Health - Ecstasy FAQ

Discussion in 'Ecstasy & MDMA' started by Nnizzle, Jan 26, 2010.

  1. Nnizzle

    Nnizzle Gold Member

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    MDMA
    [​IMG]
    [​IMG]
    [​IMG]
    Molecular Formula: C11H15NO2
    Molecular Weight: 193.2457
    Melting Point: 147 – 153 degrees C
    Stability: MDMA is an EXTREMELY stable molecule. Alexander Shulgin, the "step-father" of MDMA once said something along the lines of "if they had put some in the pyramids with the pharaohs it would still be good today." As long as it is kept in a cool, dark, dry place you will never have to worry about it degrading. The only possibility would be slight degradation of other less stable molecules with which it may be adulterated. See the thread Can ecstasy go bad?

    1. What is the MDMA experience like?

    MDMA produces a peaceful emotional experience with enhanced insight, feelings of increased closeness to others, euphoria, heightened sensory awareness etc. It is unlike any other drug, hence the reason is it classified as an empathogen rather than a psychedelic or a stimulant. Other drugs in this category include MDMA-like drugs such as MDA and MDE, however MDMA is infamous for its aptly termed "magic", which is unique to solely MDMA and not the other empathogens.

    The come-up is usually relatively quick, with most users feeling the effects within 20-40 minutes. There is often a brief period during this span where users can suffer anxiety or nausea. This is not abnormal, and the best one can do is try not to focus on it. It passes rather quickly.

    Post your MDMA experiences and read the experiences of others here.
    Best genre of music on MDMA
    MDMA and Activities enjoyed during

    2. What is the mechanism of action of MDMA at a neurological level?


    The primary mechanism of action of MDMA is a potent release of serotonin as well as inhibition of serotonin reuptake. MDMA does not cause release of serotonin via exocitosis of serotonin-containing secretory vesicles. Rather, MDMA uses a unique mechanism that causes a reverse in the direction of the normal inward bound serotonin reuptake channel, therefore serotonin in serotonin cells is "scooped" out and enters the synapse, rather than being reuptaken as is the case in the absence of MDMA. This causes a sudden increase in serotonin in the synapse and at the same time blocks reuptake. In addition, MDMA is thought to inhibit MAO-A, the enzyme which breaks it down. This causes a rapid and profound acute depletion of serotonin within 3 to 6 hours.

    The ability of MDMA to stimulate both the sympathetic and central nervous systems ultimately results from its structural similarity to the endogenous catecholamines: epinephrine, norepinephrine, and dopamine. This is the basis for its amphetamine-like effects. The methylenedioxylation of the catechol ring is responsible for their hallucinogenic activity, as it contributes to MDMA's potent serotonin release.

    Here are three pictures demonstrating how serotonin function is affected by MDMA and fluoxetine or other SSRI's.
    The first is an image which shows the different steps of serotonin biosynthesis, tryptophan>5-hydroxytryptophan>5-hydroxytryptamine. Then it shows serotonin being encapsulating in vesicles, migrating to the end of the neuron and entering the synapse and subsequently binding to postsynaptic receptors. It also shows serotonin going back into the presynaptic neuron via the serotonin reuptake transporter.
    [​IMG]

    The second shows how this normal process changes when MDMA is introduced. MDMA binds to the serotonin reuptake transporters, causing them to work in reverse, effectively dumping serotonin out of the neuron into the synapse at a much faster rate, and because it inhibits reuptake, the serotonin stays in the synapse and more postsynaptic receptors are activated.
    [​IMG]

    The third is an image which shows how this process changes when fluoxetine is introduced. Fluoxetine is an SSRI which inhibits reuptake of serotonin, however it does not cause the process to work in reverse, and because it has more affinity as a substrate, it doesn't allow MDMA to bind to the reuptake transporter; ergo, MDMA has no effect. A larger dose of MDMA can sometimes negate the effects of the SSRI.
    [​IMG]

    This fourth image is just a simple representation of the serotonergic system nerve cell structure in the brain.
    [​IMG]

    3. What is the recommended dosage of MDMA?

    Alexander Shulgin, the "step-father" of MDMA, cites 120 mg of MDMA as a dose which will induce a full-on experience in the majority of users. However, smaller users or those who are more sensitive can have the same experience at 80 mg and sometimes even a bit less. Less sensitive users might need 150 mg or so. Tolerance builds quickly, and in order to experience the same effects, users need to up the dosage if MDMA is being taken frequently. Even only dosing every week or two weeks can build a tolerance. It is generally a good idea to wait at minimum a month between experiences to avoid potential neurotoxicity or long term adverse effects (the jury is still out on this one), however some studies have shown that serotonin function sometimes takes even longer to recover. This aspect is probably dose and frequency dependent.

