As well making sweaty clubbers realise that society puts us all into little boxes, Ecstasy could be useful in treating sufferers of Post Traumatic Stress disorder.
We had two caps of 500mg vitamin c, one of 200mg magnesium glycinate, one of 5HTP, a glass half full of Berocca, and a whole galaxy of supplements, anti-oxidants, multivitamins and also a point of MDMA each.
Not quite your average Saturday night.
In the middle of a table that resembled a mash-up of Willy Wonka and Scarface lay a small gelatin capsule with a few beige crystals. These crystals might not look like much, no carefully designed logo or aesthetic colour palettes, no number of standard drinks and safety warning carefully eked out in miniscule print, but locked inside them was a psychotherapist’s dream.
MDMA, also called ‘Molly’ or ‘Ecstasy’, is a serotonergic, a psychoactive drug that makes you feel connected with everyone else. It’s a strange world we live in when the most connected you can feel with others is when you’re off your face, as anyone still in town past 3am can attest to. In flooding your brain with serotonin (the stuff that makes you happy) and limiting the rate in which your brain reabsorbs all these happy chemicals, you feel a sense of euphoria, or ‘Ecstasy’.
While usually seen rapidly disappearing into the noses of brightly dressed people in the dirty bathrooms of clubs and festivals, MDMA is starting to see use as a highly effective therapy drug in treating things from anxiety to PTSD (Post Traumatic Stress Disorder) in combat veterans.
Sinking back into my friend’s plush leather couch as he downs his share of the assortment of supplements and MDMA there is a tepid anxiety. After all, drugs are bad m’kay. The only socially acceptable means of not being sober involve waking up the next day with a hangover, the desperate need for a dart, and a Snapchat story filled with poor decisions. How else do you take your place in the world?
There is a sense of gradual lightness, as if all the little wrongs and slights we carry around with us all day, every day, were temporarily removed. Atlas shrugging and, feeling the weight lift off his shoulders, realised that Ayn Rand is a terrible human being. As if all the various battered trunks and baggage we drag along have been lost in transit, if only for a little while. You feel free. Free from your own expectations of who you are and who others expect you to be. Free from your own little doubts and fears nagging away at you in some dark, Freudian corner of your mind. As if the walls we build around us to keep us safe turn into glass and we can see past them for the first time. You feel free to be the best version of you.
This feeling of freedom from the barriers we put up in our own mind is precisely why MDMA is showing promise as a psychotherapeutic drug. MDMA helped US Army veteran Tony Macie overcome the trauma he suffered from the things he saw in combat. Post Traumatic Stress Disorder (PTSD) puts the body into a permanent state of hyper-vigilance after experiencing or witnessing a life or death experience. Tony Macie saw two of his friends being killed by an IED (Improvised Explosive Device) and lived with the knowledge that it could have been him. The amygdala, the part of the brain responsible for the fear response, becomes constantly agitated. This puts you in a near-permanent state of fight or flight, making it difficult to process the memories of the event in a rational manner.
After returning home, Tony found it difficult to reintegrate into civilian life. He was constantly in a state of alertness and fear. Because his body was unable to adjust back to being in a safe environment after exposure to combat, Tony’s brain was unable to move past what had happened. His Prefrontal Cortex, responsible for how we process memories and emotions, was suppressed by the overriding fear response from his amygdala, making it difficult for Tony to come to terms with what he had seen. PSTD is common in modern veterans, with rates as high as 25 percent in US soldiers returning from Iraq.
Something that conflates modern reports of PTSD is the associated sense of isolation that is caused by moving from a highly communal society like the army to Western society, where the individual is disconnected from the collective. Add to this the isolation of being among people to whom you can’t open up because they can’t understand what it’s like to take a life, or see someone die in front of them, and you can start to see why MDMA might be a useful treatment.
Tony returned in a permanent state of fear that was inhibiting his ability to heal, and conventional therapy with anti-depressants proved to be ineffective. In a fit of desperation, Tony signed up for a Multidisciplinary Association of Psychedelic Studies (MAPS) clinical trial that used MDMA in controlled environments to help their patients open up. The feelings of euphoria and openness enabled Tony to discuss his traumatic experiences with a clarity that he was unable to previously achieve.
MDMA is not dissimilar to an antidepressant in how it affects your brain. They both make your brain release more serotonin than usual. The key difference is the amount of serotonin released, and the feeling of empathy and connectedness. For veterans feeling disconnected and isolated in society, this feeling of connectedness may be key.
However, you could almost view MDMA as an emotional credit card – it makes you happy now but, if you’re not careful, you will regret it later, hence the supplements and vitamins. The same way you build up your credit score by making small payments with your card and paying them off in order to be able to buy bigger things (consumerism in a nutshell) you physically prepare your body so that you can put it under a bit more stress than usual. Supplements like magnesium help protect your squishy brain so that when you milk all the glorious serotonin out, you are limiting the potential harm. The supplements also help prolong your MDMA trip and make the comedown easier.
