MDMA Users Research Articles

Rapid Effects of MDMA Administration on Self-Reported Personality Traits and Affect State: A Randomized, Placebo-Controlled Trial in Healthy Adults

ABSTRACT 3,4-methylenedioxymethamphetamine (MDMA) assisted therapy has been shown to be a safe and effective treatment for PTSD and emerging research suggests a change in personality traits may be a factor in treatment response. Most prior research on MDMA and personality has focused on cross-sectional comparisons of MDMA users and non-users; as such, well-controlled research assessing personality and affective states change following MDMA vs placebo administration is needed. In the current pre-registered study, we investigated the impact of MDMA administration on five-factor model (FFM) traits and affective states before and 48 h after drug administration in a randomized, placebo-controlled study of healthy adults (N = 34). Statistical significance was not observed for the four a priori hypotheses; however, medium effect sizes were found between MDMA administration and trait Openness and Positive Affect 48 h following drug administration, compared to placebo (d = .79 and .51, respectively). This study provides initial results to help guide future well-powered studies with large samples and longer follow-up timepoints to continue to investigate how MDMA impacts personality and emotional experience, which may inform optimization of MDMA treatment approaches.

Chemical cousins with contrasting behavioural profiles: MDMA users and methamphetamine users differ in social-cognitive functions and aggression

Methamphetamine (METH, “Crystal Meth”) and 3,4-methylenedioxymethamphetamine (MDMA, “Ecstasy”) share structural-chemical similarities but have distinct psychotropic profiles due to specific neurochemical actions. Previous research has suggested that their impact on social cognitive functions and social behaviour may differ significantly, however, direct comparisons of METH and MDMA users regarding social cognition and interaction are lacking. Performances in cognitive and emotional empathy (Multifaceted Empathy Test) and emotion sensitivity (Face Morphing Task), as well as aggressive social behaviour (Competitive Reaction Time Task) were assessed in samples of n = 40 chronic METH users, n = 39 chronic MDMA users and n = 86 stimulant-naïve controls (total N = 165). Self-reports and hair samples were used to obtain subjective and objective estimates of substance use patterns. METH users displayed diminished cognitive and emotional empathy towards positive stimuli, elevated punitive social behaviour regardless of provocation, and self-reported heightened trait anger relative to controls. MDMA users diverged from the control group only by exhibiting a distinct rise in punitive behaviour when faced with provocation. Correlation analyses indicated that both higher hair concentrations of MDMA and METH may be associated with reduced cognitive empathy. Moreover, greater lifetime MDMA use correlated with increased punitive behaviour among MDMA users. Our findings confirm elevated aggression and empathy deficits in chronic METH users, while chronic MDMA users only displayed more impulsive aggression. Dose-response correlations indicate that some of these deficits might be a consequence of use. Specifically, the dopaminergic mechanism of METH might be responsible for social-cognitive deficits.

Subjective long-term emotional and social effects of recreational MDMA use: the role of setting and intentions

MDMA is a recreational drug commonly used to enhance euphoria, but it is also used in non-party settings with self-insight or social connection intentions. Yet, little is known about whether distinct consumer groups are formed based on consumption setting and intention. We aimed to characterize different types of recreational MDMA users based on consumption setting and intentions, and to examine their differences in perceptions of long-term social-emotional effects of MDMA use. We analyzed self-reports of 766 individuals (ages 18–61, mostly from Western countries), reporting on their MDMA consumption habits and perceived effects. We used a K-medoids clustering algorithm to identify distinct types of consumption settings and intentions. We identified three setting types – party settings with friends (N = 388), private home settings (N = 132), mixed settings (N = 246) – and three intention types – euphoria and energy (N = 302), self-insight (N = 219), mixed intentions (N = 245). Members of the self-insight and mixed intentions clusters reported considerably more long-term socio-emotional benefits than members of the euphoria and energy cluster. No differences were observed between the setting clusters. In this particular sample, more long-term benefits than harms were reported. Our findings suggest that the long-term social-emotional benefits of MDMA are associated with whether users seek self-insight or have mixed intentions.

