> I doubt the doctor has ever personally done opiates and MDMA

Well it's a good thing that's not a prerequisite to getting someone's opinion.

I'm all for sensible drug policy, and you may be right that MDMA and opioids are completely different classifications of substances, but the fact that the doctor hasn't personally done both is no reason to dismiss his statements out of hand.

You're right. Although I am much more likely to trust someone who has had significant experience with both (especially if they have also managed to become a doctor or something similar).

I don't have much information, but based on the article, I believe this doctor is biased by the fact that he has focused only on the very rare cases of individuals which develop an obsession with the drug and continue to use it even after it's primarily sought-after effects have stopped working. If you use MDMA every day for a prolonged time, then you are definitely going to get brain damage.

The reason this generally isn't a problem with MDMA is that, long before this happens, you will use up all your serotonin (temporary) and the drug essentially stops working, even with increased dosage. This usually means that people stop taking it before any major damage is done. Contrast this with opiates, where you can keep upping the dose and keep the high going indefinitely over a prolong time (until you overdose).

I dismiss the doctors statements not just because he hasn't done these drugs himself, all I need to do is look at the number of heroin addicts in rehab vs the number of chronic MDMA users.

Is there any proof that serotonin issues are temporary with MDMA? I've heard of people having severe long-term consequences after frequent (> once a week) use for as little as 3 months. Also, I disagree about the potential for abuse. I've heard of many people abusing MDMA, with daily use for long periods of time (all of which have reported memory issues and other permanent problems).

There aren't many good studies in the US precisely because of it's scheduling under the DEA. But serotonin levels are definitely restored. Most estimates range anywhere from a few days to six weeks before serotonin levels are fully restored. Not that permanent damage is impossible with frequent or high enough doses. More than once a week is definitely too much. More than once every month is probably still too much if you want to be safe. Most recommend 2-3 months for maximum safety.

I don't believe there are 'many' people who take MDMA daily for long periods of time, unless they only want negative side effects. They definitely aren't getting the same experience after the third day, regardless of how much they take. You only have so much serotonin. Perhaps these people are not actually taking what they think they are?

Here is an article about a decent study from the UK:

http://newatlas.com/study-effects-ecstasy/10995/

Obviously it's the minority (<1%) of users who are abusing the drug at anywhere near that level. I'm sure that the positive effects are long gone by that point, but I think people who abuse to that extent have become dependent on MDMA in order to feel normal (or have convinced themselves that this is the case). While I'm sure most of these people aren't consuming pure MDMA, there's likely some cases where it is still what's really being used.

Anyways, I've seen many people claiming to have done this (or having friends who have done this) on Reddit:

https://www.reddit.com/r/Drugs/comments/45sgbe/daily_mdma_us... https://www.reddit.com/r/Drugs/comments/1ldmka/so_really_how... https://www.reddit.com/r/MDMA/comments/2765jb/i_used_100mg_o... https://www.reddit.com/r/MDMA/comments/211jkj/ive_been_rolli...

Lots of these cases may be false, but there still seems to be at least a few real cases of this. Of course, that's no reason to make the substance illegal (and especially not a reason to stop studies attempting to use it). Better regulation as a controlled substance is probably the best solution (i.e. enforcing the 2-3 month rule by only allowing MDMA to be purchased at those intervals).

I wouldn't put too much stock in these Reddit testimonials. I agree, there are definitely cases where individuals have used MDMA chronically, but I believe the percentage is much, much less than 1% of users.

There are also cases of individuals who believe they need to eat glass on a daily basis.

Anyone can convince themselves of anything if they want to believe it badly enough. I would be willing to bet that most of these chronic users would not exist in the first place had they sufficient knowledge about the drug.

> I've heard of many people abusing MDMA, with daily use for long periods of time (all of which have reported memory issues and other permanent problems)

I've heard of many people abusing alcohol, with daily use for long periods of time (all of which have reported memory issues and other permanent problems).

Still legal though.

