Danger on the dance floor: ecstasy impurity

In 2013, Miley Cyrus released a song called We Can’t Stop, which was controversial because of the words, “We like to party, dancing with Molly.” The controversy comes from the name Molly, which is a reference to a synthetic stimulant also known as MDMA or ecstasy. This drug has been popular for decades, commonly used at raves, clubs, and music festivals, and renowned for its effects that include increased energy and feelings of closeness and empathy towards others.

Ecstasy has been in the news a lot lately. Not just because of its references in popular culture, but because of its impurity and the resulting harms. While pure ecstasy should contain MDMA only, it sometimes contains other chemicals, such as PMA or PMMA, which is nicknamed Death because of its toxic effects. For example, 27 people in Western Canada died between July 2011 and April 2012 after they ingested ecstasy that contained PMMA. More recently, last year, two young adults died at the Veld Music Festival in Toronto after they consumed drugs that they probably thought were MDMA. Similarly, this year there have been multiple incidents at North American music festivals where attendees have suffered negative effects due to drug use, including ecstasy use, including the Chasing Summer Festival in Calgary.

Drugs sold as ecstasy are sometimes adulterated with other chemicals or contain no MDMA at all. To make matters worse, individuals cannot know the exact contents of tablets or powder sold as ecstasy based on their appearance. So what can people do to avoid “bad ecstasy”?

Here are two options:

1) Laboratory testing. People can send ecstasy to a laboratory pill testing program called the Ecstasy Data Program. Individuals can anonymously mail samples to the laboratory at the cost of $40 to test tablets or $100 to test powder, and in two to three weeks the organization will post the results of the analysis online. It is important to note that the laboratory can only detect active chemicals and chemicals that their instruments are capable of detecting, and the laboratory is only allowed to post the ratio of active chemicals, not the quantity.

2) Testing kits. Although laboratory testing is fairly accurate, ecstasy users may not want to pay the fee or they may not want to wait a few weeks to find out what is in their ecstasy. So do-it-yourself reagent testing kits, are a more convenient option since they produce results within minutes. To use the kit, you apply reagents to an ecstasy sample, and chemical reactions will produce colours, which can be compared to a chart that shows colours produced by different drugs. Test kits cost about $20 to $65 online, depending on the type of kit. Harm-reduction organizations often promote the use of testing kits because they are helpful in showing if an ecstasy sample contains no MDMA; however, they cannot reveal if a sample is pure MDMA nor the quantity of MDMA it contains. While testing kits are imperfect, they can provide a significant level of protection to users as long as they are aware of the limitations of the kits.

It is important to understand that even if a drug is pure MDMA it can still have adverse effects. Firstly, consuming a high dose of MDMA is dangerous, which is why groups in the United Kingdom recently started the Crush-Dab-Wait Campaign to help protect people when they are taking MDMA crystals. Secondly, an individual might have a bad, possibly deadly, reaction to even a small, pure dose of MDMA.

Ecstasy users should inform themselves of the harms and risks associated with ecstasy use, especially in regard to impurity, so they can help protect themselves if they choose to “dance with Molly.”


Author: Melanie Callas, MA Candidate, Department of Anthropology, University of Victoria

Zero tolerance and the need for safer drug use limits

Guidelines exist for one of the world’s most dangerous and widely used drugs, alcohol. These were developed to help people and health care professionals have some idea what different level of drinking might be associated with low, moderate and high risk of harm. They are based on evidence, and although recent epidemiological data has probably underplayed the risks for cancer, properly used (e.g. within brief screening and intervention), they can help people reduce their drinking.

The problem is similar sensible guidelines don’t exist for illicit drugs. In most countries, the government line is basically, “Do not take illegal drugs because they are all bad.”

Just for the record (and the lawyers) the Global Drug Survey (GDS) states categorically that the only way to avoid all harm from drug use is to not use them. However, it’s not a very practical goal for people who like to indulge. The reality is that the risks of experiencing harms from using drugs can actually be massively reduced for most people with the right set of advice.

This is why GDS developed the world’s first Safer Using Limit guidelines. Using data collected from the 100,000 people who took part GDS2015, we are creating a number of guidelines, starting with cannabis, aimed at raising people’s awareness of the level of risk that different patterns of drug use places them at. We did this by asking respondents to rate how the risk of harm from different drugs (including alcohol) is heightened with increasing levels of use. “Risk” here refers to the probability, range and severity of harm. The higher the score, the more likely it is for a person to experience harms and problems, with higher scores indicating an increased severity of said harms. We also asked our respondents to think about the likelihood of a person experiencing harm over the next 1-2 years. By harm, we mean anything that causes a person problems, such as mental or physical health, relationships and behaviours, finances or ability to work, study, or just do the things in life they want to do.

Our first set of guidelines (on cannabis) was launch on June 18th 2015 at www.saferuselimits.co. Over 20,000 people have got their risk score so far.

Are drug users really the best experts?

A reasonable question to ask is, how valid are risk estimates based on the votes of a self-selecting group of drug users who surely have cognitive and emotional bias to minimize the risks associated with a consumptive behavior? I don’t know, but leave it to you to decide based the composite ratings from over 40,000 cannabis users that Professor Michael Linskey used to help develop the relative risk scores – shown below.

safer use screen shot

I came up with very similar ratings when I did the exercise blind before we launched GDS2015 last year. We hope to ask experts around the world to do the same thing in a project we are trying to set up to see the level of agreement between users and “experts.” The reality is, though, that the major driver for the approach we took was the fact that the people drug users trust most are other drugs users. Simply put, guidelines on safer-use limits voted by those who like to toke will be less quickly dismissed by other stoners.

I passionately believe that for most people who choose to use drugs and alcohol, they can be a source of pleasure that enhances the rich fabric of their lives. While I understand that drug use for some people is unwise (and best avoided) either because of their age, pre-existing health conditions or other vulnerabilities, the decision to use drugs is one that must always be treated with respect. I hope our work helps people, communities and governments have more honest conversations about drugs.


Author: Dr. Adam R Winstock MBBS, BSc, MSc, MRCP, MRCPsych, FAChAM, MD
Founder and Director, Global Drug Survey; Consultant Psychiatrist and Addiction Medicine Specialist, SLAM NHS Trust; Senior Lecturer, Kings College London


(Author’s note: Want to help contribute to this research? We will be launching GDS2016 in November, 2015 with focuses on psychedelics, safer MDMA dosing, drug vaping and drug tourism. We are hoping to increase our Canadian participation this year, so don’t hesitate to contact me if you would like to help us spread the word.)

 **Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC