1:59

And

2:02

these days, headlines are screaming

2:04

that this drug is so powerful

2:07

that it can do even more,

2:09

that it can heal anxiety and cure PTSD.

2:13

MDMA could have real medical

2:15

benefits, even helping people

2:17

cope with the worst of traumas. Soldiers

2:19

with PTSD using the illegal

2:21

drug known as MDMA cured the

2:24

condition within weeks.

2:25

And just this year, Australia became

2:28

the first country in the world to make

2:30

prescribing MDMA legal

2:33

under certain circumstances.

2:33

Psychedelics will soon be

2:36

used as medicine in Australia. MDMA

2:38

can now be prescribed in Australia to treat

2:40

some complex mental health disorders.

2:47

But despite all of this excitement, over

2:50

in the US, MDMA is

2:52

still very, very illegal.

2:55

There's actually a Schedule I drug right

2:57

up there with heroin. And

2:59

it's been this way for decades. In

3:01

fact, Joseph told us that back in the 90s,

3:04

from time to time, the clubs he was at would get busted.

3:07

Like one night at this famous club in

3:09

New York City called The Tunnel. The

3:11

lights flick on, the music's still blasting.

3:15

We're there, it was probably three,

3:17

four in the morning, something like that. And

3:20

dozens and dozens of police officers

3:22

start rushing in. Like everybody

3:24

out. And finally the music goes down.

3:27

And they were frisking, checking for drugs.

3:30

And this takes us to the other side of

3:32

the MDMA story. You

3:34

see, for years we've been hearing that this

3:36

is a dangerous drug that can hurt

3:38

and even kill us.

3:40

You can go out in the night,

3:42

take something

3:43

and die from it. This is Special Agent

3:45

James Hunt. And when we first interviewed him

3:47

several years ago, he was in charge of the

3:49

Drug Enforcement Administration's New

3:51

York division. He's now moved to the private

3:53

sector. And James was very

3:55

worried about people using MDMA.

3:59

You can keep on going and taking it and you know, maybe

4:02

you will never OD. Maybe you take your first

4:04

one and you'll die at one of these concerts.

4:08

Back in 2017, we at Science

4:10

vs. First took a look at what is off with

4:13

MDMA. But with the hype about

4:15

this drug just growing and growing, we

4:17

thought we'd better dust off our glow sticks,

4:19

grab a fresh pack of chewing gum and

4:22

take a new look at the science. To

4:24

find out, could MDMA really

4:27

be a powerful medicine that

4:29

can cure stuff like PTSD? Or

4:32

is it a dangerous drug that could kill

4:34

you from just one pill?

4:39

When it comes to MDMA, there are lots

4:41

of just people having the times of their lives on it.

4:44

But

4:44

then there's science. Science

4:47

vs. MDMA is coming up just after the break. Have

4:50

you ever told a friend?

4:57

Oh, I'm

5:00

fine. When you really felt

5:02

just so overwhelmed or

5:05

sent a text, can't sleep.

5:08

Are you awake? When you couldn't find

5:10

the words to say, I'm scared

5:12

to be alone with my thoughts right now. This

5:15

is your sign to reach out to the 988 lifeline

5:17

for 24-7 free confidential support. You

5:21

don't have to hide how you feel. Text,

5:24

call or chat anytime.

5:33

Welcome back. On today's show, we're getting high

5:35

on the science of MDMA. And

5:37

while MDMA might feel like a modern

5:40

drug, it was actually first cooked

5:42

up more than a hundred years ago by

5:44

the pharmaceutical company Merck. They

5:46

were trying to create a medicine to stop people

5:48

from bleeding and in the process made

5:51

MDMA. Now, as far

5:53

as we know, back then, scientists never gave

5:55

it to people. But that was

5:57

until the 1960s and 70s. When

6:00

some researchers like the so-called godfather

6:03

of ecstasy Alexander Shulgin started

6:05

experimenting with MDMA to help

6:07

their patients. George Greer,

6:10

a psychiatrist in San Francisco at the time,

6:12

says that he remembers those days quite well.

6:15

Particularly, he remembers the very

6:17

first time that he took some MDMA

6:20

with his girlfriend.

6:21

It was quite lovely.

6:23

And we were both impressed

6:27

at the ease and directness

6:29

of our communication style.

6:31

It's not like we hadn't had communication like

6:34

that before, but it was just so easy. What

6:35

did you say that then you

6:37

thought, I can't believe I just said that. Well,

6:40

it's like we would say some

6:42

of it's just too personal for me to talk about in a radio

6:44

interview. But things like, were

6:47

you upset when I did this? Normally

6:50

I would have said, oh no, no, no, no, that's fine. It was

6:52

no problem. And I said, yeah,

6:55

I was upset. I was like, wow, well

6:58

that's not the way we would communicate before we would

7:01

protect each other's feelings by not directly

7:04

just saying, yeah, I didn't like what you did.