Is it dopamine or serotonin?: Contrasting social cognition and aggression between chronic MDMA and methamphetamine users

Is it dopamine or serotonin?: Contrasting social cognition and aggression between chronic MDMA and methamphetamine users

User perceptions of long-term costs and benefits of MDMA use: findings from a large online sample

BackgroundPrevious research has focused on risks associated with non-clinical MDMA use, contrasting short-sighted hedonistic motivations with negative long-term consequences. User perceptions may be more nuanced, incorporating numerous underexplored positive long-term effects. We aimed to: (1) Assess MDMA user perceptions regarding both positive and negative long-term effects, and (2) Generate a large, open dataset with correlates to explore for future research.Methods886 non-clinical MDMA users completed an online, opt-in survey, with self-reported measures of acute, subacute, and long-term effects, motivations, use context, and polydrug use.ResultsUser perceptions of MDMA’s long-term effects were far more positive than negative. Respondents endorsed long-term increases in aesthetic appreciation, deeper social connections, and positive changes in life perspectives, among other positive outcomes. A minority of users reported negative effects (e.g. on concentration/memory and mood), which remain important. Long-term effects showed several correlations with acute effects and motivations, with use due to peer influence being repeatedly linked to lower positive and higher negative long-term effects.ConclusionMDMA users report getting much more than a momentary high from taking the drug. A nuanced appreciation of user perceptions can inform drug safety communication, and advance our understanding of drug effects by highlighting targets for further investigation.

The functional connectome of 3,4-methyldioxymethamphetamine-related declarative memory impairments.

The chronic intake of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") bears a strong risk for sustained declarative memory impairments. Although such memory deficits have been repeatedly reported, their neurofunctional origin remains elusive. Therefore, we here investigate the neuronal basis of altered declarative memory in recurrent MDMA users at the level of brain connectivity. We examined a group of 44 chronic MDMA users and 41 demographically matched controls. Declarative memory performance was assessed by the Rey Auditory Verbal Learning Test and a visual associative learning test. To uncover alterations in the whole brain connectome between groups, we employed a data-driven multi-voxel pattern analysis (MVPA) approach on participants' resting-state functional magnetic resonance imaging data. Recent MDMA use was confirmed by hair analyses. MDMA users showed lower performance in delayed recall across tasks compared to well-matched controls with moderate-to-strong effect sizes. MVPA revealed a large cluster located in the left postcentral gyrus of global connectivity differences between groups. Post hoc seed-based connectivity analyses with this cluster unraveled hypoconnectivity to temporal areas belonging to the auditory network and hyperconnectivity to dorsal parietal regions belonging to the dorsal attention network in MDMA users. Seed-based connectivity strength was associated with verbal memory performance in the whole sample as well as with MDMA intake patterns in the user group. Our findings suggest that functional underpinnings of MDMA-related memory impairments encompass altered patterns of multimodal sensory integration within auditory processing regions to a functional heteromodal connector hub, the left postcentral gyrus. In addition, hyperconnectivity in regions of a cognitive control network might indicate compensation for degraded sensory processing.

Chronic 3,4-Methylenedioxymethamphetamine (MDMA) Use Is Related to Glutamate and GABA Concentrations in the Striatum But Not the Anterior Cingulate Cortex.

3,4-Methylenedioxymethamphetamine (MDMA) is a widely used recreational substance inducing acute release of serotonin. Previous studies in chronic MDMA users demonstrated selective adaptations in the serotonin system, which were assumed to be associated with cognitive deficits. However, serotonin functions are strongly entangled with glutamate as well as γ-aminobutyric acid (GABA) neurotransmission, and studies in MDMA-exposed rats show long-term adaptations in glutamatergic and GABAergic signaling. We used proton magnetic resonance spectroscopy (MRS) to measure the glutamate-glutamine complex (GLX) and GABA concentrations in the left striatum and medial anterior cingulate cortex (ACC) of 44 chronic but recently abstinent MDMA users and 42 MDMA-naïve healthy controls. While the Mescher-Garwood point-resolved-spectroscopy sequence (MEGA-PRESS) is best suited to quantify GABA, recent studies reported poor agreement between conventional short-echo-time PRESS and MEGA-PRESS for GLX measures. Here, we applied both sequences to assess their agreement and potential confounders underlying the diverging results. Chronic MDMA users showed elevated GLX levels in the striatum but not the ACC. Regarding GABA, we found no group difference in either region, although a negative association with MDMA use frequency was observed in the striatum. Overall, GLX measures from MEGA-PRESS, with its longer echo time, appeared to be less confounded by macromolecule signal than the short-echo-time PRESS and thus provided more robust results. Our findings suggest that MDMA use affects not only serotonin but also striatal GLX and GABA concentrations. These insights may offer new mechanistic explanations for cognitive deficits (e.g., impaired impulse control) observed in MDMA users.

