Harm Reduction: MDMA pleasure and Harm Reduction (1): Difference between revisions

This guideline is intended as an "instruction manual" for the use of MDMA. It is open to corrections, improvements and suggestions from the community. There are many good guides to Harm Reduction and MDMA, so I will focus it on specific aspects

"Less is more": dosages and frequencies

Spacing out usage is a basic rule for any drug consumption. Still, in the case of MDMA, it not only allows for safer use, but also intensifies and enhances the pleasurable effects. By doing this, you can prevent the development of pharmacological tolerance, where you need to increase the dosage to achieve the same results, and delay the onset of the "loss of magic" phenomenon.

Some people will only experiment with MDMA once or twice in their lives. But other persons may want to have repeated experiences. However, recommending a universal frequency for safe use is difficult without diminishing effects. Some experts suggest that "once a week is the highest frequency with which MDMA can be used without diminishing its effects, although it would be much more sensible to use it once a month" (Eisner, 1990). On the other hand, Ann Shulgin warns that "it should not be used more than four times a year, as more frequent use causes the loss of magic."

To properly dose MDMA, it is important to keep in mind that less is more. The minimum active dose is 30mg, while a typical dose ranges from 75 to 140mg. Dosages closer to the lower end of this rank are recommended for first-time users and/or low body weight.

Women should start with lower doses than men because both the desired and adverse effects are more intense among them.
Experienced users or those with a larger build can take doses closer to 120-140mg.

The effects of a single dose usually last for 4-6 hours, and it's possible to prolong the experience by taking a supplementary dose when the effects of the first one start to decline, typically around 2-3 hours later the first intake. This second dosage should not to exceed half the initial dose. Some people use a third, additional dosage (half the second one)

Example:
T+0 h : 120 mg
T + 2:30 h: 60 mg
T + 5 : 30 mg

However, taking successive doses will not prolong the experience indefinitely. Consecutive doses will produce a disappearance of the pleasant effects of MDMA and an increase in adverse effects, both during the experience (jaw tension, anxiety, dry mouth, tachycardia, etc.) and in the following days (depression, loss of appetite, etc.).

Therefore, intelligent and responsible MDMA use involves being aware of the limits of the experience and recognizing that it's pointless to try to "stay on top" indefinitely.

Formats of presentation

Pills

The illegality of MDMA makes it challenging to know the exact content of a particular pill, so dosing can be tricky. A pill's size, shape, or color does not provide any information about the amount of MDMA or other products it may contain. Samples from the same batch usually contain similar concentrations.

The illegality of MDMA makes it challenging to know the exact content of a particular pill, so dosing can be tricky. A pill's size, shape, or color does not provide any information about the amount of MDMA or other products it may contain. Samples from the same batch usually contain similar concentrations.

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In general, adulterated pills are not very common. Data available suggest that pills from cryptomarkets have a quality more than acceptable. In the last years there is a tendency to offer high-dosage MDMA pills and it is not strange to find pills with 150-200 mg

Some "classical" adulterations are:
• PMA (paramethoxyamphetamine) and PMMA (paramethylmethoxyamphetamine). Both are highly toxic and can lead to death.
• Piperazines : meta-Chlorophenylpiperazine (mCPP). They are less toxic than PMA/PMMA but act as psychostimulant, anxiety-provoking, and pro-hallucinogenic
• The high accessibility of RCs makes any of these substances susceptible to fraudulent use as a substitute for MDMA. N-Ethyl-Pentylone, 2C-B-fly or cathinone derivatives have been detected. In recent months, tablets containing 3-CMC (3-chloromethcathinone) have also been detected in both crystal and tablet samples.
• Also, there are other recreational drugs different to MDMA that appear in pill forms. (For example 2C-B or MDA). This is not a problem if the person knows about the substance he will use. But it can be unpleasant to encounter an unexpected psychedelic experience, when one expects the warm empathy of MDMA.
• Finally, any drug in pill form can attempt to pass itself off as MDMA. In this respect, the likelihood of buying a grandmother's medication is higher if the transaction is made with a stranger in an after-hours or infested slum. Having a trusted dealer (or a vendor) is also a risk reduction strategy.

Crystal

Crystal (smaller or larger crystals or powders), at least in theory, are more susceptible to adulteration by succesive intermediaries than tablets or pill.

The color of MDMA crystals can vary and is not necessarily an indicator of purity or quality.

The color may be related to the specific chemicals or solvents used in the synthesis process, but is not a definitive way of determining the synthesis route.

