MDMA: Harm Minimisation Strategies

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Quick Summary

MDMA (3,4-methylenedioxymethamphetamine), commonly known as ecstasy or molly, is a psychoactive drug known for its empathogenic, euphoric, and stimulant effects.
While MDMA can enhance social interactions and sensory experiences, it carries significant risks, including dehydration, overheating, and serotonin syndrome.
This guide provides harm minimisation strategies to enhance safety for individuals using MDMA.

Know the Effects and Risks: MDMA increases serotonin levels in the brain, leading to feelings of euphoria and empathy. However, it can also cause negative effects such as dehydration, hyperthermia, and serotonin syndrome.
Test Your MDMA: Use a reagent test kit to check the purity and presence of other substances. Start with a small dose to gauge potency. A standard recreational dose is between 0.7 mg and 1.5 mg of MDMA per kg of body weight.

Mindset: Ensure you are in a positive and stable mental state before using MDMA. Avoid use if you are feeling anxious, stressed, or depressed.
Environment: Use in a safe, familiar, and comfortable setting, ideally with trusted friends. Avoid hot and crowded environments to reduce the risk of overheating.

Avoid Mixing with Other Drugs: Especially avoid combining MDMA with alcohol, caffeine, other stimulants, and substances that affect serotonin levels (e.g., antidepressants, DMT, methamphetamine). These combinations can increase the risk of negative effects and serotonin syndrome.

Dosage Guidelines: Follow the guideline of 0.7 mg to 1.5 mg of MDMA per kg of body weight. Avoid taking more than 150 mg in one go. Wait at least 2 hours before re-dosing.

Stay Hydrated: Drink enough water to stay hydrated but not too much. Consume 1 glass (250 ml) per hour when inactive or 2 glasses (500 ml) per hour when active. Drink plenty of water 24 hours before use.

Start Slow: Begin with a small dose (e.g., a quarter of a pill) and wait at least 2 hours before considering more. This helps gauge the strength and avoid overuse.
Parachuting: For powder, wrap it in a small amount of paper and swallow with water. This helps control dosage.

Clean and Safe: Snort on a clean surface, finely grind the MDMA, and use your own clean straw or spoon. Avoid using money. Flush your nostrils with water or saline before and after use.

Use Lubrication: Apply lubrication to avoid tearing and use a condom or latex glove to prevent scratches. Wash your hands before and after use.

Refer to Needle Use Guidelines: Follow harm minimisation practices for needle use, such as using sterile syringes and equipment.

Wait 2 Hours: Allow at least 2 hours before re-dosing to reduce the risk of negative effects from using too much.

Call Emergency Services (000): Provide clear information about what was taken and the symptoms.
Stay With the Person: Keep them calm and monitor their condition.
Cool Down: Move to a cooler environment, use cold water to cool down, and ensure adequate hydration.

Medical supervision: Seek medical advice if experiencing severe withdrawal symptoms.
Stay hydrated: Drink plenty of water to help manage symptoms.
Eat well: A nutritious diet supports recovery and energy levels.
Support from friends and professionals: Engage with family, friends, or professional services to aid recovery.

MDMA and Alcohol: Increases risk of dehydration and overheating.
MDMA and Stimulants (Cocaine, Methamphetamine): Can lead to severe cardiovascular stress and serotonin syndrome.
MDMA and Antidepressants (SSRIs, MAOIs): Increases the risk of serotonin syndrome.