Thinking of using MDMA for the first time? Here are some things to think about

Professor Adam R Winstock

Founder & CEO : Global Drug Survey

A person’s first drug experience can be particularly risky. The risks are likely to be higher if you are on your own, take the wrong dose, are in the wrong place or time or are already under the influence of something else – usually and probably most dangerously, alcohol. If people know more about what they are taking, how to take it and what to watch out for we believe they would be safer, especially on that very first occasion.

You may find the following dosage guide taken from the GDS Highway Code helpful :

We hope this information can be used to increase awareness about the potential risks of first time use and to reduce negative outcomes. If you would like to find out about harm reduction strategies most commonly adopted by users of MDMA around the world, check out the Global Drug Survey Highway Code – the guide to safer, more enjoyable drug use.

GDS harm reduction checklist for first time users of MDMA

KNOW STUFF: Know about the drug you are planning on taking. Do some research, talk to friends who have used MDMA, find out the basics like how it might make you feel, dose, how long it takes for the effect to start, how long before it peaks and how long it will be before you feel back to normal.

DON’T GO SOLO: Don’t be on your own your mates are the best harm reduction you have, so stick with them. Ideally be with trusted friends or at least some who have used MDMA before and least one who will remain sober throughout the session. It’s far from ideal to take MDMA with a bunch of other people who have never tried it either. If something does occur and all of you are intoxicated there’s no one about sort things out. If you experience something you find uncomfortable or something you are not sure is normal (e.g. feeling hot and sweaty, suddenly realising you love everyone, thinking your jaw is locked or that you have an overwhelming need to poo) you need to be able to talk to someone. And someone who knows what you might be going through is fab – the reassurance a friend can give is so valuable and of course if you feel unwell, then there is someone to take care of you. Your mates are the best harm reduction you have, so stick with them. If you’re at a festival and plan on taking a walk, let someone know – or better still maybe take someone with you, stick with your mates. If you’re not at home, then know where you’ll be spending the night and how you’ll get there.

THE LAW. Possessing illegal drugs is an offence. Many drugs are illegal to possess. In many countries supply is the simple act of passing a controlled drug to another person, money does not have to be exchanged for the offence to occur. Getting a criminal record for drug possession can be hugely damaging. Anyway, just thought we’d mention it.

USE IT SOLO: Don’t drink alcohol or use any other drugs that day, especially before you use. Most people who end up seeking Emergency Medical Treatment after taking MDMA have used other drugs and alcohol. GDS2018 found that over half were drunk before they took MDMA, 60% did not feel well in themselves at the start of the evening and 60% took more than usual. So taking MDMA that first time is definitely best enjoyed (at least on that first occasion) on its own. Having other drugs in your system, especially alcohol can make it difficult to assess the effects of a new drug and can sometimes increase the risk of unwanted effects. Other stimulant drugs can overstress your system leading to anxiety, panic and overheating. And of course, it will confuse your assessment of what MDMA itself is actually like – the same as if you cover a new type of food in ketchup!

DRUG QUALITY: Know as much about your drug and as far as possible trust the source. Although most pills and powders sold as MDMA do contain MDMA, not everything sold as MDMA does. Having your drugs tested is a good idea but know that many forms of testing can’t tell you how much MDMA is in your pills and cannot always detect the presence of other drugs. Reagent kits are very limited in their value although they can tell you if your drug quite simply does not contain MDMA. Services like The Loop, Energy Control or Checkit! use much more sophisticated technology and can provide more robust and personalised information and good advice. In the UK anyone can send their drugs to get tested at WEDINOS. If you can’t get your drug tested then try to ensure what you use has previously been used with a positive review by someone you know and trust who is experienced and knows what they are talking about (not everyone who says they know, does!). But also know that people respond to drugs differently, so just because a mate was alright on a particular drug is no guarantee that you will be. Oh yes, and please don’t buy your first pill off a stranger at a festival.

DOSE LOW: Start low, go slow and don’t re-dose for at least 2-3 hours. Less than half of first time users reported taking a test dose. We think everyone should. Because some MDMA pills contain 3-4 x time as much as most people (especially first-time users) would like/need in single dose (75-100mg), we suggest starting with a quarter and to see how you go. With powder a crystal can look like it contains nothing, but once weighed and crushed it might be 250mg which is way too much for a first-time dose (or any other time dose come to think of it). Getting your dose weighed up is the best thing to do. It can take anywhere from 30-90 minutes to come up (even longer for a hard-pressed pill or if you have a full stomach), so don’t re-dose for at least 3 hours. That first small dose may only give you milder introduction to what the effect of MDMA can be like, but taking it cautiously first time will help to reduce the risk of unwanted potentially negative effects and feeling sick and confused. Re-dosing too early or with taking too big a dose initially are common mistakes among novice users. MDMA lasts 4-6 hours and redosing too early can lead to anxiety rather than increased pleasure. If you don’t get any feeling from your pill after an hour or 2 – don’t take another one. The chances are the drug you took is not MDMA – you don’t know what it is and redosing might increase the risks of overdosing on a dangerous drug like PMMA.

