The case for MDMA (ecstasy) regulation.
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Drug-related harm is the most rational means of determining a substance's legal status. The available evidence suggests that compared to other drugs, 3,4-methylenedioxy-N-methamphetamine (MDMA or "ecstasy") poses a low level of harm to most individual users and causes negligible harm to society. There is no sound justification for criminalising the use of MDMA. .The depenalisation model adopted in Australia does not have any benefits that cannot be achieved by removing minor MDMA offences from criminal law entirely. The current model also operates within a prohibition framework that is costly to society and increases harm to ecstasy users. These arguments support the proposal by David Penington in 2012 that MDMA should be regulated on a legal market. The supply of MDMA from pharmacies appears to be a practicable law reform option with the potential to reduce harm associated with ecstasy use and the costs of prohibition.Keywords:
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Ecstasy
harm reduction
Methamphetamine
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This paper examines the strategies that ex-heavy users of MDMA employed to quit, control, or cut down MDMA use. It uses data from an online qualitative study of the life stories of ex-heavy MDMA users, taking a harm reduction perspective, rather than focusing on the pharmaceutical and problematic aspects of MDMA use. The research applied a mixed-methods approach using an online survey containing open-ended questions directed at self-identified ex-heavy users of MDMA. Participants were 104 ex-heavy users. The relevant data centered around three main themes: ex-users' stories of quitting/cutting down MDMA, advice for taking MDMA safely, and advice for quitting or cutting down MDMA. Although stopping or cutting down MDMA use was generally described as a natural process over time, ex-users also employed several strategies to quit or cut down MDMA use, including conscious lifestyle changes and distancing themselves from the associated scenes and people. Participants' advice on taking MDMA safely involved considering the drug, the mind-set, the social and physical environment and ensuring hydration. These data suggest that from ex-heavy users' perspectives, management of MDMA use is conceptualized as a deliberate and thoughtful process of which most users are in control, rather than a matter of being dependent upon or overpowered by a drug, so harm reduction and other interventions should be structured accordingly.
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Background: The recreational drug MDMA (3,4-methylenedioxymethamphetamine) or ‘Ecstasy’ is associated with heightened psychiatric distress and feelings of depression. The Drugs and Infancy Study (DAISY) monitored the psychiatric symptom profiles of mothers who used Ecstasy/MDMA while pregnant, and followed them over the first year post-partum. Methods: We compared 28 young women whom took MDMA during their pregnancy with a polydrug control group of 68 women who took other psychoactive drugs while pregnant. The Brief Symptom Inventory (BSI) was completed for several periods: The first trimester of pregnancy; and 1, 4 and 12 months after childbirth. Recreational drug use was monitored at each time point. Results: During the first trimester of pregnancy, MDMA-using mothers reported higher depression scores than the polydrug controls. At 1 year after childbirth, their BSI depression scores were significantly lower, now closer to the control group values. At the same time point, their self-reported use of MDMA became nearly zero, in contrast to their continued use of Cannabis/marijuana, nicotine and alcohol. We found significant symptom reductions in those with BSI obsessive-compulsive and interpersonal sensitivity, following Ecstasy/MDMA cessation. Conclusions: The findings from this unique prospective study of young recreational drug-using mothers are consistent with previous reports of improved psychiatric health after quitting MDMA.
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Drug-related harm is the most rational means of determining a substance's legal status. The available evidence suggests that compared to other drugs, 3,4-methylenedioxy-N-methamphetamine (MDMA or "ecstasy") poses a low level of harm to most individual users and causes negligible harm to society. There is no sound justification for criminalising the use of MDMA. .The depenalisation model adopted in Australia does not have any benefits that cannot be achieved by removing minor MDMA offences from criminal law entirely. The current model also operates within a prohibition framework that is costly to society and increases harm to ecstasy users. These arguments support the proposal by David Penington in 2012 that MDMA should be regulated on a legal market. The supply of MDMA from pharmacies appears to be a practicable law reform option with the potential to reduce harm associated with ecstasy use and the costs of prohibition.
