Clandestine Manufacture of MDMA
January 7, 2009
A correspondent recently expressed some confusion over the source of recreationally abused MDMA (“Ecstasy”; 3,4-methylenedioxymethamphetamine) because of an awareness that it typically is obtained and used as tablets. This person was under the impression that perhaps street Ecstasy was a diversion of a licit product (see ketamine). Not so.
A recent Daily Telegraph report from New South Wales in Australia supplies an excellent example.
HUNDREDS of thousands of ecstasy tablets destined for the Christmas party market have been seized by police after a $12 million drug kitchen was uncovered in a suburban house.
mmm. Doesn’t this operation look sanitary? The report indicates a kilo of powder was found in the vacuum cleaner. Wonder if that went right back into the pill press….yuck. Wait, wait, where’s my idea book…“do rat feces enhance the subjective effects of oral MDMA in a dose dependent manner?”. Hmm, the ol’ IRB might have a little problem with this one…
Sorry. Back to the point. I dunno if you just buy a pill press off Ebay or Craig’s list or whatever but they sure don’t look that sophisticated to me. Apparently they are easily set up in your average suburban bedroom or kitchen. I had been previously under the impression that surely these were at least warehouse operations (not for any reason other than just guessin’). Turns out this is not the case and a simple flat or house can probably produce quite an impressive number of pills in short order. As per Alexander Shulgin quoted in the Economist, “It’s a very simple compound to make”. He would know.
The Economist’s puffery on clinical MDMA for PTSD is typical for the class, failing to communicate that there might be some reasons for concern about MDMA use for therapeutic purposes. They bury a “can have lethal effects” statement in there but for the most part it communicates the current journalistic position of “w00000t!!!”. Where are those ‘sklowns to ‘splain to us eggheaded scientists about how to communicate science again?
One more interesting bit I noticed from the bust.
Crikey, doesn’t this look like a serious biohazard? I sure hope they had closed respirators on when running this equipment…
Oh and would you Ecstasy fans with toddlers please, please, please (please) lock up your damn stash of pills!??!! There are a disturbing number of case reports on this topic, no doubt only a small fraction of the number of actual cases of toddler exposure. In this recent Aussie case, the kid started to seize as the first symptom which is apparently typical going by the case reports. The cardiac arrest mentioned does not strike me as quite so common but I’ll have to go back and re-read the lit to make sure. Aaaanyway, the fact is that some kids will pick up anything that is lying around and put it in their mouths. Some will limit themselves to anything that looks like it might be a candy. Is it really that hard to keep your MDMA somewhere the little rugrats can’t get into it?
DrugMonkey 
January 7, 2009 at 4:42 pm
Bumper sticker in New South Wales
“Is that the truth, or did you read it in the Telegraph?”
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January 7, 2009 at 4:46 pm
Too bad people can’t buy their recreational drugs (other than tobacco and alcohol of course since they are perfectly safe and pose no risk the individual or society) through trusted sources and well regulated and taxed manufacturers.
Don’t worry though. The government has been telling us to ‘just say no’ for decades so pretty soon people are sure to get the message that drugs are bad and cannot possibly have any legitimate use.
Its a wonder people even bother to keep cooking this stuff up. It is almost as if there is a huge financial incentive for the manufacture of these products.
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January 7, 2009 at 4:48 pm
Doesn’t this operation look sanitary?
Back when I was stuck with the floor chore of maintaining the chemical weigh room, I’d have loved to walk in one day and see it looking this pristine. And at least here you know the mysterious stuff all over the floor isn’t acrylamide or ethidium.
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January 7, 2009 at 5:14 pm
Our pharmacy school was full of ancient pill presses like that – they wouldn’t trust us with this beauty for sale on, you guessed it, eBay.
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January 7, 2009 at 5:47 pm
Looks messy but I expect that, typical of illicit labs, personal protective equipment is seldom used. Which means the people doing the mixing and feeding those machines are pretty much stoned to the tits on their own product all the time from what they breath and general contact.