7:06

The fact that George could open up so much

7:09

made him think that MDMA could be really

7:11

useful for people during therapy. And

7:14

some of George's colleagues were thinking this too.

7:16

So in the early 1980s, George

7:19

decided to give it a try with his patients,

7:22

which meant he needed a supply

7:24

of MDMA. Now, even

7:26

though back then it wasn't explicitly

7:29

illegal, it existed in this sort of gray

7:31

area, so you couldn't just buy it at

7:33

the local pharmacy. And so

7:35

instead, with the help of a chemist,

7:37

George made it. And he told

7:40

us about the lab that they used.

7:42

There was a little stone fireplace.

7:44

There were shelves with colored

7:47

bottles with handwritten labels of different

7:49

chemicals.

7:50

And so they got to work. You

7:53

know, throw in a dash of piperodolacetone,

7:56

a pinch of sodium hydroxide, and

7:58

a symbol full of hydropodone. chloric acid.

8:01

And we just let it react and kept stirring

8:03

and it would get warm and so we sort of bubbling

8:06

and through a coil. After a couple

8:08

of hours he had the goods.

8:11

So we ended up with a white powder

8:13

pure white powder. George

8:14

gave that powder to his patients and

8:17

he said that they opened up and it really

8:19

helped them with their therapy.

8:20

It was medicine and it was

8:22

used for healing purposes.

8:26

George published a study on what he was doing. He

8:29

followed 29 people checking in with them

8:31

over the following months and people said

8:33

that after taking MDMA and having

8:35

therapy they had more insight into

8:38

their personal problems. Some felt more

8:40

relaxed and calm even long

8:42

after the effects

8:43

of the drug had worn off.

8:45

And George was impressed.

8:46

It was completely, there

8:48

is never a drug like

8:50

it before.

8:51

He and his colleagues thought they had stumbled

8:53

on this amazing new medicine.

8:55

But around 1983 was when I first heard

8:58

that it was being used

9:01

at cocktail parties in New York City. I said

9:03

okay the end is near. And he

9:05

was right.

9:06

Congress started to get antsy about MDMA

9:09

and in 1985 the Drug Enforcement

9:12

Administration made it illegal.

9:15

They said that the drug quote presents

9:17

a significant risk to the public health

9:20

and that it had quote

9:23

no legitimate medical use.

9:26

And that hit George hard. Oh absolutely.

9:28

It was very disappointing because you know we couldn't

9:31

help people with it anymore. So

9:32

George stopped his work with MDMA

9:34

just as he was getting started. But more

9:37

recently researchers have

9:39

been sinking their teeth into MDMA

9:41

once more. You know really grinding

9:43

away at it. And one big

9:46

question that they have is

9:48

why does MDMA make us

9:50

feel so good? That

9:52

is

9:52

what is happening in our brains when we

9:54

take it. So to find out more

9:57

we asked a real party

9:59

girl. My name's Harriet DeWitt.

10:01

I'm a professor in the Department of Psychiatry

10:04

and Behavioral Neuroscience at the University of

10:06

Chicago. Harriet first became

10:08

interested in MDMA one day at a science

10:11

conference when some researchers told

10:13

her that they'd had life-changing

10:15

experiences on the drug. Yeah,

10:17

a couple of colleagues actually, and they

10:20

were people that I didn't see as

10:22

drug users at all. And then was it then

10:24

when you thought, I kind of want to study this more?

10:26

Yes, yes, definitely. So

10:29

she dove in. She started reading all about

10:31

MDMA. And what she learned

10:33

is that the high that people can feel on this

10:35

drug, it can feel a bit like taking speed.

10:38

And that makes sense because chemically, MDMA

10:41

is similar to amphetamines. In

10:43

fact, MDMA stands for methylene

10:46

dioxymethamphetamines.

10:48

Get it? MDMA. But

10:51

there's something different about MDMA.

10:54

It does something unique. And it produces

10:57

a behavior that you don't see with any other

10:59

drugs.

11:00

The unique thing that MDMA does

11:03

is it makes you feel a real closeness with

11:05

other people, like what Joseph felt

11:07

like on the dance floor. And

11:09

a wild and very cute image

11:12

is that when you give MDMA to rats,

11:15

it even helps them bond.

11:17

So it makes rats lie

11:19

together side by side as though

11:22

they were sort of bonding, as though they were sort of

11:24

connected.

11:25

So Harriet's big question

11:27

was,

11:28

why does this happen?

11:30

Well, you may know that MDMA

11:33

can affect your serotonin levels. And

11:35

one of the ways that it does this, it's really interesting,

11:37

MDMA can latch

11:40

onto this protein that

11:41

normally removes serotonin from your

11:43

brain.

11:44

And so basically, without that protein

11:47

hoovering up serotonin, it gets to stick

11:49

around. And so this seems like

11:51

a pretty clear-cut explanation for how

11:53

MDMA works, right? I talked to Harriet

11:56

about it. The story that you

11:58

hear is just... Well,

12:00

it's serotonin. Serotonin makes you happy.