    It is hard to dose "Ecstasy" bought on the street. MDMA is VERY commonly adulterated, or in some cases pills with zero MDMA are passed off as MDMA to the naive user. It is advisable to buy a testing kit if one is going to have continuous experience with MDMA. Terrapinzflyer compiled a list of the most common adulterants in "Ecstasy" pills:

    MDA - an entactogen, similar to MDMA but more psychedelic. Does not produce the exact same characteristic MDMA euphoria. MDA is also more stimulating.
    Methamphetamine/amphetamine - added for their stimulant and euphoric properties similar to those of MDMA
    Piperazines (mCPP, TFMPP, BZP) - Piperazines are psychoactive drugs with stimulant properties, but usually more adverse side effects than amphetamines or MDMA
    Caffeine - added for its stimulant properties
    Domperidone - domperidone blocks the action of dopamine. It is probably added to reduce the adverse side effects associated with the stimulating properties of MDMA, as well as protection from vomiting.
    Metoclopramide - Metoclopramide is also an antiemetic (stops vomiting)
    4-methylmethcathinone - 4-MMC or Mephedrone is a stimulant and entactogenic drug present in many legal highs. It is a research chemical which causes euphoria, openness, and stimulation.
    Procaine - procaine is a local anesthetic
    Dimethylsulfone - an organosulfur compound
    Ketamine - Ketamine is a dissociative which causes analgesisa, hallucinations, and sedation
    Ephedrine/Pseudoephedrine - These are stimulants, and amphetamines can be derived from these two drugs.
    Diphenhydramine - an antihistamine, at high doses it can cause delirium and hallucinations
    Phenylacetic acid - PAA is a white, organic solid. It may be present because it is a component of the synthesis of amphetamines
    Lidocaine - a local anesthetic
    phenylpropanolamine - Is a drug of the phenethylamine and amphetamine class, which has stimulating properties.
    Dextromethorphan - The active ingredient in most cough syrups, a dissociative which causes perceptional distortion, hallucinations, etc.

    An Overview of Ecstasy Ingredients
    50% of the ecstacy pills contain mCPP instead of MDMA
    Cleaning pills via a simple acetone wash
    Want a Pill ID from us? Read this?
    Safe amount of MDMA per dose?


    4. Is MDMA addictive?

    There is some ancedotal evidence of addiction potential, although it does not appear to be widespread.
    Many studies on MDMA addiction have been relatively inconclusive. As of now, it is thought that it is virtually non-addictive, however there is anecdotal evidence of addiction potential. In any case, psychological addiction is much more of a concern than physical addiction.

    5. How long does MDMA remain in the body?

    MDMA and its main metabolite, MDA, can be identified and quantified up to 24 hours after ingestion in the blood, saliva and sweat. The half life of MDMA is around 5-10 hours, which means that after this time, 50% of the MDMA will have been metabolized. 2/3 of MDMA is eliminated in the urine. After 24 hours, there is only 3% of the initial dose left in the body.

    6. Is overdose with MDMA possible?


    Yes. As with any drug, there is a limit to how much the body can handle. Cases of massive ingestion with documented elevated serum MDMA levels have been reported. Both experienced minimal toxicity, including somnolence, confusion, hallucinations and tachycardia. In the absence of malignant hyperthermia or hyponatremia these cases may present similar to a moderate amphetamine overdose. Severe cases can lead to coma, cerebral edema, malignant hyperthermia, seizures and serotonin syndrome.

