How to take MDMA as safely as possible

Our resident drugs columnist’s TikTok comment section is awash with FAQ’s on taking drugs, so he aims to answer (most) of them, all in the name of reducing potential harms.

In 1985, THE FACE reported on a new party drug” which had recently arrived on the club scene. That drug was MDMA. It can make you feel very close and empathetic – you might feel like hugging your friends,” culture journalist Peter Nasmyth wrote. More than 35 years later, it’s safe to say that the drug went on to revolutionise dance floors, influencing music, fashion and youth culture in the process.

While drug trends often come and go, ecstasy has remained the high priest of the dance floor – no substance has touched the hearts, bulged out the eyes and tweaked the jaws of the masses in such a spectacular way. But, even so long into its epic reign, there are still some misconceptions and misunderstandings about pinging. Over on my TikTok, it’s the most common drug that people ask me questions about. So, here are some FAQs from the comments section.

Is MDMA safe?

No. No drug is safe, all drugs are dangerous to varying degrees. The safest thing is to obviously not take drugs. But for the people who will do it anyway, here’s some information you should know.

Can you overdose?

Yes. Every year people in England and Wales die after overdosing on MDMA. If you look at the latest statistics on this, you will see that it was listed as the main cause of death for 67 people in 2021. That number was 82 in 2020, 78 in 2019 and reached an all-time high the year before that with 92 deaths. Let’s be real, it’s not the most dangerous drug in society – in this study, it was ranked 17th when it comes to overall harms out of 20 – but you do need to respect it. You can increase the risk of MDMA overdose if you mix the drug with alcohol and other drugs, and if you take multiple doses at once or in a short space of time.

Is MDMA the same as ecstasy?

Yes. The drug MDMA (full name, are you ready for it, 3,4‑Methyl​enedioxy​methamphetamine) is also known as ecstasy, mandy, pingers, MD, Es, molly (for our American cousins) and a flurry of other names. But whether it comes as a pill, a powder or in crystals, it’s the same thing. An ecstasy pill is just MDMA crystals mixed with a binding agent and stamped into a shape. Whatever form the drug comes in, it’s impossible to tell what you are taking unless it has been tested.

How much should I take?

That is a difficult question to answer because there are so many individual factors to consider, person to person. Bristol Drugs Project, a drug and alcohol services charity, gives this as a guide (though dosage still depends on tolerance, gender and how it’s taken):

Recommended dose = 50mg + your bodyweight in kilos

E.g. if you weigh 70kg the recommended dose is 50 + 70 = 120mg

The problem is, unless you get your MDMA tested (which we strongly advise), you don’t know
what purity you have bought, and so you should always proceed with caution.

The Loop advises you to consider just ¼ of a pill, or a small dab of powder”. It can take an hour or more for it to kick in, so don’t redose for at least a couple of hours. Less is more anyway with MDMA: if you take more than 150mg you won’t get any more of the euphoric psychological effects, but you could find yourself with more of the negative physiological effects, such as high blood pressure, increase in heart rate, dehydration, overheating and even anxiety.

How do I know if someone needs help?

Always pace yourself, know your limits and look out for people around you. If you see someone who is sweating excessively, or is disorientated or agitated, seek medical assistance (if the club has an on-site medic) or a member of staff. And if you’re worried about getting kicked out of the rave, there’s no need to – you won’t be shown the exit for helping out a mate in trouble. It’s a potential medical emergency, so get some help and tell them what your friend has taken and in what doses.

How much water should I drink when I’m high?

When you’re taking MDMA, it is important to take on the right amount of water. Too much or too little can be dangerous. According to The Loop, you should sip water regularly” when you’re high. Aim to drink around ½ a pint (250ml) per hour. MDMA makes it difficult to pee and makes you feel thirsty. This means it’s easy to drink too much.” They add: If you don’t urinate enough this can cause overhydration, which is dangerous. If you are sweating a lot you will lose essential electrolytes your brain and body needs. Drink slowly and replenish these.”

In other words, if you’ve bought a 500ml bottle of water from a club, that should last you two hours. You could refill it in the toilets rather than pay again, plus it’s also a legal requirement for clubs to provide free tap water. The Loop says a sports drink is a good choice because they contain electrolytes”, but, to be honest, I don’t think I’ve ever seen them for sale at a club. (No, Red Bull does not count as a sports drink.”)

What if I start getting too hot?

To keep you cool when you go out raving, wearing baggy, loose clothes is a good idea. Taking regular breaks in a cool area, such as an outdoor space, is good, too. Remember, it’s a marathon, not a sprint.

Can I take MDMA if I’m on antidepressants?

Don’t take MDMA if you are on antidepressants. Studies have found that if you take MDMA when you are also taking selective serotonin reuptake inhibitors (SSRIs) it can take a long time for the drug to kick in and give the user little or no high. Taking these drugs together can increase the risk of overdose and serotonin syndrome (where your brain gets too much serotonin) which can be fatal.

What about if I’m on ADHD meds?

Again, it’s best to avoid mixing these drugs. This study looked at the combined use of Ritalin and MDMA. The researchers concluded that mixing the two does not produce more of the positive psychoactive effects [such as empathy, making the tunes sound amazing and feeling like you could dance into next week] compared with either drug alone, but potentially enhances cardiovascular and adverse effects”.

Side note: It’s also best to avoid coke when you’re on ADHD meds. This study concluded that mixing Ritalin with coke is likely to be a real hazard in view of its sharing neurochemical effects with dopaminergic drugs”, meaning that too much dopamine builds up in the brain. Having a high dopamine level in the brain can lead to an increased chance of developing addictive behaviours, risk-taking and mental disorders.

How should I prepare for a rave?

Eating a healthy meal before the sesh is a good idea – personally, I go with pasta or a jacket potato. It took me years to discover my favourite flavour of raving, and it goes like this: get an early night on Saturday, set an alarm for 7am on Sunday morning, have a coffee, a decent meal and hit a club night that starts on Sunday morning. That’s where, in my subjective opinion, you’ll find the most dedicated ravers and the best atmospheres.

The Blue Punishers are the strongest pills, right?

The logo or design pressed onto a pill is pretty much meaningless. For some people, this is a misconception; they think that because one Blue Punisher, for example, was tested and it contained, say, 250mg of MDMA, that all Blue Punishers contain that. In reality, pill presses are very easy to come by so anyone could make their own Blue Punishers. All batches will be totally different as anyone can buy the pill press and put whatever they want in it.

How often can I take MDMA?

Try not to use it more often than once every month or every two or three months, saving it for special occasions,” Professor Adam Winstock, founder of the Global Drugs Survey, advises. That way, he argues, you can magnify your enjoyment and give your brain enough time to recover in between. It might surprise you that most users of MDMA use 10 times or less per year,” he says. Using less than monthly gives your brain (especially serotonin levels) and body time to recover and return to baseline.”

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