12:02

Put them together, it sounds like that's the feeling

12:04

of being high. It's a

12:06

nice story, but there's no

12:09

way there's going to be just a little bump of

12:10

one neurotransmitter that corresponds

12:12

to feeling high or feeling good or

12:15

feeling...

12:15

I mean, it's just much more complicated than that.

12:17

So, for example, MDMA

12:19

can affect other neurotransmitters like

12:22

dopamine and norepinephrine, as

12:24

well as this hormone that's linked to

12:26

bonding called oxytocin. So,

12:29

Harriet told me about this one study that she

12:31

did where the MDMA produced a

12:33

very

12:34

large increase in oxytocin.

12:37

But Harriet reckoned there must

12:39

be even more to this story. So,

12:41

to unlock the mysteries of MDMA,

12:44

much like the researchers before her, her next

12:47

step

12:48

was to score some.

12:50

Heather Rogers and I asked Harriet about this.

12:53

And I guess, like, you find it through

12:54

just researchers in

12:57

the know. Yes,

12:59

exactly. Kind of like how

13:01

you find it on the street.

13:03

No.

13:04

So,

13:08

where do you get it from? There

13:10

was one chemist who has

13:12

now actually retired, and he produced

13:15

a fairly large quantity of it that

13:17

he has made available

13:18

to researchers. So,

13:20

now that Harriet had the goods, she got a bunch

13:22

of participants, gave them a pill. She

13:24

wasn't shy about the dosage. People

13:27

compare it to something that they might get

13:30

in a rave situation, and it's

13:32

a fairly, they wouldn't want

13:34

more, put it that way. In her first

13:37

experiment with MDMA, which was published

13:39

in 2009, Harriet gave

13:41

nine people the drug. And then she showed them

13:44

pictures of faces with various emotional

13:46

expressions, like a person smiling

13:48

or someone frowning. And she repeated the

13:50

experiment by giving them a placebo.

13:54

And what she saw is that when people were

13:56

high, their brains had a stronger

13:58

response to seeing happier faces.

14:01

And curiously, their brains

14:03

also weren't so affected

14:05

by the angry pictures. So it

14:07

sort of makes them less able to

14:09

detect negative emotions. So

14:12

they're less responsive to angry faces.

14:14

One way that MDMA might

14:16

be doing this is by dampening the activity

14:18

in this part of the brain associated with fear

14:21

called the amygdala. And Harriet

14:23

reckons that this superpower of MDMA

14:26

to make you care less about negative stuff

14:28

around you. It's one of the things

14:30

that makes this drug unique. You

14:32

can feel good because you aren't distracted by

14:35

what you think are negative expressions

14:37

in your friends around you. And you

14:39

can just enjoy your mates. You

14:42

can imagine if the people are at a party, then

14:44

they're going to be less sensitive to kind

14:46

of judgmental expressions or,

14:50

you know, in a social situation, you're feeling

14:52

a little bit like people are looking at you and

14:54

people are judging you. That is amazing.

14:57

Just kind of a mechanism or a process

14:59

that we would never have thought of otherwise

15:01

until we had done these studies.

15:09

And other research has come along showing similar

15:11

things. And just this year,

15:14

Harriet published a study where she gave MDMA

15:16

or a placebo to two strangers and

15:18

then got them to have a chat. And

15:21

she found that MDMA makes them feel that

15:23

the conversation is more meaningful and

15:25

that they feel more connected with the other

15:27

person that they're talking to. And

15:30

they like the other person that they're talking to. And

15:32

to Harriet, the fact that MDMA

15:34

can do all of this opens up a lot of

15:37

possibilities. Like to go back

15:39

to the idea that MDMA could help you

15:41

during therapy. Well, if you think

15:43

about it, if they're less responsive

15:46

to negative emotions in other people, then

15:48

to the extent that this therapist has

15:50

some negative expression

15:53

or the person perceives some negative

15:55

expression in the therapist, if that's taken away,

15:58

then the patient is

15:59

to address negative things

16:02

in their

16:02

own lives or reveal more negative things.

16:04

And just a few years ago, Harriet wanted

16:06

to know if maybe MDMA wasn't just

16:09

affecting our brains, but

16:11

maybe also our sense of touch. There'd

16:14

been some research suggesting that when our

16:16

oxytocin levels rise, it can

16:18

make some types of touch feel nicer.

16:21

And Harriet knew that MDMA bumps

16:23

up our oxytocin levels. So

16:26

she got people into her lab, gave them MDMA

16:28

or other stuff like a placebo, and then

16:31

a colleague grabbed a soft brush

16:33

made of goat hair and slowly

16:36

stroked their skin. It's

16:38

kind of a consistent rate, that kind

16:40

of rate that you might pat your dog or that you

16:43

might stroke someone if you're calming them. Interesting.