    Deaths or serious injury associated with MDMA are often a result of polydrug use. There are few (as in likely less than ten), if any, documented cases of deaths contributed to solely MDMA. MDMA has an LD50 in rats ranging from 100-300 mg/kg. The LD50 in humans is not known, but results from rat studies allows us to make an assumption of a human LD50 of perhaps 10-20mg/kg orally. This would equate to about 700-1400mg for a 70kg (140 lb) person; however obviously this is not a fact, and people are different sizes so one must still be quite careful. After years of study, much is not known about MDMA. Nevertheless, the majority of the literature indicates that it is in fact an incredibly safe drug when used responsibly, for example taking the smallest dose necessary for an enjoyable experience, limiting frequency of use, and staying hydrated.

    MDMA overdose?
    What to do in case of MDMA overdose?

    7. What to do to manage MDMA overdoses/adverse effects?


    Hyperthermia: Complications due to hyperthemia (overheating) are the most common causes of death or injury. To avoid hyperthermia, drink water frequently in small quantities, get some fresh air (especially important in crowded indoor locatios such as clubs/raves), and splash the nape of your neck with cold water. A good idea is to drink at least a pint of water per hour, however this needs to be augmented if one is more active.

    In severe cases, benzodiazepines may be useful like diazepam. Non-depolarizing paralytics may also be used in grave cases. If you think you are experiencing hyperthermia, you need to go to the hospital. You will not get arrested for being high at the hospital. Even if somehow you got into some sort of trouble, it is better to risk a fine or a few days in jail than to risk your life.

    Seizures: Attempt initial control with a benzodiazepine (diazepam or lorazepam). If seizures persist or recur, administer phenobarbital followed by phenytoin or fosphenytoin if necessary. In any case, get to a hospital.

    Hyponatremia:
    This is an overload of water, or more specifically, too large a ratio of water to salt in the body. The media has led us to believe that massive amounts of water need to be ingested when using MDMA because it is such a dangerous drug. This is not the case. Hyponatremia is actually one of the most common adverse consequence of MDMA use. This problem can be easily avoided by drinking something like Gatorade which contains electrolytes, or eating something salty (although MDMA suppresses appetite) such as crackers.

    8. What are the short-term and the long-term effects of MDMA?
    Short-term/immediate effects:

    The effects show themselves generally 30 minutes after the ingestion with a stimulating "rush" that some compare with the effects of the cocaine, however MDMA's rush is truly unique. This rush is transformed into euphoria which can persist from 3 to 6 hours, followed by a gradual decrease of the effects.
    MDMA produces: a lessening of inhibitions, a feeling of happiness, physical and mental well-being. MDMA stimulates, relaxes, increases self-confidence and modifies perception. In addition, an increase of body temperature, blurred vision, muscular tension, high blood pressure, sweat and dehydration, libido modification.

    Long-term effects:

    There is growing evidence of a permanent neurologic injury related to MDMA use. The long-term effects of MDMA are related to damage and depletion of the serotonergic nerve terminals themselves. This is dose and frequency dependent. Possible neurotoxicity is much more of a concern in heavy, frequent users than light/normal, infrequent users. To date the deficits appear to be related to memory function.
    Also let us note that the destruction of the dopaminergic endings would predispose one to Parkinson's disease.

    After 20 years of heavy use
    Overdoing it on MDMA: Long-term effects?

    9. What are the toxic effects of MDMA?

    Neurotoxicity:

    MDMA appears to produce damage to and depletion of serotonergic nerve terminals. It is unknown at this time if there is axonal regeneration from the damaged cell bodies or if the damage is permanent. There is much literature on the subject if one is so inclined.

    An Analysis of MDMA-induced neurotoxicity
    Toxicity, MDMA: eMedicine Emergency Medicine

    Liver toxicity:

    Elevated liver transaminases and Fulminant Hepatic Failure have been reported in a number of cases.
    This appears to be an idiosyncratic event. A number of cases of fulminant hepatic failure and of acute hepatitis have been described after a single dose. However in other cases hepatotoxicity occurred after chronic abuse.
    The onset of hepatic injury is delayed in most cases by 2 to 3 days after the ingestion of MDMA. However in some cases it was up to 15 days.

    The mechanism for injury has not been clearly elucidated but several possible explanations have been offered:

    1) It may be an idiosyncratic event (in several cases eosinophils in the portal track have been documented, but fever and erythmatous rash were not seen).

