Advertisement
Drugs

A Guide to Taking Ecstasy as Safely as Possible

Some harm minimisation advice for the thousands of people who'll take MDMA this summer, with or without pill testing.

by Gavin Butler
11 November 2019, 5:20am

Image via Wikimedia user Psychonaught

Despite some 100 years of police, politicians, and lawmakers telling us drugs are bad, about half a million Australians will have wilfully taken an ecstasy pill by the end of this year. On a purely survival basis, that may seem reckless—but there are good reasons why people take illicit substances. Drugs are usually euphoric, invigorating, and enlightening, as almost anyone who’s ever used them recreationally will attest. Sometimes, though, they’re none of these things.

Of the half a million Australians who will have taken ecstasy by the end of this year, thousands will likely be forced to seek emergency medical treatment. The causal factors for this are manifold, but they can often be traced back to a general lack of understanding around the contents of pills, their effects, and the safest way to take them. And that’s because, in the midst of the cacophanus shouting match around whether or not people should be allowed to take drugs, few authorities are bothering to properly educate users on how to minimise the risks.

So we remain at an impasse. People will continue to take drugs—blindly, for the most part—and many will subsequently run the risk of overdose and death. But if the authorities won’t provide information and tools for harm minimisation, we will.

Here’s how to take pills as safely as possible. Think of it as a guide to your night on the gear—along with some bonus tips to help you deal with that inevitable comedown.

Preparing for Your Night

There are typically two main factors to consider when looking at the contents of an ecstasy pill: purity and dose. Purity essentially refers to how much of your pill is actually MDMA (the active ingredient) and how much of it is something else—whether that be an innocuous cutting agent, a toxic contaminant, or some chemical that's a bit like MDMA but cheaper and/or more readily available. Dose refers to how potent the pill is, and thus determines how intense its effects are going to be. It’s the dose that makes the poison, according to an age-old adage of toxicology—which is to say that while cyanide can be harmless at small enough doses, even water can be poisonous if consumed in excess. It all depends on how much you’re having.

It’s therefore worth stressing that pure, unadulterated ecstasy will still kill you if you ingest too much. MDMA triggers a sharp rise in internal body temperature, and this can pose serious problems in the case of a particularly strong batch—especially if taken within certain circumstances, or in combination with other substances. We’ll talk about ways that you can mitigate these risks, but ideally you’ll have at least a semi-informed understanding of what it is you’re taking beforehand.

This starts at the point of sale. Just as you’d exercise due diligence to ensure that any food, drink, or general substance you’re about to put into your body isn’t going to make you sick, you should do the same with drugs.

Buying from someone you know and trust is ideal, though not always possible. If you’re getting the ecstasy in the form of a pressed pill, you can usually find info about your particular pill on Pill Reports and do your research on what to expect according to some user-generated reviews. Short of that, and in lieu of more official pill testing services, you can take matters into your own hands and test the pills at home with an over-the-counter reagent testing kit. You should be able to pick up one of these at your local pharmacy, tobacconist, or online for about $20 AUD.

These kits are essentially a litmus test for drugs, offering a rudimentary method of figuring out what a pill’s main ingredient is—whether it be ecstasy, meth, ketamine, or something else. Pour a little bit of your pill or powder onto a plate, remove the cap of the reagent bottle, squeeze a few drops of the substance (usually a combination of formaldehyde and sulfuric acid) onto the sample and wait to see what colour it changes to. By comparing this against the colour chart provided, you should be able to get some loose indication of the pill’s main ingredient.

To be clear though, reagent testing kits are not a bulletproof way of verifying whether your drugs are safe. As Monica Barratt, Senior Research Fellow at RMIT University’s Social and Global Studies Centre, told VICE in 2017: "it's a presumptive test. It's saying that an ecstasy-like substance is present, but it's not telling you necessarily what else is present… and the thing you can't really do is go for 'how many milligrams have I got.'"