16:45

Were you involved in the study? Did you put

16:47

yourself up to be a guinea pig? I should

16:50

have. No, I didn't. Good idea. Would

16:54

have been so nice, the soft goat hair.

16:56

It would have been, yeah. And

16:58

she found that it was nice. In fact,

17:01

people on MDMA said that that soft

17:03

touch was nicer on average

17:05

than the people who were on a placebo.

17:08

But something happened in that experiment

17:11

that really freaked Harriet out. So

17:14

these participants are coming in, getting MDMA

17:17

and filling out forms, saying how pleasant

17:19

it all is. And this was going

17:21

on as expected, until

17:23

this one

17:25

guy. This

17:27

was a regular participant

17:29

in that study, and at the

17:32

bottom of his form he said, in capital

17:35

letters, he said, now I know what

17:37

I have to do. Yeah, he wrote

17:39

quotes. This experience helped

17:41

me sort out a debilitating personal

17:44

issue. Google my name, I now

17:46

know what I need to do. And

17:49

Harriet was like, what?

17:52

Google my name? So we

17:54

did that. And it turns out he was

17:57

the leader of a white supremacist group.

18:00

in Illinois. Yeah. So

18:02

Harriet had just given a powerful drug

18:05

to a guy who headed up a notorious white

18:07

supremacist

18:08

group

18:09

and he just left her a note saying, I now

18:12

know what

18:12

I need to do.

18:14

So that made me really worried. You

18:16

know, I was, I was alarmed by it. I have to say. So

18:19

what did you think? Well, I thought I have to, if

18:21

he's already got these beliefs, racist

18:24

beliefs, he might think that he has to go and I

18:27

don't know,

18:28

shoot someone. You

18:31

know,

18:32

the drug somehow had made him angrier.

18:35

So I sent the research assistant in there

18:38

to ask the subject a little bit more. And

18:40

he was still, so the subject was still

18:42

in the lab at that point. He's in the room. Yeah.

18:45

Right. Yeah. Oh

18:47

gosh. So it was like happening in real time. It

18:49

was in real time. mean

18:51

there? And what, how are you feeling? And

18:54

the guy said, I realized that

18:56

what's

18:56

really important

19:00

is love. Love

19:03

after getting a single dose of MDMA,

19:06

he said he felt a transformation

19:08

and that quote, love is

19:11

the most important thing. So

19:14

this is somebody he reported that he

19:16

sort of had gotten his values wrong

19:19

and that there, there

19:21

are things that are more important in his life

19:23

than, than worrying about what,

19:25

you know, what race people are or whether immigrants

19:28

are coming in. That's not something to focus

19:30

on. Focus on something that's important,

19:33

like your connection with other people. And

19:35

he said it really did change his life.

19:37

Harriet wrote this up in a case report.

19:40

This story made headlines around the world.

19:43

I know. MDMA pill completely rehabilitates

19:46

the Charlottesville white supremacist leader.

19:48

Harriet DeWitt, who led this whole research,

19:50

said this. It's what everyone says about

19:52

this damn drug, that it makes people feel

19:55

love. Did

19:57

you really say damn, Harriet?

20:01

And

20:04

have there been other cases, I mean

20:06

so many people who have racist views must have taken

20:08

MDMA and not had a complete

20:11

transformation. Yeah, yeah.

20:13

I don't know why did he

20:16

experience love and other people who

20:19

use the drug don't. Do you think maybe it was

20:21

the goat hair that did it? Or the lovely soft

20:23

goat hair? There you go, there you go. Could have been.

20:29

And Harriet told me that this guy

20:31

wasn't completely cured. He did have

20:33

some racist and anti-Semitic thoughts.

20:36

But

20:36

still,

20:37

in the future, she wants to do a study

20:39

where she gets people into her lab with different

20:42

political views and gets them to take MDMA

20:45

to see if perhaps conversations

20:46

go a little smoother.

20:48

But

20:50

no matter what, it doesn't look like MDMA

20:53

is some anti-racist

20:55

cure-all.

20:57

So our next question is,

21:00

what can MDMA cure? Because

21:03

researchers are looking to see if MDMA

21:06

can help with all kinds of things, from different

21:08

kinds of anxiety to alcohol use disorder.

21:11

But the best evidence that we have comes

21:14

from research on post-traumatic stress

21:16

disorder. So let me

21:18

tell you about this one study that was published

21:20

just a few

21:20

months ago.

21:22

A hundred people with PTSD were

21:24

split into two groups, half given MDMA,

21:27

the other a placebo. And they take the

21:29

drug or a placebo and then talk to a

21:31

therapist for a session that lasted

21:34

eight hours. I talked

21:36

to Harriet about this. Eight for eight

21:38

hours. Oh my gosh. I know. So

21:41

long to talk to a therapist. I know. That's

21:43

what the MDMA helps with. They

21:46

did this once a month for three months. And

21:48

after all that, on average, both groups

21:51

had fewer PTSD symptoms, as measured

21:53

by this questionnaire. But

21:55

Team MDMA were doing better. In

21:58

fact, around four

21:59

months.