1. You are correct about the potential for long term damage. However the evidence I have seem indicates the permanent damage is due to neurotoxicity while the serotonin is depleted, while the serotonin depletion itself is temporary. Contrary to other posts here, the serotonin depletion can last in the order of 2 years, however, although this is usually in extreme cases.

2. When speaking about potential for abuse, it's worth making a distinction between drugs which cause dependency and/or chemical craving, and drugs that don't. You can develop habits without dependence or craving, but that can apply to almost anything, and is much less of an indicator that the thing is harmful. MDMA certainly had Prentiss for habitual use, usually as part of a multiple-drug-abuse condition, but in and of itself does not have dependence or craving properties.

Fortunately, both of your arguments make clear the need for more research, and thankfully it's finally happening.

While I tend to agree with you, I think the opiate epidemic is salient as an illustration of unintended consequences. Do I think this will lead to addicts? No. Do I think people will get hurt? Most likely; it's not exactly a brisk cup tea in terms of physiological AND psychological effects. Will it get abused? Of course. People abuse sugar.

My point being, there's a line between caution and fear mongering. I think you COULD interpret this as being cautious rather than illustrating an irrational fear.

I agree, I don't think the doctor is intentionally fear-mongering. I think this doctor is probably just biased from his own second hand experience with a very, very small and unrepresentative portion of MDMA users. Misguided.

My issue with the doctor's statements is concerning only the potential for abuse/addiction (which is not even worth talking about when compared to opioids). The potential for harm is definitely worth being cautious over.

The comparison with opioids is erroneous because prescribed opiates are given to a patient to take home, allowing abuse and diversion. MDMA use will take place at a medical practice. No abuse or diversion will take place (barring theft).

> MDMA has an exceptionally small potential for long term abuse when compared to most other drugs.

(Citation Needed)

See my additional reply to DINKDINK's comment, further below for source/citation.

Source?

Primary. Can confirm. Not even in the same ballpark.

If you've ever been in love and been with with that person and it feels like a moment could stretch on to eternity and everything is perfect... thats what opiates feel like.

With MDMA everything seems unique, there is a pronounced clarity of mind including insight, and vision. Tactile senses are heightened - it is a full, wholistic high. Perspective often shifts from minutae to space/time. Heightened senses (tactility) and feelings of empathy, understanding, oneness are universal. You may want to dance, sit down, look at the carpet, hug a friend.

The difference may seem subtle to a drug-naïve individual but they are two totally different head spaces

I want to try a light psychedelic but not sure where to start. Never taken any sort of drugs before, including alcohol. Any suggestions?

Edited

LSD is not a "light" psychedelic by any sense of the word. It's pretty great in many ways, but one of the big downsides is the duration of the drug. Mushrooms would be a better first bet, solely because the duration is significantly shorter. "light" is a hard term to use for any psychedelic as most can put you into total, terrifying ego loss. That being said, safe and sane mushrooms are your best bet IMHO. Just read trip reports to get an idea of the proper set and setting to get the most from the experience.

I'd have to disagree, despite being a proponent of occasional mushroom use. Any significant dose of psilocybin has the potential to turn into a VERY overwhelming experience. Especially for a first time user.

As others have mentioned I'd recommend starting with cannabis, which in my opinion very much qualifies as a psychedelic.

For sure, as I mentioned, it's hard to call any common psychedelic light or casual for that reason. But, 3 hours of too much is much much better than 6 hours of too much :)

Speaking of duration: it can be really long, way longer than regular 10 hours. Once a trip on piracetam+L was 40 sleepless hours. Shrooms for starters.

Completely unrelated. Not comparable. I suggest you visit http://bluelight.org/ to learn more, including a lot about safety.

I'd also recommend https://www.erowid.org/ .

I second erowid. Fantastic resource.

Thanks, I'll start there.

First of all, if you have a family history of mental disorders, like schizophrenia or bipolar, I would highly recommend not trying any psychedelic. There exists a possibility of uncovering a latent genetic mental disorder that otherwise would not have appeared.

