The researchers behind the Global Drug Survey, the world’s largest drug survey, want to be clear: They aren’t recommending that you start taking drugs. What they are advising, however, is that if you do take drugs, you might as well do it right. The drug that seems to be tripping people — mostly Europeans really — up right now is MDMA, which is typically mixed with other chemicals or synthetic cathiones to create Ecstasy and Molly. People like buying MDMA and they like taking it in oversized doses.
What lead author Dr. Adam Winstock and his team are particularly concerned about is that people are simply taking too much MDMA at a single dosing. After surveying 50,000 MDMA users across 50 countries, the researchers realized that the current average dose of MDMA used in a session is over 200 mg. They write that to feel the “pleasurable effects of energy, euphoria, and empathy” without the negative effects of “nausea, panic, paranoia, agitation, and gurning” people only need to take a dose of 80 mg.
One explanation behind this high dosing is that people have a confused sense how much of the drug they need to have a good time. The Global Drug Survey demonstrates that people typically see MDMA pills and powder as the best bang for the buck drugs. When subjects were asked to rate drugs based on their value for money (one being poor value and 10 being excellent) MDMA pills and powder were on average ranked a 7. Comparatively, cocaine received a four and alcohol was given a five.
The survey reveals that there has never been more MDMA available, more people using MDMA, and more MDMA within Ecstasy and Molly. Meanwhile, users have a skewed idea of purity, potency, and what makes for a “quality” drug. When it comes to drugs purity is the percentage of the powder that contains the drug and potency is the amount of drug you need to get an effect. If there is such a thing as an “optimum dose” for a drug, it’s when a desired effect is produced when little of the drug is used.
“Currently one of the issues facing users is that higher dose pills and high purity MDMA powders can make safer dosing more difficult and it is very easy to inadvertently take too much,” writes Winstock. “To this end for me, at least, a pill containing 300 mg of MDMA is not a quality pill. It’s got too much drug in it.”
Luckily, this high dosage isn’t correlated with many medical emergencies. Less than 1 percent of ecstasy users sought medical treatment following the use of MDMA in the past 12 months. People who are medicalized for MDMA use have often paired the drug with alcohol or other drugs. MDMA induced fatalities often include the person overheating and cardiovascular problems.
Winstock and his team write that “it would be nice” if MDMA manufactures agreed to produce standard pills of 100 mg that could be broken into 4 equal doses (they propose a hashtag to help: #dontbedaftstartwithahalf). But advising MDMA manufacturers what to do is obviously a tricky business — MDMA is illegal and the Global Drug Survey isn’t trying to help increase the use of the drug. But the authors are refreshingly honest about it all: They understand that people use the drug because it’s fun. They might as well do what they can to help people be safe.
“I believe that we are missing a huge opportunity and one that is easier to start implementing than changing drug laws,” Winstock writes. “The recent failure of [the United Nations General Assembly Special Session] to significantly shift from zero tolerance to one of adult acceptance that drugs can enhance people’s lives, and that there are other approaches in addition to regulation that might help reduce drug related harm, means that we have to change the conversation now.”
If you want to help the Global Drug Survey out with its research for next year, fill out your survey here.