21:59

after the whole experiment began, almost

22:02

half of the people who got MDMA had

22:04

improved so much that they were

22:06

considered in remission. That was compared

22:09

to around 20% in the placebo group.

22:14

So,

22:15

in a therapy situation, the

22:18

patients with PTSD are having to face

22:21

very negative things about themselves, often

22:23

shame and often terrible

22:25

things that they've had to do or that they've witnessed.

22:28

So those are very negative thoughts and so there's

22:30

a possibility that the drug makes them better

22:33

able to, that suppresses some of those negative feelings

22:35

and self-judgments. Now,

22:37

of course, not everyone had a huge

22:39

improvement here. But like we mentioned,

22:42

the results of these kinds of trials are so

22:44

promising that over in Australia, certain

22:47

psychiatrists can now prescribe

22:49

MDMA for PTSD. And

22:52

from what we know from animal research and

22:55

human clinical trials, MDMA

22:57

isn't very addictive. So,

23:00

all of this is making this drug

23:03

sound pretty good, like great

23:05

even. But

23:07

is MDMA really all love

23:10

and soft touches from goat

23:12

hair brushes? I don't know why

23:14

she takes it. She always gets so

23:16

depressed coming down. Because growing up, this

23:19

was the message that I kept hearing.

23:20

I didn't know how many health problems it could cause.

23:23

She just wanted to try something new. Ecstasy.

23:26

You don't know what it'll do to you.

23:30

After the break,

23:32

the calm down.

23:44

Welcome back. We just found out that MDMA

23:46

is proving to be a really promising treatment

23:49

for PTSD. But

23:51

now, the sun is up, the

23:53

high is gone, and we feel

23:56

like shhh. And we're

23:58

asking, is MDMA really all love and soft touches from goat hair brushes? First,

24:03

let's talk about the days after. Because

24:05

some people say that they feel low and depressed.

24:08

In fact, this phenomenon is so commonly

24:10

known that it's got nicknames like the

24:12

Tuesday Blues and even Suicide

24:15

Tuesday, which could be

24:17

pretty concerning, particularly if we're

24:19

about to give this drug to people who

24:21

are struggling with their mental health. So,

24:25

is it true?

24:26

The MDMA come down.

24:28

Well, there

24:29

are studies that find yes, some

24:31

MDMA users can feel a bit down

24:34

or depressed in the days after taking the drug.

24:37

And a lot of the scientific literature on this seems

24:39

to blame serotonin. So

24:41

we asked Harriet DeWitt from the University

24:43

of Chicago about it. So what about this

24:45

idea that you take it,

24:47

you get this serotonin burst, and

24:50

two days later your brain

24:52

doesn't have enough serotonin so you feel sad?

24:55

Yeah, right. Well, it's a nice story to tell,

24:57

but it's been questioned a certain amount.

25:00

And there are a few good reasons to think that this

25:03

idea that MDMA maxes out your

25:05

serotonin, giving you a come down, isn't

25:07

quite true.

25:12

So, for one, as part

25:14

of Harriet's research, she asked about 40 people

25:17

about their moods two days after taking

25:19

her MDMA. And?

25:23

And we don't see this crash. They were

25:25

totally normal. Yeah,

25:28

you go to Harriet's lab, take some MDMA,

25:31

no come down. Plus,

25:34

a small trial looking for the come down effect

25:36

on people who were taking MDMA to

25:38

help with alcohol use disorder also

25:41

didn't find any evidence of it. In

25:43

fact, they wrote,

25:44

quote,

25:45

We found that rather than a come

25:47

down, participants maintained a positive

25:50

mood during the week after each MDMA

25:52

session. End quote. The

25:55

recent clinical trials on MDMA and PTSD

25:58

also didn't find that MDMA included increased

26:00

your risk of having suicidal thoughts? So,

26:03

what do we make of all this? Well,

26:06

Harriet has a couple of ideas about why

26:09

recreational users might feel this, but

26:11

the people in research studies mostly don't.

26:15

You see, unlike partygoers, the people in her

26:17

study, they're well rested. They're

26:19

told to eat before they come in. They're

26:22

hydrated, so we make sure that they drink

26:23

water while they're here. We control the temperature

26:26

in the room. We might not be

26:28

producing the experience that they're getting in

26:30

their party situation.

26:32

Yeah, you're not drinking alcohol either. This

26:35

could also be a dose thing, like Harriet gives

26:37

people enough MDMA to get high,

26:39

but maybe she doesn't give them enough to have a big

26:42

crash later. And finally,

26:44

it's possible that the MDMA

26:46

come down just isn't as common as

26:49

we think, because in one

26:51

of the PTSD clinical trials,

26:53

out of 46 people who got MDMA,

26:57

one person did bow out of the trials,

27:00

partly because of what sounds

27:02

a bit like they got the Tuesday blues.

