Data from the 2016 Global Drug Survey (GDS) shows that more people than ever before are using MDMA. As the purity and availability of the drug increases, it is essential that people know how to use it safely.

Last year, almost 1 per cent of people worldwide who used MDMA sought emergency medical treatment. You cannot eliminate the risk of harm, except by not using drugs - but you can reduce the risk by being aware of what you use and how you should use it. To begin with, remember these two major misconceptions around drug use: that better quality drugs are safer to use, and that taking more of a drug makes the experience more fun.

In 1999, an ecstasy pill bought in the UK would contain around 70-100mg of MDMA. For most people who used MDMA, a dose of 80mg provided the pleasurable and sought-after effects - energy, euphoria, and empathy. This was sufficient for many, though some more experienced MDMA users would take another dose or two as their session continued.

The GDS finds that the average total dose per session is growing, both in the UK and abroad. This increase in average session use, accompanied by an increase in quality and a reduction in price, has correlated with an increase in MDMA-related deaths in the UK.

If you take 150-200mg at once, you may feel sick, anxious, or agitated. Taking larger doses of MDMA can lead to physical and psychological symptoms that can be dangerous. This is when people describe feeling “out of it” and stay high for too long. Having studied GDS data, and having spoken to many experts and users about the subject, I suggest limiting a session to 200mg - divided into doses. Of course, the added benefit of keeping your dose down is that your recovery and comedown time will be shorter and less intense.

Please make sure you understand: I am not saying that low doses of MDMA are safe, but that they carry lower levels of risk.

So, what are MDMA-related deaths?

Unlike, say, with heroin use, dose size is not a significant factor in deaths. I believe the causes of death can be divided into two types:

Death caused by an interaction between MDMA, the individual, and their behaviour/environment

For example, dancing in a hot club and not drinking water can lead to overheating and dehydration, and this is exacerbated by MDMA, which affects your body’s ability to control its temperature.

Resting and regularly rehydrating reduces the risk of death from this first type. Importantly, you can reduce your risk by not mixing MDMA with alcohol or other drugs. Only 10 per cent of people seeking emerge treatment after MDMA use claim to have used just MDMA – mixing is all too common, and can have disastrous consequences.

Death caused by idiosyncratic reactions

MDMA use can cause sudden liver failure, heart attacks, and water intoxication.

Such deaths cannot necessarily be prevented by testing drugs’ purity.

This second type – rare, though unpredictable – is less likely to occur if the individual has taken a smaller dose. Bigger doses make people more vulnerable to behavioural environmental factors that can result in death. Using smaller doses of MDMA makes you less vulnerable to your environment. Having a high tolerance to MDMA can therefore increase the risk of unpleasant effects. Professor David Nutt, formerly the government’s chief drugs adviser, recommends leaving at least one month in between MDMA sessions – to let your brain and body fully recover.

So the next time you get some MDMA, be mindful of the fact that more MDMA is not more fun, and that you can never ‘untake’ a drug. Overall, MDMA is a remarkably safe drug for most people who use it. Just remember the GDS’ Highway Code: “Safer drug use is more enjoyable drug use”.

Key points for safe MDMA use

Try not to use more than 200mg per session, and ensure to divide this into smaller doses.

Try not to use more often than once a month.

Stay cool and hydrated.

Avoid mixing with alcohol or other drugs.

Test dose a new batch by trying a small amount to begin with.

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