The man who took 40,000 ecstasy pills in 9 years | Hacker News Reader

The man who took 40,000 ecstasy pills in 9 years

psy.psychiatryonline.org

84 pointshenning58 comments

For what it's worth, the recommended dosage of pure MDMA is 125mg no more than every three months. Meaning this guy actually managed to take 2,250x the RDI for years without dying. (Not even counting all of the other drugs he was on.)

... and had the longest most awesome RAVE evar!!!! </ sarcasm>

You would think after a while he couldn't get the same feeling anymore.

This is actually quite interesting. I'd love to see some hard data on the actual impact this use had on the serotonergic system; for as large a part as it plays in the brain, and all of the diseases that we believe are related to it (everything from mental illnesses like depression and schizophrenia to migraines and cluster headaches), we really know very little about it. Our current drugs acting on serotonin receptors are brute-force hacks -- we need to know a whole, whole lot more.

I always likened SSRIs to a "Game Genie" for your brain. I do concur with the brute-forced nature of it.

So does the medical establishment at large - it's well acceptd that while SSRI's seem to work, there is no way, other than trying them out, to know which one will work for person X.

That said - given the possibility of serotonin syndrom and the mad bender this guy was allegedely on, it's a wonder he's alive.

Picking a nit, but SSRIs don't actually act on serotonin receptors. Although the action of SSRIs isn't completely understood, they generally work by increasing the level of serotonin in the brain by reducing reuptake.

as do I, SSRIs are terrifying, addictive and something I've avoided completely.

It's worth noting that the term "ecstacy pill" encompasses a huge array of psychoactive and non-psychoactive substances. Go and scare yourself at sites like PillReports:

http://www.pillreports.com/

Unless he or one of his friends was an organic chemist, MDMA - a relatively expensive drug to synthesize - is likely to be way down the list on the menu of chemicals that Mr A actually consumed.

or he just had a reputable dealer? x is on my hell-no list, but I've known people that take it and buying from someone with connections is quite different than the randomness you'll get if you try to buy at a rave. There is a whole social hierarchy about manufacture and distribution of pure samples of stuff like that.

Not only can you buy from reputable dealers, but there are organizations like dancesafe that will help you test your X.

I knew a guy who took to extreme ecstasy benders. He would take 2-3 or more a day for a week, was probably under the influence half the time or more. This went on for a year, he took hundreds of doses.

Then he had a long stint in a mental hospital.

But he probably was crazy before doing that, right?

Crazy in that he would do that, but not crazy in the sense of catatonic depression.

Really, an average of 12 pills a day?

Wouldn't that make you continuously high?

I imagine that was the goal at the time.

After a few weeks of this, it was probably only able to make him feel (his version of) normal.

Can you imagine what life would be like to this guy when he is "feeling his version of normal"?

I would imagine it would be worst to his sense of time: weeks and months blurring together into a jumbled pile of years for the latter of those nine. Terrifying.

Well you won't know until you try it.

Sounds suspicous - unless he's some kind of genetic anomaly, he'd be completely depleted of serotonin and the drug would have nowhere near the effect even a single pill had the first time around, at least as I understand it - all my E-tard friends back in the day used to tell me it was kinda pointless to do E two nights in a row, and definitely pointless ot do it every night - severe diminishing returns (no idea if that's true or not - i like my brain intact)

I read the article, and it doesn't seem beyond possibility that he wasn't exactly the smartest dude on the block, before he took all that e.

That said, if street e is as impure and subject to cutting as people say it is, then he was exposed to an enormous amount of other garbage as well.

One thing that struck me. Does e run on the same mechanisms as the SSRIs? This got a couple of mentions in the article, so you'd think there'd be an enormous number of people on SSRI's long-term to study.

> Does e run on the same mechanisms as the SSRIs?

No. MDMA causes the forcible release of neurotransmitters, especially serotonin. SSRIs simply prolong the action of serotonin that is spontaneously released, so they tend to be much milder.

Yeah, that's my understanding as well that x and lsd and shrooms build a massive tolerance quickly. I mean he's self reporting taking this much, if he was even taking x every few days, smoking weed daily, doing some lsd or heroin and we're gonna trust his account?

"uh yeah man, I took like 12 pills a day man, I'm so weird man..."

I find this incredibly hard to believe, even allowing for the 'average daily use of 3.4 tablets' to encompass large doses over 3 or 4 nights of clubbing. But rising to ~25/day? Such a claim needs supplementary evidence to be credible.

Besides the logistical questions of where he found sufficient money for this or indeed any time to eat, the report that he felt like he was still on ecstasy for several months after he halted consumption doesn't ring true. MDMA's effect basically comes from causing the brain to dump its reserves of serotonin, dopamine and norepinephrine. These need replenishing, and almost every ecstasy user I've ever known reported 'hangover Tuesday' following consumption on a Saturday night (the ones that didn't tailored diet and vitamin intake to offset the effects).

