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Why do some people urgently need to go to the toilet after they’ve taken a pill?

“Almost every time my best friend takes MDMA not long after they have to get to a toilet really quickly or they mess themselves. One of our other mates told us that this happens to a lot of people who use cocaine. Is this true and why does it happen?”

Although this sounds quite strange, this effect is often be reported by those who use stimulants. Stimulants are drugs that speed up the central nervous system such as ecstasy (MDMA), speed, ice or cocaine. Many cocaine users, in particular, comment on the need to go to the toilet after taking the drug, causing some to believe that the drug is actually ‘cut’ with baby laxative. But some ecstasy users, like your friend, also report a similar effect. So why does this happen?

Experts believe that it could be do with what is called the ‘fight or flight response’. This refers to a situation when we are faced with stress or danger and our sympathetic nervous system (SNS) automatically kicks in, resulting in us either fighting or fleeing the scene.

The SNS is a network of brain structures, nerves and hormones and in a moment of danger, (e.g., a car is driving towards us at great speed as we’re crossing the street), a flood of hormones makes our heart pump faster and blood is sent to major muscles. We breathe faster, delivering more oxygen to the brain and we get an immediate energy boost. When combined, these sudden physical changes enable us to jump clear of the oncoming car and safety. This all happens so quickly that we aren’t even aware of it.

So where does the urgent need to go to the toilet come in?

To enable your body to respond in this way, all functions that are not needed are shut down. Digestion stops and even your immune system is temporarily turned off. Excess waste is also eliminated to make you light on your feet, enabling you to jump higher and run faster than you could before. As such, this activation of the SNS tends to loosen the bowels and can lead to a desperate need to quickly get to a bathroom.

So it would seem that when someone takes a stimulant drug the SNS can be activated and your body responds by saying ‘get me to the toilet as fast as you can!’

First published: July 2022

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