Lists of drug harmfulness (physical harm of MDMA)

[bulla]

My question is that how often these drugs in the lists are supposed to be taken and what about the doses? Is those drugs with a big dependence potential supposed to be taken much more often in the lists?

https://en.wikipedia.org/wiki/Drug_harmfulness

Wouldn't the comparison of physical harm be equal if all the drugs is supposed to take as often and the dose would be such that most people find it effective? Well, i know this "effective dose" is very indefinite because of tolerance and people's different preferences...

But anyway I'm wondering the position of MDMA so low in the lists. For example, if there were 10 people and everyone used a different drug for a year, let's say once every week. Wouldn't the MDMA-person be at least mentally in much worse condition than other people?

 

[PINKoPANaTHER]

You're absolutely right. The MDMA user (if using once a week) would have the most long-lasting mental damage, and maybe even physical (cardiotoxicity, piperazine cuts etc..) However that graphic takes into account addiction liability and accessory behaviors that surround taking the drug. Health wise, pure pharmaceutical grade heroin administered sterilely using proper technique really doesn't carry a health liability - but that's not how it works most cases. There are cuts, sloppy needle technique using risky water (unsterilized) and the withdrawal symptoms that can result in monetary consequences the like of which you've never seen (stealing, prostitution, pawning your life away, incurring serious debt etc.).

MDMA just isn't as likely to cause you to want to use it every day, nor would that be sustainable/effective as tachyphylaxis occurs with MDMA (skyrocketing tolerance, within one use, like pot and nicotine). If you tried to take it everyday, by the third day it would likely have minimal effects (ask those who attend festivals/shows for multiple days binging on it and other substances). Heroin is all alone in the highest category because almost anyone can become dependent, and eventually desperation leads to dangerous injection/smoking habits that sometimes require money to fix (like sterile wheel filters/micron filters, bacteriostatic water, fresh unused needles). This is why needle exchanges are becoming more common in the USA, they can freely provide these things to you to prevent some of the more imminent dangers of IV drug use.

 

[PINKoPANaTHER]

Oh, and that graphic is old, there's a newer more accurate one that has separate methamphetamine/amphetamine categories, plus things ling mephedrone, Khat chewing, steroids, etc.

Drug safety/harmfulness is highly dependent on the user though, so these are rough estimates.

 

[bulla]

Thanks a lot for your answer. I understand there is a lot of other factors using drugs than the substance itself that make you more harm (even physical harm that you mentioned above).

Also the harm coming for the substance itself may be very difficult to put in order. Some research can emphasize more the damage in your brain (memory, cognitive skills etc) and another the damage in heart or other parts of the body.

 

[Cotcha Yankinov]

Regarding MDMA, some people have horrible adverse reactions after even a couple times, so there isn't always a linear correlation between use and damage - some people get damaged a lot easier.

 

[Phil.McKeer]

I'm not convinced that long term MDMA use presents serious consequences. For instance, it is a well known urban myth that MDMA "burns holes" in your brain which I highly doubt can be confirmed by long term studies.

Usually these are spread by fear mongering parents, school staff, D.A.R.E. instructor cops, etc who have never touched a drug beside alcohol or tobacco (not unlike the "study" that suggested THC kills brain cells which came as a result of a researcher strapping lab monkeys with gas masks funneling cannabis smoke into the monkeys lungs, neglecting to mention that they weren't getting any oxygen, thus the neural cell death).

Until a double blind controlled study produces any results suggesting otherwise, I am prone to think long term MDMA use is not only not harmful, but probably beneficial and therapeutic (mentally).

But I could be wrong.

 

[Cotcha Yankinov]

Here is a meta analysis of studies testing for cognitive deficits in MDMA users http://www.ncbi.nlm.nih.gov/m/pubmed/17082969/ But even without that based on what we know about the neuroscience of it I would say that MDMA has the potential to be very harmful. Now that being said, I think it's important to understand that some people get year long, or longer, long term comedowns off of their first or second pill. So there is a vulnerable population, studies have shown this is probably a serotonin mutation but LTCs can probably happen to anybody who abuses it enough.