Hugs & Other Drugs

Hugs & Other Drugs

The legalisation of MDMA, or ecstasy, has popped back into discussion. Also known as Molly, Eve, the Hug Drug, Love Drug or Scooby Snacks, we take a look into why legalisation would ever be considered and why hesitations remain.

Clinical toxicologist, Dr Paul Quigley, recently told Radio Live that he felt there should be access to safer drugs as an alternative to alcohol and the often unsafe synthetic highs available legally. Quigley suggested that MDMA in its purest form could be a safer alternative. He also argued that the legalisation of MDMA would mitigate its presence on the black market and that users would have access to a less harmful product — it would be pure ecstasy and not cut with other substances. Quigley believes that control would provide a better, safer product.

When asked for his thoughts on the topic, Associate Health Minister Peter Dunne said he wasn’t against discussing the idea, but did explain that it would be a very long time before anything like this was possible. Prime Minister John Key has flatly said that there would be no way for MDMA to be legalised while National is in government.

Advocates for the legalisation of cannabis have expressed frustration that people would consider legalising MDMA without first considering cannabis, arguing that the naturally grown plant is much safer and has had a much longer and ongoing campaign for legalisation.

The United Nations plays a pivotal role in the legalisation of all drugs throughout the world — not only MDMA, but also substances like cannabis and LSD. Any country under the UN abides by these standards, New Zealand included. The current drug standards upheld by the UN were created in 1960 (the UN Single Convention on Narcotic Drugs) and 1971 (the Convention on Psychotropic Substances). This is where the class A, B and C drugs come in — A being the highest risk and C the lowest. Ecstasy, also known as Molly, is a class A drug, the same as heroin, but, according to Quigley, MDMA is comparatively low risk.

Research into how illegal substances actually work is limited. Every time someone attempts to research the substances, they’re unable to gain funding because the drugs are illegal. The issue is the same with cannabis. Even if people try to conduct studies in places where the drug is legal, their research is still often turned down for funding. When the money is available, researchers have to leap through many bureaucratic hoops before even beginning the research; most people don’t have the time, energy or money to go ahead with this kind of research.

David Nutt is a neuropsychopharmacologist who specialises in how drugs affect the brain. In an article published this year, he explained how these drug control conventions have limited research. He argues that the UN’s standards need to be revised to allow neuroscience to move forward. The strict UN drug laws are there to prevent recreational use and have been created to control the availability of drugs and their potential harms. Instead of research being conducted on the effects of classified drugs, various new synthetic drugs are being created that do not fall under the UN’s drug umbrella. This is where the legal highs come from. The Republic of Ireland has banned the sale of all drugs that may be used recreationally. Nutt stated that this will be extremely detrimental to pharmaceutical research in the country if it’s actually enforced.

Nutt’s main concern is that many of these drugs have medicinal uses, offering examples like using opioids as treatment for pain “and even cocaine for local blood control and anaesthesia in ear, nose and throat surgery”. Outdated laws prevent people from making medical use of drugs because it’s illegal and because it’s near impossible to get funding from anyone. According to Nutt, clinical research suggests that MDMA could be used to help the dyskinesia (impairment of movement) of Parkinson’s disease. As soon as legal forms were developed, people started selling similar versions of the drug for recreational use. After media explosions, all forms of MDMA were banned and the development of this drug has come to a halt because it is no longer affordable. 

The strict regulations on drugs are intended to stop access to highly dangerous substances. However, for the most part, if people want to find a drug through dealers and even via the internet, they can. At the moment, these drugs aren’t tested or regulated and, due to the unknown additives in these “black market” drugs, they are far more dangerous.

What We Do Know About MDMA?

MDMA increases the activity of neurotransmitters like serotonin, dopamine and norepinephrine (happy hormones!). Specifically, it causes a lot more serotonin to be released into the brain. This means that the user’s mood elevates and they get that euphoric feeling MDMA is known for — hence the name “ecstasy”. Initially the street name for MDMA was going to be empathy, after the feelings of love and camaraderie that it’s known for. However, the name was changed to ecstasy because “empathy” doesn’t really scream life of the party.

The effects of MDMA include euphoria and a sense of intimacy with others. So, often, you’ll have lots of friends when you’re on it — or at least feel like you do. Some studies have suggested that it may be useful as a treatment for PTSD and anxiety. One of its unique effects is that it can ease fear without sedation. Dr. Julie Holland, a psychiatrist at the New York University Medical Center, advocates for the medicinal use of MDMA as a treatment for these issues. She states that “MDMA is a non-sedating anxiolytic”. Which means that it “completely ablates the anxiety response and the fear response in most people”. This is useful because when someone comes into a psychiatric emergency room, they are often given anxiolytics like Valium and Xanax to calm down. However, these drugs also sedate people. The patients often just fall asleep for hours, and the doctors are unable to help them. Use of MDMA in this circumstance would be useful because it can reduce the fear and anxiety people feel, but they’ll still be alert.

According to the New Zealand Drug Foundation, MDMA has both short- and long-term effects. In the short term, you can experience teeth grinding/jaw clenching, concentration issues, nausea and anxiety. It can also raise body temperature, heart rate and blood pressure. These are all things typically experienced during the high and rush. However, as with many drugs, there is a comedown period. The symptoms include more nausea and anxiety, mild depression, fatigue, insomnia — all things you’d expect after being on a high-energy drug.