That said, I wholeheartedly recommend starting with Marijuana. It's not a psychedelic in the traditional sense, but it's a good introduction to mind-altering drugs.

From there, either LSD or Mushrooms. These are more typical psychedelic experiences, with long durations. LSD can last 8-12 hours depending on the dose, mushrooms is 6-10, depending on dose and species. I personally prefer LSD, but you should be cautious and ensure you get legitimate stuff. Taking precautions and purchasing off the internet from a reputable vendor is the safest method in my opinion.

When it comes to LSD, I always recommend swallowing over just leaving it on your tongue, especially if purchased from an irreputable source. The common Research Chemicals sold as LSD are only activated sublingually (through the mouth/gums), whereas LSD is sublingual and oral. For a newbie 100ug I believe is considered a light dose, although you could go down to 50ug and still feel Something.

General trip advise would be to ensure you're in a positive mindset, and in a secure, safe, comfortable setting. Taking a walk through nature is nice, as well. Set and setting is important.

I would advise against trying any research chemicals (25X or 2C-X, where X=[A-Z]), just because they are newer and less known, but with the right research and precautions you could be okay.

Avoid mixing until you know what you're doing. A lot of people like to mix marijuana and lsd/shrooms, and I find it definitely intensifies the experience, while clouding it a little.

Overall, you should conduct a lot of research and read people's trip reports so you know what you're getting into. Tripsit.me is a wonderful resource, and includes an IRC channel for support and conversation while tripping. Erowid is a popular site for information as well.

A friend of mine actually discovered his latent schizophrenia through Marijuana usage. So yeah, not as safe as people want to believe. I honestly think that there is less mental health risk in taking MDMA, Speed or Alcohol compared to THC.

Interesting point about schizophrenia and bipolar. I'm still in the "curious" phase, so I'll definitely be doing more research. Anyhow, thanks for the other tips man; I've saved this to my HN favorites.

Besides family history of mental illness, i remember reading that a "bad childhood" , or a period of very high stress are also risk factors to getting mental illness with marijuana.

I would recommend starting with LSD; it's much easier to take compared to something like mushrooms, and it's easy to reduce dosage.

I often took a 1/4 hit when I was in college; aka cut a normal hit into 4 pieces. I found this to be a really nice, 'mellow' (well for LSD anyway...) trip; You won't hallucinate much (probably none at all), and so you'll still be able to function and get around, go on a hike, that sort of thing. You'll still have an incredible experience full of self discover and personal insight, but of course each persons milage may vary.

At some point once you have a feel for it you'll want to take a full hit and experience the full effect. But that takes more planning and you should definitely find a designated 'watcher' because you can make some really irrational decisions on this stuff, esp. if you are inexperienced. Always good to have a straight friend around to stop you from making phone calls to family (bad idea), going out for a hike in a blizzard (also attempted this one), you get the idea.

Mushrooms in my experience are much more unpredictable and given the option I personally always chose LSD.

A big problem with LSD it that it can last an insanely long amount of time. The first time I took it I was tripping 16 hours later.

True, my first full trip was similar. That's also why I recommend taking a small dosage the first time (hell most times); my 1/4 hit trips last around 6-8 hours. I also found I could sleep without trouble on that dosage as well, another major issue if you take a full hit (you tend to not be able to sleep at all that night).

I find I can't sleep while I'm affected by the drug, but when I am able to sleep again, I know the drug's worn off. I also try to plan accordingly and drop earlier in the day

Do you know what the dose was? If it was a tab, what did it taste like? Did you swallow or leave it under the tongue?

Unfortunately, there are a lot of Research Chemicals that are sold as LSD. They can have wildly different effects and durations, and are much less 'known' compared to LSD.