In that hyper relaxed and carefree state there is going to be a certain amount of spillage. I’m surprised it isn’t worse.
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January 7, 2009 at 6:01 pm
Buying pressed pills as ‘ecstacy’ while trying to obtain MDMA is risky. It’s a hassle to check the melting point with all those binders. Most individuals I interact with just use a KBr press and the weigh crystal powder themselves.
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January 7, 2009 at 6:06 pm
I thought that the current state of knowledge on MDMA lethality was that it is actually marginally safer (in terms of recreational to lethal dose) than even some OTC drugs. certainly i’ll agree there are scientific concerns about its therapeutic use, but there are perhaps more of those about in-use psychotherapeutic drugs.
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January 7, 2009 at 6:17 pm
I thought that the current state of knowledge on MDMA lethality was that it is actually marginally safer (in terms of recreational to lethal dose) than even some OTC drugs
what is the “recreational dose”? meaning what do people do intentionally for recreational purposes versus intentionally with “some OTC” products for therapeutic purposes?
why is actual lethality our only concern?
there are perhaps more of those about in-use psychotherapeutic drugs
so what?
Before we go down the usual paths when it comes to cannabis and MDMA postings, a thought.
I am not impressed that comparisons to other sources of risk in life tell us much about the nature and scope of the risks associated with MDMA (or cannabis or other substances that I’m interested in studying or discussing on the blog). My questions are whether they are indeed risky, in what way, under what circumstances and for whom.
so dragging up comparisons with other drugs, therapeutic or recreational, tends to be a red herring drawn across the trail to distract.
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January 7, 2009 at 6:25 pm
but there are perhaps more of those about in-use psychotherapeutic drugs.
Now this is a special case of nonsense. You know this, right?
We have no real knowledge of how MDMA might be used in actual clinical practice. doses, frequency, etc. As I’ve detailed on my posts the dosing protocol has been going in a constantly upward direction and we do not know where it will end.
The initial PR was that this would be a one- or two-time thing using a single acute and fairly low dose in the therapy session. Now we’re seeing a boosting regimen, up to 4 times, interval between dosing becoming uncertain and the dose has ever increased. Just from start to finish of this most recent phase of formal clinical trials, the estimate of risk has changed substantially.
so what comparison would we make? the state of knowledge about risk of your favorite clinical compounds when they were still at the Phase I/ Phase II stage? By all means throw out some compounds of interest and we can try to reconstruct knowledge of lethality or other adverse effects at that point of the development…
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January 7, 2009 at 6:49 pm
“We have no real knowledge of how MDMA might be used in actual clinical practice”
Now I’ve never used MDMA myself, but I know some who have, and from what I’ve gathered, there really isn’t any use of the drug clinically. At leased not in the doses people use for recreation. The main thing I’ve notice, aside from people acting completely loony while high, is that for a day or two after use, depression kicks in, heavily. I knew a girl back in the dorm day’s who came quite suicidal afterward (didn’t stop her in the future, though). I believe this may be due to lack of Serotonin. Also read I a story a long time ago of a High School Honor student who thought it was smart to mix MDMA with ketamine. She ended up in a K-Hole (as they call it), wouldn’t come out, ended up in a coma for a few days, and now has the brain capacity of a 4 year old.
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January 7, 2009 at 6:57 pm
Re; the size and safety measures of illicit labs.
I have very limited experience with MDMA, but I did do some work in trade with a guy who was producing MDMA, among other things (I wanted to try pure amphetimine in a pill form, to see if Adderall might be helpful for me). He had a midsize camper trailer, with a work space about the size of a medium kitchen. He was rather keen on safety, wearing a full coverage respirator and using air filtering ventilation. He most assuredly did not want to breath any of his product, or the solvents he used.