Further to these three precautionary measures—buying from a reliable source; doing your research online; and using a reagent kit to get at least some idea of what’s in your pills—the next most effective way of knowing what you’re looking at is by taking a small amount of the drug in a safe, controlled environment with sober people or tripsitters you can trust. Take a crumb or one small hit of powder and really focus on what the effect is. If the drugs make you feel speedy, nauseous, anxious, hot, or uncomfortable in literally any way, you should reconsider taking them.

And finally, if you’re buying your MDMA in a crystal or powder form, then some extra precautions are probably called for. “Dipping” from the bag can be risky, as there’s little to no way of keeping track of how much you’re taking in each hit or how much you’ve already had. If you can, get your hands on some scales and some gelatin caps—the latter should also be going cheap at your local pharmacy—and prepare your own carefully measured doses. The standard dose of an MDMA cap is typically between 70 and 125 milligrams, but half-doses will give you more control over how high you’re getting, and how quickly.

Getting Through the Night

Of course, even when you feel that you have a fairly good idea about the effects of the drug you’re taking, you should remain diligent. MDMA, no matter how pure, can have different effects in different circumstances, and that adds some level of unpredictability.

Start by taking a small amount—maybe a half or quarter-dose—and see how it makes you feel. Most of the time it will kick in after about 45 minutes to an hour, but it’s best to wait at least an hour-and-half to be sure of the effects. Some of the more common adulterants that have been showing up in ecstasy pills recently have a delayed release and are slower to start, but hit much harder when they do—which can lead to serious problems for users who get impatient, thinking they’ve taken a weak pill, and then drop a very dangerous second dose.

Another factor worth considering is something called “dose-response”: that is, the relationship between the size of a drug dose and the effect it has on the user. Alcohol has a linear dose-response, meaning each standard drink has the same effect as the one that preceded it. This means two drinks will more or less make you twice as drunk as one drink, but half as drunk as four drinks, and so on. As Dr Barratt points out, though, this is not how MDMA works.

“MDMA is different to alcohol in that it doesn’t appear to have a completely linear dose response, which makes it difficult,” she told VICE over the phone. “Non-linear means if you add an extra 50 milligrams on top of 100 milligrams you’re not necessarily going to get 50 percent more.”

“There are also some people who can have a normal dose of MDMA but have much worse effects,” she added. “Even if someone knows they’re having 100 milligrams, there are people out there for whom that dose would be too much.

“There’s something non-linear and a bit idiosyncratic about how MDMA affects people. We don’t know where the tipping point is for some people, so it’s not as simple as some other drugs in terms of dose-response.”

Hence, the most important thing to keep in mind when taking ecstasy is to always be circumspect. Take small doses. Be aware of what you’re feeling, and how much the drugs are affecting you. Always wait at least two hours before taking another dose. And never double-dunk.

There’s a good chance you already know this, but you should also avoid combining MDMA with other drugs. If you know you’re going to be mixing it with alcohol, don’t drink too much before your first dose, and make sure you keep track of how much you’re drinking while high. It’s unlikely that you’re going to get many of the positive effects out of alcohol once you’re rolling anyway, so if you’re only swigging the drinks out of habit then maybe just save your money. Beyond that, don’t add any other chemicals to the mix.

One of the ways MDMA can be fatal is by triggering a condition known as “serotonin syndrome”, where the body loses its ability to regulate heat. This is particularly worrisome in already hot settings, and so it’s important to keep tabs on how you’re travelling temperature-wise. If you’re feeling inordinately hot, you may be at risk of overdosing. Alex Wodak, a physician and former Director of the Alcohol and Drug Service at Sydney’s St Vincent's Hospital, suggests taking some time out to minimise the risk of this happening.

“Avoid overheating by spending 10 minutes every hour NOT dancing,” he told VICE via email. “If there is a cool, air-conditioned area, go there for 10 minutes every hour.”

Dehydration is also a risk, of course, but so too is overhydration. There is such as thing as drinking too much water, and this can lead to something called hyponatremia: a condition that arises from a low concentration of sodium in the blood and which has, in the past, led to MDMA-related deaths.

