title: Linking the pharmacological content of ecstasy tablets to the subjective experiences of drug users.
abstract: BACKGROUND
  Most studies on the subjective effects of ecstasy are based on the assumption that the substance that was taken is 3,4-methylenedioxymethamphetamine (MDMA). However, many tablets sold as ecstasy contain other substances and MDMA in varying doses. So far, few attempts have been made to take this into account while assessing subjective effects.
  
  
  OBJECTIVE
  This study aims to link the pharmacological content of tablets sold as ecstasy to the subjective experiences reported by ecstasy users.
  
  
  METHODS
  Self-reported effects on ecstasy tablets were available from 5,786 drug users who handed in their tablets for chemical analysis at the Drug Information and Monitoring System (DIMS) in the Netherlands. Logistic regression was employed to link the pharmacological content of ecstasy tablets to the self-reported subjective effects and compare effects with MDMA to other substances present.
  
  
  RESULTS
  MDMA showed a strong association with desirable subjective effects, unparalleled by any other psychoactive substance. However, the association of MDMA was dose-dependent, with higher doses (>120 mg/tablet) likely to evoke more adverse effects. The novel psychostimulants mephedrone and p-fluoroamphetamine were considered relatively desirable, whereas meta-chlorophenylpiperazine (mCPP) and p-methoxymethamphetamine (PMMA) were strongly associated with adverse subjective effects. Also, 3,4-methylene-dioxyamphetamine (MDA) and benzylpiperazine (BZP) were not appreciated as replacement for MDMA.
  
  
  CONCLUSIONS
  Linking the pharmacological content of ecstasy sold on the street to subjective experiences contributes to a better understanding of the wide range of subjective effects ascribed to ecstasy and provides a strong rationale for the prolonged endurance of MDMA as the key ingredient of the ecstasy market.
authors: Drug Information and Monitoring System, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands. tbrunt@trimbos.nl
authors: Tibor M
authors: TM
authors: Brunt
authors: Maarten W
authors: MW
authors: Koeter
authors: Raymond J M
authors: RJ
authors: Niesink
authors: Wim
authors: W
authors: van den Brink
mesh_terms: D004305:Dose-Response Relationship, Drug; D055030:Drug Users / Q000523:psychology*; D006801:Humans; D013287:Illicit Drugs / Q000737:chemistry / Q000494:pharmacology; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000737:chemistry* / Q000494:pharmacology*; D009426:Netherlands; D057566:Self Report; D013607:Tablets
chemical_list: D013287:Illicit Drugs; D013607:Tablets; D018817:N-Methyl-3,4-methylenedioxyamphetamine