This MDMA harm reduction guide is not intended as a medical advice. It is merely of the author’s experiences and opinions formed through reading research articles and anecdotal reports. It is recommended that you speak to your doctor before you try MDMA.
MDMA – MDA – Ecstacy
In this post, MDMA harm reduction will imply the same for MDA and Ecstacy. The harm reduction steps are the same for these drugs.
Ecstacy can often come in a pressed pill with additives in it. Sometimes it may not contain any MDMA or MDA at all. Pressed pills will likely contain more toxic additive and is not recommended.
Safety & Toxicity
Below is a large scale analysis conducted by The Lancet Peer Reviewed Medical Jounal, from the UK. The graph shows the overall harm scale of 20 recreational drugs.
As for the relative harm scale, Ecstacy (MDMA) is listed near the bottom, making it one of the least harmful recreational substances. As for alcohol, which is legal in most countries, is listed as the most harmful drug.
Australia also conducted a large scale analysis, and came up with a very similar result. Again, alcohol as the most harmful drug, and MDMA as one of the least harmful. This raises the questions of whether if practicing MDMA harm reduction is necessary.
MDMA can potentially become harmful if:
- Combined with excessive dancing
- Not hydrated properly
- Used in a hot environment
- Mixed with alcohol or other drugs
- If inappropriately large doses are taken at once
Don’t take this as a medical fact, but nearly all MDMA related deaths are not overdoses, but overheating.
MDMA Harm Reduction
The Exaggeration of MDMA Harm?
Study shows that previous research on Ecstacy induced serotonegic pathway alteration may be greatly overestimated for the average users. In this study, “average use” indicates 2 pills twice a month.
The average dose of a single pill is 100 mg. The neuro-imaging conducted in the older study was targeted for the heavy users that took 720% more pills than the average users. So the difference is like casual drinkers to alcoholics. If we only studied the alcoholics, we will see only the heavily damaged drinkers.
Why I’m Writing This Guideline
During my youthful drug endeavors, I spent a lot of time searching for a comprehensive and well compiled MDMA harm reduction guide, but with no success. I had to personally read through many scientific studies, anecdotes, and do my own trial and error to figure out the best ways. So let’s get right into it.
1. The Serotonin Propaganda
Perhaps you’ve seen this scary image. It’s put off many people from taking MDMA.
It is not yet proven that serotonin is really the happy chemical. Having an abundance of serotonin isn’t necessarily a good thing, contrary to popular belief. There are different types of serotonin receptors to consider, and also each of those have their own subtypes.
Ecstacy downregulates 5HT2A receptor, which is often considered to be the “bad” serotonin receptor. So this downregulation effect might be favorable in the long term, and might even be responsible for the afterglow effect that many users report.
Many researches indicate that high serotonin levels leads to depression, inflexible thinking, anti-novelty, timid personality, and anxiety. People that take serotonin increasing meds report these symptoms as a side effect.
So the theory that MDMA induced serotonin depletion leads to a long term depression may not be valid at all. At least it’s more complex than what we can observe. More importantly, it might not be something that should concern the average users at all.
I have taken MDMA close to 100 times, and sometimes took irresponsible doses like 1500 mg in a night. I have not noticed any reduction of overall sense of happiness or quality of life since. But I encourage you to exercise proper MDMA harm reduction, and not take more than 250 mg per night.
2. Is MDMA Harm Reduction Necessary?
The neurotoxicity of MDMA may have been greatly overhyped. Regardless, it is wise to practice proper MDMA harm reduction. This is true for any other substances.
Some people go to great extent with MDMA harm reduction. For example, they take pre-loads of supplements, and then take some morning after pills. But usually the same group of people that practice MDMA harm reduction won’t do the same with alcohol. Alcohol is likely exponentially more toxic than MDMA, and obviously leads to beasty hangovers and other physical burden.
I have never gotten a hangover from MDMA unless if I had taken an unreasonable doses in a session or if I mixed it with alcohol. Even then the hangover isn’t nearly quarterly as bad as what alcohol does.
One time I had taken MDMA 3 times in a span of 2 weeks. I exercised proper MDMA harm reduction such as responsible dosing, and not mixing alcohol. I did not take any pre-load of vitamins either. After this, there were no noticeable depressive hangovers.
3. Supplements for MDMA Harm Reduction
There are many supplements that are known to prevent the supposed neurotoxicity of MDMA. But these are the same supplements that partially block the effect of MDMA. If you’ve been taking these supplements, and notice that your MDMA tolerance is increasing or you just don’t get so high anymore, then this could be the culprit.
Whether if these supplements are necessary as a means of MDMA harm reduction is a very good debate. If taking them before MDMA results in ruined session, then perhaps consider taking them just before you come down instead.
Alpha Lipoic Acid may prevent serotonin depletion.
Acetyl L-Carnitine may prevent serotonin depletion.
Vitamin C may reduce oxidative stress caused by MDMA.
Resveratrol can protect the dopamine neurons from damage.
Magnesium can be helpful for bruxism.
Grape Fruit Juice can inhibit P450 enzymes and thus block the conversion of MDMA to MDA. There is no solid evidence that MDMA is anymore harmful than MDA, however.
5-HTP is a precursor to serotonin that MDMA users take the following days after.