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Ecstasy
harm reduction
Methamphetamine
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Despite the growing popularity of MDMA (ecstasy/molly) among African Americans, their motives for using the drug are still largely unknown. The purpose of this study was to identify and describe the most salient motivations for using MDMA among this understudied population. In-depth interviews (n = 15) were conducted with a sample of African American young adults in Southwest Florida between August 2014 and November 2015. The primary motivations for using MDMA included: (1) altering the effects of marijuana and alcohol; (2) lasting longer sexually; (3) enhancing sexual pleasure; and (4) facilitating "freaky" sexual experiences. This is the first study to directly examine MDMA motivations specifically among African American drug users, and findings shed light on why some African Americans use MDMA. A better understanding of why African Americans use this drug should help to inform prevention and harm-reduction efforts. Study findings show the need for health messages that include the potential consequences of mixing MDMA with other drugs, and engaging in high-risk sexual behaviors after taking MDMA. These data contrast with motivations (e.g., introspection, self-enlightenment, getting into the music) commonly reported among groups of largely White MDMA users, suggesting that interventions tailored specifically for African American users are needed.
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Although the Internet is a growing source of information on MDMA/ecstasy, no studies so far have investigated the level and quality of ecstasy information available to the typical Web user. In the present study, 280 Web sites were identified and analyzed; 50.4% had an anti‐drug approach, 16.2% a harm reduction approach, and 24.8% a pro‐drug approach. MDMA pro‐drug Web sites appeared significantly earlier in the search engines' results list than both anti‐drug and harm reduction Web sites (F (3; 159) = 3.288; p = .022). This study represents the first systematic analysis of information available online on ecstasy. Implications for further research are discussed.
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Presented is a case of acute paranoid psychosis in a patient who took MDMA (Ecstasy), became violent and was prosecuted by law. After the repeated intake of MDMA, the second psychotic episode occurred, or maybe even several episodes (about which we have no data). The patient reacted well and fast to the therapy was normal. Those who had psychotic reactions after taking MDMA have a great chance to react in the same way when taking the drug again. Other authors present similar observations. This article is aimed to warn our expert population to seemingly approaching greater wave of Ecstasy drug, as well as to point to its consequences and treatment.
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Abstract 3,4‐methylenedioxymethamphetamine (MDMA or Ecstasy) has been implicated in the onset of a number of psychological disorders and associated with a number of psychiatric symptoms that have persisted after cessation of the drug. This paper is a review of the published psychiatric case studies from the last 10 years involving MDMA. Only 24% of patients had a previous psychiatric history and 34% had a psychiatric illness amongst first degree relatives. The percentage of patients not having had a personal or family history of psychiatric illness and the temporal relationship between MDMA ingestion and the experience of recurring symptoms strongly suggest a causal relationship between the drug and neuropsychiatric manifestations. Further supporting evidence comes from several studies using non‐clinical samples. Ecstasy users that don't present themselves in healthcare settings as having clinical symptoms have significantly higher scores on certain subscales of the SCL‐90 compared with Ecstasy‐naive controls, with higher pathology scores in heavier Ecstasy users. The full‐blown psychiatric cases may represent the broad end of this problematic spectrum. Copyright © 2001 John Wiley & Sons, Ltd.
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Ecstasy, a popular drug among the younger generation, the primary psychoactive component of which is 3,4-Methylenedioxymethamphetamine (MDMA), is rarely known to have acute psychiatric effects and when it does, it is usually short term. We describe a patient who presented to the emergency room in a psychotic state after using ecstasy recreationally. Given his aggressive behavior in the community and risk for self-harm, he was emergently hospitalized to ensure safety. He developed persistent psychotic symptoms (delusions) after one dose of recreational MDMA and the team had the opportunity to observe, monitor, and treat his psychosis. This case along with few other documented cases highlights the gaps in research about the chronic, persistent effects and long-term consequences of MDMA. It also suggests that neuropsychiatric symptoms may not be readily reversible after cessation of use. There is an emphasis on the need for physicians to inquire about MDMA use and include it in toxicology screenings and as a potential differential diagnosis.
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Ecstasy use have raised in recent years and it have been related to psychopathological symptoms. The comsumption pattern associated with psychiatric complications is unknown.Thirty-six case reports about psychiatric complications due to ecstasy and published from 1985 to 1997 were studied.The disorders with higher prevalence were psychosis (n = 21), panic attacks (n = 12) and depressive symptoms (n = 3). Seventy two per cent were substance abusers. Urinary drugs screening were present in 28%, only in two subjects might detect amphetamine. Men had higher MDMA doses compsumption and higher prevalence of background psychiatric disorders than women. Subjects with psychotic symptomatology had more psychiatric background, higher doses of MDMA comsumption and for a long time than individuals with depressive or panic attacks symptomatology.The review of the case reports of psychiatric complications related to ecstasy use do not allow to conclude that ecstasy use was the main responsible factor for psychiatric symptoms. They could be related to an individual vulnerability and or to lasting of comsumption.
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