MDMA Harm Reduction Guide

Effects

• ✦Intense feelings of empathy, love, and emotional openness
• ✦Euphoria and increased energy
• ✦Heightened sensory pleasure (music, touch)
• ✦Mild visual enhancement
• ✦Jaw clenching (bruxism)
• ✦Reduced fear and anxiety

Duration

3–5 hours (with afterglow 1–2 hours)

Dosage

Individual sensitivity varies. Always start at the lower end if you're new to this substance.

Risks

• ⚠Hyperthermia (overheating) — the most common cause of MDMA deaths
• ⚠Hyponatremia (overhydration) — drinking too much water without electrolytes
• ⚠Neurotoxicity from frequent use or high doses
• ⚠Post-use depression ('comedown'), sometimes lasting days
• ⚠Cardiovascular strain
• ⚠Serotonin syndrome when combined with other serotonergic drugs

Harm Reduction Tips

• ✓Test your substance — MDMA is one of the most adulterated drugs; use a Marquis reagent
• ✓Dose by body weight: 1–1.5 mg/kg is a reasonable guideline
• ✓Stay cool — dance in ventilated areas, take breaks, don't overheat
• ✓Drink water moderately: ~500ml/hour if dancing, less if resting
• ✓Add electrolytes if drinking significant amounts of water
• ✓Follow the 3-month rule — wait at least 3 months between uses to reduce neurotoxicity risk
• ✓Avoid redosing more than once, and keep the redose below half the original
• ✓Supplement with antioxidants (ALA, Vitamin C, EGCG) — evidence is mixed but low-risk

Dangerous Combinations

Always research interactions before combining any substances.

• ✕MAOIs — serotonin syndrome risk; potentially fatal
• ✕SSRIs/SNRIs — serotonin syndrome; also blunts effects
• ✕Lithium — seizure risk
• ✕Tramadol — serotonin syndrome
• ✕Other stimulants — excessive cardiovascular strain