Yellow crystals of MDMA may result from impurities in starting materials or by-products, brown crystals of MDMA may indicate the presence of safrole, and purple crystals of MDMA may indicate the presence of anthocyanin dye. The pH in crystallization may also influence the coloring.

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Other imaginative options

There are other possibilities to enjoy the effects of MDMA and, additionaly, reduce the risk of legal problems. Many countries in the Americas and Asia punish possession for personal use with imprisonment. The risks arising from Drug Policies that do not respect Public Health and Human Rights are among the most important.

MDMA is soluble in water and can be administered in liquid form. Its solubility is 7 mg/ml, so one gram can be dissolved in a volume of 150 ml. Thus, eight doses of 125 mg would be obtained, in a volume of 18 ml for each dose. Using this form of administration it is essential to ensure the product is well dissolved and to have a dosing device (syringe) to calculate the exact dose.

A little bit of liquid food colouring will give it a magic potion feel and could be an e-cig liquid.

MDMA can also be prepared in gummies, jellies or chocolates, calculating the dose carefully. Some people find that the nauseating bitter taste of MDMA combines particularly well with dark chocolate.

Any of these forms of administration implies ensure that no person will use it without knowing its contents.

The plan

At least in theory, MDMA should only be used on special occasions, planned and scheduled in advance, as an exception to the usual routine rather than a habit. The goal is not to avoid spontaneous situations where consumption might occur naturally but to plan for the best possible outcomes, as with any other activity.

It is important to carefully choose the day on which to consume MDMA, taking into account that it may cause tiredness or irritability for the following two to three days. It's best to avoid obligations, work, decisions, and stressful situations as much as possible during this time. Massive family dinners (with brother-in-law, aunts, nephews, grandparents…) are not recommended 24-48 hours after taking MDMA.

Holidays, long weekends, or Fridays (in case you can rest the whole weekend ) may be good options. Being in good physical and mental health is also essential to achieve the desired effects. If one is excessively tired, nervous, stressed, depressed, convalescing from an illness, or dealing with personal problems, it is best to postpone MDMA consumption to another time.

Just as important as the date is the choice of context. If you are looking for a purely recreational use, you can choose a specific concert, club or rave. It is essential to consider whether travel is necessary and the way of transport. Although MDMA is not a drug that modifies perception through the senses too much, driving a car under its effects is an unnecessary risk to avoid at all costs. It is always preferable to use public transport or, failing that, to wait until the effects have completely worn off.

But entertainment venues (, clubs, raves...) are not the only environment to enjoy ecstasy. The scenarios can be very different: a walk on the beach, a country house, a gathering of friends at home, a museum... it is all a question of using a little imagination and common sense, avoiding potentially dangerous elements, situations and activities, knowing that you are under the effects of a drug for a few hours.

Although electronic music is most often associated with MDMA, any music with rhythmic and/or emotional content (tribal music, classical, opera, reggae, soundtracks...) can provide exciting experiences. For most people, more "aggressive" music styles (hard-rock, heavy metal, hardcore...) do not fit well with MDMA.

Bad Bunny is especially discouraged (although I think this has more to do with my personal pet peeves).

The MDMA experience has profound emotional and interpersonal connotations. Using it with good friends or partners can be a very intense and enriching experience that can help strengthen bonds, solve problems and explore new ways of relating. By being able to communicate without the usual barriers and fears, deep emotional bonds can be formed with strangers. MDMA can facilitate interpersonal relationships, but there is also a risk that under the effects of MDMA, feelings can be confused and not in accordance with reality, especially when relating to people towards whom one has emotional doubts. It is essential to consider who the companions will be, and whether they are planning to use ecstasy as well, and whether any of those present will be taking it for the first time, in which case special attention should be given to those person(s), providing the necessary support and care.

Routes of administration

The oral route is the most appropriate when taking MDMA.
The rest of the other possible forms of administration have more disadvantages than advantages and suppose an unnecessary increase in risks.

Sublingual administration (allowing the compound to dissolve under the tongue) achieves a somewhat faster absorption than the oral , but it is very uncomfortable due to the unpleasant taste of MDMA.

Through the intranasal route (snorting MDMA powder) the effects are faster and less long-lasting, but the sensation of nasal irritation is very intense. Calculating the intranasal dose is very difficult and MDMA reaches the brain directly through the nostrils without first distributing throughout the body and passing through the liver. Therefore, the risks to the nervous system are, at least in theory, much more critical.

The use of MDMA by injection (intravenous or intramuscular) does not provide any advantage and multiplies the risks exponentially.

Intrarectal route (plugging) is another possible route. Suppositories or enemas are not considered an adequate way to administer drugs. Leaving aside the predictable and obvious jokes inevitably associated with the issue, some people who are particularly sensitive to nausea and vomiting consider the intrarectal route to have this advantage.