My first trip was 10 or 11 hours and that was on ~200ug.

cannabis.

it's incredibly non-toxic, cheap, easy to get, actually legal in some places, easy to confirm that what you bought is what you think it is, and will produce a pleasant and mild high that has some attributes in common with psychedelics (though it isn't a true psychedelic in the classical sense).

Hmm I guess that's something to consider. Thanks.

imo Cannabis is far and away more physically harmful than LSD and MDMA despite being orders of magnitude more commonly available

LSD is also incredibly non-toxic. it's such a strong drug though that even though it's very safe for your body I really can't recommend that a person uses that for their first ever experience with drug-altered consciousness.

MDMA is just objectively more toxic than cannabis. this isn't really subject to your opinion.

if what you're referring to is the fact that cannabis is frequently smoked, that's not a fair comparison. oral cannnabis products exist too.

Smoked cannabis is harmful to the lungs and oral cannabis is easily overdosed.

No matter how you spin this one, you have to be careful with whatever road you choose to go down.

remember, you started this as a comparison of the relative dangers of cannabis vs. lsd or mdma. stay focused. you tried to make a point and I disagreed with it. accusing me of spinning is disengenuous.

are you really going to start talking about "easily overdosed" when the drugs you're comparing it to are lsd (active in the microgram range) and mdma (active in the milligram range)?

seriously, you feel like you can get away with claiming that cannabis is more dangerous than a drug that most people encounter as mystery pills at a party? get real.

You are of course completely correct. But given one hit of acid vs one hit of a cannabis brownie, people are more weary of the hit of acid and tend to subdivide it into pieces whereas novices typically trust cannabis brownies to be weak or they eat multiple of them and receive an overwhelming dose more often than not. Or maybe not. Your thoughts?

my thoughts are that cannabis is remarkably safe in general, but that everyone using it should be well informed and not be taking edibles that they don't know the content of.

in legal states you can buy properly labeled edibles at a shop. if it's homemade stuff, you really have to be a lot more careful. either make it yourself or really trust your supplier. personally I would never take edibles bought from a dealer unlabeled. that's a real risk of an uncomfortable experience.

I think smoking (or vaping if you're sensitive to the smoke) is by far the safest and most effective way to take cannabis though.

LSD and MDMA there are really no safety tips that can possibly help. you either trust your source or you don't. if you trust your source and follow the dosage guidelines it's fine. both of those drugs are very safe at appropriate doses.

WTF!?!

You CANNOT overdose on cannabis. As in it will not kill you.

The only way you could say that is if you have some weird definition where by having a "bad trip" counts as an overdose.

I think he literally meant unknowingly taking so much that it overwhelms you.

This

As someone who has dabbled with all three I'd recommend starting with cannabis then MDMA and finally, in a safe environment, LSD. With one-off doses toxicity isn't your major concern, it's potential self harm through being unacquainted with different states of mind and control. Start on the more familiar end and work your way up if you're confident in your state of mind and sense of control.

For the record I've never had a bad experience with any of them. I'd say cannabis and MDMA are my favorite substances, though I mix them with tobacco and alcohol so I suspect there's a synergistic effect where my reward center is being lit up like a Christmas tree. FWIW I don't go out to raves or clubs - I'm old and an introvert - I just hang out with friends in our own homes or outdoors near our homes so the risks are lower.

I would add not to use LSD alone - have a sober 'trip sitter' with you. If things take a negative turn, they might be able to turn it back around, or at least calm you down and stop you doing anything silly.

If I had absolutely no experience with drugs, but had my current knowledge, I would start not with psychedelics, but with low doses of an empatogen (MDAI, preferably, which is hard to obtain but still legal in some countries, if not, then MDMA). This experiecne is much more manageable than psychedelics and if I would meet any resistance (which can happen), it would be easier to climb down. Only after that would I try psychedelics (mushrooms, for a shorter experience or LSD, for a longer one). With an experienced sitter I can trust.

