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House parties and teddy bears
The emergence of online and festival-based resources are welcomed . They are , however , most accessible to tech-savvy club and festival-goers who are interested in harm reduction and aware that they are taking MDMA .
Young people taking pills and attending house parties are at very high risk and fall outside these information channels . Pills are cheap , well-pressed , colourful and increasingly attractive with designs such as Instagram , Snapchat or teddy bears that inevitably resonate with younger people .
At £ 2-3 a pill ( strong enough to share ) it ’ s cheaper than cider or a bag of weed , and teenagers may not associate this Molly , Mandy , E – or whatever the pill is called – with MDMA and the risks that it entails .
Incidents of young teenagers taking MDMA pills in atypical settings demonstrate why websites and festival testing need to be backed up by high quality education and awareness-raising . Young people at house parties , with no access to the festival or club welfare services , need to be equipped with the knowledge and skills to respond to MDMA-related incidents for themselves .
Harm reduction
For young people contemplating use , key messages include general risks around strong stimulants and hallucinogens , especially in unfamiliar settings , and should include information about potency , overdose prevention and managing emergencies .
Crush – dab – wait has become a key message about starting with low doses of MDMA . Developed by the Loop , it is a field-appropriate method of taking a smaller drug dose on a moistened finger and waiting for one to two hours before taking further doses . In practice it can be hard to crush dense tablets in festival settings and if the drug in question is highly potent ( such as a SCRA or a fentanyl ) even dabbing could be a risk .
Starting with low tablet doses – quarter to half a tablet – will reduce risk , although a quarter of a tablet for a young user is still a potentially dangerous dose when tablet strengths are possibly 220mg +. In groups , one person taking a very low ‘ tester ’ dose can help reduce risk to the rest of the group .
ANXIETY AND PANIC are common especially for new users , so it is helpful to have more experienced , sober friends who can reassure and calm the person . As ever , set and setting matter , so using when feeling well in a familiar , safe environment is protective .
SEROTONIN SYNDROME , caused by excessively high levels of serotonin , could be caused by high doses of MDMA . Risk increases where other serotonin-elevating drugs are used , including some antidepressants , tramadol , some antihistamines and many other compounds . Indicators of serotonin syndrome include agitation , delusions , fast heart rate , elevated body temperature , muscle twitching , seizures and convulsions , and it can be fatal . Where serotonin syndrome is suspected , an ambulance should always be called .
CONVULSIONS : safe management of people convulsing means always calling an ambulance , allowing the person to convulse unrestrained , removing things in the vicinity that could cause injury where possible , and protecting but not restraining the head . Nothing should be placed in the mouth as it increases risk of choking .
OVERHEATING caused by elevated serotonin levels is highly dangerous . Chilling out from dancing and staying hydrated can help reduce the risk . If a person feels excessively hot , complains of feeling too hot , is panicked , complains of headaches , has excessive sweating , or conversely stops sweating , these could be indicators of overheating . Reduce body temperature by spraying their unclothed torso with tepid water , under moving air , but always seek medical help as overheating can lead to blood clotting and organ failure . Don ’ t try to give the person cold drinks or immerse them in cold water .
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HYDRATION AND OVER- HYDRATING : Excess water consumption , combined with MDMA ’ s anti-diuretic properties , can cause water retention and in extreme cases can cause electrolyte imbalance and swelling of the brain . This can be life threatening . Advice remains to drink around a pint of water or an isotonic drink , sipped over the course of an hour , which helps maintain hydration but minimises risks of hyponatraemia .
SELF-CARE : MDMA use can lead to significant depletion of serotonin after use and can cause quite serious low mood and depression . Stress the importance of taking long breaks after use , eating well and avoiding other substance use .
Kevin Flemen runs the drugs education and training initiative , KFx .
Visit www . kfx . org . uk for free-todownload leaflets on ecstasy – Fest-E ( about the wisdom of doing ecstasy for the first time at a festival ) and First-E ( guidance for first-time users ). Both were produced by KFx in 2014 and illustrated by a 17-year-old , in response to growing concern about ecstasy .
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New production methods and the massive marketplace that is the dark web have seen manufactur ers competing on strength and price , so low cost is no longer indicative of a low-dosed pill . |
Everynight Images / Alamy Stock Photo |