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On Nov. This news appeared in headlines throughout the world, as it represents an important — yet somewhat unorthodox — advance in PTSD treatment. However, the media have largely been referring to Ecstasy — the street name for this drug — as the treatment in this trial, rather than MDMA 3,4-methylenedioxymethamphetamine. This can lead to misunderstanding, as recreational Ecstasy use is a highly stigmatized behavior. Using this terminology may further misconceptions about the study drug and its uses. While Ecstasy is in fact a common street name for MDMA, what we call Ecstasy has changed dramatically since it became a prevalent recreational drug. Ecstasy now has a very different meaning — socially and pharmacologically. Not only has much of the public at least heard of Ecstasy and would not recognize MDMA , but this also increases shock value and readership. But referring to a therapeutic drug by its street name such as Ecstasy is misleading — especially since MDMA is known to be among the most popular illicit drugs used at nightclubs and dance festivals. This leads some to assume that street drugs are being promoted and provided to patients, perhaps in a reckless manner. About percent of high school seniors and young adults disapprove of someone even trying Ecstasy once or twice. But stigmatizing attitudes tend to be much harsher than mere disapproval. I investigated stigma toward Ecstasy users, and among young adults age who reported no lifetime use of the drug, many reported strong negative feelings toward those who use Ecstasy. When Ecstasy boomed in popularity in the early s, it tended to consist of pure MDMA, or sometimes its chemical sister MDA 3,4-methylenedioxyamphetamine. Throughout the s and s, drugs such as cocaine, ketamine and methamphetamine were common adulterants in Ecstasy. Demand grew. While pills said to be pure MDMA were certainly marketed and sold throughout the s, more expensive Ecstasy in powder form sold in capsules slowly grew in demand. Molly is commonly marketed as being pure MDMA. Deaths related to Ecstasy use appear to have increased in recent years, but many of these deaths appear to have been largely dependent on environmental conditions. MDMA can raise blood pressure and interfere with regulation of body temperature , which can certainly make it dangerous, especially in large doses and to those with preexisting conditions. But what we often fail to consider is that Ecstasy-related deaths have tended to occur after hours of dancing — often in very hot conditions such as crowded nightclubs or at festivals in 85 degree Fahrenheit or higher temperature , without adequate rest or proper hydration, or both. Would these deaths have occurred without Ecstasy? Probably not. But most of these outcomes were very much dependent on extreme environmental conditions. Many deaths in the U. In Europe, however, deaths have been increasing due to use of very high-potency pills over mg. Extreme environmental conditions, adulterants, use of high-potency Ecstasy products, and ignorance about drug effects are all potential recipes for disaster when Ecstasy is used, especially when harm reduction techniques are not applied. Is it really appropriate, then, to compare the therapeutic use of MDMA in this study to individuals using illegal, adulterated, or high-potency ecstasy, and dancing for hours in the heat? The researchers are using pure MDMA, and in low doses. The drug is also used under medical supervision in a safe office, and patients receive medical clearance before entering the trial. MDMA is by no means a new drug, but misconceptions have continued for decades. We have known this since the s, but have largely lacked the formal research supporting its efficacy. The drug was administered by thousands of therapists in the early s before it hit the nightclub scene and was made illegal in We also often forget to consider that these same stigmatized drugs may also have important medical value. For example, amphetamine has been a drug of abuse since the s, but it is efficacious in treating ADHD under the trade name Adderall. And despite increasing abuse of opioids in the U. Like opioids and amphetamine, MDMA appears to have its place in medicine. Some of these drugs appear to be very useful in medical or therapeutic contexts. Edition: Available editions Europe. Become an author Sign up as a reader Sign in. Joseph Palamar , New York University. Events More events.

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