I also knew a couple of chemists who synthesized LSD and both of them were very careful not only about safety, but also about contaminants. One of them actually created a reasonably well sealed, three lock system for getting into the actual production space. He showered off and changed clothes before entering the actual lab. Both of them were also very careful about breathing anything. Of course it pays to be extra careful when one is dealing with ergot spores.
CHCH –
Speaking as one who would love to see legalization as a rule, can we please not go there? Lethality is merely a small portion of the problem and while it can easily be argued that some of the fatalities we have seen are a result of clandestine production, that’s far from the whole story.
If used carefully and properly, yes, it can be quite safe. If not used properly, with due consideration, then it can be fatal. While I just don’t believe that should prevent it from being legal and produced more safely, lets not pretend it’s something it’s not.
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January 7, 2009 at 7:03 pm
jj –
The depression issue can usually be handled by taking an SSRI.
The ketamine combination is far more nefarious. Even a “safe” dosage that is unlikely to harm most people, can cause serious problems, though I haven’t heard of such a dosage causing quite the damage you’re describing. That is probably a problem of manufacturing and/or dosage.
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January 7, 2009 at 7:07 pm
Also read I a story a long time ago of a High School Honor student who thought it was smart to mix MDMA with ketamine. She ended up in a K-Hole (as they call it), wouldn’t come out, ended up in a coma for a few days, and now has the brain capacity of a 4 year old.
I’ll just go ahead and call shenanigans on that before someone gets too het up. I’m not saying it didn’t happen but I’d view this with a lot of suspicion.
GHB? now that maybe is associated with actual coma. perhaps. but ketamine? it has a very wide therapeutic index where the intended result is to knock you out. meaning it is pretty safe dosing past the knock-out point. so even wider when it comes to recreational index where the goal is to not-quite go unconscious.
MDMA inducing a coma? perhaps although this sounds like some of the downstream effects of an untreated medical emergency situation like a lasting high body temperature that was never treated. I guess that could leave the person pretty cooked although I’ve never seen anything like this in the case report lit. there the outcomes are either death or apparently normal recovery.
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January 7, 2009 at 11:33 pm
wow, you guys are brutal!
It seems important (at least if your goal is patient care) to examine the risk of MDMA *relative* to approved psychotherapeutic drugs. lethality is just one basis for comparison; obviously there are more factors to consider, and I don’t intend to specify them all.
I do appreciate the invitation to specify a compound for comparison, but a) i don’t know enough about this field to do so, b) i worry the relatively unique political history of MDMA would thwart fair comparisons, and c) i think discussion of the scientific literature is more worthwhile than that kind of qualitative analysis.
i assumed i’d missed some landmark paper from the last few years about how MDMA is in fact very dangerous (in the range of recreational doses). Judging from the absence of citations in this discussion, I can now see i haven’t missed much. And that’s the real problem here, isn’t it? We just don’t know…
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January 8, 2009 at 12:29 am
Took me all of a minute. Seriously, it took me longer to type this comment than it did to find you some cites. I was actually looking for a specific study, but figured I would go ahead and link my google search. Unfortunately, I can’t find the full text of the study online anymore.
Again, I am quite adamantly pro-legalization. I am absolutely dead against the war on drugs and believe that legalizing illicit drugs would do a great deal of good in terms of harm reduction. Too, I believe that personal liberty should include the liberty to take substances that you know might cause significant harm or even death.
But when you choose to pretend that the risks don’t exist, you aren’t doing anyone any favors, least of all those who support legalization. Every drug has certain inherent risks, including MDMA. It is important to express those risks, especially if you want to make a drug legal.
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January 8, 2009 at 12:52 am
right back at you. I’ve never pretended MDMA didn’t have risks, and I am well aware of the fatalities – reread either of my comments and you’ll see that my only point is about using relative, not absolute risks as the benchmark. Can we continue this discussion under the assumption that none of us are idiots?
Basically, at this point I think we’re waiting on an update from this post.
