A carefree mood and an energetic feeling: at festivals and parties, some people regularly take ecstasy (MDMA). NU.nl readers say on NUjij that they also occasionally take a pill. They wonder: how bad is the occasional ecstasy pill for you?
A large part of the people who take ecstasy have a good night. “But there are also people who end up in the first aid,” Steven Biemans, expert at the Trimbos Institute, tells NU.nl. “Taking ecstasy is never safe. It remains a risky activity.”
Psychiatrist Renske Blom agrees. For years, she gave drug users information about the side effects. “Many people see the use of ecstasy as ‘quite normal’,” she says. “At the same time, there are physical risks involved.”
“The safest thing is of course not to use any substances,” says Kenan de Leeuw, (neuro)psychologist at addiction expertise center Jellinek. “But just like with alcohol, there is a kind of mentality: it is not good for you, but if you keep it within limits and take the right measures, it does not have to entail a huge health risk.”
De Leeuw does emphasize that absolute safety cannot be guaranteed. “There are rare cases known of people who have used ecstasy in a ‘safe’ way and still die. For example, due to acute liver failure. The chance is small, but it cannot be ruled out.”
Risks differ per person
What the risks of an occasional pill are differs per person. “It is often difficult to predict when someone will or will not suffer from side effects,” says clinical pharmacologist Tessa Bosch of the Maasstad Hospital in Rotterdam. “Risks include overheating, water intoxication and high blood pressure.”
Trimbos expert Biemans confirms that the risks differ per person. “For example, if someone is already taking medication for ADHD and also takes ecstasy, then that person is using two stimulants,” he explains. “Then you can get a dangerously high blood pressure. There are all kinds of different risks and it differs per person how much chance you have of that.”
How do overheating and water intoxication occur?
If you take ecstasy, more of the substance ADH (antidiuretic hormone) is released. This makes it difficult to urinate and you retain too much fluid. “Drinking enough when taking ecstasy is important, but if you drink too much it is dangerous and someone can get water intoxication,” Biemans explains.
Ecstasy also increases body temperature. If you dance for a long time in a warm environment, you can overheat.
Read up on it and discuss it with your doctor
If you still want to take a pill, according to Biemans you can reduce the risks by reading up well and taking measures. “An important measure is to keep the dose as low as possible. Also read up on what a dose is for you. Do not combine ecstasy with other drugs, medicines or alcohol. And take enough rest before, during and after use.”
Psychologist De Leeuw emphasizes that it is good to make use of drug testing services. “All major cities have them and you can do it anonymously. This way you know if there is only MDMA in it and nothing else.”
If you are not feeling well or have physical or psychological conditions, it is wise to be careful. “Often it is then much riskier to use,” says Biemans. “Ecstasy can amplify this.”
De Leeuw also says that it is important to pay attention to this. “For example, with epilepsy and cardiovascular diseases it is wise to be cautious or even not to do it at all,” says De Leeuw. “People don’t do it quickly because ecstasy is forbidden, but don’t hesitate to discuss this with your doctor.”
What is a ‘Tuesday dip’?
One or two days after using ecstasy, people often feel less well. It is a hangover from the pill. For many people this comes on Tuesday, which is why it is called a ‘Tuesday dip’.
“We don’t know exactly what happens,” says psychiatrist Blom. “MDMA releases a lot of serotonin (happiness hormone) in the brain. It seems that a shortage of this occurs a few days after use. People feel empty and somber, among other things. In my patients who are vulnerable to depression and anxiety, it can take longer to pass.”
A very small percentage of people still have complaints long after taking an ecstasy pill. For example, they see noise in their field of vision or get the feeling that the world is not real. “But you cannot say that this is a standard effect of ecstasy,” says Biemans. “People who are sensitive to this sometimes get these complaints from MDMA. It is then as if the body of these people is out of balance for a while.”
Does ‘occasionally’ using reduce the risks?
On our reaction platform NUjij, several readers claimed that the risks remain limited if there are a few months between your ecstasy use. According to Biemans, there are reasons to say that you should keep a few months between your use, but this cannot guarantee safety.
“One and a half to two or three months is advised, opinions are divided on this. But that has to do with your body having to replenish certain substances, and with behavioral tolerance,” he says. “By the latter I mean keeping the use fun and that you can still party without using anything.”
It is a way to reduce risks, but it can also lead to false security. “Someone may therefore think that he can take a higher dosage. But even then someone can end up in the first aid or suffer physical damage. Keeping the dosage low and feeling good before use are much more important factors to reduce risks,” says Biemans.
Alcohol and ecstasy difficult to compare
On NUjij, readers also wrote that alcohol is more harmful than ecstasy. According to Biemans, De Leeuw and Bosch, that comparison is difficult to make. “They are chemically different substances and the usage pattern differs enormously,” says De Leeuw. “For example, people drink alcohol more often and take ecstasy occasionally.”
“If you only look at addiction, you can see that fewer people are dependent on ecstasy,” says Biemans. “But you cannot say that ecstasy is safer. They are both substances that are not safe, with their own risks.”