The most ecstasy pills ever taken by a single person is 40,000. Mr A (as researchers referred to him as) necked them all between the ages of 21 and 30 and, as you can imagine, when someone is shoving pills down their throat like multivitamins, it wasn’t all sunshine and rainbows. It messed him up pretty bad. The story of Mr A was told in a little-known 2006 case report which was published in the psychiatry journal Psychosomatics. We had a chat with the author of the study, Dr Christos Kouimtsidis.
“For the first two years, he took five tablets every weekend,” Dr Kouimtsidis wrote in the report. “It escalated to an average daily use of three-and-a-half tablets for the next three years, and further to an average of 25 tablets daily over the next four years.”
His lifetime intake of ecstasy pills was estimated to be more than 40,000 in nine years. “[Mr A] was brought to my attention because of his memory difficulties. That was his main problem,” Dr Kouimtsidis told THE FACE. At that point, he was 37 and he didn’t take pills anymore. He had quit seven years previously after being hospitalised because he kept collapsing at parties. There was so much ecstasy in his system that he was high “for a few months” after he quit.
He wasn’t having a good time, though, inundating the hospital radio station with requests for old-school trance and king-size skins. He actually suffered several episodes of “tunnel vision” which eventually morphed into “severe panic attacks, recurrent anxiety, depression, muscle rigidity (particularly at the neck and jaw levels), functional hallucinations and paranoid ideation.”
This is an exceptional case given the monumental amount of pills involved. Also because someone became dependent on MDMA which is unusual – it’s not usually considered a more-ish drug. “It is far less dangerous than many other drugs,” Dr Kouimtsidis says. “But excessive use of any drug, legal or illegal, could lead to problems. So that was an exceptional case of high use over a prolonged period of time; typical use is not every day and not the amount of tablets he was taking. It was extreme, his use was really, really high. And then he went into withdrawals. He was unable to move for several weeks and had tunnel vision.”
What possesses a man to take enough MDMA to get the Hulk’s eyes rolling in the back of his head? Just trying to locate your jaw would be exhausting enough without even thinking about the other pitfalls of the drug, like telling your friends you fancy them. “As far as I remember, he had easy access to ecstasy,” Dr Kouimtsidis recalls. “It was more like a management of his mood rather than excitement and having fun. It seems like he was very much into the club scene, providing ecstasy for himself and others and so forth.”
Mr A didn’t just use MDMA, he had a history of polydrug use (“solvents, benzodiazepines, amphetamines, LSD, cocaine and heroin”) and was still smoking weed when he got help. Can we be sure that the pills alone caused this? “It’s very difficult to establish a cause in medicine,” Dr Kouimtsidis says. “You cannot say 100 per cent, but we can safely attribute the memory difficulties that he had experienced when I’d seen him to the heavy use of ecstasy for a prolonged period of time.”
When the researchers did memory tests with Mr A, they concluded that he was suffering from “disorientation to time, poor concentration and short-term memory difficulties”. He had to repeat activities several times and “his concentration and attention were so impaired that he was unable to follow the sequence of the tasks required”. When he toned the weed down it “led to both the disappearance of his paranoid ideas and hallucinations and a reduction of his panic attacks”. But the other symptoms remained.
Mr A’s case is totally unique, it’s the biggest recorded MDMA intake in history and is unlikely to ever be repeated. He was “using ecstasy as if it was an antidepressant”. It’s a fascinating case study, but it can’t be generalised across MDMA users as a whole, because nobody else before or since has decided to neck what some users would take in several years in one day.
“We need to be very careful how we use those extreme cases,” Dr Kouimtsidis says. “Because people might say, ‘Oh, I have been using ecstasy for such a long time and I have no issues with my memory so it’s not relevant.” If ecstasy isn’t used to excess, it is considered one of the safer recreational drugs.
What happened to Mr A in the end? “We were trying to get him into a residential unit for people with memory problems,” Dr Kouimtsidis recalls. “And then he left that unit and disengaged from the services. That was 20 years ago.”