    2) In some cases the hepatic damage may be due to ischemic shock secondary to heat stroke (as a number of the patients presented with MDMA-induced hyperthermia and shock).

    3) It may be related to contaminants of the drugs ingested (quality control in the clandestine manufacture of MDMA is non-existent).

    Heart problems:

    The cardiovascular effects of the MDMA could result from its complex influences on the noradrenergic transmission at the level of the heart and of the sympathetic nervous system.
    So, the MDMA perturbs the regulations exercised by the peripheral vegetative system, by acting on noradrenergic transmissions, similar to the actions of MDMA.

    Hyperthermia:

    The exact mechanism responsible for the hyperthermia has not been elucidated but is probably related to the serotenergic control of thermo-regulation in the hypothalmus. Elevated ambient temperature (room/environment temperature) after MDMA ingestion has been shown to cause an increase in core body temperature, loss of thermo-regulation and an increase the damage seen in serotenergic neurons. This is a potentially significant risk factor to those who use MDMA at "rave" parties where the ambient temperature is elevated from the large active crowds and inadequate ventilation / cooling facilities.

    10. Is there a risk in using MDMA with other drugs?


    Amphetamines + MDMA: increase serotonergic neurotoxicity. The theory behind this is that the excess dopamine from taking amphetamine enters into serotonin cells once the serotonin is depleted, and dopamine is toxic to serotonin cells. This research is somewhat dated however, current opinion seems to be that neurotoxic damage caused by taking MDMA is mostly related to increased body temperature.

    Another thing to note is that taking MDMA with other stimulants can be dangerous because it can lead to excessively high blood pressure.

    Cannabis + MDMA:
    The cannabis strengthens the psychedelic effect of MDMA. Some users smoke cannabis during the comedown. This is a relatively safe combination physiologically.

    Energy drinks + MDMA:
    We can find at present some drinks with high concentration of caffeine and/or guarana (stimulating plant), called "smart drinks" (for example Red Bull, Virus). They are often consumed in the form of alcoholic cocktails. The combination of energy drinks with MDMA increases the general nervousness, the stress and the risk of cardiac disorders.

    LSD + MDMA: The effect is unpredictable. The probability of losing contact with the reality (bad trip, depersonalization, hallucinations) is increased.

    MAOI’s + MDMA:
    Taking MDMA while using a Monoamine Oxidase Inhibitor (MAOI) can lead to dopamine poisoning in the brain. This is because MAO is the enzyme which breaks down dopamine, and taking amphetamine causes high levels of dopamine to be released into the brain. This combination can also cause high blood pressure.

    Opiates + MDMA: These substances tend to neutralize the stimulating effect of MDMA. They are mainly consumed in the comedown. Attention should be paid to the quick dependence which can arise with these substances!

    Viagra (sildenafil), Cialis (tadalafil) + MDMA: This combination is strongly inadvisable because of the cardiac disorders that it can cause. There is also concern that this combination can increase the risk of users having unprotected sex, which can lead to pregnancy and an increased risk of Sexually Transmitted Diseases including HIV. There is also an increased risk of irritation of mucous membranes in cases of prolonged sexual relations, and an increased risk of priapism, or excessively long erection which can cause damage to penile tissue.

    Sex on Ecstasy

    Alcohol + MDMA:
    MDMA's stimulation masks the drunkenness: once the effect of MDMA is over, the drunkenness can arise brutally. This is particularly dangerous, at the end of the party, when you want to take your car (bad perception, decrease of the reflexes, sleepiness). Furthermore, this mixture contributes strongly to the dehydration and to the overload of the liver.

    Mixing MDMA and Alcohol

    The Drug Combinations forum has a lot of experience threads and relevant information concerning polydrug use with MDMA.

    11. What I can take to Pre/Post Load?

    SSRI’s

    Pre-treatment with a serotonin reuptake inhibitor, such as paroxetine (Paxil), fluoxetine (Prozac) or sertraline (Zoloft), blocks the effects of MDMA.
    This is likely a result of their similar mechanism of action. SSRI's (selective serotonin reuptake inhibitors) bind to the serotonin transporter which normally returns unused serotonin from the synapse back into the neurons. MDMA is thought to also bind to the serotonin transporter, but it is not an SSRI in the same sense. Pretreatment with an SSRI, therefore likely makes it difficult or near impossible for the MDMA to have any effect on serotonin release.

