Summary: Researchers at Johns Hopkins University report that offering free, anonymous pill testing for ecstasy at music festivals and raves may discourage some people from ingesting adulterated or fake drugs. The study strengthens evidence that on-site pill-testing services can be a practical public health tool to reduce harms associated with illicit stimulants.
Source: Johns Hopkins Medicine.
Study also shows that the substance marketed as a purer form of MDMA, often called “Molly,” is rarely pure.
Johns Hopkins investigators analyzed five years of data collected by volunteer testers who provided free, no-blame chemical screening of pills and powders at U.S. music events. Their analysis indicates that when users learn a sample does not contain MDMA or contains unknown or dangerous additives, many decide not to take the drug.
Published online July 10 in the Journal of Psychopharmacology, the study also found that pills sold as Molly carried as many hazardous additives as tablets marketed as Ecstasy. Contrary to some earlier reports, the most common adulterants identified in this dataset were synthetic cathinones—substances often labeled as “bath salts.”
“People would be safest not taking any street drugs at all, but if free, no-fault testing can reduce deaths and other catastrophic consequences, it may be a service worth having,” says Matthew W. Johnson, Ph.D., associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “Our results suggest that some people will reject taking a pill to get high if it doesn’t contain what they thought it did, or has harmful additives.”
MDMA (3,4-methylenedioxymethamphetamine) is a psychoactive drug with both stimulant and empathogenic effects, commonly used at raves and music festivals to enhance mood and sensory experiences. MDMA itself carries risks—nausea, hyperthermia, dehydration, chills and, more rarely, seizures—while common fillers or adulterants such as caffeine, amphetamines or other stimulants can increase the risk of overdose and fatal complications.
From July 2010 to July 2015, volunteers affiliated with the nonprofit DanceSafe offered on-site testing of pills and powder that attendees believed to be MDMA. Testing was free and largely publicized by word of mouth. Volunteers scraped a tiny sample—roughly one milligram—from a pill or capsule and used reagent color tests that change color in the presence of specific chemical families.
Test results were read by comparing observed colors to a reference chart covering 29 known substances (for example, MDMA, MDA, cocaine, caffeine or sugar). These colorimetric tests identify many common constituents but cannot detect trace contaminants or measure concentration, and samples that do not match a listed compound were reported as unknown.
Of 529 samples submitted, 318 (about 60 percent) contained MDMA or the chemically related MDA. The remaining 211 samples were classified as adulterated or non-MDMA; in 90 of those adulterated samples the exact additives could not be identified by the color tests. Among identified adulterants, methylone (a synthetic cathinone) appeared in 35 samples and other cathinones in 21 samples. Methamphetamine was detected in 13 adulterated samples, and three samples contained PMA, a dangerous amphetamine-like substance associated with overdoses and deaths.
These findings reinforce that pills sold under different brand names or marketed as “Molly” frequently contain a mix of substances rather than a single, pure compound. “People who take pills and first responders need to know that no matter how the pills are branded or what name they are sold as, they almost always contain a mix of ingredients,” Johnson emphasizes. “Our results should discourage a false sense of security about the purity and safety of so-called Molly.”
After testers reported results to the individuals who submitted samples, participants were asked whether they still intended to use the pill or powder. Of 168 respondents, 46 percent of people whose samples contained MDMA said they planned to take the substance, compared with 26 percent of people whose samples tested negative for MDMA. The investigators note that testers could not independently verify whether participants ultimately consumed, discarded, gave away, or sold the material.
The researchers acknowledge limitations: colorimetric field tests cannot identify all substances or quantify dosage, and volunteers could not track outcomes after testing. The study also underscores the legal and logistical challenges of offering on-site testing. Event organizers sometimes resist permitting pill testing because they fear legal liability for knowingly allowing drug use on their premises.
Johnson and colleagues argue that on-site testing can play a role in harm reduction by informing users and first responders about dangerous adulterants, and that developing improved methods to detect highly potent synthetic opioids such as fentanyl and carfentanil could help address rising overdose fatalities tied to those agents.
For context, a 2014 survey by the federal Substance Abuse and Mental Health Services Administration estimated that nearly 7 percent of the U.S. population age 12 and older had used Ecstasy at least once, a figure often cited as roughly 20 million individuals over time. The Drug Abuse Warning Network reported a 120 percent increase in emergency department visits for Ecstasy-related toxicity from 2004 to 2011. Street prices for these pills typically range from $10 to $20.
Additional authors on the study include Sarah Saleemi and Steven Pennybaker of Johns Hopkins, and Missi Wooldridge of Healthy Nightlife, LLC. Johnson is affiliated with the Behavioral Pharmacology Unit at Johns Hopkins Bayview Medical Center.
Source: Nancy Fliesler – Johns Hopkins Medicine
Image source: NeuroscienceNews.com image used for illustrative purposes.
Original research: The study is published in Journal of Psychopharmacology.
