3,4-methylenedioxymethamphetamine (MDMA, ecstasy) and driving impairment

3,4-Methylenedioxymethamphetamine, or MDMA, is increasing in popularity in the United States as a drug of abuse. It has stimulant and empathogenic moo d altering properties with the potential to, affect psychomotor skills and impact driving. This report reviews the literature relating to the relevant psychomotor effects of the drug, the relationship between dose and blood c oncentrations, and studies and case reports on specific effects of the drug on driving. The latter reports include both laboratory driving simulator s tudies and anecdotal reports, and case series. We also report details of ei ghteen cases of apparent MDMA impaired driving, including six drivers, whos e blood tested positive for MDMA alone. Most subjects displayed muscle twit ching and body tremors, dilated pupils, slow pupillary reaction to light, e levated pulse and blood pressure, lack of balance and coordination, and mos t were perspiring profusely. Five six subjects were given field sobriety te sts, (one leg stand, walk and turn test), and all five performed poorly. Th ere was no clear correlation between the blood concentration of MDMA and th e specific demeanor of the subject. These findings are consistent with othe r reports, and lead to the conclusion that MDMA use is not consistent with safe driving, and that impairment of various types may persist for a consid erable time after last use.