4 ms·

Kinda wild that MDMA is on the list with those other three (opioids, meth, and coke). Seems firmly in a less harmful tier to me.

qwerty456127 4y ago
Arguably single-dose MDMA is less than single-dose coke and equals meth in terms of physical harm. Of course very different story if you consider repeated usage.
- netizen-936824 4y ago
  What, exactly, is a single dose of each of those substances? What makes them equal pharmacologically?
  - qwerty456127 4y ago
    The dose an ordinary person (not a regular abuser) would take. Coke is not equal (I mean it is arguably zero harm if taken rarely, but pretty addictive and serious harm if taken regularly), MDMA and meth are extremely similar substances chemically (MA=meth) and have similar mechanisms of action. Same harm prevention techniques work great with both. The most important difference is MDMA being harder to abuse than meth is, because a number of reasons. Most of MDMA users take it occasionally for good, most of meth users take it regularly for harm. AFAIK. Obviously there are many exceptions.
    - netizen-936824 4y ago
      I would argue that MDMA and methamphetamine, while slightly similar in chemical structure, have very different mechanisms of action. Methamphetamine, at high enough doses. This is why dose is important, some recreational doses will cause dopamine efflux from the dopamine uptake transporter but MDMA does not do this Doses are incredibly portant when discussing the mechanisms of drugs and comparing them because a compound may interact with new and different proteins when the concentration gets high enough. Recreational doses for methamphetamine and cocaine are all over the place partially due to the fact that you can develop tolerance and increase your dose. This doesn't really happen with MDMA as much, and while you can take repeated doses they will rapidly stop working if taken within a small enough time frame. Methamphetamine and cocaine do not have the same tolerance build up While cocaine is a triple reuptake inhibitor and does interact with serotonin, I don't think its comparable to MDMA
      - netizen-936824 4y ago
        >Methamphetamine, at high enough doses. Causes dopamine efflux out of the uptake transporter*
tokai 4y ago
Its neurotoxic like meth and coke. It might not be as dangerous and the damage is less persistent. But it's way more harmful than cannabis or psychedelics. If you want to group drugs by harmfulness, it is definitely together with the other stims.
- sudosysgen 4y ago
  Neurotoxicity is a bad criterio imo. Alcohol and nicotine are neurotoxic, and technically so is caffeine. The better criterion is the typical harm to the user. It's lower in MDMA because it's very difficult to use too much, seems to have a low potential for addiction, and is very rarely lethal. Generally usage patterns for MDMA users are much less harmful than illegal cocaine or meth users.
- 52-6F-62 4y ago
  And parsnips are phototoxic, too. We better do something about them.
- netizen-936824 4y ago
  What dose is it neurotoxic? How do we know that? The studies I'm aware of were done on mice, which have a significantly different metabolism than humans. Not to mention there has been no mention of neurotoxicity from the current MAPS studies.
Tenoke 4y ago
MDMA seems more harmful to me with semi-frequent use. The comedowns are brutal and repeated use seems to make it worse. Either are fine taken occasionally but opioids and meth (vyanese) can be taken daily with fairly small negative effects while I doubt you can do MDMA even once weekly for a year without being much worse off in the end.
- sudosysgen 4y ago
  Vyvanse isn't meth. It's lisdexamphetamine, and it's significantly less neurotoxic than meth (yes, even at equivalent dosages). Methamphetamine is rarely prescribed for ADHD, but even when it is (Desoxyn), it's chemically different to meth you'd find on the street, because it's only the d-enantiomer, and thus has much less off-target effects outside of the CNS. Sometimes steet meth is also only the dextro form, but that's far from assured. In any case, the idea that vyvanse shows that meth can easily be taken with small negative effects is wrong, because Vyvanse isn't meth, and meth is very rarely prescribed because it's worse for your health than other amphetamines, and even when it is prescribed it's typically far safer than steet meth.
  - Tenoke 4y ago
    Sorry I meant Desoxyn. > it's chemically different to meth you'd find on the street Well yeah, but the MDMA on the street isn't really pure MDMA either.
    - sudosysgen 4y ago
      Yeah, but Desoxyn is a last resort for a very good reason, and it most often has pretty serious negative effects. Just not as serious as severe unmedicated ADHD.
      - Tenoke 4y ago
        The reason seems to be stigma as far as I can tell. The negative effects don't seem to be worse than Adderall/Dexedrine and the positive effects are usually a bit better. https://astralcodexten.substack.com/p/know-your-amphetamines https://astralcodexten.substack.com/p/know-your-amphetamines
Tiktaalik 4y ago
This policy move is coming out of the fact that all these street drugs are toxic and frequently not as advertised and so many people are dying because they don't know what they're using. It could be that the reason MDMA is included in that the health officers want to encourage drug users (whether they're addicted users of fentanyl or party drug users) to use drug testing services and not shy away from this because they're holding an illegal substance.
c7DJTLrn 4y ago
In terms of societal harm sure but MDMA is still dangerous. With the pills around today it's easy to overdose. Not to mention all the people that've died from overheating or overhydrating. It's not a 'whatever' drug like cannabis. I say this as somebody who has a positive view on MDMA.

