(p. 494) Disorders relating to the use of ecstasy and other ‘party drugs’ 

MDMA, methamphetamine, GHB, and ketamine are all capable of producing acute adverse psychological experiences in normal users and exacerbating symptoms in those with underlying psychological disorders. They also to varying degrees pose the risk of long-term neuropsychiatric consequences. Although dependent patterns of use are not commonly seen with this group of drugs, methamphetamines certainly can result in the very rapid development of severe dependence. Most acute presentations are typically short-lived and self-limiting and are only very rarely life-threatening. The precipitation of an underlying psychiatric disorder or an exacerbation of premorbid traits may well be one of the longer term consequences of heavy use of these drugs. In those who present with acute drug-related psychological symptoms there should be an emphasis on follow-up since in some cases the symptoms will represent the onset of a persistent independent disorder which requires treatment. Users who have experienced acute psychological problems should be encouraged to make the attribution that there may be something inherent in them that makes them susceptible to experiencing the unpleasant reactions with a drug and that they are likely to remain vulnerable to those adverse experiences. This may be difficult to accept for potentially vulnerable young people who may prefer to think that the experience was not enjoyable because the drugs were not good – ‘it was a bad pill’.