Dr. Kristin Hillman of Otago’s Psychology Department, who teaches on drugs and behaviour, shed some light on MDMA. She said that there are two main areas of risk. First, there are the physical risks, which include heart attack, seizures and hyperthermia due to the cardiovascular effects of the drug. These effects make MDMA potentially fatal. Just last year, a 16 year old in the UK, Daniel Spargo-Mabbs, died following multiple heart attacks as a result of an overdose. Another teenager in Sydney, aged 19, died last November following an adverse reaction to the MDMA pill given to her. She died within a few hours and her friend was charged with supplying the drug, resulting in a criminal conviction for the tragedy.

One of the other more serious and scary effects of the drug is hyperthermia (getting too hot, as opposed to hypothermia, where you are too cold). MDMA produces a lot of energy, so it’s commonly used by people who go clubbing so they can dance all night without noticing their exertion levels. MDMA can cause the body to lose its ability to regulate heat — so essentially users won’t notice they’re overheating. Another risk comes from not drinking enough water (because they don’t realise they’re dehydrated), which contributes to hyperthermia. At the same time, drinking too much plain water is also risky as it causes hyponatremia (low salt), also known as “water intoxication”.

To explain: the body maintains an equilibrium of electrolytes, including salt, in the bloodstream. Sweating causes the body to lose salt, but MDMA users are at particular risk if they drink enormous quantities of water because it dilutes the salt in the body to potentially lethal levels. If their system becomes out of balance, their body systems can fail, leading to diarrhoea, vomiting, tremors and confusion, and the brain begins to swell. This brain swelling (“brain edema” or “cerebral edema”) can lead to brain injury, paralysis and even death. To avoid this happening, it can help to add salt to your water, or have a sports drink that replaces the electrolytes.

Aside from the physical effects, Hillman explained that the other type of risk is that it is impossible to know exactly how you are going to behave under the influence of MDMA. You can end up “inadvertently killing yourself”. There is a lot of variability both inter- and intra-individual. On the inter-individual level, two people can take the exact same amount of MDMA at the same time, and have totally different experiences. One person might sit still for their trip, and the other might try to fly out the window. Hillman also explained that on an intra level, you can take MDMA one day and have a fantastic experience, and then take the exact same drug a week later and have an awful trip, completely different to what was experienced before. She said that people “build a false sense of confidence” after taking it a few times, “but it can act differently just randomly — that’s always a risk”. MDMA poses “a lot more risk than something like nicotine or caffeine”, basic, common drugs that “always affect people the same way” on an inter- and intra-individual level.

It’s important to note that taking higher doses of MDMA does not increase the likelihood of experiencing positive effects, but does increase the likelihood of experiencing negative ones.

Pure New Zealand

Keep in mind that all of the things we do know about MDMA are based on the assumption that it is indeed ecstasy that is being consumed. It is very rare to get your hands on the pure product in New Zealand. MDMA is created by a chemist. Essentially, if you own a pill press, you could put almost anything into it to create pills. Often MDMA is cut with other substances ranging from methamphetamine to household cleaning products like Ajax. This is where the main argument for legalisation comes in — pure MDMA is better than a mystery pill that might be MDMA.

It will be a long time before MDMA would ever be legalised in Aotearoa. However, according to Quigley, there is room for it to be legalised under the Psychoactive Substances Act (2013). The act means that producers of synthetic drugs are responsible for having their drugs clinically tested before they are sold. The aim of the act was to regulate the onslaught of highly dangerous synthetic drugs coming through the market.

Geoff Howard, a counsellor from the drug and alcohol counselling service, Drug Arm, feels that the risks of legalisation outweigh the benefits. He said, “alcohol is the most problematic drug in New Zealand.” However, while MDMA may be safer to use, he is concerned that this is under the assumption people will use the drug with the recommended restrictions. The guidelines for alcohol use are very low but, as we all know, “the community doesn’t drink like that. The reality is that people don’t follow the guidelines.”

Over time, people develop a tolerance to drugs, and will take more and more to get the same high. Howard is concerned that this will happen to MDMA users, and they will see the negative effects come through. Howard also said that “in the 12 years of doing this job, I have never seen addiction like that to synthetic drugs.” He believes that the normalisation of drug use in the form of legal highs puts youth at risk. Popping a pill or snorting a line of something is already in the comfort zone of youth today.

He also argued that even if MDMA is legalised, this doesn’t mean that people won’t still cut it with other substances. It might be more regulated, and some people might use it responsibly, but what about those who don’t? Howard thinks that legalisation would not improve the situation but rather would compound it. He is, however, completely behind medicinal use of MDMA.

Hillman reflected a lot of what Howard had to say about ecstasy. She said that alcohol has a very high harm index, and is “hands down” the most damaging drug in New Zealand — but this doesn’t necessarily mean that MDMA is safer or better. Simply because we already have the legal use of a dangerous drug doesn’t mean we should add another dangerous drug into the mix and make it more readily available. She said that people tend to forget, or not realise, that the “MA” in MDMA stands for methamphetamine.

However, Hillman advocates for the controlled, clinical use of the drug for psychotherapy in treating the likes of PTSD and end-of-life anxiety. She also said that the case for medical or clinical legalisation can be made for any drug — if it can be helpful, then why not take advantage of that?

The discussion has been going on for years. There has always been debate about the benefits and downfalls of legalisation and regulation versus blanket prohibition of dangerous substances. This argument extends to the majority of drugs, not only applying to MDMA. There are risks in legalising a known dangerous substance, and it could backfire. But unsafe, impure versions of MDMA are circulating around New Zealand. Specialists are calling for this to change and are looking for a better answer, allowing medical and scientific research to be undertaken. We really need a better understanding of what we’re putting into our bodies before we go ahead and use it for making new friends every weekend.

This article first appeared in Issue 16, 2015.
Posted 1:01pm Sunday 12th July 2015 by Laura Starling.