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Aims: To improve our understanding of the pharmacology of 'ecstasy' in recreational environments; in particular, to describe the composition of ecstasy pills, patterns of ecstasy use and the relationship between dose of 3,4-methylendioxymethamphetamine MDMA and resulting plasma concentrations. Design, setting and participants: A naturalistic observational study of 56 experienced 'ecstasy' users in recreational settings in Australia. Measurements: Drug use patterns number of pills consumed, other drugs consumed. The dose of MDMA per pill ranged from 0 to mg and users consumed from one-half to five pills, with the total dose consumed ranging up to mg. Use of larger numbers of pills was associated with extended exposure to the drug. Conclusions: MDMA is the major active drug in ecstasy pills, but there is a high degree of variation in doses. Use of multiple pills over the course of one session is common and results in a sustained increase in MDMA plasma concentrations over a number of hours. This is likely to lead to a much greater exposure of the brain to MDMA than would be predicted from controlled single-dose pharmacokinetic studies. Abstract Aims: To improve our understanding of the pharmacology of 'ecstasy' in recreational environments; in particular, to describe the composition of ecstasy pills, patterns of ecstasy use and the relationship between dose of 3,4-methylendioxymethamphetamine MDMA and resulting plasma concentrations. Publication types Research Support, Non-U. Substances Hallucinogens Tablets N-Methyl-3,4-methylenedioxyamphetamine.

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