Melatonin can help with sleep after MDMA use.
I’ve wasted quite a few MDMA sessions due to my ignorance. Pre-loading with supplements prior to MDMA resulted in many harsh disappointments like getting high but not feeling euphoric at all.
I thought that I had developed a permanent tolerance to MDMA. Only when I stopped pre-loading with vitamins, I rolled just as hard as I used to when I first started.
Magnesium completely kills the euphoria and causes some anxiety. Acetyl L-Carnitine and Alpha Lipoic Acid does pretty much the same thing; blocks the euphoria and make the high uncomfortable.
I will take these supplements at the end of the MDMA session if I remember to. But I either way I still do my best to exercise other MDMA harm reduction measurements.
4. Mixing & Interactions
Mix at Your Own Risk
LSD may potentiate and extend the effects of MDMA, reduce the side effects, and reduce the comedown symptoms. Most users take MDMA about 4 hours after taking LSD
Psilocybin may potentiate and extend the effects of MDMA, reduce the side effects, and reduce the comedown symptoms. Most users take MDMA about 3 hours after ingesting Psilocybin.
Piracetam is known to enhance the roll of MDMA. It’s reported to help bring back the “magic” and prevent the depressive comedown. Taking pre-loads of racetams ensures for full benefit. Piracetam is sometimes considered as MDMA harm reduction nootropic.
Memantine is prescription drug is known to reverse tolerance to many drugs. It is an NMDA receptor antagonist, so it’s similar to ketamine. May potentially reduce neurotoxicity?
Bromantane may reverse tolerance to MDMA and extend the roll.
Ketamine may reverse the tolerance and enhance the effects of MDMA. Using ketamine while coming down from MDMA may effectively ameliorate the depressive feeling. May also reduce MDMA neurotoxicity. Both drugs may lower seizure threshold however.
Cocaine may seem to not mix well together if you’re trying to practice MDMA harm reduction. But if it means not taking anymore MDMA for the night, and keeping to a responsible dose of cocaine, then it could a better plan. If you’re still partying while the molly is wearing off, then cocaine can keep you at it. It might even make you bypass the molly comedown altogether.
Alcohol can take away the therapeutic potential of MDMA. It will likely amplify the neurotoxicity of MDMA because alcohol can cause excitotoxicity by itself. The mix may trigger MDMA hangover which otherwise would’ve not materialized. Perhaps because alcohol depletes the enzymes and neurons that protects the brain from oxidative stress. Alcohol itself causes very heavy brain damage that can last anywhere from a week to a month after last use.
Amphetamines or no amphetamines? This variable might determine whether you get a hangover or not. Amphetamines likely greatly increase MDMA side effects, comedown, and hangover. The experience will most definitely be enhanced, however. The most common ingredient in ecstacy, second to MDMA, is amphetamines.
5. Quality of The Drug
As for MDMA harm reduction, the quality of the drug is the game changer.
The general rule is that pressed pills are almost always cut with other substances. They might call for more fun, sure, but we’re looking at much greater neurotoxicity where otherwise pure MDMA would’ve not caused.
Using test kit is going to be harder and less accurate with pressed pills too.
Personally, I don’t condemn the pressed pills. But really, if I have access to uncut Molly then why bother?
If your batch looks something like the picture to the left, then there’s much greater chance of it being unadulterated.
The lighter the colour, the more chance of it being meth. If there’s no test kit available on hand then small amount can be placed on the tongue to see if it goes numb. If it does then it’s meth.
Purple, brown, and pink are usually safe. Pink often means higher purity in my experience.
6. Dosage & Redosing
Dosage and redosing is a big topic for MDMA harm reduction. You can do everything else well but if you take too much then you could still get a hangover. If you can only take one pill and be okay with it, that would be the best. But that’s not always easy.
The general MDMA harm reduction practice to keep is to not take more than 250mg of MDMA per night. The reason for this is to ensure that you do not build a permanent tolerance. There’s been countless cases of people building permanent tolerance because they take too much, too frequently.
If you are redosing, then it’s generally recommended to only redose once. Taking a second or third dose may increase the neurotoxicity. If you take the redose too soon, you may feel too high. If you wait too long then you may have missed your redose window and it’ll do nothing.
I generally redose between 60 – 90 minutes after the last dose because for some reason MDMA has a short half life in my body. Most people are better off redosing between 90 – 120 minute after the first dose.
About The Author
I have taken MDMA about 100 different times in the span of 4 years. 30% of the time was for recreational reasons. 10% to get me out of a bad trip or a low mental state. 20% of the time to treat PTSD and anhedonia. 20% for bonding and intimacy. 10% for science and experiment. 10% for spiritual reasons.
I have experimented with about 50 different supplements and chemicals taken together with MDMA. And I’ve also spent at least 300 hours on reading about MDMA, serotonin, GABA, dopamine, and related topics.
After being unable to find a throughout guideline on MDMA harm reduction, I decided to make some myself.
Please share this with your rolling buddies so that more people may benefit. If you would like to support me, please consider donating. Thank you.
That is all for MDMA harm reduction guide. If you are using clean MDMA, at a dose of 250 mg or below per night, in a suitable environment, then I’d say there’s really not much to worry about. Using supplements before taking MDMA will likely block the high. So best to take them as you’re coming down.