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Health

Ecstasy’s Risks to the Average User May Be Less Severe Than Previously Thought

Past research on MDMA has contained some noteworthy flaws.
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A new study suggests that the risk of ecstasy causing brain damage in typical users may be overblown, because previous research overestimated just how much of the drug an average user consumes.

The study, published in the Journal of Psychopharmacology, questioned previous research suggesting that “low to moderate” ecstasy users had their brains’ serotonin systems permanently altered by using the drug.

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Serotonin is a powerful brain chemical associated with mood. MDMA, the primary constituent of ecstasy, causes the release of serotonin; that’s part of what creates the feel-good high. It also produces an emotional crash in many users after the serotonin is depleted.

Balázs Szigeti, a researcher at the University of Edinburgh, examined previous findings, particularly a neuroimaging study that produced evidence that using ecstasy led to lower levels of brain serotonin transporter (SERT). But Szigeti took issue with how the study categorized ecstasy users. “I found it weird that they called users who take two pills twice a month ‘low to moderate users,’ I suspected that it is much more than what the average user takes,” Szigeti told PsyPost.


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To quantify just how much ecstasy the typical user consumes, Szigeti turned to the Global Drug Survey (GDS), which collects anonymous web data on drug use. Examining responses from 11,168 people who’d said they’d used ecstasy pills at least once in the previous year, Szigeti and GDS researchers found much lower numbers: Respondents averaged 12.2 pills a year. The brain imaging participants reported 87.3 pills a year on average. That’s obviously a massive difference—720 percent.

That likely means most typical ecstasy users aren’t risking brain changes as suggested by previous research. “Our analysis suggests that ecstasy-induced serotonergic alterations are likely to be overestimated for the majority of users. This is good news for ecstasy users and for the medical application of MDMA, but as we emphasize in the paper, it does not imply that all ecstasy/MDMA use is harmless,” Szigeti told PsyPost.

Even as MDMA shows potential to treat eating disorders and has been declared a breakthrough treatment for PTSD, its legal status makes it difficult for researchers to answer basic questions about safety. Relying on self-reporting from people using the drug illegally obviously isn’t ideal, but in this case, it’s shown without a doubt that more research is necessary—ideally among truly moderate users.

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