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
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...