).

In 2002 the DEA began a program called Operation X-Out, which focused on identifying and dismantling organizations that make and distribute club drugs like ecstasy. Investigations involving ecstasy and club drugs increased, new task forces were created in cities like Miami and New York, and cooperation with international law enforcement was expanded. Some law enforcement agencies have begun to work with communities to form anti-rave initiatives to try to minimize the use of club drugs. They have passed new ordinances that deal with licensing requirements for large public gatherings and have been enforcing existing fire codes and health, safety, and liquor laws. In some areas juvenile curfews have been put in place.

For More Information

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O'Malley, Nick. "Toxic Drug Warning for Party Goers." Sydney Morning Herald (September 30, 2004).

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Other

Park, Michael Y. "New, More Dangerous Drug Threatens Teens." Fox News, June 5, 2000.

See also: Amphetamines; Designer Drugs; Ecstasy (MDMA); Methamphetamine