|
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.
|
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.
|
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 |