The harmful health effects of recreational ecstasy: a systematic review of observational evidence

Abstract

It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, from the public and consumer groups and from professional bodies such as royal colleges and NHS trusts. These suggestions are carefully prioritised by panels of independent experts (including NHS service users). The HTA Programme then commissions the research by competitive tender. Second, the HTA Programme provides grants for clinical trials for researchers who identify research questions. These are assessed for importance to patients and the NHS, and scientific rigour. Third, through its Technology Assessment Report (TAR) call-off contract, the HTA Programme commissions bespoke reports, principally for NICE, but also for other policy-makers. TARs bring together evidence on the value of specific technologies. Some HTA research projects, including TARs, may take only months, others need several years. They can cost from as little as £40,000 to over £1 million, and may involve synthesising existing evidence, undertaking a trial, or other research collecting new data to answer a research problem. The final reports from HTA projects are peer reviewed by a number of independent expert referees before publication in the widely read journal series Health Technology Assessment. Criteria for inclusion in the HTA journal series Reports are published in the HTA journal series if (1) they have resulted from work for the HTA Programme, and (2) they are of a sufficiently high scientific quality as assessed by the referees and editors. Reviews in Health Technology Assessment are termed 'systematic' when the account of the search, appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. The research reported in this issue of the journal was commissioned by the HTA programme as project number 07/64/01. The protocol was agreed in October 2007. The assessment report began editorial review in April 2008 and was accepted for publication in August 2008. As the funder, by devising a commissioning brief, the HTA programme specified the research question and study design. The authors have been wholly responsible for all data collecti...

A prospective study of learning, memory, and executive function in new MDMA users

“…With regard to cognitive performance, a large number of cross‐sectional studies and a handful of longitudinal investigations indicate that the most consistent findings have been decrements in memory and learning performance . However, deficits in working memory, planning ability and central executive control, as well as high cognitive impulsivity, have also been reported .…”

RESIDUAL NEUROCOGNITIVE FEATURES OF ECSTASY USE: A RE‐INTERPRETATION OF HALPERN ET AL. (2011) CONSISTENT WITH SEROTONERGIC NEUROTOXICITY

“…[1] was digit span, and in the meta‐analysis by Rogers et al . [2] their Figure 16 revealed a mixture of non‐significant and significant changes, although the pooled data showed a significant overall impairment for ecstasy users compared to polydrug controls ( P = 0.017). This same pattern emerged with many of the other cognitive tasks.…”

“…In a comprehensive meta‐analysis of the ecstasy and cognition literature, Rogers et al . [2] noted marked variation across studies. One of the tasks used by Halpern et al .…”

“…Rogers et al . [2] conducted a meta‐analysis on seven dependent variables, and six of these showed significant deficits for ecstasy‐exposed individuals: Rey Auditory Verbal Learning Test (RAVLT) immediate word recall, RAVLT delayed word recall, Rivermead Behavioural Memory Test (RBMT) immediate prose recall, RBMT delayed prose recall, digit span forwards and digit span backwards. The only measure where ecstasy users did not differ from controls was the National Adult Reading Test Intelligence Quotient (NART IQ) index, showing that the groups did not differ in basic intelligence (Table 4 in their reference 2).…”

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

“…For instance, people who use illicit drugs are vulnerable to homelessness, imprisonment and other forms of social exclusion , and have high rates of tobacco smoking and harmful alcohol consumption. There are diverse subgroups of people who use drugs, and people who smoke cannabis or use illicit drugs occasionally may have better health outcomes than people who use drugs such as heroin, crack cocaine and methamphetamine .…”