MDMA education website RollSafe suggests drinking about two glasses of fluid per hour if you’re dancing—ideally something with electrolytes in it, like Gatorade—and one glass per hour if you’re not. If you can’t get your hands on electrolytes, make sure you eat some salty foods. Typical symptoms of hyponatremia include nausea, vomiting, headaches, confusion, and fatigue.

In the event that something does go wrong—if you or someone close to you starts feeling or acting strange—seek help immediately. Call security, first aid, or venue staff and tell medical personnel what you or your friend have taken, as well as how much and how long ago. The more information the better. If your friend can’t stand up, place them on their side in the “recovery” position on their side. We really can’t stress this enough: do not be afraid to ask authorities for assistance.

The New South Wales coroner’s court heard this year that 19-year-old Alex Ross-King, who died at a music festival in January, started showing signs of distress several hours before she overdosed. “Alex told me a number of times, ‘I’m fucked up’ and ‘I’m hot,’” a friend said in their statement to the court, adding that they initially thought it was due to the sweltering conditions inside the festival. “I just felt like, oh, me too, I was the same.”

It was only when Ross-King was spotted by a nearby medical officer, after bumping into a group of people and falling over, that she was taken to the medical tent—with a body temperature of 41 degrees and a rapid and irregular pulse. She was transported to Westmead hospital shortly thereafter, arrived unconscious, and quickly went into cardiac arrest. After four hours of attempted resuscitation she was declared dead.

“Be aware of how you’re feeling, and seek medical treatment if you feel unwell,” says Dr Barratt. “That’s one of the biggest issues: people being afraid to seek treatment, or people saying ‘I’ll sleep it off’ or ‘I’ll ride it out.’ We know of people who have done that and they haven’t been able to get up again, and nobody’s gone to get medical help, and that’s been the end. That is a huge message: don’t be afraid to seek medical treatment.”

Surviving the Next Day

For most people, the hardest part of the trip is usually the aftermath: when the trace elements of the pill start to fizzle out, the serotonin reservoirs dry up like a parched creek bed, and the dreaded comedown rears its ugly head.

Try and get some relatively decent sleep—as naturally as you can in your state—and if possible drop a Berocca or two before you rest your weary head. When you do finally rise from the dead, make sure you reimburse your body for the punishment you’ve just inflicted upon it. Have a shower—a cold one, if you can manage it—and replenish yourself with some water and half-decent food. Dark fruits, nuts, and fatty, omega 3-heavy fish like salmon is ideal, but if we’re being honest you’re probably just ordering takeaway to your door anyway. That’s fine too—just as long as you’re eating something to try and fill the cold, dead hole that’s growing inside you. If you’re in no state to eat, try a smoothie or a light soup.

From there on it’s just a matter of waiting out the storm. Surround yourself with positive people, go easy on the physical exertion, and don’t watch, read, or listen to anything that could potentially topple your fragile emotional state. Also try to wait a little while before you take MDMA again—ideally at least three to five weeks. You’ll be better placed to maximise the benefits that way.

In Summary:

  • Buy the drugs from a reliable source: someone you know and/or trust
  • Do your research: know what you’re taking
  • Test for contaminants with a reagent kit and, if possible, sample the drugs first in a safe and controlled setting
  • If possible, create your own carefully measured caps instead of consuming straight powder
  • Don’t take pills alone (or any drugs, for that matter)
  • Go slow; take a small amount first and see how you feel after about an hour to an hour-and-a-half
  • Don’t redose until at least two hours after your last drop
  • Never double drop
  • Avoid combining MDMA with other substances
  • Stay cool; take at least 10 minutes every hour to sit down and chill out
  • Drink fluids, but not too much: between one and two cups every hour
  • Be aware of how you’re feeling
  • If things start going wrong or feeling uncomfortable, get security or first aid and tell them what drugs have been taken, how much, and how long ago
  • Don't be afraid to ask for help
  • Take care of yourself, and each other

Follow Gavin on Twitter or Instagram

The 2020 Global Drug Survey is now open. Have your say in the world's biggest global study of drug-taking behaviours here.

Tagged:
Health
ecstasy
MDMA
music festivals
Molly