MDMA is used by millions for a host of reasons. Some use it purely for fun, as MDMA produces intense euphoria, music appreciation, increased pleasure, openness, etc. (among a host of other effects which can be seen in the EFFECTS SECTION). Others use it for spiritual reasons; MDMA has the ability to induce a profound sense of well-being that can continue after the experience is over, as well as the ability to diminish insecurities, soften the ego, and induce a feeling of acceptance and/or belonging. It has the potential to produce life-changing experiences. In addition, its ability to diminish fear and anxiety, induce forgiveness, etc. make it an excellent candidate in a therapeutic setting (hence the outrage in the psychiatric community when it was outlawed)--whether that therapy be in a clinical setting or not.
[top]Administration of MDMA
[top]Routes of administration
MDMA can be administered orally, sublingually, intravenously, rectally, or can be insufflated. It is inadvisable to attempt IV administration if the product is bought on the street, i.e. the user does not know exactly what might be present in the pill or the powder. The other methods are much more safe aside from insufflating which is incredibly painful as MDMA. In addition,
snorting anything (especially unknown substances) causes damage to the nasal lining if done frequently.
[top]Bioavailability
MDMA bioavailability in humans has not been concluded. It is known that when taken orally, MDMA's pharmacokinetics are non-linear. This is related to the dose-response curve--small increases in dose induce disproportionately higher plasma concentrations.
[top]Recreational
120 mg of MDMA is a dose which will induce a full-on experience in the majority of users. However, smaller users or those who are more sensitive can have the same experience at 80 mg and sometimes even a bit less. Less sensitive users might need 150 mg or so. Tolerance builds quickly, and in order to experience the same effects, recreational users will need to up the dosage if MDMA is being taken frequently.
Some users also double dose in order to prolong the experience. With 120mg, 40mg after about an hour can increase the length of the plateau. It is not necessary to take the same amount twice as the brain has a limited amount of
serotonin and therefore there is a limit to how high a user can get. Too much will merely increase the adverse side effects.
Dose is dependent on huge number of variables. 120mg is enough for most, and weight or gender is generally a good guideline, but it also depends on what the user has eaten beforehand, how often one takes MDMA, genetic variance, and a multitude of other factors. 120mg after a huge meal might not produce the desired experience, or it might be way too much for a 170lb man. It is important to start low and experiment to find a dose that works. 100-120mg is generally a good starting dose for most because the negative side effects will be minimal and there is virtually no risk of overdose or a severely adverse reaction.
MDMA also has a non-linear dose-response relationship (i.e. a steep dose-response curve). What this means is that small increases will not necessarily mean small changes. A dose-response curve is a measure of magnitude of stressor (mg of MDMA) vs response of the receptor (subjective experience). 240mg will not be twice as enjoyable as 120mg. Similarly, 150mg is not five quarters as fun as 120mg. This is why double-dosing the same amount is inadvisable (and for other reasons) and why it is important to start low. It is incredibly unlikely that 200mg is necessary for a first timer or even for a 50th timer (provided use is not heavy), and often that amount can be uncomfortable or overwhelming for the user, not to mention physiologically unsafe.
Erowid provides an excellent recommended dose table:
| MDMA Dosage | |
|---|
| Threshold | 30mg |
| Light | 40-75mg |
| Common (small or sensitive people) | 60-90mg |
| Common (most people) | 75-125mg |
| Common (large or less sensitive people) | 110-150mg |
| Strong | 150-200mg |
| Heavy | 200mg and up |
[top]Therapeutic
In a therapeutic setting, or if one desires to use MDMA for therapeutic reasons but does not require or desire euphoria, stimulation, etc., 120mg is not necessary. A lighter dose is enough to induce the sorts of changes in consciousness or feelings that make MDMA a valuable therapeutic tool. There is not enough published literature to make a definitive statement, but one study [mdmatherapy.pdf] administered 50-75mg of MDMA to a small sample of women being treated for PTSD. Again, doses are not set in stone. 50mg may not be enough to be helpful and 75mg might be more than enough (although this is quite unlikely).
[top]Effects of MDMA
[top]Subjective effects
MDMA can produce a variety of effects. Most marked are euphoria (physical and mental), openness, empathy, increased sensory awareness (notably visual and aural), and a sense of belonging. Many others are quite common but the aforementioned are the effects that most users desire when taking MDMA. Contrary to popular belief, MDMA does not commonly increase one's libido, and in addition it actually makes sexual intercourse quite difficult as many users report a physical shrinking of the penis and difficulty achieving erection and/or orgasm. It is more of a sensual rather than a sexual drug, although the fact that it increases tactile pleasure can make intimacy extremely enjoyable.
