Subjective long-term emotional and social effects of recreational MDMA use: the role of setting and intentions

Introduction

MDMA (3,4-methylenedioxymethamphetamine) produces well-documented short-term effects such as euphoria, reduced fear, and increased sociability, and it is widely used recreationally in many Western countries. Previous research has focused largely on negative cognitive and emotional consequences of recreational MDMA use or on positive outcomes in therapeutic contexts; comparatively little is known about long-term social and emotional effects following recreational use, or about how users' intentions and the contexts in which they consume MDMA (set and setting) relate to those long-term outcomes. Johnstad and others have argued that naturalistic patterns of psychedelic use vary widely and that some patterns are associated with better long-term outcomes, but empirical characterisations of those patterns for MDMA are limited. Elmer and colleagues set out to fill this gap by identifying distinct types of recreational MDMA users based on (a) the physical and social settings in which they typically consume the drug and (b) their self-reported intentions for use, and then testing whether these user types differ in perceived long-term socio-emotional benefits and harms. Using an existing open dataset of recreational MDMA consumers, the study asks three questions: which setting-based user types exist, which intention-based user types exist, and whether these types report different long-term social-emotional effects of MDMA use. The investigators additionally planned multivariable analyses to adjust for potential confounders such as age, gender, frequency of recent use, an MDMA-adapted addiction screener, and mental health diagnoses.