Pretty much any drug can be extremely dangerous. I see this response often (and I’m not critzizing you here) but look: painkillers, right? Given all the time. Can be EXTREMELY dangerous. Alcohol: CAN BE extremely dangerous. Millions of people die a year in alcohol related death. Nicotine: dangerous. Blood pressure medication: can be dangerous. Birth control pills...also dangerous. Drugs are freaking dangerous. Anything you take, could be dangerous yes. But that does not mean drugs should not be approved. Every drug is dangerous. So I am really sick and tired of people pointing out that “this could be dangerous”. Yes it could. It could also save lives. Might it kill some people due to complications? Yes it might. Lots of drugs have complications that could potentially end in death. Just watch any damn tv ad for a drug in the US!!

Yes but MDMA specifically will mangle your brain after very little recreational usage relative to almost all other drugs. Recreational use of MDMA a few times a week is _very bad_ on the long term health of your brain, very few other drugs are on that level — certainly none of the drugs you’ve listed.

"a few times a week" is considered pretty insane for even heavy users. I don't think that just about anybody is advocating that frequency of use. Regardless of long term effects I think most people would be feeling pretty messed up by the end of that week.

Once a week is sustainable in the short term but I am not recommending that and make no claims as to its safety in the long term. I would have no way of knowing other than googling studies.

That being said I'd still like a source for the claim:

"Yes but MDMA specifically will mangle your brain after very little recreational usage relative to almost all other drugs."

like the other poster said, a few times a week is not recreational at that point. Recreational use tends to be at most every other month, but for many more folks is going to be much less than that - 1 to 3 times a year.

I've known a person or two that simply didn't know how to space out their use, and did wind up with depression as a result. But this is the sort of thing that you can teach so long as you are honest about the rest of your drug education. It is something you can teach when you sell it to people. You can limit what folks can buy and keep a record of when people buy it - we already do this with some decongestants, after all. It isn't that there is not risks, but your comment is misguided on what constitutes more common recreational use of this particular drug and the things we can do to avoid this situation.

Sorry but few times a week is not recreational anymore. your brain needs rest for some months to rebuild/rest the receptors. truly these substances are controlled because they need little to get an overdose (at least in developed countries). It is a risk prevention measure because not everybody has the iq of 100

Recreational usage is not relative to the substance, it’s dependent on behaviour. If you’re dependent on a substance (whether that’s physically dependent or mentally) you’re no longer a recreational user but if you’re using something frequently or infrequently for enjoyment then you are a recreational user — regardless of whether or not that substance is safe to use at your chosen frequency.

I think the point was you can’t claim recreational usage when you are using the substance in such a way that you will be doing harm.

>> is _very bad_ on the long term health

Would you prove that please?

MDMA is well understood to have the potential to induce neurotoxicity, so people may want to slow down and learn more about why that is before they take the ‘yolo’ approach.

I completely agree with you. I just don't want to reinforce the impression that MDMA can be treated/used in the same way as tobacco, alcohol, marijuana, or even LSD. I am not opposed to its use, medically or recreationally, I just want to make clear that it is something that should be treated with more care and caution that, say, marijuana.

This Lancet study [0] rated the 'harm to self' of ecstacy much lower than alcohol:

https://www.thelancet.com/cms/attachment/b3a9c7d1-bb08-42f3-...

Two points to note: (a) The study looked at the effect of the 'street' drug Ecstacy - ie. cut with other harmful drugs - not pure MDMA; (b) Perhaps the low 'harm to self' rating is an indirect product of the fact that it is illegal - if it was more widely available people would abuse it much more than alcohol and it would get a higher 'self harm' rating

[0] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

No one said anyone should consume MDMA at the same frequency you could safely consume alcohol.

> It disgusts me that the stuff is illegal while cigarettes and alcohol

Alcohol and cigarettes are not really comparable to MDMA, and I just wanted to make that point. Marijuana? Sure, in much the same category, probably safer. MDMA is a whole different class of chemical.

Of course they're not comparable because MDMA is much, much safer than either alcohol or cigarettes. We're talking millions of deaths a year for alcohol and cigarettes vs. a few isolated deaths with MDMA. Socially, there is no comparison or doubt which of the three is the worst: alcohol by far. Can you even find an instance of domestic abuse or murder facilitated by MDMA? I could find a whole bunch that happened just this past hour.