qwerty456127 4y ago

Arguably single-dose MDMA is less than single-dose coke and equals meth in terms of physical harm. Of course very different story if you consider repeated usage.

netizen-936824 4y ago
What, exactly, is a single dose of each of those substances? What makes them equal pharmacologically?
- qwerty456127 4y ago
  The dose an ordinary person (not a regular abuser) would take. Coke is not equal (I mean it is arguably zero harm if taken rarely, but pretty addictive and serious harm if taken regularly), MDMA and meth are extremely similar substances chemically (MA=meth) and have similar mechanisms of action. Same harm prevention techniques work great with both. The most important difference is MDMA being harder to abuse than meth is, because a number of reasons. Most of MDMA users take it occasionally for good, most of meth users take it regularly for harm. AFAIK. Obviously there are many exceptions.
  - netizen-936824 4y ago
    I would argue that MDMA and methamphetamine, while slightly similar in chemical structure, have very different mechanisms of action. Methamphetamine, at high enough doses. This is why dose is important, some recreational doses will cause dopamine efflux from the dopamine uptake transporter but MDMA does not do this Doses are incredibly portant when discussing the mechanisms of drugs and comparing them because a compound may interact with new and different proteins when the concentration gets high enough. Recreational doses for methamphetamine and cocaine are all over the place partially due to the fact that you can develop tolerance and increase your dose. This doesn't really happen with MDMA as much, and while you can take repeated doses they will rapidly stop working if taken within a small enough time frame. Methamphetamine and cocaine do not have the same tolerance build up While cocaine is a triple reuptake inhibitor and does interact with serotonin, I don't think its comparable to MDMA
    - netizen-936824 4y ago
      >Methamphetamine, at high enough doses. Causes dopamine efflux out of the uptake transporter*

tokai 4y ago

Its neurotoxic like meth and coke. It might not be as dangerous and the damage is less persistent. But it's way more harmful than cannabis or psychedelics. If you want to group drugs by harmfulness, it is definitely together with the other stims.

sudosysgen 4y ago
Neurotoxicity is a bad criterio imo. Alcohol and nicotine are neurotoxic, and technically so is caffeine. The better criterion is the typical harm to the user. It's lower in MDMA because it's very difficult to use too much, seems to have a low potential for addiction, and is very rarely lethal. Generally usage patterns for MDMA users are much less harmful than illegal cocaine or meth users.
52-6F-62 4y ago
And parsnips are phototoxic, too. We better do something about them.
netizen-936824 4y ago
What dose is it neurotoxic? How do we know that? The studies I'm aware of were done on mice, which have a significantly different metabolism than humans. Not to mention there has been no mention of neurotoxicity from the current MAPS studies.

Tenoke 4y ago

MDMA seems more harmful to me with semi-frequent use. The comedowns are brutal and repeated use seems to make it worse. Either are fine taken occasionally but opioids and meth (vyanese) can be taken daily with fairly small negative effects while I doubt you can do MDMA even once weekly for a year without being much worse off in the end.

sudosysgen 4y ago
Vyvanse isn't meth. It's lisdexamphetamine, and it's significantly less neurotoxic than meth (yes, even at equivalent dosages). Methamphetamine is rarely prescribed for ADHD, but even when it is (Desoxyn), it's chemically different to meth you'd find on the street, because it's only the d-enantiomer, and thus has much less off-target effects outside of the CNS. Sometimes steet meth is also only the dextro form, but that's far from assured. In any case, the idea that vyvanse shows that meth can easily be taken with small negative effects is wrong, because Vyvanse isn't meth, and meth is very rarely prescribed because it's worse for your health than other amphetamines, and even when it is prescribed it's typically far safer than steet meth.
- Tenoke 4y ago
  Sorry I meant Desoxyn. > it's chemically different to meth you'd find on the street Well yeah, but the MDMA on the street isn't really pure MDMA either.
  - sudosysgen 4y ago
    Yeah, but Desoxyn is a last resort for a very good reason, and it most often has pretty serious negative effects. Just not as serious as severe unmedicated ADHD.
    - Tenoke 4y ago
      The reason seems to be stigma as far as I can tell. The negative effects don't seem to be worse than Adderall/Dexedrine and the positive effects are usually a bit better. https://astralcodexten.substack.com/p/know-your-amphetamines https://astralcodexten.substack.com/p/know-your-amphetamines

Tiktaalik 4y ago

This policy move is coming out of the fact that all these street drugs are toxic and frequently not as advertised and so many people are dying because they don't know what they're using. It could be that the reason MDMA is included in that the health officers want to encourage drug users (whether they're addicted users of fentanyl or party drug users) to use drug testing services and not shy away from this because they're holding an illegal substance.

c7DJTLrn 4y ago

In terms of societal harm sure but MDMA is still dangerous. With the pills around today it's easy to overdose. Not to mention all the people that've died from overheating or overhydrating. It's not a 'whatever' drug like cannabis. I say this as somebody who has a positive view on MDMA.