A good first time psychedelic is 2-CB [0] (low dose 10-15mg). It will give you fairly intense visuals, somewhat similar to those on LSD, with virtually no anxious or weird thoughts. As always set and setting are still important, and you should be prepared for the chance of a bad trip, but I would say you're significantly less likely to have a scary experience on 2-CB than LSD.

[0]: https://en.m.wikipedia.org/wiki/2C-B

Note that you need a very accurate scale (measures down to the milligram) to accurately measure dosage for this substance. Please make sure you don't take too much. It is impossible to measure by eye.

it's also ridiculously rare and hard to find (requires well connected sources or pretty complicated darknet/btc/dropsite setup).

in addition to that, you're talking about a white powder drug where the effective dose is in the milligrams range. confirming purity and appropriateness of dose is stuff that requires a lot of experience. this is not beginner stuff.

Educate yourself thoroughly on your options, on the risks, and benefits of anything and everything you might be considering.

There's a lot of really great material written on these substances. erowid.org is a good starting point, but don't stop there! Get some good books on the subject.

Be wary of what some random person tells you. Most people are really misinformed, and there are a lot of myths and urban legends floating around that are bandied about like facts.

Do your own research! Be very thorough. Know what you're getting yourself in to. Be very respectful of the substances, and take them very seriously.

You missed out on the golden age of MXE. God what a drug. Not a psychedelic but with light negatives and high positives.

Take one of the shorter-lived 2C-x drugs and watch Flash Gordon and Heavy Metal.

My preferred combination is AMT and 25C-NBOME (VERY DANGEROUS TO DOSE WRONGLY) with some ethylphenidate. The sight of a rising sun turns from being saccharine to something "beyond man and time". The 25C-NBOME is less for unique effects and more for the fact that you could literally have months worth of trips (1x a week) in a tiny bag.

If you want an escape plan, have a benzo like clonezepam (sp?). It'll tranquilize you out of a nightmare if some fucked up shit appears.

And remember, the interesting thing about psychedelics isn't the "oneness with everything" bull that idiots talk about. That's just a temporary addictive feeling. One of the interesting parts is the enhanced capability for visual modeling and making connections. The other interesting part is that it makes you feel like a golden man Prometheus thing. You conjure up mythologies and struggles from just observing the local area outside.

Also take 200-400 mg of magnesium.

I also recommend having a benzo before taking any psychedelic for the first time. It will bring you out of it for the most part if you start having a bad time.

The best place to start is a substituted phenethylamine rather than a tryptamine, as these compounds tend to be gentler, more euphoric and less reality-shattering. Some research chemicals that are good options:

https://psychonautwiki.org/wiki/2C-C https://psychonautwiki.org/wiki/2C-E

In terms of consciousness expanding, DMT (in the form of Ayahuasca) is probably the most potent psychedelic. It can be emotionally intense though, so not the place to start.

Phenethylamines tend to have more side effects and feel less natural.

The ones you listed, such as 2C-C and 2C-E are quite different different. 2C-C may be gentle but 2C-E can be extremely intense / reality shattering. I will never look at reality the same after a 20mg dose of 2C-E. Also, many of the phenethylamines are now illegal. Including the NBOME series which are extremely toxic.

I'd say stick with the tryptamines like 4-HO/AcO-DMT/DIPT/MIPT, DPT, ALD-52 as they tend to be more enlightening rather than entertaining, IMO.

LSD and MDMA are different things.

Perhaps start by reading wikipedia pages.

Wikipedia is a good source but for those interested recreational drugs I strongly encourage those interested to visit bluelight.org over Wikipedia because Wikipedia provides less practical information for end-users.

If you don't know if there's a difference between MDMA and LSD, your first source shouldn't be something like bluelight. You should have a lot of information before you even consider being an end-user.

Avoid LSD.

Good advice if you aren't in a positive mindset

SOme oif the best times in my life have been on LSD.

I feel that the first chart/plot on this wiki gives a pretty good estimate on the relative potentials for abuse of various drugs.