    Additionally, treatment within one hour of MDMA ingestion with a selective serotonin reuptake inhibitor blocks the loss of tryptophan hydroxylase (TPH), and potentially reduces the nerve terminal damage.
    A proposed cause of MDMA neurotoxicity is reuptake of dopamine by serotonin transporters. Since MDMA deplenishes massive amounts of serotonin, it is possible that during this period dopamine is accidentally reuptaken by serotonin transporters into the nerve cells. There, it is broken down and dopaminergic metabolites are toxic to serotonin neurons. Timing is important, but it is possible that if an SSRI is blocking reuptake around the time that dopamine would potentially be reuptaken, it could prevent neurotoxicity.

    In addition, if neurons are continuously inactivated for a period of time, it is possible that they will cease to do what they are supposed to ("die"). An absence of serotonin could result in complete or incredibly low activation of serotonin neurons, perhaps inducing cell death.

    Antioxidants


    One group of supplements commonly used to pre/post load are antioxidants. Some antioxidants include: vitamin C, vitamin E, vitamin A, alphalipoic acid, selenium, zinc, magnesium, grape seed extract, gingko biloba, milk thistle, green tea, co-enzyme Q10 etc.

    Antioxidants are substances that reduce oxidation (also called oxidisation). Oxidation can cause the production of free radicals, which are highly reactive molecules that can damage cells in the body. MDMA appears to cause some damage to brain cells by a process of oxidation (there are a few theories on how MDMA damages brain cells, but they nearly all involve
    oxidation of free radicals). Taking additional antioxidants should help to reduce the formation of free radicals during MDMA use, which means less risk of neurotoxicity.
    Antioxidants often work better when taken in combination for example, vitamin C regenerates exhausted vitamin E; grape seed extract enhances vitamin E. Some studies in rats have shown significant attenuation of toxicity when pre-treated with vitamin C.

    What are the risks?


    Antioxidants appear to be safe to combine with MDMA, and if used in the manufacturers recommended doses, are generally free of side effects. Therefore, it’s probably safer to use antioxidants + MDMA, than it is to have MDMA alone. As antioxidants haven’t been studied in regards to reducing MDMA neurotoxicity in humans, there are no guidelines on appropriate dosages. Therefore, follow the manufacturers recommended doses.

    What is 5-HTP?

    5-HTP also known as 5-hydroxytryptophan, an amino acid your body converts to serotonin. Serotonin is depleted after MDMA use, and this may be the cause of the negative after effects of MDMA. 5-HTP may help restore serotonin. There are no clear guidelines on appropriate dosages for this purpose. Manufacturers usually recommend 50 - 150mg a day for other purposes, taken on an empty stomach.

    What are the risks?

    People on antidepressants or other medications that increase serotonin should not take 5-HTP. There may be a risk of serotonin syndrome (a medical condition caused by high levels of circulating serotonin) if you combine 5-HTP with MDMA.
    There are many anecdotal reports from the internet of people who have tried to increase their peak by taking 5HTP with MDMA. Most have found that taking 5HTP during MDMA does not allow you to peak for longer, nor does it allow you to get greater effects from multiple MDMA pills. Therefore, it is likely more useful as a post-load only.
    Some people report reduced effects from MDMA if they take 5-HTP prior to MDMA. 5-HTP may cause upset stomach, headaches, vivid dreams and sleepiness if taken in the daytime, so be careful if you need to drive.

    Magnesium


    A mineral that is involved in muscle relaxation. There are numerous anecdotal reports from MDMA users that magnesium reduces jaw clenching (trisma) and tooth grinding (bruxia) caused by MDMA and other amphetamines. High doses of magnesium may cause diarrhea; magnesium is not recommended for people with kidney problems. Otherwise, it is generally safe.

    Multivitamins


    Many people like to take a multivitamin prior and after MDMA. This might help to partially compensate for poor nutrition (due to reduced appetite) after MDMA use.