27:07

That is what we know about the come down a couple

27:09

of days later. But what

27:11

about the long-term consequences of using

27:14

MDMA? Like say if you take it every

27:16

weekend for months or even years,

27:20

will it fry your brain? This is

27:22

your brain, this is drugs. This

27:25

is your brain on drugs. Any

27:27

questions?

27:27

Well,

27:30

just a couple.

27:32

You see, this idea that MDMA

27:34

could break your brain has been

27:37

around for decades, but it really

27:39

caught fire in the early 2000s when

27:41

a study in monkeys suggested that

27:43

MDMA could kill brain cells. But

27:46

in one heck of a, whoopsie, the

27:49

researchers later realized that they accidentally gave

27:52

the monkeys meth instead of MDMA.

27:56

I hate it when you do that. The researchers

27:59

retracted their. paper but the idea that

28:01

MDMA can fry your brain stuck

28:04

around. So,

28:06

away from monkeys and meth,

28:09

what do we know here? How bad

28:11

is MDMA for us? Well,

28:14

to find out, several years ago, a big review

28:16

paper analysed studies involving more

28:19

than a thousand people who had taken

28:21

a lot of MDMA. And I

28:23

mean a lot. Averaging almost 350 pills.

28:28

After all that partying,

28:29

how were they doing?

28:33

Well, for the most part, these people

28:35

were actually fine, but there were a

28:37

few things to worry about.

28:39

So, heavier users tended to find

28:41

it trickier to move from one task

28:44

to another. And their memory could also

28:46

be worse. In fact, there is

28:48

one case study of a guy who took an estimated 40,000

28:50

ecstasy pills over

28:53

about a decade and years after

28:56

he stopped the drug, his concentration

28:58

and memory still sucked. Here's

29:01

how I add. People can use a

29:03

lot if they keep using it, yes.

29:05

It's almost certainly damaging to their brains.

29:07

So, for example, in one study, researchers

29:10

found that it was more common for heavy users of

29:12

MDMA to say things like, I forgot

29:14

what I wanted to say in the middle of a sentence.

29:17

But still.

29:19

Now,

29:20

I forgot what I was going to say.

29:22

Oh, the researchers said that

29:25

the effects were small, mostly.

29:27

We're still working out why MDMA

29:29

in high doses might affect our cognition.

29:32

Some studies in animals suggest

29:34

that the drug could damage or turn down

29:37

the activity in neurons. So, that could

29:39

be part of what's going on.

29:40

Now, so far, we've been focusing

29:43

on the real party animals.

29:45

But

29:45

for some of us, we're just dabbling, you

29:47

know, taking MDMA during a therapy

29:50

session or three, or perhaps just popping

29:52

some while the kids are asleep. So,

29:55

what about these people?

29:58

If they use it occasionally.

29:59

And finally, chances are we don't have

30:02

very good evidence. We don't have very strong evidence.

30:04

And certainly I wouldn't be giving it in the laboratory

30:07

if I had any inclination, if I had any belief

30:10

that it was producing any kind of brain effect, lasting

30:12

brain effects.

30:14

So here's where we're at. Taking a lot

30:16

of MDMA can probably hurt your

30:18

brain and particularly your memory. But

30:20

we don't have good evidence that taking a little bit once

30:22

in a while can cause brain damage.

30:26

Except,

30:27

well, there is one very

30:29

big caveat.

30:32

There are times when it can kill.

30:34

On

30:37

a November night in 1995,

30:39

a young woman in the UK was celebrating her

30:41

18th birthday. Her name was Leah

30:44

Betts and she was partying with friends at home.

30:46

She popped some ecstasy and seemed totally fine.

30:49

But as the night went on, things got bad.

30:53

And what happened next got tons of

30:55

media attention around the world. And

30:57

Leah became a kind of poster child

30:59

for how dangerous

31:00

MDMA could be.

31:02

You see, Leah had started drinking

31:05

water. A lot of water. News

31:07

reports at the time said that she was downing

31:10

glass after glass of it. She

31:12

started to feel sick and then she lost consciousness.

31:15

And her stepmom called the emergency. The

31:17

call was later broadcast on the BBC.

31:20

Ambulance emergency. Our daughter's

31:22

at a party and she's taken ecstasy

31:25

along with alcohol. How old is she? She's 18.

31:28

We've gone to have water. She's been sick but she

31:30

just stopped breathing. Is she breathing again?

31:33

She's not breathing.

31:34

OK, we've got the ambulance on the way to

31:36

your med. You've got a flat on her back of the floor.

31:38

Yes, now have some...

31:44

A few days later, Leah died in hospital.