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January 8, 2009 at 12:54 am
right back at you. I’ve never pretended MDMA didn’t have risks, and I am well aware of the fatalities – reread either of my comments and you’ll see that my only point is about using relative, not absolute risks as the benchmark. Can we continue this discussion under the assumption that none of us are idiots (and without your apparently projected denialism)?
Basically, at this point I think we’re waiting on an update from this debate.
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January 8, 2009 at 12:59 am
What I’m rather curious about, is what you think we don’t know about it. I mean there is always more to figure out, but ultimately, we know quite a bit about MDMA. For example, the best figure (i.e. most common) I can find is that there is one death for every ten thousand users. But that doesn’t take into account deaths due to MDMA interacting with other substances, something that really can’t be ignored. It also doesn’t take into account accidental deaths due to acute MDMA intoxication, again unreasonable to ignore. And finally, it doesn’t take into account overdose – whether you like it or not, unreasonable to ignore.
But back to that one in ten thousand figure. Gosh, that’s awfully low isn’t it? No, not really. Especially given that it is very likely that most of those deaths can be prevented. Except that folks like you want to pretend it’s no big deal, it’s not important. The problem is that it is.
What else do you want to know? How about neurotoxicity? How about information from the vaults of Erowid.
Or do you want to find out about post MDMA depression? Again from Erowid.
And if you want to come here and babble about comparisons to the deaths caused by OTC medications, then be prepared to be specific. Because if your not prepared, then expect people to call you on your bullshit.
Of course if you want to make comparisons, heroin, cocaine and methamphetimine are just as “safe” within the range of your average recreational dose. The deaths we see from any of them are almost always because of overdoses or interactions.
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January 8, 2009 at 1:10 am
When you say something like this;
…reread either of my comments and you’ll see that my only point is about using relative, not absolute risks as the benchmark.
It makes this;
Can we continue this discussion under the assumption that none of us are idiots…
rather difficult.
Or more to the point, so what? Take regular, recreational doses of cocaine and the relative risk is minimal. Does that mean it’s a good idea to use cocaine? Or that we should rethink the use of cocaine?
In all honesty, I will note that I’m rather fond of the cocaine. I also rather like the meth. I don’t take either because neither is any good for me.
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January 8, 2009 at 8:05 am
Ah. I didn’t know what MDMA was until just now. They use it in the lyrics of a Waltari album I bought, but I didn’t know it was ecstasy.
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January 8, 2009 at 10:35 am
furthermore, you are completely missing the point in your cocaine example; if cocaine were a treatment for some ailment you have, and the other drugs have a higher risk relative to their therapeutic value, then YES, IT WOULD BE A GOOD IDEA TO TAKE COCAINE.
as for your question about what i need to know, it was clear as day in the link I posted. In it, DM says: “We simply did not then, and still do not now, have very tight estimates about the likely threshold for MDMA-induced damage of a lasting nature.” Erowid does not have an answer for this, and for the record, “citations” doesn’t mean a google web search.
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January 8, 2009 at 1:28 pm
CHCH @#21: It is indeed the case that we do not have very tight estimates for toxicity. I am reasonably certain you will have an appreciation for central tendencies and variances in human populations. Not to mention the way that sub-stratifying the populations can lead to decreased variance and therefore tighter estimation. You are presumably familiar with the concept that a certain undesirable variance in the measure does not mean that we know nothing and can infer little.
What you may be somewhat less familiar with is the translation of data from non-human model systems to the human condition. It also involves uncertainty and variance. Again, this is a VERY far cry from thinking that we do not know anything at all. When acute effects of MDMA such as blood levels, metabolic pathways, metabolites, physiological effects such as body temperature, ADH, and CSF 5-HIAA, lasting effects on SERT by PET, mode of medical emergency and death, etc all are lining up to a reasonable fit between rat, pig, rabbit, monkey and human….well, the chances that humans are magically unique under some highly selected circumstances (like the precise dosing in the clinical protocol) but not others is hard to sustain.
