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We need to talk about Mandy

Six Answers About MDMA from an expert


MDMA, Molly, Mandy and ecstasy – if you are lucky they are all the same thing – ideally at a dose of about 80mg/pill or dab. Sadly and sometimes with tragic consequences that is not always the case. So here are few things that might
help keep you informed and safe.

1) What’s with MDMA powder, is it any different or better than pills?
MDMA crystal or powder (which is just crushed crystals) is just another preparation of the drug but one that is now the most common form of ‘ecstasy’ that people report taking according to last year’s Global Drug Survey. Most users consider it to be a more premium product and this was especially during the period a few years ago when poor quality pills were being sold in abundance. But while people think powder equals better purity and quality it’s really no better or worse and powder is no guarantee that what you are getting is MDMA alone, or something else altogether. If used
sensibly it could reduce the risk of taking much (or exposing yourself to a big dose of something really nasty like PMA (Para Methoxy Amphetamine) or PMMA (Para Methoxy Meth Amphetamine). But, in exactly the same way you
don’t know what you’re getting with pill by the logo or color, with powders it's the same. Of particular worry is that good quality MDMA crystal can look exactly like good quality methamphetamine – that would end up being a very different sort of night and day and night......

2) So is the ‘ecstasy’ that's about now better?
If so why? If by better you mean more likely to contain MDMA then yes. It really does seem to be the case that good quality MDMA is available in abundance across much of the world. Pill seizures/amnesty bins sample analyses in the UK and Europe are showing most pills as containing MDMA (sometime in very high dose – more of that later). One of the most plausible explanations for the return to good quality MDMA is the adoption of new synthetic pathways using less tightly regulated precursors.

3) What do people die of when they say someone died from pills/MDMA?
Most people die either as a result of severe idiopathic (unknown and unpredictable) reactions to MDMA which are not usually dose related or due to a combination of severe overheating and dehydration, leading to multi-organ failure.
Abnormal heart rhythms leading to heart attacks, liver failure and strokes also feature as do cases of serotoninergic syndrome (very high body temperatures, muscle rigidity and extreme agitation or coma) and the exceedingly rare but media loved water intoxication (actually it’s called SIADH and it's due to the excess secretion of a hormone called Anti
Diuretic Hormone, so you don’t pee out excess water you take on board).

4) If contaminated pills are about, would it be useful to test my pills or powder?
Even if you know what’s in your pill you can’t guarantee yourself a good or fun time (but would it help – yes). Remember, when someone dies of a pill at a club for example the likelihood is that loads of other people took the same pill and got home safely that night. But it’s not easy to know what's in your pill. If you had a mobile GC-MS or HPLC machine (your own personal scientist in a white coat kind of thing) which could give you the precise composition of your pill (or powder) so that you knew what drugs were in it and at what dose, then that information could be useful. The home pill test kits you can get offer some limited confirmation that your pill or powder might contain MDMA but unless you have full complement (usually 4 different chemical reagents) you won’t spot really nasty stuff like PMA. Remember none of these kits tell you the dose or purity – and size does matter when it comes to the dose of drugs. Big doses of MDMA (>150-200mg) can make you feel very very unwell and can be potentially quite dangerous. So don’t put your foot down until you know what you are driving!

5) OK, death is very rare, dodgy pills are also probably very rare, but it would be nice to know how to minimize the risk of it. Any tips?

A) STAY COOL AND STAY HYDRATED
MDMA affects your body’s ability to regulate its temperature, as well as causing you to urinate and sweat more, causing dehydration. Given that most potentially avoidable deaths involve dehydration and overheating common sense says stay cool – take a breaks from dancing if you feel too hot, are sweating loads, and feel faint- step outside, sit down, drink nonalcoholic fluids and settle for a while.

B) TEST YOUR DRUGS
Unless you're a chemist with a mass spectrometer you'll never know exactly what you're about to take so by starting with a small test dose you can reduce the risk of being exposed to something nasty as well as get a feel for what’s in your pill. If your pills are contaminated with something toxic, the less you take, the less harm you are likely to do, so take a half (or a quarter) first, wait for an hour and only take more if there are no ill effects and you feel like you would expect to, when you would expect to. If you are in a group who have all scored your drugs from the same place maybe one of you should test drive for the group and the others can keep an eye on you. Don't be on your own and don’t score off random strangers.

C) DON’T MIX WITH MEDICATION
Always avoid taking ecstasy with medication that affects the heart and liver (most drugs are metabolised by the liver including antibiotics) so taking them together increases the risk of sudden heart problems and liver failure. If you’re on anti-depressants, don’t take ecstasy at the same time. Not only can the combination be risky by causing dangerous levels of serotonin in the body, but ecstasy can make the antidepressant less effective and lower your mood further. And don’t mix with other drugs or lots of alcohol.

D) PRAGMATIC HEDONISM

Banging pills every weekend will eventually take a physical and mental toll. No one is invincible. Getting moody, feeling down, worrying and poor sleep are all warning signs? Have a week (or 2 of 3 or 4) off once in a while, maybe go to the cinema, go out for food, play Scrabble (it’s got ‘E’s in it!) whatever, just give your brain and body time reboot and repair.

E) IF YOU FEEL SICK, FIND HELP
Big clubs and events should have trained, friendly staff who will know how to help if you feel ill. It might be embarrassing, but you’re feeling right, let a friend know and get yourself checked out. If there is something seriously wrong, the earlier you seek treatment, the more likely you will be OK.


6) How do I minimize my comedown?
That feeling a day or two after taking MDMA of being tired, a little moody, fragile, snappy and not being able focus is
due to depletion of serotonin and other neurotransmitters that have squeezed out leaving your brain a little low on happy ‘monoamine’ chemical reserves. MDMA also irreversibly inhibits the enzyme that turns tryptophan (an amino acid) into serotonin – so that delays recovery as well. Depending on your baseline and how much you have stressed the system it can take anywhere from 1-5 days to feel back to normal. Eating and sleeping well before and after using MDMA can help. Foods rich in the amino acid precursors tryptophan, tyrosine and phenylalanine (e.g turkey, almonds,
bananas, kiwi fruit, honey, Marmite) can make an awesome recovery smoothie (OK turkey and kiwi fruit would be weird). As a general rule comedowns tend to be longer lasting and more severe in those with underlying depression, so if you are depressed, especially if you are on medication, best avoid MDMA. The bigger the dose, the longer your session, the worse your comedown. This will be compounded by using lots of alcohol and other stimulant drugs at the same time. Leaving at least 2-4 weeks between sessions gives your brain time to recover as well.

Take part in this year's Global Drug Survey and help us get better information to you next year! And it’s safer than taking drugs kids!

Words: Dr Adam R Winstock

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