31:46

So what happened

31:48

here? Well, it's

31:50

thought that Leah died from drinking

31:53

too much water. You see, your

31:55

body needs a perfect balance of salt

31:57

and water to keep you alive. And

32:00

when you're on MDMA, it can mess with that

32:02

salt water balance. Now, this partly

32:04

happens because MDMA can trigger the release

32:06

of a hormone that stops you from peeing. So

32:09

you're basically retaining all of this water. And

32:12

then if you're drinking a lot,

32:14

that can make the situation worse.

32:15

Basically, your body just gets too much

32:18

fluid, your cells can start to swell,

32:20

and the cells in your brain can

32:22

swell too, which can ultimately kill

32:24

you. Now,

32:27

what happened to Lea does not happen

32:29

often. In fact, one review paper

32:31

looking for cases like this found only around 20

32:33

instances of people dying

32:36

like that. And that was over almost

32:38

three decades. And

32:40

while this story of drinking too much water

32:43

on MDMA got a lot of attention, deaths

32:45

from hypothermia or overheating

32:48

are actually more common. And that's because

32:50

MDMA can drive up your body temperature.

32:53

But just generally, even considering that,

32:56

deaths from MDMA are rare. We

32:59

couldn't find a number from the US on how

33:01

many people died from taking just MDMA.

33:04

But in England and Wales, on average, 43

33:08

deaths each year have been linked to

33:10

taking MDMA. That's

33:12

out of roughly a million ecstasy

33:14

users each year. That's

33:17

not good. To put it into perspective,

33:20

one scientist has said that it's safer to take

33:22

the drug

33:22

than to ride a horse.

33:27

And the thing is, for these

33:29

deaths,

33:31

they might not all be MDMA's

33:33

fault. Because the vast majority

33:35

of people who take MDMA, they don't get

33:38

it from guys like Harriet's chemist.

33:41

They buy it on the street. Here's

33:43

what former DEA officer

33:44

James Hunt told us about that. These

33:47

guys are not skilled chemists. If

33:49

you're not skilled chemists, you just start throwing stuff in there. Bad

33:52

things could happen.

33:53

So to find out more about what's actually being

33:56

thrown into our MDMA, we

33:58

talked to Joseph Palomar.

33:59

My prime year was probably 2000. Yeah.

34:03

Remember

34:03

our club kid from the beginning of the episode?

34:05

That was a good summer. Well,

34:08

he's not a club kid anymore. He's all grown

34:10

up, and he's a public health researcher at

34:12

New York University, researching what

34:15

you really get when you think you're buying

34:17

MDMA on the street. Joseph

34:20

and his team stand in front of New York City

34:22

clubs, asking people what drugs they're using,

34:25

and then they collect hair samples.

34:27

And we don't mention the hair usually

34:29

until they're maybe halfway done with the

34:31

survey. Good move. Yeah.

34:33

They're collecting hair samples

34:35

because traces of what's in MDMA

34:37

and other drugs can show up in your

34:40

locks months after you've taken

34:42

a drug. But as you can imagine,

34:44

getting hair samples for people clubbing

34:47

can get

34:48

a little hairy. I

34:51

was outside of a club, and there

34:53

was this female on

34:56

roller skates wearing a big fake afro

34:59

who really wanted to participate, but she

35:01

didn't want to mess with the fake afro that she

35:03

was wearing. And

35:05

she was there voluntarily

35:07

plucking out pubic hair. She insisted

35:09

on plucking them one by one. But

35:12

she only plucked out two or three or four hairs.

35:16

So Joseph had this sad little pile

35:19

of pubic hair to work with,

35:21

which wasn't enough to run his experiment. But

35:24

luckily, through other people, he'd gotten

35:27

plenty of hair. And when he did this study back

35:29

in 2015, he got samples from more than 170 people. And

35:34

after analyzing all that, what did he find? Well,

35:37

a lot of MDMA, as he was expecting.

35:41

But then he found something perhaps

35:44

unexpected.

35:46

Barf salts.

35:48

Now, barf salts aren't actually

35:50

barf salts. That's a slang term

35:52

for a group of chemicals that can feel a lot

35:55

like amphetamines when you take them, so

35:57

they can make you panic, hallucinate,

35:59

and feel pain. There's been

36:01

reports that they can turn you into a cannibal,

36:03

but that was after this creepy case

36:06

in Florida where a guy chewed

36:08

off a man's face. But

36:10

he actually wasn't on bar salts. That's

36:13

just like a regular Tuesday night in Florida.

36:15

So

36:17

of the 34 people in Joseph's

36:20

study who said that they had never used

36:22

bar salts or similar stuff, more

36:24

than 40% of them had evidence

36:27

of it in their hair. And so

36:29

what does that tell you?

36:31

Tells me that they're using

36:33

drugs that are potentially more dangerous than

36:36

ecstasy without knowing it.

36:38

Or they're lying to you. Yeah,

36:45

well, some people would lie,

36:47

but a lot of these kids

36:50

have no idea what they're taking.