Here’s what we do know.
1) MDMA is capable of killing people and animals all by its own self
2) MDMA is capable of inducing reasonably selective and lasting decrement in serotonergic function in multiple animals species. Evidence from humans is less clear (not absent, less clear) but on the whole there is no reason to think that humans are any different than experimental species (save mice but that could be a dosing issue).
From there, the most obvious place to go (for me) is to talk about dose. Which I’ve done in multiple posts with respect to the clinical doses published in the MAPS protocols. One thing I haven’t done exhaustively (and likely won’t on blog) is review the tissue levels reported in the Case Reports- I’d encourage anyone to do so. My read is that in many cases the tissue levels for medical emergency and even death are consistent with one or two tablets consumed, undeniably in the “common recreational dose” range. To me this is a blaring warning that there are knowable but yet unknown factors which may substantially increase risk. Obviously it is my concern that the more patients get enrolled in clinical trials, the more likely it is that some people with these unknown liabilities will be enrolled. In a sense it is the very rarity of lethal complications that advise caution until we know more.
Even for the general population, review of the subject samples in experimental studies will disabuse you of the notion that seemingly high (likely multi-tablet) doses are at all unusual. I have, in prior posts, kept us focused on the mg/kg as well because a adult woman and an adult man of relatively common description can vary to the extent that with a fixed tablet content the mg/kg dose is doubled/halved within the population of interest. The clinical protocols have continually increased the dose. Where will it stop?
oh and don’t be an ass about teh Google search CHCH, it pulls links to the primary literature just fine in my hands. in any case most of the relevant MDMA lit is freely available from the MAPS database (see sidebar for link)
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January 8, 2009 at 2:34 pm
CHCH –
First, I posted the link to my google search, because while it included a link to the abstract of a paper I actually wanted to link, it also linked several other papers. Rather than posting several comments so I could link several papers without getting caught up in a spam filter, I just linked the search.
Second, I have yet to see much evidence that MDMA has any more therapeutic value than LSD or for that matter cocaine. That’s not to say it doesn’t exist, but as DM mentions, there are knowable unknowns that need to be investigated. And such investigations are taking place in the case of MDMA. While it is perfectly reasonable to push for study, it is very unreasonable to just say that the relative risks make it all ok, based on our current understanding.
as for your question about what i need to know, it was clear as day in the link I posted.
And I’m supposed to magically discern that was your question? Seriously?
So we don’t yet have very tight thresholds. What exactly is your point? That we should find out more? If that’s the issue, then be assured that studies are being done to determine just that. If you want to argue that there should be more, I could even agree with you. The same is true of LSD, which has been around a whole lot longer and who’s study is virtually non-existent. But if you’re arguing that we know enough now, you’re sadly mistaken. While we know there are significant risks, we don’t know what causes the risk factors and that is critical. Given that there is significant risk of brain damage and fairly high risk of long term clinical depression, I think we need to know a lot more before we decide to put MDMA into clinical therapeutic usage.
And before you bite back with some notion that currently prescribed psychotropics also have risks, I will heartily agree with you and take it further. Those drugs should also be subject to further investigation. Two wrongs don’t make a right.
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January 8, 2009 at 2:34 pm
@DuWayne: one death for every ten thousand users? Where did you get that? That’s gotta be way too high.
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January 8, 2009 at 2:58 pm
Go to the google search and start looking through papers linked. There were estimates that were higher and ones that were lower, but the most common figure cited was one in ten thousand. Indeed it was the only figure that showed up repeatedly.
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January 8, 2009 at 3:59 pm
despite all the bluster, i don’t think we disagree. i’m agreed there are risks, that much caution is needed in proceeding with clinical trials, and that there is clear evidence for some risk in the range of recreational doses in patients of unknown predisposition. my point is that ultimately the standard for comparison should be risk relative to efficacy-matched alternative treatments. this is not to say two wrongs make a right, but that relative comparisons are the name of the game.
i’m going back to my blog now – enjoy your groupthink!
