Specific harm reduction strategies employed by 3,4-methylenedioxymethamphetmine/ ecstasy users in the United States and the United Kingdom

Abstract

Both recreational and problematic MDMA/ecstasy users could benefit from employing harm reduction interventions intended to preserve health and prevent negative consequences. To evaluate whether use of such interventions varied by country of residence and frequency of ecstasy use, we used web-based surveys to assess how often 104 lower-frequency and higher-frequency American ecstasy users and 80 lower-frequency and higher-frequency British ecstasy users employed each of 19 self-initiated harm reduction strategies when they used ecstasy during a two-month period. Several significant differences notwithstanding, at least 75% of participants had used 11 of the 19 strategies one or more times during the two-month assessment period, regardless of whether they lived in the United States or United Kingdom and whether they were lower-frequency or higher-frequency ecstasy users. When proportions of American and British participants using a strategy differed significantly, it was typically larger proportions of Americans using those strategies. Many of the less frequently employed strategies are not applicable on every occasion of ecstasy use. However, because ecstasy is not a diverted pharmaceutical of known quality/potency, testing for the presence of MDMA, other stimulants, and adulterants is a strategy that everyone should employ, regardless of country of residence or how frequently one consumes ecstasy.

Prevalence of reagent test‐kit use and perceptions of purity among ecstasy users in an electronic dance music scene in New York City

“…More frequent ecstasy pill and crystal users were more likely to have tested their ecstasy in the past year. This finding corroborates previous studies finding that more regular or frequent users are more likely to report using a test kit . Higher frequency of ecstasy use may result in more experiences of adulteration and greater knowledge of mitigation strategies.…”

“…Many people who consume ecstasy/Molly are aware that what they consume may not actually be entirely MDMA or contain any MDMA at all, and studies have found that most users desire to know the content and dose of their drug prior to consumption . In 2017, there were ‘drug checking’ or ‘pill testing’ services available in 20 countries, where drug consumers can provide samples of substances to be analysed using laboratory equipment to determine content and/or purity .…”

“…If test results are interpreted with their limitations in mind, they are considered accurate at detecting the presence or absence of specific psychoactive compounds . Popular with toxicologists and law enforcement agents, these tests have also been adopted by a significant minority of people who consume drugs, especially ecstasy .…”

Microdosing psychedelics: Subjective benefits and challenges, substance testing behavior, and the relevance of intention

“…Additionally, it is quite possible that many participants were unaware of substance-testing kits or services, leading them to rely on a nextbest option: buying their substance from a source they trusted. Indeed, this was the second most popular reported testing behaviour, in agreement with the finding that this approach is widespread (Davis & Rosenberg, 2017;Johnston et al, 2006). Educating the public about using test kits as well as progressive legislation and regulation both have the potential to reduce harm in those who use psychedelics both recreationally and therapeutically.…”

Regular MDMA use is associated with decreased risk of drug injection among street-involved youth who use illicit drugs

“…Among numerous other benefits, it is essential to minimize the potential adverse events that can be associated with illicit MDMA use including extended depressed mood, rhabdomyolysis, and serotonin syndrome, among others (Michael White, 2014). It is equally important to note that illicit MDMA use has been shown to be associated with an array of harm reduction behaviours such as the avoidance of solitary substance use and the use of test kits to determine substance identity and purity (Davis and Rosenberg, 2016; Davis and Rosenberg, 2017). These behaviours may extended to other substance use and may help explain the observed associations in the current study.…”