36:52

Joseph just published a study this year

36:55

showing that these days, MDMA in New

36:57

York is way less likely

36:59

to be cut with bar salts. But

37:01

there's a new concern, fentanyl. Back

37:06

in 2019, Joseph found evidence for it in

37:08

someone's hair, even though they told him that

37:10

they only took MDMA. And

37:13

across the US, we don't have good numbers

37:15

on how often MDMA is getting cut

37:17

with fentanyl. In Mexico City,

37:20

a study of 22 MDMA samples

37:22

taken from a music festival found

37:24

that just over half of them had fentanyl

37:27

inside. And research

37:29

has found that MDMA can be mixed

37:31

with other stuff like ketamine or caffeine,

37:34

which Joseph says might be dangerous or

37:37

it might not.

37:38

We don't know how these drugs work at the

37:40

same time. It might be quote

37:43

unquote good effects that are increased, or

37:45

it might be really bad effects that are increased. Or

37:48

you never know what that's going to do to your brain, your body,

37:51

a combination of drugs that we don't know

37:53

about.

37:54

And online, it is hard to know the chance

37:56

that when you buy MDMA on the street or

37:58

at a music festival, it's going to be pure

38:00

or not. Studies from the UK,

38:02

Spain, and Australia suggest that roughly

38:05

one in five samples are adulterated.

38:07

Roughly.

38:08

So

38:10

I guess it's just best

38:12

to score your MDMA from the scientists.

38:16

All right. So

38:17

when it comes to science versus MDMA,

38:20

where does this leave us? Well,

38:23

the funny thing about MDMA is

38:25

that there's always this feeling behind

38:27

it that there has to be a bad consequence

38:30

of feeling so good. I

38:32

mean, surely you can't have this much fun and

38:34

not

38:34

break your brain.

38:36

The chemicals don't work like that. They don't

38:39

decide to punish you for having too much fun.

38:42

They're not your Catholic grandfather. And

38:45

from what we're seeing, this drug, MDMA,

38:47

it's actually pretty safe.

38:50

And for some people, it could be a really

38:53

powerful medicine. That's science

38:55

versus.

39:05

Hey,

39:07

Joel, when a supervising producer at science versus.

39:10

Hey, Wendy. Do you want to take a guess

39:12

at how many citations are in

39:14

the MDMA episode? I

39:17

sure do. I

39:20

reckon we have definitely cracked 100.

39:23

Got a century, not just up to a century. Yeah.

39:27

Look, there's 180 citations

39:29

in this week's episode. What?

39:33

What?

39:33

Are you sure? Did someone double up on

39:36

a couple? I don't think

39:37

so. I don't think we have because

39:39

I guess I was updating the science.

39:42

So

39:43

we already had a lot of citations

39:45

in there that I guess I added

39:47

a bunch. Oh, goodness. If people want to read

39:50

about about

39:52

MDMA, bath salts, that

39:57

in Florida, who is accountable.

40:00

If you want to know more about all of this stuff,

40:02

go to our

40:03

show notes and there is a link to

40:06

the transcript.

40:07

You might need some MDMA to get

40:09

through the whole lot.

40:19

Next week, we're sticking

40:21

with the drug theme and we're

40:23

exploring the science of caffeine,

40:27

which is super interesting. And I am

40:29

very, very invested.

40:31

I

40:33

drink so much coffee. This

40:35

could be really bad news for me. And

40:38

it could be great. It could be great news. See

40:41

you then. Bye. Bye.

40:47

This episode was produced by Heather Rogers

40:49

and me, Wendy Zuckerman, with help from Shruti

40:52

Ravindran, Caitlin Soory, Rose Rimmler,

40:54

Joel Werner, Nick Del Rose and Michelle Dang.

40:56

We're edited by Blythe Terrell. Back checking

40:59

by Michelle Harris, Ben Kubrick and Diane

41:01

Kelly. Sound designed by Martin Peralta,

41:03

Hegley Shaw and Boomi Hidaka. Music

41:05

written by Bobby Lord, Peter Leonard, Emma Munger,

41:08

So Wylie and Boomi Hidaka. Thank

41:10

you to all of the researchers that we reached out

41:12

to for this episode, including Professor

41:14

Gerald S. Meyer, Professor Nied McDade,

41:17

Dr. Brian Earp, Dr. Karl Roberts

41:20

and Dr. Matthew Baggett. An extra thanks

41:22

to Lucy Little, Johnny Dinell, Jesse

41:24

Redoy, Joseph LaVell Wilson and the Zuckerman

41:26

family. Science Versus is a Spotify

41:29

Studios original. Listen to us for free

41:31

on Spotify or wherever you get

41:33

your podcasts. Yes, you can find Science

41:35

Versus anywhere. If

41:37

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give us a rating, a five star rating.

41:47

Yes, do it. I'm Wendy Zuckerman, back

41:49

to you next time.