SAFE SPACE AND TRAVELS: Make sure you are in a familiar and safe place, don’t drive / cycle and avoid cliffs, pools, ponds and other big bodies of water. Being in safe familiar place is so important. Familiarity with your environments can provide reassurance when other things appear very strange. Because MDMA can also alter your sense of time, space and coordination it can be easy to accidentally hurt yourself if you misjudge your footing (for example if you’re high up near a window or cliff edge). Staying (physically) on solid ground while your mind wonders is a good tip. And don’t drive or cycle – both can be really risky under the influence of MDMA. If you need to move – walking (or dancing) is the way to go.

BE A PLANT – WELL WATERED: Stay well hydrated, avoid alcohol and keep cool. MDMA (like alcohol) can dehydrate you and if you’re off your head, you might forget to drink. MDMA can also make if difficult or not important to pee. If your clubbing or at a festival where the sun is shining (so probably not in the UK), dehydration and overheating are genuine risks. Drink a glass of water (or juice/other non-alcoholic drink) and if you feel too hot take some time out – and ask a mate to go with you with you. Signs of dehydration include feeling dizzy and faint, but don’t drink too much water either since very rarely (usually in combination with not peeing) this can lead to lowering of salt levels in your body. Feeling too hot? Then stop dancing, get out of the sun, loosen any tight clothing and chill. If you feel unwell – either in mind or body – then tell a mate or look for first aid nearby. Don’t drive or cycle, both can be really risky under the influence of MDMA. If you need to move – walking is the way to go.

BE HAPPY: Feel physically and emotional well, and happy in yourself. Like most drugs MDMA will tend to lead your brain in the direction it was pointing before you took the drug. Niggling doubts, worries or fear can become amplified. The time to try MDMA for the first time is when you feel well, settled and happy in yourself (and in the presence of those you are sharing the experience with). Although currently being explored for its therapeutic potential (within clinical settings), MDMA can worsen many conditions like depression and anxiety. Avoid MDMA if you are on medication for epilepsy or are on psychiatric or heart medication.

BE FREE: Make sure you don’t have any commitments coming up in the next day or so. Although most people feel pretty much back to normal within 24 hours of taking MDMA, some people do get bad comedowns normally kicking in 1-2 days following day of use. Knowing you have nothing to do in the next few days can be reassuring during your drug experience and give you a bit more internal comfort space. Remember MDMA can make it difficult to sleep and in the days afterwards you may feel tired and a bit emotional.

TELL SOMEONE: If you feel unwell, tell someone and seek help. Feeling a little sick (or even throwing up) can be a normal part of the MDMA experience, when you are coming up. It passes quickly and shouldn’t be a cause of worry. Feeling a bit sweaty and noticing your heart racing can also be part of a normal MDMA experience, like feeling more talkative and emotionally attached to those around you. But feeling anxious, very restless, really hot, confused or being unable to communicate clearly are not and might signal somethings up. If in doubt take some time out and tell someone. People can get confused, frightened and sometimes very agitated. Although in many cases these feeling pass, very rarely they can indicate something more serious is up. Getting checked out by first aiders or emergency medical services if in doubt is the safest thing to do. If someone fits, is acting in way that might place them or others at risk or is unarousable or if you are just worried about something the safest thing to do is to call emergency services – 999 (or the equivalent).

NO RUSH: Plan ahead and if doubt delay. Although spontaneous initiation into a new drugs experience can be exciting, it appears most people do plan ahead and do their homework (see points 1-9). Before you first take MDMA, you need to think about where you will be, who you will be with, what you’ll be doing and know you’ll be in a good headspace. If on the day it just doesn’t feel right (or if something is troubling you elsewhere in your world) then hit the pause button and know that it’s not now or never, and that there’ll be another chance.

GDS is very clear that the only way to avoid drug related risk to zero is not to use drugs. This is the choice for the majority of people globally.

Download our MDMA checklist: MDMA first time use – check list

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