MDMA use is now mainstream in much of Europe, and no longer confined to dance culture. Here in Ireland, its popularity is topped only by alcohol and cannabis.
For years, much of the harm-reduction advice for the drug focused on the risk that ecstasy tablets might be cut with toxic substances.
But now MDMA manufactured in Europe tends to be pure, and very strong, says Nicki Killeen, team leader of the Online Digital Services Team at the Ana Liffey Drug Project. This also carries risks.
“The problem is the MDMA is so pure that it is dangerous,” Killeen says. Overdosing on MDMA is a real risk, and can cause brain damage, she says.
Killeen and her team are at the forefront of researching trends in Irish drug taking, so that they can respond with clear, credible information and advice for users, to try to keep them safe.
In 2015, they ran campaign in partnership with student unions and Irish universities, offering tips on safer use of recreational drugs. Posters for their “What Is in the Pill?” and “What Is in the Powder?” campaigns have been used widely in bars, festivals, and student events.
Do drug users actually pay any attention to harm-reduction campaigns like these?
Dublin poet Emmett O’Brien says he and most other recreational drug users he knows don’t. But Anna Liffey Drug Project Director Tony Duffin says such campaigns can be effective.
Nicki Killeen has for a long time had an interest in drug culture.
Growing up in Dublin, she noticed how in different parts of the city there are different cultures around drug taking. She recalls, as a child, asking her mother why heroin was prevalent in one area and not in another.
“I was always fascinated by the cultural side of it … If you are part of a particular music scene or subculture, that might be the reason why you take a particular drug,” she says.
A young woman with cropped brown hair, blonde at the tips, Killeen wears thin gold hoop earrings. She did an MA in addictions, a course that covered psychotherapeutic approaches to addiction, cultural issues, and research methodology.
“You got to study cannabis use by the Rastafarians in Jamaica … [and] people using plants religiously for psychedelic experiences, to prolong the religious experience,” she says.
Cultural issues impact on drug trends, and different groups will use drugs based on availability, supply, and local culture, she says.
The Online and Digital Services Team that Killeen leads works on campaigns to raise awareness about emerging trends in drugs. Supported by the HSE, they run the website Drugs.ie, which provides information and support.
The first of their campaigns was rolled out when PMA/PMMA started appearing in ecstasy tablets in Ireland. There were hospitalisations and deaths as a result of this trend in 2013 and 2014, says Killeen.
PMA takes longer to take effect than MDMA and is toxic at lower doses. Because it was taking a long time to kick in, some users may have thought they had weak ecstasy and then taken more, and overdosed, she says.
In addition to being stronger and purer these days, the appearance of pills being tested in Europe is different, Killeen says. “They have defined shapes and logos with clear vibrant colours,” she says. “Many of the pills in circulation are made to halve, or break into thirds – some even have a quantity on them.”
It is always best to take a test dose and wait for that to kick in, so you can judge the strength, Killeen says. Bear in mind that some pills take a lot longer to take effect than others, don’t mix MDMA with alcohol, and drink a pint of water every hour, but avoid over-hydrating, she says.
Of course, there is still the risk that pills could be cut with other substances. Unlike the Netherlands and the UK, Ireland does not have services whereby people test drugs that are around, but the team at Drugs.ie gather information about what is in different branded pills and such from the Gardaí, who test what they seize.
The team also use their networks of local and international contacts to gather information on drug trends, and, based on what they learn, decide which campaigns to run next.
Is Anyone Listening?
There are popular websites where users of recreational drugs share information and review different “brands” of ecstasy, which indicates that some users do want more information about the drugs they take.
“It is great that people are thinking about what they are taking,” says Killeen, but she warns against relying on online reviews.
“You could have a lot of producers across Europe making the Blue Ghost [a type of ecstasy], and you have no idea that your Blue Ghost is the same as the Blue Ghost you read about online,” she says. That’s why she recommends a test dose, first.
O’Brien, the poet, says he knows a lot of young people who take drugs, and most do so in order to get “fucked up for the sake of getting fucked up”.
They are unlikely to heed harm-reduction advice, however it is presented, he says, and are likely to mix MDMA, ketamine, cocaine and whatever else they can get their hands on.
“There is a distinction between drug use and substance abuse,” O’Brien says. The reckless use of drugs is substance abuse, he says, while the considered, moderate use of drugs is something that can be positive.
O’Brien says he used to take stimulants, but no longer does so. Instead, he takes LSD or mushrooms in moderation, to change his perspective on life, and help him with his writing.
“I classify myself as self-educated on drugs,” he says. “I don’t read articles on how to take drugs. Every drug is an individual journey and no article you read is going to be the same as what you will experience.”
For example, he says that he has never hallucinated on LSD. Rather, it changes his perception of colour and how he sees life, and helps him to connect his spirit and his mind, he says.
O’Brien says the best harm-reduction advice he can offer is to always buy from trusted sources.
“You need to be comfortable with who you are getting your drugs off,” he says. “If you are getting them off a scaldy 17-year-old around the corner, it’s going to fuck you up.”
We need to have more open conversations about drugs, O’Brien says. He thinks a social stigma around them has developed because “people are taking them in irrational quantities and taking them for the wrong reasons”.
Removing stigma is essential to getting people talking openly about drug use, says Duffin, of the Anna Liffey Drug Project.
“If you feel shame and stigma you hide your behaviour away and that doesn’t lead to anything positive,” he says.
Duffin says the Drugs.ie harm-reduction campaigns are different to the anti-drug campaigns that preceded them. “The ‘just say no’ campaigns simply don’t work,” he says. “People who use drugs want to have credible information.”
The message of the Drugs.ie campaigns is “It is always safest not to take drugs, but if you decide to, this is what you need to know,” Duffin says.
Information campaigns for people who use drugs are essentially health-promotion campaigns, and research from the UK shows that such campaigns are effective, he says. He points to NHS research that shows how publicity campaigns around health issues have impacted on public opinion in a number of areas.
One example is the roll-out of major awareness-raising campaigns around the issue of HIV in the late 1980s and early 90s.
According to that research, in 1986, just 66 percent of people surveyed realised that using a condom could help to protect them against HIV. That figure increased to 95 percent by 1997. Condom usage increased significantly at the same time.
“Drug use is happening, and we want to keep people as well as possible and as safe as possible,” says Duffin. “You cannot rehabilitate someone who is dead.”