Note the relative positions of Ecstasy, Cannabis, and Heroin:

https://en.wikipedia.org/wiki/Substance_abuse

PDF for the actual paper containing the chart:

https://www.thevespiary.org/rhodium/Rhodium/Vespiary/talk/fi...

And even heroin as a drug causes less physical harm in principle than stated - proper administration primarily results in constipation and very rarely organ damage. The primary danger come from improper intravenous drug use along with variable concentrations of drug due to buying from a black market, resulting in accidental overdose.

Khat is a funny one - didn't we already go through the racial disparities in prosecuting "crack" and "cocaine" differently? It's too bad the African Khat-using community didn't muster as much political muscle as the kratom community is.

Spoiler for anyone that doesn't want to click through to the first link: MDMA is apparently roughly the same in physical harm as marijuana, but rates lower on the dependence scale. I did not expect that, but then, I've never done MDMA.

That seems highly misleading. I think MDMA is far more physically dangerous than cannabis. Many people have directly died from irresponsible use of MDMA, but no one has (directly) died from any use of cannabis. MDMA can certainly be safe and beneficial if taken responsibility, but:

- Doses should generally be spaced at least 2 (many recommend 3) months apart.

- The minimum effective dose should be taken. Even a light overdose can create an uncomfortable, traumatizing, or even physically dangerous situation.

- Hydration and access to cool environments is important. Overhydration can also be a risk, so it's good to have access to electrolyte-laden drinks (Gatorade etc.). Overhydration, dehydration, and brain overheating are the leading causes of MDMA-related death.

- Supplements should be taken to reduce the inherent neurotoxicity even if you do all of the above things right. Some good examples on http://www.rollsafe.org.

It's true that dependence-wise, cannabis is probably worse, though. It's pretty hard to build a dependence on MDMA, as you'll likely only feel the uncomfortable stimulant effects (and other negative symptoms; this can lead to long-term or permanent neuroreceptor damage and dysfunction) if you take it on a weekly or daily basis.

No one has ever died directly from an MDMA overdose (as far as I know). Yes there have been indirect deaths usually from over-hydration (which causes the brain to swell, with or without MDMA), which usually happens in a rave/dance setting.

I'm sure there have been many indirect deaths from cannabis as well. Lung cancer, car crashes, falling down an elevator shaft, etc.

This is going to be true of any sufficiently powerful psychoactive substance.

If you completely ignore deaths for a moment, many report severe negative symptoms, lasting weeks or more, resulting from dehydration or overheating from MDMA. Overheating is also speculated by many researchers to be responsible for some of MDMA's neurodegenerative and neurotoxic effects.

You probably won't die due to MDMA, but if you're not careful you can certainly cause brain issues. And that makes it more physically dangerous than cannabis.

Perhaps. Personally if I drew the graph, I would put MDMA and cannabis closer together in terms of physical harm. I think they are dangerous in different ways and it's difficult to say which is more dangerous in absolute terms.

Like you say, if you are careful and informed, you can avoid lots of the dangers of MDMA with responsible use. It's difficult to smoke pot and not do some damage to your lungs, no matter how careful you are. Vaporizers not withstanding, but vaping was probably not considered in the graph.

I think one of the biggest problems with MDMA is that what you are getting is not always MDMA[1]

Better access to drug testing for consumers could help here.

[1] https://www.ecstasydata.org

I agree, but this isn't a problem with MDMA, but with illicit drugs in general. When you buy cannabis, LSD, cocaine, or anything else on the street, you have no way of knowing what's in it for sure unless you have a way to test it.

This is one of the big arguments for legalization / decriminalization. It won't be an issue with the MDMA these trial patients are receiving for example.

that's not a very accurate way of phrasing it. in some scales it's considered similar in abuse potential but that is extremely different than physical harm.

both are considered medium for abuse potential. cannabis is so non-toxic it doesn't even chart for physical harm. mdma is medium toxic, especially with sustained use.

Not according to the graph or the study. Source? Toxicity is not the only measure for physical harm.