In fact, so long as you use MDMA carefully and in moderation, both in dose and frequency, it is one of the safer drugs you can do. A 2010 UK Drug Harm report that rated drugs on a 100-point scale based on multi-criteria decision analysis (using expert opinion and relevant scientific knowledge from prior studies) gave MDMA a harm score of 9, compared to a whopping 72 for alcohol, 55 for heroin, and 26 for tobacco. Follow up studies conducted in 2016 by different organisations have come to similar conclusions.
A large part of this is the low risk to others – it takes a lot more effort to be a dick than to not be one, and if you’re already in a good mood then there is no need to be one. If you’re on a substance that fills you with a sense of joy and love, you’re not going to want to light a couch on fire or throw a punch. You’re far more likely to hug an acquaintance and tell your friends you love them. Generally, the biggest danger when you’re ‘rolling’ (up in the outer limits of the stratosphere with your dear friend Molly) is not drinking enough water, or drinking too much water.
That being said, it’s not all sunshine and roses. Falling too deep into the psychological rabbit hole of addiction is dangerous with anything, let alone something that can permanently fry your brain. Because MDMA temporarily uses up all your available serotonin and limits its reabsorption, abusing it has severe consequences.
While it is an amazing thing that a few beige crystals can make you feel joy, those same crystals can also permanently reduce how much of it you can experience. Safe and responsible drug use, as advocated by organisations like Rollsafe and Students for Sensible Drug Policy, stresses the importance of not taking too much at once, and not doing it too often. While it might feel fine to roll every weekend and smash out a few lines, you are maxing out your emotional credit card and the debt collectors have no qualms about breaking your things.
As a general rule of thumb you want 1-1.5 milligrams for every kilo of body weight. On average a ‘point’ (0.1 grams or 100 milligrams) is more than enough for most people. As for frequency, your dear friend Molly is a special occasions kind of a gal, a classy lady, the kind you wine and dine (and hopefully 69). So ideally once every 3-4 months with 6-8 weeks being the absolute minimum between uses. Break that rule and you will learn to fear the MDMA comedowns, the ‘Suicide Tuesdays’ as veteran rollers like to call them. It can very easily become a self-destructive cycle of needing more MDMA to get that same high, and doing even more damage to your brain, which necessitates – you guessed it – even more MDMA, until there is no joy left for you in a substance that is designed to give you joy.
However, the criminalisation of MDMA has caused far more harm than the actual drug itself. MDMA is classified as a Schedule I Drug, a classification that supposedly targets the most harmful drugs (like heroin with its drug harm score of 55, LSD with its score of 7 and MDMA with its score of 9...). These strict anti-drug laws and the war on drugs create a dystopian monopoly.
After all, such a system, incentivises that MDMA be cut with amphetamines (if you’re lucky) or battery acid (if you’re unlucky) because of the economic principle of supply and demand. The only people who can effectively operate in this criminal black market are those who have both the money and the muscle to evade police detection. These people have a dominant market share and can do whatever they want with the product without needing to worry about health and safety regulation.
As a result, it is the street version of MDMA that causes the most harm, the ‘Ecstasy’ pills that could contain just about anything with only a small amount of actual MDMA to simulate the effect. With no quality control, drug dealers are given every economic incentive to produce a defective product.
In response to the harm that MDMA’s illegal status causes, emergency physician and toxicologist at Wellington Hospital Paul Quigley has openly called for pure MDMA to be legalised. In a 2015 interview with Radio NZ, Paul stated that synthetic drugs that aim to simulate the effects of MDMA and are often cut into ‘Ecstasy’ pills are far more harmful than the pure substance. Citing the difficulties his staff has faced in dealing with patients who were suffering from psychosis and damaged internal organs caused by synthetic alternatives that were easier to obtain, Paul believes that MDMA is the lesser of two evils – so long as there is some measure of quality control.
People are always going to want to escape sobriety. In a country that has one of the worst rates of alcoholism and binge drinking in the developed world, we can’t escape this fact. Feeling the crunch of broken glass under your shoes as you walk into lectures from Castle or Hyde, you know that people will do whatever they can to cut loose and escape from the world. If that is the case, then shouldn’t we be asking ourselves if there is a better way?
Part of the experience of university is being confronted with absolute freedom and how you choose to deal with it. For many students, being at Otago might be the first time they’ve ever been able to decide for themselves what they want to do. No parents, no judging eyes from your small town community. But the price of absolute liberty is absolute accountability – if you make a decision of your own free will and volition then you are ultimately responsible for the consequences.
So be smart about it.
If you want to experiment and try things you’ve never done before then at least educate yourself on the basics. We have access to the largest repository of information that has ever existed in the form of the internet and there is more to the internet than porn and memes. Websites like erowid and rollsafe will at least let you know what you are getting yourself into – as well as providing useful resources for where to get things like tester kits, supplements, and harm reduction guides.
Just like alcohol and tobacco and all the other vices we indulge in, there are hidden costs and dangers to MDMA. However, the see no drugs, do no drugs, hear no drugs approach we’ve taken to substances like MDMA has caused far more harm than good.
So just look after your mates, look after yourself, and have fun.