I can have a beer every night for the rest of my life and experience little to no permanent effects. Long term MDMA use on the other hand has been shown to cause "marked neurodegeneration in striatal, hippocampal, prefrontal, and occipital serotonergic axon terminals. Neurotoxic damage to serotonergic axon terminals has been shown to persist for more than two years."

There's simply no way to substantiate your claim. Plenty of people who drink daily get sick and die from the effects of alcohol, including drinking one beer a day. Also, if you're comparing one beer, you need to compare it to the equivalent MDMA dose which would not cause any psychoactive effects just like one beer typically doesn't.

> I can have a beer every night for the rest of my life and experience little to no permanent effects.

And a certain percentage of people that tried that would get addicted and die from either acute or chronic effects.

Addiction potential and usage patterns are part of the harm profile of a drug. Alcohol is measurably worse.

Safety has more than one axis. Also, if we sold MDMA in pubs, and told everyone "hey, take as much as you like, as often as you like" are you sure things would go swimmingly?

More specifically, MDMA is neurotoxic.

Indeed, this is a good overview: https://thedea.org/mdma-risks-science-and-statistics-technic...

no it's not! it references a retracted paper https://en.wikipedia.org/wiki/Retracted_article_on_dopaminer... where he used methamphetamines instead of MDMA.

The author was one of the key critics that got that paper withdrawn! From the overview:

> In the fall of 2002 George Ricaurte, the Dark Prince of suspect science, published an article in the prestigious journal Science that claimed that a “common recreational dose” of MDMA caused severe damage to the dopamine systems of monkeys.[26] (Parkinson’s disease involves the death of dopamine neurons, so extensive damage to your dopamine axons could presumably cause symptoms similar to Parkinson’s.) The press and politicians went mad. Draconian new anti-MDMA laws were passed, including the infamous RAVE Act, which made it illegal to throw a party if you “should have known” that some people would be using drugs at it. MAPS, which had been on the verge of finally having its MDMA post-traumatic stress disorder research approved, was stopped cold in the face of the apparent new evidence of MDMA’s horrific dangers.

> More than a year later, after scathing criticism from TheDEA.org, the house of cards collapsed when Ricaurte sheepishly admitted that the experiment never really happened: The monkeys had actually been given massive doses of methampetamine, not MDMA! He also admitted that no matter what they had tried, they had been unable to damage monkey’s dopamine systems with real MDMA.

yes, long-term effects of alcohol are much worse, mostly because it damages the body as well as the brain, is used in larger amounts and through longer periods. Meanwhile people who have used MDMA at parties when young (and then stop using it, as most will) will have mostly no noticeable adverse long-term effects.

Now of course if you consumed alcohol at anywhere near the frequency you consume water that wouldn't be good either, but why would that be a fair comparison?

so you comparing long term heavy alcohol use, vs minimal MDMA use during youth.

Not really comparable. Would be comparing someone who has used MDMA 1-2 a week for 20 years against someone who had a couple of beers a week in college then stopped.

Heavy prolonged use / abuse of MDMA is damaging. Same with any drug

> so you comparing long term heavy alcohol use, vs minimal MDMA use during youth.

Which are real-world, observable patterns. I'm not sure why we should ignore that?

Well exactly, what would be a good comparison here? Why mention heavy long-term abuse of MDMA (which is I think very unusual compared to heavy abuse of alcohol) in an article about MDMA treatment? The MAPS PTSD protocol involves, if I remember correctly, in all cases under 20 doses of MDMA in the whole life, mostly much less.

"but if you consumed MDMA at any where near the frequency it is safe to consume alcohol it would not go well"

If you consume 20 joints of marijuana a day it won't go well either compared to tobacco. But nobody does that (I mean few do).

Yes, it's a nonsense to compare that.

What frequency is it safe to consume alcohol at? Last I checked, never, unless of course you want to cite studies funded by the alcohol industry. Your opinion is that MDMA is worse than alcohol. I don't even think it's in the same league. In my opinion and extensive experience talking with addicts, alcohol is by far the most destructive drug, worse than heroin (and other opiates/opioids) and even methamphetamine. It is most destructive to the self, mind and body, and it's certainly most destructive to society. MDMA has a handful of deaths over many decades and billions of doses whereas alcohol kills 2.5 million people worldwide every single year. There is no comparison.

Indeed, a relative of mine recently died of oral cancer, which was thought to be caused by moderate drinking.