Dose is important to the experience because negative effects tend to become more prominent if the dose is too high. Excessive stimulation, nystagmus, muscle tension (especially in the jaw) anxiety, etc. are more likely at higher doses. Higher doses are also more dangerous physiologically. MDMA has stimulant properties, therefore it can increase blood pressure, heart rate, body temperature, and dehydration. This will become more of a worry and/or an issue if the dose is too high.
- mild to extreme mood lift, euphoria
- increased willingness to communicate
- increase in energy (stimulation)
- ego softening
- decreased fear, anxiety, and insecurities
- feelings of comfort, belonging, and closeness to others
- feelings of love and empathy
- forgiveness of self and others
- a sense of inner peace and acceptance of self, others, and the world
- increased awareness & appreciation of music
- increased awareness of senses (eating, drinking, smell)
- increased pleasure from the sense of touch and being touched
- life-changing spiritual experiences
- sensations bright and intense
- urge to hug and kiss people
- analgesia, anti-nociception, decreased pain perception
- appetite loss
- visual distortion
- rapid, involuntary eye jiggling (nystagmus)
- mild visual hallucinations (uncommon)
- moderately increased heart rate and blood pressure
- restlessness, nervousness, shivering
- change in body temperature regulation
- upwellings of unexpected emotion, emotional liability
- strong desire to do or want more when coming down
- inappropriate and/or unintended emotional bonding
- anxiety or paranoia (less common than opposite)
- agitation (less common than opposite)
- tendency to say things you might feel uncomfortable about later
- mild to extreme jaw clenching (trismus), tongue and cheek chewing, teeth grinding (bruxism)
- difficulty concentrating & problems with activities requiring linear focus
- short-term memory scramble or loss & confusion
- muscle tension
- insomnia, inability to fall asleep when physically tired
- erectile dysfunction and difficulty reaching orgasm
- increase in body temperature, hyperthermia, dehydration
- hyponatremia (sodium deficiency as a result of too much water)
- nausea and vomiting
- headaches, dizziness, loss of balance, and vertigo
- sadness on coming down, sense of loss or immediate nostalgia
- post-trip crash- unpleasantly harsh comedown from the peak effect
- hangover the next day, lasting days to weeks
- mild depression and fatigue for up to a week
- severe depression and/or fatigue (uncommon)
- possible strong urge to repeat the experience, though not physically addictive
- possible psychological crisis requiring hospitalization (psychotic episodes, severe panic attacks, etc) (rare)
- possible liver toxicity (rare)
- possible neurotoxicity (controversial; very likely but has been exaggerated and can be combatted)
- small risk of death; approximately 2 per 100,000 users have extreme negative reactions resulting in death (rare)
The MDMA experience, from the time of ingestion until the user is completely back to "baseline" is usually about 4-6 hours (give or take a few). MDMA has a relatively quick onset, anywhere from 20-90 minutes. After this, the user will begin to notice a definite in perception and the experience will begin extremely quickly, with a come-up of about 5-20 minutes. For 2-3 hours after the come-up, the effects will remain at a plateau. A helper dose an hour after the original can extend this plateau by an hour or so. After the plateau, the effects will begin to diminish over an hour or two until they are not noticeable. This come down can be accompanied by physical
exhaustion or other undesirable feelings, especially if the dose was excessive. Residual after effects, for example an afterglow or feeling a bit tired, can last for a day or so after the experience. Excessive doses will likely result in a "hangover" the day after wherein the user crashes due physical and mental overexertion. Using a safe amount of MDMA and staying hydrated does not often result in an unpleasant comedown or crash.
Erowid provides an organized table of the timeline of the MDMA experience:
| Duration | |
|---|
| Total Duration | 3-5 hrs |
| Onset | 20-90 mins |
| Come up | 5-20 mins |
| Plateau | 2-3 hrs |
| Come down | 1-2 hrs |
| After effects | 2-24 hrs |
| Hangover | 2-72+hrs |
In graph form:
[top]Combinations with MDMA
It is inadvisable to combine MDMA, which has stimulant properties with other substances that influence cardiovascular function, for example
stimulants or
depressants. It is also extremely important to keep in mind how MDMA gets into and out of the brain--inhibiting or inducing the enzyme that breaks it down in the liver can make it more effective or less effective at the same dose as well as perhaps increase neurotoxicity, and inhibiting
monoamine oxidase, which breaks serotonin down in neurons can have fatal consequences--when combining MDMA with other substances.
[top]MDMA and other stimulants
[top]Amphetamine
This is a common mix in Ecstasy pills, that may produce an intense empathy, pleasure and increase in energy. But this can be dangerous because it can lead to excessively
high blood pressure and dangerous increases in body temperature (severe hyperthermia). It has been also showed that this combination will increase neurotoxic damage. This is because
Amphetamine is mainly a dopaminergic drug, and
dopamine is toxic to serotonin cells and endings when serotonin is depleted under MDMA.
