We're launching a campaign to promote safer ecstasy use

Duncan Dick, Mixmag Editor For over three decades Mixmag has been chronicling dance music and club culture in the UK and around the world. For two decades the scene has included, to varying extent, the taking of ecstasy pills and MDMA. We’ve never endorsed drug use, but we’ve always recognised that for many people it’s a fact of life.

This weekend, over a century since it was first synthesised, hundreds of thousands of people around the world will be taking ecstasy on a night out. But recent testing has shown that the pills available in the UK and around Europe now contain more MDMA than at any time in history. Below, Dr Adam Winstock of the Global Drug Survey, a long time collaborator with Mixmag and someone who cares deeply about preventing harm to recreational drug users, explains why that is – and why it’s a very dangerous thing.

What I know as Mixmag Editor is that we have a responsibility to our readers, our followers on social media and everyone who lives and breathes club culture to try and keep you as safe as possible – especially in 2016, when deaths from MDMA are rising and there seems to be no meaningful effort on the part of the authorities to educate recreational drug users on best practices.

Drug deaths and hospitalisations aren’t just a horrific tragedy for the people affected and their family and friends, they have a huge impact on clubs staying open and festivals going ahead, and ruin those great experiences of partying and dancing together that we all love. That’s why, in conjunction with Global Drug Survey, we’re launching this campaign to encourage anyone who plans on taking an ecstasy pill to dose carefully.

The message couldn’t be more simple: taking a small amount of ecstasy and waiting a couple of hours before redosing could save your life. Telling your friends ‘don’t be daft, start with a half’, could save their lives. If you’re a DJ or an artist, helping us spread this simple message could help save the lives of your fans.

So have a great weekend, have a safe weekend, and hopefully we’ll see you on the dancefloor, not in the first aid room.

Dr Adam R Winstock, on behalf of Global Drug Survey: While 2014 might have been the year everyone was talking about ecstasy pills contaminated with PMA, 2016 is the year that reminds us that the drug that causes the most issues in things sold as MDMA or ecstasy is still, in most cases, MDMA itself. GDS has found that in many EU countries high purity MDMA crystal now competes with high dose MDMA pills where the average is now 100-150mg/pill - with doses over 300mg having been reported. The increase in MDMA related deaths, from 8 in 2010 to 50 in 2014, mirrors the rise in availability of high purity MDMA powder and the amount of MDMA in pills across Europe. Since the start of summer there have been a dozen or more stories implicating MDMA in teen hospitalisation and deaths. With 2 more possible MDMA deaths related at Fabric last week we need to ensure that people who like drugs don’t equate better quality and higher doses with more fun. It seems to GDS that better quality drugs need better quality drugs education (actually rubbish drugs need better education as well).

While drug testing has a role to play, just knowing what’s in your pill or powder does not make it safe. And for the foreseeable future it is likely that only the tiniest minority of people who use drugs will have access to such potentially useful services.

Data from over 50,000 ecstasy users collected as part of GDS2015 and GDS2016 suggest that just under 1% of ecstasy users sought emergency treatment following the use of pills and powders sold as MDMA in the previous 12 months. Young women were 2-3 times more likely to present than men (unrelated to body size or consumption patterns), with the rate among UK female clubbers increasing fourfold over the last 3 years.

With one consequence of the UK Government’s ban on ‘everything that gets you high’ being more people returning to traditional drugs, it seems like a good time help people use drugs more safely.

Giving advice on drug dosing is complicated. People vary widely in their sensitivity and tolerance to drugs. No dose can ever be 100% safe - and people are generally not interested in a dose that is so low they don’t get a buzz. But despite MDMA quality and patterns of use showing wide cultural variation, some universal truths still hold. The more you take the greater the effects. For most drugs there is an optimum dose at which the balance of positives and negatives is about as good at it gets. A dose of about 80mg of MDMA for most people (without tolerance and assuming average body weight) gives them the pleasurable effects of energy, euphoria and empathy, which outweigh the negative effects that become more common with bigger doses such as nausea, panic, paranoia, agitation and gurning. Higher doses tend to leave people feeling too wasted for too long and being less able to enjoy the people around them and their environment. The current average dose of MDMA used in a session across many countries is over 200mg. In UK it’s nearer half a gram! GDS thinks for most people this too much. While people who die from MDMA tend not to take huge doses, bigger doses of MDMA can make you more vulnerable to MDMA related harms like overheating and cardiovascular problems.

Other than having an enhanced experience there are other benefits of keeping your dose down and using less frequently. These include a less intense and prolonged comedown and the avoidance of tolerance. It might surprise you that most users of MDMA use it 10 or fewer times per year. Using less than monthly gives your brain (especially serotonin levels) and body, time to recover and return to baseline.

Although it would be nice if all MDMA manufacturers agreed to produce standard pills of 100mg with a cross allowing easy breaking into 4 equal doses this is planet earth in 2016. Other than keeping a close eye on your mates and getting help if you are worried, 3 things would make a huge difference to most people. It isn’t rocket science - harm reduction rarely is!

1) Aim to use less MDMA (typically <150mg in a session in 2-3 divided doses) and use it more smartly (stay cool and hydrated). If you are using pills try half or a quarter first.

2) Try not to use more often than once every month

3) Try to avoid / minimise mixing with other drugs and / or alcohol. 90% of those seeking emergency medical treatment had used alcohol and / or other drugs.

Please make sure you understand I am not saying that lower doses of MDMA are safe, but generally moderation reduces the risk of harm. Nothing you read here and nothing you do when you take drugs can reduce the risk of harm to zero. The only way to avoid drug related harm is not to use drugs. But to any critics of my advice I say this: It doesn’t matter how you get there, as long as people who choose to use drugs adopt safer use strategies and reduce their risk of ending up in the emergency department (or worse). Most people who use drugs are not idiots and don’t want to ruin their night or their lives. So the next time you get some MDMA be mindful of the fact that more MDMA might not be more fun. Less is more. Don’t be daft, start with a half.

The latest GDS mini-survey looks at pill testing and festival first aid