Lifetime ecstasy use is associated with lower odds of impairments in social functioning, study finds

A study of a large, nationally representative sample of U.S. adults has revealed that those who reported lifetime use of ecstasy (i.e., using ecstasy at least once in their life) were less likely to report having difficulty dealing with strangers, participating in social activities, and being prevented from participating in social activities by their mental health issues. Participants with lifetime use of mescaline also had lower odds of difficulty dealing with strangers. The study was published in Scientific Reports.

Human are social beings. We live in a society and performing literally any activity requires at least some interaction with other people or the use of things other people have created. Even activities that are by their very nature solitary are at least partly performed using tools and resources created by other people or using spaces created or respected by other people. Due to this, being able to interact with others competently and function in a society is a key faculty of all humans.

However, impairments in social functioning are a hallmark feature of many different mental health disorders. These include generalized anxiety, depression, schizophrenia and others. Social impairments of individuals suffering from these disorders represent a large share of the cost to both individuals and society that these disorders inflict.

Unfortunately, methods for treating impairments in social functioning are still very limited in their effectiveness. Due to this, researchers are constantly exploring novel ways in which these impairments could be prevented or treated. One venue of research that started attracting a lot of scientific attention is using the drug ecstasy or classic psychedelics for this purpose.

Ecstasy or 3,4-Methylenedioxymetahmphetamine (MDMA), as it is scientifically called, is one of the most widely used recreational drugs in the world. It produces prosocial feelings and enhances empathy and sociability. It is also known to produce hallucinogenic effects and to facilitate a host of adverse mental health consequences through prolonged use.

Created first in Germany in the scope of researching a possible appetite suppressor, it is now banned in most of the world. However, preliminary evidence indicates that there might be a way to use ecstasy and classic psychedelics for treating or improving symptoms of multiple mental health disorders.

The lead author of this study, Grant Jones, and his colleagues wanted to explore possible protective associations between the use of ecstasy and classic psychedelics and social impairments. They analyzed data from 214,505 participants of the National Survey on Drug Use and Health (2015-2019), an annual survey on substance use and mental health in the United States population aged 12 and older.

The researchers analyzed data on impairments in social functioning caused by mental health problems and emotional difficulties. These impairments were difficulty of interacting with strangers (“How much difficulty did you have dealing with people you did not know well?”), being prevented from interacting with strangers due to mental health issues (“Did problems with your emotions, nerves, or mental health keep you from dealing with people you did not know well?”), difficulty in participating in social activities (“How much difficulty did you have participating in social activities, like visiting friends or going to parties?”), and being prevented from engaging in social activities due to mental health issues (“Did problems with your emotions, nerves, or mental health keep you from participating in social activities?”).

Jones and his colleagues also analyzed participants’ answers on questions about the lifetime use of ecstasy, psilocybin, LSD, peyote and mescaline, and various other legal and illegal substances as well as risky behaviors. These were yes/no questions. The person was supposed to answer yes if he/she used the particular drug at least once in his/her life. Sociodemographic data were also used in the study.

Results showed that people who reported using ecstasy at least once in their lives (lifetime use of ecstasy) had lower odds of three of the four studied social impairments. Lifetime use of mescaline was associated with lower odds of one of the social impairments.

Additionally, people who reported lifetime use of ecstasy tended to be younger, a bit more often male, and less often married. They reported more often engaging in risky behavior. There were no differences in household income between participants reporting life time use of ecstasy and those that did not report such experience.

“The association between use of MDMA/ecstasy and reduced odds of social impairment is possibly linked to the drug’s effects on several critical neurotransmitters in the brain, namely, dopamine and serotonin—which lie upstream of other potential mechanisms at the neural and behavioral levels, mentioned later,” the researchers wrote.

“Some evidence exists to suggest that MDMA-induced changes to these neurotransmitter-receptor systems in the brain are indeed long-lasting, offering a plausible explanation for how limited intake of MDMA could be linked to persistent changes in social behavior. Given that MDMA mainly impacts serotonin levels, it is worth considering that the association between lifetime use of MDMA and lowered odds of social impairment can be ultimately linked to changes in serotonergic neurotransmission.”

The study contributes to scientific knowledge on associations between psychedelic use and behavior. However, it also has limitations that need to be taken into account. Notably, the study does not allow any cause-and-effect conclusions to be made. It is possible that the use of ecstasy indeed has effects on social functioning or can prevent social impairments. However, it is also possible that people with better social skills and more resilient to social impairments are also more prone to trying ecstasy in the scope of their social activities. Additionally, all assessments were based on self-reports.

The study, “Examining associations between MDMA/ecstasy and classic psychedelic use and impairments in social functioning in a U.S. adult sample”, was authored by Grant Jones, Joshua Lipson, and Erica Wang.

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