[top]Methamphetamine
In a recent study of the acute and chronic effects of MDMA, the possible interactions of
caffeine and MDMA were examined. Caffeine exacerbated the acute hyperthermic response to MDMA and tended to increase the loss of serotonin (forebrain 5-HT or hydroxytryptamine) and 5-HIAA (5-hydroxyindoleacetic acid). Thus, caffeine may aggravate the hyperthermic and neurotoxic effects of MDMA, possibly through a mechanism involving dopamine release. It was also found that higher doses of caffeine (10 and 20 mg.kg-1 body mass) when co-administered with MDMA (20 mg.kg-1 body mass) had lethal effects in experimental animals.
These results suggest that caffeine enhances the effects of MDMA and could possibly exacerbate dehydration due to separate diuretic effects.
[top]MDMA and alcohol
[top]MDMA and depressants
[top]Benzodiazepines
[top]Opiates/Opioids
[top]MDMA and cannabis
[top]MDMA and nitrous
[top]MDMA and viagra
[top]MDMA and psychedelics
[top]Psilocybin mushrooms
[top]MDMA and antidepressants
[top]MDMA and antipsychotics
[top]MDMA and research chemicals
[top]Tryptamines
[top]Phenethylamines
[top]Cannabinoids
[top]Piperazines
[top]Different Uses of MDMA
[top]Recreational use
MDMA is used recreationally by millions. It is often prevalent at music-related events (especially dance, electronic, or house music) because it produces an increased appreciation and awareness of music and can provide the user with the energy to dance for hours on end. It is popular in nightclubs, raves, and the like because many find fast, upbeat music with lots of bass to be extremely pleasurable while under the influence, however this is not always the case. Different people find a variety of genres to be enjoyable. Some only enjoy listening to dance music, others only metal or jazz, some enjoy both, some, all, or none. It depends on the person, although its association with the rave culture is justified.
It is also used because it is undoubtedly one of the most emotionally and physically pleasurable/enjoyable drugs in existence. MDMA produces intense physical euphoria, unrivaled mood lift, astounding empathy, and much more. Many people use it at concerts, but just as many use it in the comfort of their own home or with a group or alone in any situation, whether it be just a quiet night watching a movie with a lover, a dinner party with a group of friends, or alone in a warm bath; it tends to make nearly everything more enjoyable.
[top]Therapeutic Use
MDMA's therapeutic value is vastly underestimated, partly because though nearly all of the evidence is anecdotal due to it becoming illegal before its use in therapy was properly documented. Its properties allow it to be a suitable adjunct to all kinds of therapy--increased willingness to communicate, openness, empathy/love and forgiveness can be beneficial in couples or family therapy; diminished fear and anxiety, and acceptance make it extremely valuable in treating anxiety disorders (it was recently approved for a trial involving patients with Post Traumatic Stress Disorder--the study concluded in 2008 with promising results; a study involving anxiety in cancer patients is currently underway); increased pleasure and awareness, forgiveness of self or others, diminished insecurities and feelings of comfort and well being can help those who suffer from mood disorders.
Alexander
Shulgin wrote in
PIHKAL about MDMA's value as a therapeutic tool:
Quote:
What does MDMA do that could be beneficial to a patient? First, it powerfully suppresses emotional fear, to such an extent that people under the influence are often able to openly discuss deeply traumatic events, such as rape, suicide attempts, etc. MDMA produces complete emotional honesty with yourself. Second, it is a moderately powerful stimulant, not simply allowing the patient to sit there indifferently, but prodding them to examine and discuss their lives. Animal experiments also indicate that MDMA enhances learning, allowing what is discovered and experienced during the MDMA state to strongly affect and stay with the patient long after the session.
The net result is a patient who, for a few hours, is almost perfectly primed to grow as a person. Their fears are gone. They feel strong, at peace, and able to handle almost anything emotionally. They're also hyperactive and extremely talkative, eager to explore ideas and issues and share their thoughts. The 'hyper-focused' MDMA state can also allow the therapist to steer the conversation into otherwise highly charged topics...they don't have to tease the story out of them; the patient is truly ready to talk about what's on their mind. And finally, the experience seems to allow a high degree of incorporation of what they learn about themselves back into their normal lives.
|
It is important to keep in mind that while for some, MDMA alone can be enough to allow the alleviation of depression or to stimulate the reconnection between a husband and a wife, in the context of clinical therapy it is not viewed as a panacea. MDMA, like any other drug, will not automatically allow someone to come to terms with a traumatic incident, it can only make it easier to do so. It can put the patient in a more receptive, forgiving, or happier state, but it is just as necessary that the patient desire to get better and that the therapist continue to do whatever necessary to help them achieve their goal.
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