    There is an in-depth thread concerning common pre/postloading substances/regimens here.

    12. MDMA and psychotic reactions


    Increased anxiety, dysphoric and psychotic reactions and risky behavior have been reported in individual case reports of entactogen users. Personality traits, set and setting, dose and quality of the substances used, as well as interactions with alcohol or other psychoactive drugs have been suggested as critical factors contributing to the differences in psychological responses to MDMA.
    Moreover, a recent paper on MDMA-related psychiatric complications further indicates that persons with a previous history of illicit drug abuse or psychiatric disorders are particularly at risk for short and long-term adverse MDMA effects, although in a few case reports, psychiatric complications were also noted in “normals” after a single dose of MDMA.

    13. Is there MDMA legal alternative?


    Methylone (bk-MDMA) resembles MDMA in its behavioural profile, as methylone substitutes for MDMA in rats trained to discriminate MDMA from saline. Methylone does not substitute for amphetamine or for the hallucinogenic DOM in animals trained to discriminate between these drugs and saline.
    Further, also in common with MDMA, methylone acts on monoaminergic systems. In vitro, methylone is threefold less potent than MDMA at inhibiting platelet serotonin accumulation and as potent as MDMA in it inhibiting effects on the dopamine and noradrenaline transporters.
    In spite of these behavioural and pharmacological similarities between methylone and MDMA, the observed subjective effects of both drugs of abuse are not completely identical.

    Shulgin wrote about the effects of this drug: "Methylone has almost the same potency of MDMA, but it does not produce the same effects. It has an almost antidepressant action, pleasant and positive, but not the unique magic of MDMA". Methylone is not yet scheduled as a drug of abuse, but is considered to be a psychoactive medicine.
    Until now, no research has been conducted on the toxicity of methylone, so nothing is known about the harmfulness of this new drug.

    Some also think bk-MBDB aka Butylone or B1 shares some of MDMA's properties. While bk-MDMA/methylone is often seen as having similiarities to the euphoric effects of MDMA, some thing bk-MBDB offers some of the more therapeutic effects, allowing one to to see their lives in a different light. Some feel this substance is closer to the therapeutic effects MDMA is used for in psychological research.

    Methylone Basics
    Methylone Experiences
    Methylone as a replacement for MDMA?
    Recreating the MDMA experience (with mephedrone/methylone)


    14. Is there a cross-tolerance between MDMA and the other drugs?

    As MDMA is an amphetamine derivative, when it comes to its action on the brain, some properties overlap with those of amphetamines. Amphetamines cause a release of dopamine and norepinephrine, and to a lesser extent serotonin. They do this two ways, one of which is causing the monoamine neurotransmitter reuptake system to work in reverse, like MDMA. Although amphetamines action on dopamine is primarily responsible for its subjective effects, it also induces the same change in serotonin and norepinephrine transporters. This means that the concentrations of all three neurotransmitters in the synapse is increased. This causes downregulation of the receptors for these neurotransmitters, ergo tolerance.

    While MDMA's subjective effects, on the other hand, are caused by its similar action on serotonin transporters, it too has the same effect on dopamine and norepinephrine transporters. If too much amphetamine is taken prior to MDMA use, it is possible that these receptors could still be downregulated, thus potentially requiring more MDMA to produce a normal high (ie tolerance). As tolerance with most drugs (at least with amphetamines) is usually not significant after one dose, it is unlikely that using amphetamines once a day or two prior to MDMA will have a significant effect, although continuous and/or extensive recent use would likely become an issue.

    As well as amphetamines, any other drugs which could potentially cause significant enough downregulation of serotonin receptors might produce tolerance to MDMA.

    15. MDMA and hallucinations.

    MDMA is a very unique drug in that it has psychedelic ("mind-manifesting") properties, but it does not generally produce true hallucinations or trippy thoughts which one usually associates with psychedelics such as psilocybin (in "magic mushrooms") or LSD. Even in its unique class, called empathogens or entactogens, MDMA is unique. The other members, such as MDA or MDEA (MDE), are more prone to hallucinations.