(267) Ecstasy' - Accurate or Deceptive Name? A Systematic Review of MDMA Effects on the Male Sexual Response Cycle

Abstract Introduction 3,4-Methylenedioxymethamphetamine (MDMA, ‘Ecstasy’ or ‘Molly’) is a synthetic psychostimulant and entactogenic drug of abuse that augments feelings of pleasure, increases energy, and distorts sensory perception. MDMA increases serotonin, dopamine, and norepinephrine neurotransmission within the mesolimbic reward pathway, which impacts human sexual function. While dopamine is implicated as a facilitator of sexual arousal and orgasm, serotonin is associated with inhibitory effects. Unlike most psychostimulants that function primarily via increased dopaminergic neurotransmission, MDMA generates approximately equivalent and simultaneous increases in both dopamine and serotonin. In alignment with its central neurochemical impact, MDMA is reported to enhance arousal while impairing sexual function in other domains, such as orgasm, erectile function, and ejaculation. Objective To evaluate MDMA effects on different domains of the male sexual response cycle. Methods We conducted a systematic review of the effects of MDMA on various domains of male sexual response. PubMed, Embase, and MEDLINE were queried, and results were screened using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six search terms, including “MDMA” or “ecstasy” in combination with “desire,” “orgasm,” “pleasure,” “libido,” “erection,” and “ejaculation” were utilized. Inclusion criteria were: MDMA was used by study subjects, outcomes in at least 1 domain of the sexual response cycle were reported, and the manuscript was written in English and published between January 2000 and June 2022. Case reports and studies that did not examine male sexual response were excluded. Results We identified a total of 90 studies, and 8 met inclusion and exclusion criteria. Seven studies evaluated the effects of MDMA on desire and/or arousal, 5 on erection, 3 on orgasm, and 2 on ejaculation. The average age of study participants was 25 years. Primary outcome measures were highly variable and largely qualitative; however, common measures included the Sexual Arousal and Desire Inventory (SADI) and the International Index of Erectile Function (IIEF) score. Two studies were double-blind, crossover trials that evaluated MDMA effects relative to placebo or other psychostimulants (methylphenidate, modafinil) with mixed conclusions. One reported no effect of MDMA on sexual arousal compared to placebo and less arousal than methylphenidate, while the other reported increased sexual desire with MDMA compared to both methylphenidate and modafinil. The remaining studies were interview-based, with 5 of 6 evaluating sexual arousal. Sixty percent of interview-based studies reported increased desire, while 40% reported mixed or no effect. Of 5 studies evaluating erection, 2 reported impairment, 2 reported mixed effects, and 1 reported “fear of erection impairment.” All studies evaluating orgasm reported difficulty achieving orgasm, but increased intensity and pleasure if achieved. Conclusions This systematic review demonstrates mixed effects of MDMA on different domains of male sexual response. While there are few high-quality studies investigating effects on distinct domains of male sexual response, our findings suggest that MDMA increases sexual desire, enhances sexual pleasure, and intensifies orgasm in males despite potential impairments in erectile and ejaculatory function. Given MDMA's illicit and unregulated nature, these results should be interpreted with caution and MDMA users must consider the potential for adverse drug-related behavioral and health effects. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Abbvie, Coloplast

Concomitant medications associated with ischemic, hypertensive, and arrhythmic events in MDMA users in FDA adverse event reporting system.

3,4-Methylenedioxymethamphetamine (MDMA) is currently being investigated as an adjunctive treatment to therapy for posttraumatic stress and other anxiety related disorders in clinical trials. Within the next few years MDMA-assisted therapy is projected for approval by regulatory authorities. MDMA's primary mechanism of action includes modulation of monoamine signaling by increasing release and inhibiting reuptake of serotonin, norepinephrine, and, to a lesser extent, dopamine. This pharmacology affects sympathomimetic physiology. In controlled trials, special attention has been given to cardiovascular adverse events (AEs), because transient increases in heart rate and blood pressure have been observed during the MDMA-assisted therapy sessions. Finding and quantifying the potential drivers of cardiac AEs in clinical trials is difficult since only a relatively small number of participants have been included in these studies, and a limited set of allowed concomitant drugs has been studied. In this study a more diverse set of reports from the FDA Adverse Event Reporting System was surveyed. We found 17 cases of cardiovascular AEs, in which the individuals had taken one or more substances in addition to MDMA. Interestingly, all of those concomitant medications and illicit substances, including opioids, stimulants, anticholinergics, and amphetamines, had been previously associated with cardiovascular AEs. Furthermore, in none of the reports MDMA was marked as the primary suspect.

