Ecstasy (EXTC)

CPT Code: 80101
Specimen: Urine
Volume: 30 mL
Container: Use plastic urine drug bottle and evidence tape or tamper-evident container for forensic specimen. Collection kits are available by request from the laboratory.

Urine specimens may be collected in plastic (i.e., polypropylene, polycarbonate, polyethylene) or glass containers.  Some plastics can absorb certain drugs.

Fresh urine specimens do not require any special pretreatment.  No additives or preservatives are required.  Boric acid should not be used as a preservative. 

Specimens may be encountered that display turbidity.  It is recommended that such specimens be centrifuged before analysis.

Specimens should be within the pH range of 5-8.  Specimens with a pH outside this range should be adjusted to this range by the addition of 1N HCl or 1N NaOH before analysis.

Specimens should be at a temperature of 20-25 ⁰C before analysis.

Stability: If not analyzed immediately, specimens should be stored refrigerated for less than 24 hours.  Specimens should be frozen if storage longer than 24 hours is required.
Cutoff: 500 ng/mL
Note: This method provides only a preliminary analytical test result.  A more specific alternate chemical method must be used in order to obtain a confirmed analytical result.  Gas chromatography/mass spectrometry (GC/MS) is the preferred confirmatory method.  Other chemical confirmation methods are available.  Clinical consideration and professional judgment should be applied to any drug of abuse test result, particularly when preliminary positive results are used.
Use: Measurements obtained with EXTC method are used in the diagnosis and treatment of cocaine use or overdose.

“Ecstasy” is a popular street name used to refer to methylenedioxymethamphetamine (MDMA).  Ecstasy and related drugs, methylenedioxyamphetamine (MDA) and methylenedioxyethylamphetamine (MDEA), are amphetamine derivatives.  The tablets, as sold illicitly in Europe and North America, may also include amphetamine and methamphetamine in the preparation. 

Ecstasy drugs are listed by the U.S. Drug Enforcement Administration as Schedule I designating no acceptable medical application with great abuse potential.  These compounds are central nervous system stimulants that produce an initial feeling of euphoria and also a feeling of increased well-being, self-esteem, with heightened mental and physical capacity.

Adverse effects include confusion, ataxia, restlessness, poor concentration, and phychoses.  Long term consequences of its abuse include changes in mood, sleep disturbances, anxiety and impairment in cognition and memory.

MDMA is readily absorbed from the intestinal tract.  Peak plasma concentrations occur approximately 2 hours after oral dose and are generally low, since MDMA passes readily into tissues.  MDMA is metabolized in the liver and the excretion of the drug occurs with over 95% of the drug cleared in about 2 days.  Approximately 65% of the drug is excreted unchanged, with 10-15% of the dose excreted as methylenedioxyamphetamine (MDA) and a similar small amount converted to amphetamine and methamphetamine.