    Hallucinations caused by psychedelics are thought to be mostly a result of a drugs action on 5-HT2A receptors (a specific serotonin receptor). LSD, for example, has a high affinity for 5-HT2A receptors. Its mechanism is much more complex than that but many other psychedelic drugs agonize 5-HT2A receptors.

    MDMA does bind to 5-HT2A receptors, but has a very weak affinity (meaning it doesn't bind very well). MDA has a stronger affinity, which is thought to be the reason for its more obvious hallucinations. In addition, MDMA also modulates dopamine's synaptic concentrations, which is postulated to be responsible for hallucinations in schizophrenics (the dopamine theory of schizophrenia), but the change is not as pronounced. Higher doses of MDMA increase the amount of the drug available to produce changes in 5-HT2A and dopamine function, and anecdotal evidence has shown MDMA to be truly psychedelic at higher doses.

    This is not to say that MDMA is entirely hallucination-free. Most users don't experience profound visual changes such as objects morphing or seeing something that truly isn't there; however, the reason for its presence in the club scene is partly a result of its ability to alter how one hears music. While not a "hallucination" in the sense that most people think, MDMA causes a profound change in auditory perception. As for visual hallucinations, trails and other mild visual changes are not uncommon, especially when around stimuli like lights.

    16. MDMA and Alcohol

    MDMA and alcohol are frequently, but should never be combined. MDMA and alcohol are a tad similar: alcohol is a "social lubricant", and anyone who has has an MDMA experience knows that openness is one of its primary effects. MDMA and alcohol do not, however, work the same way at all. Alcohol inhibits neuronal firing--literally inhibits brain function, which causes a perception of disinhibition on the user--while MDMA's openness is probably a result of the combination of brain changes it produces.

    A huge danger when combining MDMA and alcohol is dehydration. MDMA and alcohol both dehydrate--MDMA because of its stimulant properties, increases heart rate, which requires more energy and water, while alcohol is a diuretic, meaning it basically helps the body to lose water (partly why you have to pee all the time while drinking... but that is also because you're, well, drinking.) Not often does MDMA alone cause dangerous levels of dehydration (nevertheless, it is important to drink water during an experience). In combination with other stimulants and alcohol, or other drugs which affect blood pressure/heart rate, the risk is quite high. In addition, MDMA is often taken while one is dancing at a concert in a hot room, putting a user even more at risk of hyperthermia as a result of dehydration.

    Another danger is there combined effect on the heart. Dehydration is really a side effect, one which indicates that the heart is working extra hard to keep the body working normally. Alcohol combined with MDMA can put enormous stress on the heart, especially while dancing.

    Finally, MDMA and alcohol combined have reciprocal effects. Like when combining alcohol with other stimulants, MDMA attenuates the sedation associated with alcohol intoxication, however one study showed it did not affect "drunkenness". Nevertheless, this could lead a user to believe that they are less drunk than they really are, therefore drink more and put themselves in exponentially increasing danger.

    17. MDMA and driving


    One should never drive on MDMA for many reasons. For one, MDMA produces a profound distortion of perception. While visual perception is generally satisfactory, one should not take the risk of suffering intense nystagmus while trying to see if anyone is in their blind spot. In addition, sometimes the euphoria caused by MDMA can literally cause a user to lose important motor functions involved in driving such as gripping a steering wheel or consciously exerting force upon the gas or brake pedals.

    Finally, there is the risk of going to jail for many years if one is somehow discovered to be under the influence of MDMA while driving. Even worse, indubitably it would change a conviction if one killed a pedestrian whilst on MDMA.