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January 8, 2009 at 8:03 pm
Maybe i just don’t know enough, but how strongly should we suspect that MDMA has possible clinical benefits? Because if it doesn’t have some reasonably plausible unique clinical benefits, trials with this stuff just aren’t ethical.
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January 8, 2009 at 9:40 pm
CHCH –
my point is that ultimately the standard for comparison should be risk relative to efficacy-matched alternative treatments.
But even this is jumping ahead of things. We haven’t any evidence for the efficacy of MDMA in treating anything. It is not unreasonable to explore, but not without learning a lot more about who is most likely to suffer the significant side effects of using MDMA and why. It is also important to learn more about exactly what MDMA does to the human brain, because MDMA is classified by those who support it’s use as a neurotoxin. While that doesn’t automatically make it unworthy of investigation, it certainly calls for significant caution.
i’m going back to my blog now – enjoy your groupthink!
Dammit! Are you going to take all your cool toys too?
And just be to crystal fucking clear, I started reading DM because he’s an authority on a topic that I find very interesting – interesting enough that I’m going to school for it. I quite often find myself agreeing with DM, but for the most part my agreement was preconceived. I believe the first (or one of the first) post that caught my eye, was one that discussed the false dichotomy of psychological, versus physiological – a huge pet peeve of mine.
The funny thing is, that while DM and I agree for the most part, about MDMA, I suspect that our conclusions based on that agreement are rather divergent. DM is rather notoriously reticent to state his opinion on legalization, but I suspect that if he supports it, it is with far more reticence than I.
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January 8, 2009 at 10:45 pm
Pal –
That is rather the question. This is one of the most recent papers on the topic and like most everyone that I have seen, the conclusion is that there are too many other issues to be determined before arguments can be made for clinical use. Mind you, this is the same conclusion that folks who have a definite pro-MDMA bias have come to.
At the same time, it has already been used in rogue pyschotherapy, more recently in a study for use for PTSD. The argument for it’s efficacy is compelling, as it could effectively help people who have depersonalization disorder, or who have become completely detatched from their feelings. There is little question that it could have very profound therapeutic value, the major question is it’s safety.
Of course the other problem is the same problem that plagues the use of cocaine and even LSD, in a similar fashion. It puts the therapist in a position to exert remarkable influence over the patient. With the patient under the influence of MDMA, they are likely to develop something akin to absolute Faith in their therapist. I’m not sure if you’re at all familiar with the rash of cocaine therapists in the late seventies, but this phenom proved to be something of a problem, with some therapists committing rather extreme absuses against their patients. And the same occured in the fifties and sixties with LSD therapies.
It should be noted that a not entirely distinct problem with these therapies, has been a tendancy for the therapist to use the drug themselves – especially big with the LSD therapies. Having rather extensive (read extreme, really extreme) experience with LSD, I understand the idea behind it and even see some validity to it. The idea is that the therapist and patient are achieving a whole different level of empathy. But when you start talking about this sort of therapy, the variables are just way too complicated to even attempt to control for. And therein lies the problem across the board, whether the therapist is using the drug or not – the variables are just way too complex, whether we’re talking LSD, cocaine, or MDMA.
I honestly do see a value in further investigation, but until we have a better understanding of why the people who have adverse reactions have them, we need to hold back. I would also argue that cocaine, which has almost exactly the same therapeutic value, is probably a safer bet, in spite of it’s addictive qualities. As I understand it, cocaine is not as toxic and with tight controls, the addiction factor can be significantly lowered. I also would love to see LSD explored further, but will admit that one, I have a bias (Im a junky and acid is my junk) and two, it is far more complicated.
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January 9, 2009 at 1:18 am
It occurs to me that I should probably clarify that I haven’t actually used the acid I’m so very fond of, in several years….
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