Ecstasy experts want realistic messages.

BETHESDA—As the popularity of the drug ecstasy (MDMA) continues to climb—11% of high school seniors have tried it, according to a National Institute on Drug Abuse (NIDA) survey— behavioral researchers are recommending control strategies that may seem antithetical to ever-expanding law enforcement efforts. Instead of focusing on eradication and punishment, these social scientists take another tack: they encourage harm reduction that acknowledges the realities of ecstasy. At a recent NIDA conference, a halfdozen speakers advocated this immediate action approach. Providing plenty of water at rave parties to prevent dehydration (a common adverse effect), offering purity testing to help users avoid ubiquitous adulterants, and developing peer-led programs will go a long way toward reducing dangers, they said. Ecstasy pills sold in the United States generally contain 100 mg or less of MDMA. According to the social scientists, typical users take no more than one pill at a time during a “session” and most limit their use to once or twice per week. “Ecstasy is seen as relatively benign,” said Robert Carlson, PhD, an addiction researcher at Wright State University of Medicine in Dayton, Ohio. “[Prevention] messages are not getting across, and something needs to be done.” Skepticism about government studies, perception that ecstasy is safer than other drugs (including alcohol and tobacco), and willingness to take calculated risks all factor into the ecstasy equation, said Patricia Case, ScD, director of the program in urban health at Harvard University. “A lot of [ecstasy users] make clear decisions, despite the known or unknown risks, that the benefits outweigh those risks,” she said. With considerations like these, Carlson and his colleagues are emphatic that one-size-fits-all campaigns hyping the dangers of ecstasy fail to sway users. Instead, they want messages that reflect reality: the effects of ecstasy feel good, different groups use it for various reasons in a range of settings, and evidence of addiction remains scant. Claire Sterk, PhD, professor of behavioral sciences at Emory University’s