MDMA is absorbed faster and more effectively on an empty stomach. The feeling of "knot in the stomach" during the onset of effects, which can cause nausea and vomiting in sensitive people, is less if no food has been ingested. For these reasons, it is often recommended not to eat for a few hours before taking ecstasy. Some psychonauts go so far as to fast for 12 to 24 hours before taking MDMA to maximize its effects. This does not seem like a good idea if you use ecstasy to dance all night, as your body will need enough energy. But it is advisable that at least an hour and a half or two hours elapse between the last meal and the intake of MDMA, and that it be both light and energetic (pasta, cereals, fruit, legumes...), avoiding very fatty,heavy or abundant food.

Some tips during the experience

The sensation of "onset" can be strange, even unpleasant, especially for people who have never experienced it. When describing the effects of MDMA, it is often forgotten that in the first few minutes, it can cause difficulty in thinking, dizziness, tachycardia, shortness of breath, nausea... which can increase with the logical nervousness of a first experience.

If the novice consumer is aware of these effects, of their short duration and is sufficiently supported by someone close to him/her, they will be able to cope with it without any particular problem. If problems occur, removing the person to a quiet place for a few minutes, sitting down, reminding that these are regular and temporary effects and conveying positive feelings is usually sufficient. On the contrary, a person who is not informed about this fact in his first experience may have an anxiety crisis when he sees that the effects are not as expected.

While under the effects of MDMA, avoiding the risks associated with heat stroke is important. Avoid extremely stuffy, humid and hot environments. Protecting yourself from the sun is crucial, especially in the summer and during the central hours of the day. If you are dancing, it is necessary to recover fluids lost through the evaporation of sweat and urine. Juices, isotonic sports drinks, and soft drinks are more suitable than water, as they also allow the recovery of mineral salts. Moderate amounts of alcoholic beverages are not incompatible with MDMA, but replenishing fluids with beers and drinks is a dangerous idea.

MDMA decreases the sensation of thirst, so it may be necessary to "remind" yourself to drink fluids without making it an obsession. As discussed in the toxicity section, excess fluids can cause problems. As a guideline (without having to keep an eye on the watch and the bottle) half a liter of liquids per hour can be considered an adequate amount.

Under the effects of MDMA, the appetite diminishes, and eating is challenging; however the perception through taste is increased, so small amounts of sweets or fruit (watermelon, strawberries, cherries...) can be cosmically delightful.

In relation to the different uses of MDMA, there is an academic, clear distinction between therapeutic, psychoactive and recreational uses. But, in real world, many people who approach MDMA for intellectual or spiritual reasons will find the experience also fun. And for most people who use ecstasy for fun there are beneficial aspects that can enhance daily life: experiencing the loss of fear and insecurities, being able to overcome the usual obstacles to honest and open communication with oneself and other people, feeling in the "here and now" without the weight of the past or fears of the future, feeling in harmony with oneself with its virtues and flaws, valuing interpersonal relationships in a new way...these are profound experiences that are lived in a very realistic way, so they can leave an imprint on daily life.

Aftercare

Psychological effects that appear in the days following the intake of MDMA can be very different. Reports from therapeutic and psychoactive uses often refer to the "afterglow" effect as a period of mental clarity and positive emotional state in which many of the empathogenic and entactogenic effects of MDMA persist in an attenuated form. This state may persist for days or even weeks after the experience.

But in the following days sadness, depression, difficulty in concentrating and sleeping can also appear... A condition called "mid-week blues syndrome" has even been described, since these effects do not usually appear immediately, but two or three days after having used MDMA. Negative effects after ecstasy use are much more frequent in recreational users.

MDMA by itself can certainly produce negative effects (adverse effects have even been described in studies in which it has been administered to volunteers in laboratory conditions). But they are more noticeable in recreational settings. The reason for these differences can largely be explained by the circumstances under which the use occurs.

Recreational users dance for many hours, often disrupting sleep, wakefulness and feeding cycles, use other drugs, and use higher and more frequent doses than different types of users. They also tend not to schedule their use, leaving the following 24-48 hours completely free of obligations so that they can integrate the experience and recover in peace. Therefore, controlled and spaced consumption, not mixing with other drugs (or combining with common sense) and respecting diet and sleep rules (for example, try to go to bed before dawn so as not to break the biological rhythm) can help to minimize the risk of appearance of problems.

Credits

Full credit goes towards DoctorX on Dread! (sourced from /post/a8a49b4caa1dd821d355) - http://www.doctorcaudevilla.com/doctorx