Striatal Iron Deposition in Recreational MDMA (Ecstasy) Users

BackgroundThe common club drug MDMA (also known as ecstasy) enhances mood, sensory perception, energy, sociability, and euphoria. While MDMA has been shown to produce neurotoxicity in animal models, research on its potential neurotoxic effects in humans is inconclusive and has focused primarily on the serotonin system. MethodsWe investigated 34 regular, largely pure MDMA users for signs of premature neurodegenerative processes in the form of increased iron load in comparison to a group of 36 age-, sex-, and education-matched MDMA-naïve control subjects. We used quantitative susceptibility mapping, a novel tool able to detect even small tissue (nonheme) iron accumulations. Cortical and relevant subcortical gray matter structures were grouped into 8 regions of interest and analyzed. ResultsSignificantly increased iron deposition in the striatum was evident in the MDMA user group. The effect survived correction for multiple comparisons and remained after controlling for relevant confounding factors, including age, smoking, and stimulant co-use. Although no significant linear relationship between measurements of the amounts of MDMA intake (hair analysis and self-reports) and quantitative susceptibility mapping values was observed, increased striatal iron deposition might nevertheless point to MDMA-induced neurotoxic processes. Additional factors (hyperthermia and simultaneous co-use of other substances) that possibly amplify neurotoxic effects of MDMA during the state of acute intoxication are discussed. ConclusionsThe demonstrated increased striatal iron accumulation may indicate that regular MDMA users have an increased risk potential for neurodegenerative diseases with progressing age.

Charakterystyka demograficzna i zdrowotna osób zażywających 3,4-metylenodioksymetamfetaminę (MDMA, Ecstasy)

MDMA is one of the most commonly used drugs in the world. Clinical studies are currently being conducted around the world on the use of this substance in the treatment of PTSD and alcoholism. However, little demographic information is available on users who use the substance for recreational purposes. The aim was to determine basic demographic and helath characteristics with validated tools. The authors prepared an original questionnaire on the demography of MDMA users and combined it with the General Health Questionnaire-28 (GHQ-28) and the Hospital Anxiety and Depression Scale (HADS). The survey was sent to Polish MDMA users via the Internet. 304 responses were received from people over 18 years of age. MDMA is widespread among young adults, in many different places of residence and regardless of gender. The users take MDMA in both pill and crystal form and very rarely test drugs bought from a dealer. Most users feel that MDMA has had a good impact on their lives. MDMA is rarely used as the only psychoactive substance. MDMA users rate their health higher than people using other psychoactive substances.

Reported Cases of Serotonin Syndrome in MDMA Users in FAERS Database

3,4-Methylenedioxymethamphetamine (MDMA), is investigated as a treatment for post-traumatic stress disorder and other anxiety-related conditions in multiple placebo-controlled and open label studies. MDMA-assisted therapy is projected for approval by the United States Food and Drug Administration (FDA) and other regulatory agencies worldwide within the next few years. MDMA is a monoamine releaser and uptake inhibitor affecting serotonin, potentially increasing the risk of serotonin syndrome (SS). No instances of SS have occurred in clinical trials. The relatively small number of patients in controlled trials warranted a survey of FDA Adverse Event Reporting System data for the occurrence of SS in a larger database. We found 20 SS cases in people exposed to MDMA, all of which had also taken one or more substances with serotonergic properties in addition to MDMA, including amphetamines, stimulants, and opioids. There were no cases of SS associated with MDMA where MDMA was the sole reported compound taken.

Evenings with Molly: Adult Couples' Use of MDMA for Relationship Enhancement.

Within the modern resurgence of psychedelics as medicinal agents for a range of conditions, the story of MDMA (Ecstasy, Molly) has been re-narrated from a dangerous street drug to a breakthrough mental health therapy. Even still, the story of MDMA remains incomplete within a binary discourse of deviant recreational use versus psychotherapeutic-medical use. The present research aimed to uncover an emerging model of MDMA use grounded in the experiences of adult couples using MDMA privately and in the context of their committed relationships. Eight adult couples who self-reported active MDMA use were recruited for confidential in-depth interviews exploring questions related to drug, set, and setting as a general framework for understanding their private experiences with MDMA. A general inductive coding process was used to arrive at four overarching themes: Conscious Use, A Tool for Exploring, Planned Recovery, and Difficult Experiences. Couples reported making purposeful decisions about MDMA use, collaborating together on becoming physically and emotionally "set" for their drug experience. Couples described positive effects on communication, intimate bonding, and providing a relationship "tune up," among other durable changes to the relationship. An emerging cognitive-relational model of "evenings with Molly" contrasts with existing models of use by suggesting the possibility of informed, non-problematic adult use of the drug for cognitive and relational enhancement. With a small, homogenous sample reporting generally positive experiences with MDMA self-administration, findings from this study cannot be generalized. It remains unknown what proportion of the total MDMA user population might align with the non-problematic adult use of MDMA explored in this study. Additional focused investigations might examine the prevalence and varieties of non-clinical use among adults in order to arrive at rational, science-based regulatory frameworks.

White matter alterations in chronic MDMA use: Evidence from diffusion tensor imaging and neurofilament light chain blood levels

3,4–Methylenedioxymethamphetamine (MDMA, “Ecstasy”) is a serotonin- and noradrenaline-releasing substance, currently among the most widely used illicit substances worldwide. In animal studies, repeated exposure to MDMA has been associated with dendritic but also axonal degeneration in the brain. However, translation of the axonal findings, specifically, to humans has been repeatedly questioned and the few existing studies investigating white matter alterations in human chronic MDMA users have yielded conflicting findings. In this study, we combined whole-brain diffusion tensor imaging and neurofilament light chain (NfL) analysis in blood to reveal potential MDMA-induced axonal neuropathology. To this end, we assessed 39 chronic MDMA users and 39 matched MDMA-naïve healthy controls. MDMA users showed increased fractional anisotropy in several white matter tracts, most prominently in the corpus callosum as well as corticospinal tracts, with these findings partly related to MDMA use intensity. However, the NfL levels of MDMA users were not significantly different from those of controls. We conclude that MDMA use is not associated with significant white matter lesions due to the absence of reduced fractional anisotropy and increased NfL levels commonly observed in conditions associated with white matter lesions, including stimulant and ketamine use disorders. Hence, the MDMA-induced axonal degradation demonstrated in animal models was not observed in this human study of chronic MDMA users.

Serotonin transporter availability, neurocognitive function and their correlation in abstinent 3,4-methylenedioxymethamphetamine users.

MDMA or Ecstasy has made a resurgence in popularity and the majority of users consist of teenagers and adolescents. Therefore, it is important to determine whether MDMA causes long-term damage and what this damage entails. There is an ongoing debate about possible neurocognitive changes in 3,4-methylenedioxymethamphetamine (MDMA) users related to MDMA's neurotoxic potential. Multiple neuroimaging studies have shown that Ecstasy use leads to lower serotonin transporter (SERT) availability in multiple brain regions. This may express itself in a loss of cognitive functions like memory, attention and executive function. However, there is increasing evidence reporting that MDMA's induced serotonergic adaptations are reversible over time. The question we thus address is whether the recovery of SERT function predicts a recovery of cognitive function. This review aims to investigate MDMA's long-term effects on SERT availability and cognitive functioning. A literature search was performed in PubMed. Studies that investigated the effects of MDMA on both SERT availability and cognitive performance were eligible for inclusion. SERT availability positively correlated with time of abstinence, whereas memory performance did not show this correlation, but remained impaired in MDMA users. No significant correlation between SERT availability and memory function was found (r=0.232, p=0.581; r=0.176, p=0.677). The main findings of this review are that MDMA-use leads to an acute decrease in SERT availability and causes an impairment in cognitive functions, mostly memory. However, SERT availability recovers with sustained abstinence while memory function does not. This suggests that SERT availability is not a biomarker for MDMA-induced cognitive impairment and likely also not for MDMA-induced neurotoxicity.

Concomitant drugs associated with increased mortality for MDMA users reported in a drug safety surveillance database

3,4-Methylenedioxymethamphetamine (MDMA) is currently being evaluated by the Food and Drug Administration (FDA) for the treatment of post-traumatic stress disorder (PTSD). If MDMA is FDA-approved it will be important to understand what medications may pose a risk of drug–drug interactions. The goal of this study was to evaluate the risks due to MDMA ingestion alone or in combination with other common medications and drugs of abuse using the FDA drug safety surveillance data. To date, nearly one thousand reports of MDMA use have been reported to the FDA. The majority of these reports include covariates such as co-ingested substances and demographic parameters. Univariate and multivariate logistic regression was employed to uncover the contributing factors to the reported risk of death among MDMA users. Several drug classes (MDMA metabolites or analogs, anesthetics, muscle relaxants, amphetamines and stimulants, benzodiazepines, ethanol, opioids), four antidepressants (bupropion, sertraline, venlafaxine and citalopram) and olanzapine demonstrated increased odds ratios for the reported risk of death. Future drug–drug interaction clinical trials should evaluate if any of the other drug–drug interactions described in our results actually pose a risk of morbidity or mortality in controlled medical settings.

