Sex, Drugs, and Techno Music

Why the rap against Ecstasy has a familiar ring to it

Jacob Sullum from the January 2002 issue

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Adam Newman, an Internet specialist in his 20s, believes his MDMA use has helped improve his social life. "It kind of catapulted me past a bunch of shyness and other mental and emotional blocks," he says. Even when he wasn't using MDMA, "I felt a lot better than I had in social interactions before." Bruce Rogers, a horticulturist in his 40s, says one thing he likes about MDMA is that "you can find something good in somebody that you dislike." He thinks "it would make the world a better place if everybody did it just once."

That's the kind of assertion, reminiscent of claims about LSD's earthshaking potential, that tends to elicit skeptical smiles. But the important point is that many MDMA users believe the drug has lasting psychological benefits, even when it's taken in a recreational context -- the sort of thing you don't often hear about alcohol.

Not surprisingly, people who use MDMA in clubs and at raves emphasize its sensual and stimulant properties, the way it enhances music and dancing. But they also talk about a sense of connectedness, especially at raves. Jasmine Menendez, a public relations director in her early 20s who has used MDMA both at raves and with small groups of friends, says it provides "a great body high. I lose all sense of inhibition and my full potential is released. -- It allows me to get closer to people and to myself."

Too Much Fun

Euphoria is a commonly reported effect of MDMA, which raises the usual concerns about the lure of artificial pleasure. "It was an incredible feeling of being tremendously happy where I was and being content in a basic way," Stevenson recalls of the first time he felt MDMA's effects. He used it several more times after that, but it never became a regular habit.

Menendez, on the other hand, found MDMA "easy to become addicted to" because "you see the full potential in yourself and others; you feel like you won the lottery." She began chasing that feeling one weekend after another, often taking several pills in one night. "Doing e as much as I did affected my relationship with my mother," she says. "I would come home cracked out from a night of partying and sleep the whole day. She couldn't invite anyone over because I was always sleeping. She said that my party habits were out of control. We fought constantly. I would also go to work high from the party, if I had to work weekends. The comedown was horrible because I wanted to sleep and instead I had to be running around doing errands."

Menendez decided to cut back on her MDMA consumption, and recently she has been using it only on special occasions. "I think I've outgrown it finally," she says. "I used e to do some serious soul searching and to come out of my shell, learning all I could about who I really am. I'm grateful that I had the experiences that I did and wouldn't change it for the world. But now, being 23, I'm ready to embrace mental clarity fully. Ecstasy is definitely a constructive tool and if used correctly can benefit the user. It changed my life for the better, and because of what I learned about myself, I'm ready to start a new life without it."

Sustained heavy use of MDMA is rare, partly because it's impractical. MDMA works mainly by stimulating the release of the neurotransmitter serotonin. Taking it depletes the brain's supply, which may not return to normal levels for a week or more. Some users report a hangover period of melancholy and woolly-headedness that can last a few days. As frequency of use increases, MDMA's euphoric and empathetic effects diminish and its unpleasant side effects, including jitteriness and hangovers, intensify. Like LSD, it has a self-limiting quality, which is reflected in patterns of use. In a 2000 survey, 8.2 percent of high school seniors reported trying MDMA in the previous year. Less than half of them (3.6 percent) had used it in the previous month, and virtually none reported "daily" use (defined as use on 20 or more occasions in the previous 30 days). To parents, of course, any use of MDMA is alarming, and the share of seniors who said they'd ever tried the drug nearly doubled between 1996 and 2000, when it reached 11 percent.

Parental fears have been stoked by reports of sudden fatalities among MDMA users. Given the millions of doses consumed each year, such cases are remarkably rare: The Drug Abuse Warning Network counted nine MDMA-related deaths in 1998. The most common cause of death is dehydration and overheating. MDMA impairs body temperature regulation and accelerates fluid loss, which can be especially dangerous for people dancing vigorously in crowded, poorly ventilated spaces for hours at a time. The solution to this problem, well known to experienced ravers, is pretty straightforward: avoid clubs and parties where conditions are stifling, take frequent rests, abstain from alcohol (which compounds dehydration), and drink plenty of water. MDMA also interacts dangerously with some prescription drugs (including monoamine oxidase inhibitors, a class of antidepressants), and it raises heart rate and blood pressure, of special concern for people with cardiovascular conditions.

Another hazard is a product of the black market created by prohibition: Tablets or capsules sold as Ecstasy may in fact contain other, possibly more dangerous drugs. In tests by private U.S. laboratories, more than one-third of "Ecstasy" pills turned out to be bogus. (The samples were not necessarily representative, and the results may be on the high side, since the drugs were submitted voluntarily for testing, perhaps by buyers who had reason to be suspicious.) Most of the MDMA substitutes, which included caffeine, ephedrine, and aspirin, were relatively harmless, but one of them, the cough suppressant dextromethorphan (DXM), has disturbing psychoactive effects in high doses, impedes the metabolism of MDMA, and blocks perspiration, raising the risk of overheating. Another drug that has been passed off as MDMA is paramethoxyamphetamine (PMA), which is potentially lethal in doses over 50 milligrams, especially when combined with other drugs. In 2000 the DEA reported 10 deaths tied to PMA. Wary Ecstasy users can buy test kits or have pills analyzed by organizations such as DanceSafe, which sets up booths at raves and nightclubs.

Nervous Breakdown

Generally speaking, a careful user can avoid the short-term dangers of MDMA. Of more concern is the possibility of long-term brain damage. In animal studies, high or repeated doses of MDMA cause degeneration of serotonin nerve receptors, and some of the changes appear to be permanent. The relevance of these studies to human use of MDMA is unclear because we don't know whether the same changes occur in people or, if they do, at what doses and with what practical consequences. Studies of human users, which often have serious methodological shortcomings, so far have been inconclusive.

Still, the possibility of lasting damage to memory should not be lightly dismissed. There's enough reason for concern that MDMA should no longer be treated as casually as "a low-calorie martini." If the fears of neurotoxicity prove to be well founded and a safe dose cannot be estimated with any confidence, a prudent person would need a good reason -- probably better than a fun night out -- to take the risk. On the other hand, the animal research suggests that it may be possible to avoid neural damage by preventing hyperthermia or by taking certain drugs (for example, Prozac) in conjunction with MDMA. In that case, such precautions would be a requirement of responsible use.

However the debate about MDMA's long-term effects turns out, we should be wary of claims that it (or any drug) makes people "engage in random sex acts." Like the idea that certain intoxicants make people lazy, crazy, or violent, it vastly oversimplifies a complex interaction between the drug, the user, and the context. As MDMA's versatility demonstrates, the same drug can be different things to different people. Michael Buchanan, a retired professor in his early 70s, has used MDMA several times with one or two other people. "It's just wonderful," he says, "to bring closeness, intimacy -- not erotic intimacy at all, but a kind of spiritual intimacy, a loving relationship, an openness to dialogue that nothing else can quite match." When I mention MDMA use at raves, he says, "I don't understand how the kids can use it that way."