    18. Some advice for beginners

    DO's:
    DO drink water. Shoot for around a pint an hour. If one is paranoid of dehydration, more can be drunk, but eating something salty or a drink like Gatorade is advised to avoid too much water upsetting the bodies salt balance. Don't worry- unless one is gulping down gallons of water in a few hours, the risk of a water overdose (hyponatremia, too little salt) is quite low.
    DO take frequent breaks if dancing or exerting oneself. The heart is working extra hard, therefore it needs more breaks.
    DO think about set and setting. While MDMA usually provokes a profound sense of well-being, being in the wrong place with the wrong people can still be an issue.
    DO test the pill/powder if possible. Testing kits are widely available and are relatively inexpensive. They will tell you if MDMA is present and will also tell you if some other drugs are present. Quantity cannot be discerned with simple reagent kits.
    DO start small. One pill (although this is really an arbitrary value) is enough for a first timer. 100-120mg is generally enough to deplete serotonin in the average user. No one will be able to tell you how much MDMA is in a pill, so start small to avoid possible overdose or adverse side effects.
    DO do MDMA with someone trusted, sober if possible. With any psychedelic drug, for the first time a sitter is highly advisable. While this is not usually necessary with MDMA, it is still a good idea.
    DO ponder pre/postloading. While MDMA's toxicity is not clear, its proposed toxicity indicates certain supplements which may help to counteract toxicity as well as also contributing to the experience
    DO have fun! MDMA can be an incredibly profound, "ecstatic", rewarding, euphoric, and enjoyable experience.

    DON'Ts:
    DON'T combine MDMA with any other drug. Most notably MAOI's, other stimulants, other psychedelics, pretty much anything really.
    DON'T forget to drink water.
    DON'T for a second think you have any idea what's in your pill/powder before testing it.
    DON'T listen to a dealer's sales pitch if you didn't physically watch the product being synthesized, pressed, and handed to you. Double and triple-stacked mean nothing. Molly means nothing. Designs, colors, sizes mean nothing. These are just words spoken so that prices can be jacked up. Anything can be in your pill.
    DON'T do anything with your MDMA besides eat it. Snorting it will give a quicker, sometimes more intense rush, shorter high, and could be overwhelming for a first timer. In addition, generally the adulterants in pills/powder are better suited for the stomach than the nasal cavity. DON'T even think about IV'ing.

    Please post any relevant FAQ's here so the FAQ can be updated. Also thank Dr. Satan and Terrapinzflyer and the Ecstasy Forum Crew for their enormous contributions to the FAQ
     

    Attached Files:

    Last edited by a moderator: Sep 10, 2017
  2. Alfa

    Alfa Productive Insomniac Staff Member Administrator

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    Please keep this thread about the discussion of the DF Ecstasy FAQ above.
    Texts from other sites should not be added to this.
     
  3. sundayraver

    sundayraver Newbie

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    Nice read!

    Although you wrote :
    Then you put


    I personally see nothing wrong with mixing the 2
     
  4. Nnizzle

    Nnizzle Gold Member

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    That advice is in the section:
    18. Some advice for beginners

    You can do whatever you like but I will never recommend polydrug use involving a drug with which one has no prior experience.
     
  5. Nnizzle

    Nnizzle Gold Member

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  6. Wanderer

    Wanderer Platinum Member & Advisor

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    Very nice addition here. SWIM and his hamster haven't looked at the FAQ in a while.

    Mr. Hamster definitely thinks it looks great and is well on it's way to setting an example.

    Good job!
     
  7. Dickon

    Dickon Platinum Member

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  8. NP-9

    NP-9 Silver Member

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    MDMA - ecstacy - Molly: heart valve damager

    There seems to be a gap in this FAQ that needs addressing.

    MDMA has been implicated as a drug that over time causes heart valve damage (ie cardiac fibrosis, cardiac valvopathy, mitral regurgitation) in research studies.

    References:
    This one shows significant increase of mitral valve regurgitation (heart valve leakage due to damage) of MDMA users over controls:

    Droogmans, S., Cosyns, B., D’haenen, H., Creeten, E., Weytjens, C., Franken, P. R., ... & Van Camp, G. (2007).
    Possible association between 3, 4-methylenedioxymethamphetamine abuse and valvular heart disease.
    The American journal of cardiology, 100(9), 1442-1445.

    This one discusses the link between MDMA activity on serotonin 2B receptors and heart valve damage:

    Hutcheson, J. D., Setola, V., Roth, B. L., & Merryman, W. D. (2011).
    Serotonin receptors and heart valve disease—it was meant 2B.
    Pharmacology & therapeutics, 132(2), 146-157.


    Other prescription drugs like flenfluramine were withdrawn from the market for this reason.

    Users and potential users may want to think twice about using MDMA, for the long term sake of their heart health.

    NP
     
    Last edited: Mar 22, 2015