Developing a new national MDMA policy: Results of a multi-decision multi-criterion decision analysis.

Background:Ecstasy (3,4-methylenedioxymethamphetamine (MDMA)) has a relatively low harm and low dependence liability but is scheduled on List I of the Dutch Opium Act (‘hard drugs’). Concerns surrounding increasing MDMA-related criminality coupled with the possibly inappropriate scheduling of MDMA initiated a debate to revise the current Dutch ecstasy policy.Methods:An interdisciplinary group of 18 experts on health, social harms and drug criminality and law enforcement reformulated the science-based Dutch MDMA policy using multi-decision multi-criterion decision analysis (MD-MCDA). The experts collectively formulated policy instruments and rated their effects on 25 outcome criteria, including health, criminality, law enforcement and financial issues, thematically grouped in six clusters.Results:The experts scored the effect of 22 policy instruments, each with between two and seven different mutually exclusive options, on 25 outcome criteria. The optimal policy model was defined by the set of 22 policy instrument options which gave the highest overall score on the 25 outcome criteria. Implementation of the optimal policy model, including regulated MDMA sales, decreases health harms, MDMA-related organised crime and environmental damage, as well as increases state revenues and quality of MDMA products and user information. This model was slightly modified to increase its political feasibility. Sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of variability in weight values.Conclusion:The present results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy that is likely to reduce both adverse (public) health risks and MDMA-related criminal burden.

MDMA Use by Paris Medical Students: Prevalence and Characteristics

Background: 3,4-Methylenedioxy-N-methylamphetamine (MDMA) is increasing being used by youth in Europe and in France, but characteristics of its use are unknown. Objectives: The aim was to characterize MDMA use in a sample of French medical students. Methods: Cross-sectional study of Paris VII medical students (N = 592) with an online self-reporting questionnaire. Results: 592 students completed the online questionnaire. 21.5% (n = 127) had experimented with MDMA. Use of MDMA was associated with male sex (p < 0.001), older age (p < 0.001), left the parent’s home (p < 0.01), and belonging to a fraternity (p < 0.05). Most experimenters (90.7%) used MDMA in a club or during a music festival. Among users, 42.5% used it more than once a year and less than once a month. During the use, users drank alcohol (90.6%), smoked tobacco (70.9%), smoked cannabis (42.0%) or used cocaine (20.5%). In the days after the use, some smoked tobacco (40.9%), smoked cannabis (29.1%), drank alcohol (22.0%), used cocaine (1.6%) and also took benzodiazepines (5.5%). According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, criteria, the prevalence of MDMA use disorder was 8.5% in our sample and 40.9% among MDMA users. As compared with students who never experienced MDMA, fewer users thought that occasional intake could be dangerous (66.9% vs 83.9%, p < 0.001) and that MDMA could be addictive (74.0% vs 90.3%, p < 0.001). Conclusions: Other studies focusing on drug consumption among students are necessary to define specific public health strategies of prevention and harmful reduction.

Sexual Risk Behaviors among African Americans Who Use MDMA (Molly/Ecstasy): Implications for HIV Prevention

ABSTRACT Numerous studies have linked sexual risk taking to recreational use of MDMA. Questions remain, however, regarding the extent and type of sexual risk behaviors that occur among MDMA users, especially African Americans who use the drug. Because the MDMA literature has historically relied on samples with little minority representation, little is known about Black MDMA users and their sexual risk taking. The primary goal of this study, therefore, was to describe patterns of sexual risk behaviors among African Americans who use MDMA. This study used survey data to identify (a) which sexual risk behaviors occurred among Black MDMA users and (b) the prevalence of each behavior. Qualitative interview data are also presented to contextualize the role that MDMA and the club/nightlife environment might play in contributing to these behaviors. Results show that sexual risk taking (e.g., sex without a condom, “hooking up,” sex on MDMA, and group sex) was prevalent and that the mind-set and context in which MDMA was consumed are contributing factors. The current study adds to the limited amount of data on African Americans who use MDMA and is a step toward better understanding the link between MDMA and sexual risk taking. These data can be used to inform social workers in their efforts to prevent HIV in this population.

Harm reduction and quitting techniques used by heavy MDMA (ecstasy) users

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.