MDMA legalisation will be a hard pill for New Zealand to swallow

The following commentary by Victoria University's Professor Susan Schenk and Professor David Harper was published on Stuff, 29 June.

A dangerous case is being made in New Zealand for the legalisation of MDMA, the primary active ingredient of the street drug, Ecstasy.

Ecstasy rose in popularity amongst the rave party scene in the early 1980s. Use has since spread to more mainstream groups. New Zealanders are some of the heaviest users of ecstasy worldwide with an estimated 13% of them having used ecstasy in the past year.

Supporters of the move to legalise claim the drug is safe, and recent comments made by Wellington Hospital emergency department specialist, Dr. Paul Quigley, would seem to support this position. Dr. Quigley has reported few ER admissions related to ecstasy use, and from this he has incorrectly assumed this means that MDMA use poses minimal harm.

Emergency room admissions are a flawed benchmark for determining the safety of a drug such as MDMA as the major harm associated with MDMA is the death of brain cells, and associated behavior changes. These effects are generally not life-threatening and would therefore not lead users to seek out emergency care.

This does not, however, indicate that MDMA is safe. Rather, considerable published evidence has demonstrated that memory loss and attention issues are common in MDMA users and there is compelling evidence for the loss of the brain chemical, serotonin, which leads to further problems associated with sleep patterns and emotional wellbeing.

These effects can seriously impact the individual’s ability to lead a productive life, and it is common for users to experience negative emotional after-effects of ecstasy. Importantly, there are no quick fixes for the many detrimental effects of ecstasy and these effects may persist for years.

It has also been suggested that MDMA dependence is not a likely consequence of use, providing proponents of legalisation another indication that MDMA use poses minimal harm. This too is unsupported in the scientific literature.

For most drugs of abuse, including cocaine and methamphetamine (“P”), about 10-15% of users become dependent on the drug. The same is true of Ecstasy users. Studies have suggested that a subset of ecstasy users progress to misuse and consume the drug frequently and in high dosages. In New Zealand, the Illicit Drug Monitoring System provides a snapshot of heavy drug users over time. According to this authoritative survey, ecstasy use amongst heavy drug users is substantial, and 15% use ecstasy weekly. An online survey in the UK suggests that MDMA users were more likely to report dependence symptoms than users of cocaine. 

Another assumption is that by regulating the supply of MDMA both producers and users will engage in safe drug production and use. While it is true that most users don’t know what else they are actually taking when taking an ecstasy pill - it is frequently mixed with any range of other substances, some harmful, some not. That doesn’t mean that pure MDMA is actually safe. Perhaps ‘safer’ but not ‘safe’.

New Zealand has toyed with legalisation of psychoactive substances for many years. First there were the BZP-TFMPP ’legal highs’ that were subsequently banned as they were shown to be dangerous after all. The same was true of synthetic cannabis products that have also recently been banned because they were shown to pose more than an acceptable risk of harm.

Despite what has recently been suggested in the media, there is substantial evidence of harm and risk arising from the use of MDMA. We have been studying the effects of MDMA on brain and behaviour for about 10 years, and the negative effects of ecstasy have been well-documented by us and many other researchers.

Knowing what we know about ecstasy use, and the well-documented negative consequences of its use, the potential for misuse and the persistent and prolific adverse consequences of MDMA use, it is clear that unrestricted use of MDMA poses a great risk of harm, and that it would be irresponsible to provide MDMA for legal sale in New Zealand.

Professor Susan Schenk, School of Psychology, and Professor David Harper, Dean of Science, Victoria University of Wellington.