The self-reports of someone with such measurable impairment, even consistent reports separated by a long period, are not a reliable metric. The physicians don't even tell us what his body weight is or was, which might yield some clue about base tolerance. What of his liver and kidneys, which should show some response to such an enormous metabolic load? And what of this estimate of 40,000 over the lifetime of his consumption? They talk of 'further escalation to an average of 25 tablets daily over the next 4 years,' (emphasis added) but the 40k total would require him to have sustained that 25/day intake over the same period. Whether this ambiguity is the result of skimpy reporting or a poor grasp of statistics I can't tell, but having reread the letter several times now I'm left with more questions than answers.

It's clear that Mr. A took an absurd quantity of drugs and is now severely impaired. But this report seems like a bid for notoriety rather than a contribution to clinical knowledge. It's like finding some tall tale of a giant catfish in the Journal of Aquatic Biology.

It would be difficult to keep it discrete.

Everything in moderation - if you took 40,000 aspirin's in 9 years you'd see some strange effects.

And MDMA is absolutely incredible; I recommended everyone tries it just once. Had some of the best nights of my life on it - completely untouchable experiences.

I guess even reading the internets for 40000 hours in 9 years will cause a similar effect.

I'm curious if elevated levels of serotonine for extremely long periods of time would cause memory loss alone. It seems to me that memory is very much a "wow that just stood out from the norm." sort of tracking system. Under high levels of serotonine, maybe nothing can stand out from the norm long enough to be remembered?

The thing about this story at is hard to believe is that the more you use ecstasy, the less it makes you happy. You burn out those neurons. Takes years before it will effect you again. Can't imagine he was getting anything but speediness off most of at stuff, would have been pure dependence, not a high.

How much money was spent on 40,000 pills? It must be at least a down payment on a house. How did he keep a job with the residual mental effects of the drugs? Or maybe it was family money.

It's probably safe to assume he dealt.

Saw this years ago... would be nice if they did a follow up; this must be at least 5 years old now ?

"Guy takes cocktail of drugs every day for 10 years and winds up with mental problems - of course! It must be the ecstasy that did it!"

I seriously question the scientific method of anyone who draws any conclusions from this account.

Mr. A reported current cannabis consumption, together with a previous history of polydrug misuse (i.e., solvents, benzodiazepines, amphetamines, LSD, cocaine, heroin).

Decrease in level of cannabis intake led both to disappearance of his paranoid ideas and hallucinations and reduction of his panic attacks

I agree; they have no idea what caused what. Why didn't they at least mention how extensively he used (for example) solvents? Plus, who knows what was actually in the pills? Is ecstasy typically pure? A few times I thought about taking a small dose of ecstasy before a psychotherapy appointment (its original intended use,) but as far as I know, there's no way to reliably get a pure, known dose illegally.

"As far as I know, there's no way to reliably get a pure, known dose illegally."

http://www.ecstasydata.org/send_sample.php

http://www.dancesafe.org/shop/?page=shop/browse&category...

If you don't want to pay $120 for molly or $40 for pills to have your stuff analyzed at the lab using mass spectrometer, then the next best option is the complete kit from DanceSafe for $50. If I ever tried MDMA I would probably just do both, but then again my anxiety is why I don't partake in the first place.

Quite informative, especially their stats page:

http://www.ecstasydata.org/stats.php

32% of the street ecstasy tablets they tested were pure MDMA, and 50% contained no MDMA at all. 29% contained stimulants, so you're just as likely to get a dose of unknown stimulants as you are to get pure MDMA. Yeah, drug lottery? No thanks.

Where did he get the cash to continually use and abuse all of the above for 9 years?

I wonder if he was born rich and blew through all his family's money, since most loans would have come back at him well before then.

Either that, or he was a dealer and was sampling his own product(s).

Ecstasy is not typically pure MDMA. Around here (Kansas) it is usually entirely dextromethorphan, caffeine, methamphetamine, MDA or a combination of the lot. Very rarely a batch will turn up that is pure MDMA or a mixture of MDA/MDMA (usually called Molly in the club scene.)

Getting pure MDA or MDMA feels very different than a mixture. It is pretty easy for one who's past all the glitz/glamor associated with early years of drug use to become a kind of connoisseur and nail down long term relationships with the dealers who supply reliable product.

This is a "case report": http://en.wikipedia.org/wiki/Case_report

It is not intended to provide conclusions. It is intended to be raw material for later people to use as evidence for their conclusions. This is not a scientific paper, this is raw material you make scientific papers out of. Medical fields tend to use these quite a lot.

I seriously doubt the people involved are ignorant of the possibility that this person went into this experience with a non-normal brain. Nevertheless, a subject that appears to have consumed over an order of magnitude more of a certain drug than any other known person is intrinsically interesting.

Nevertheless, a subject that appears to have consumed over an order of magnitude more of a certain drug than any other known person is intrinsically interesting.

I guess they, or the journal editors, didn't think it was all that interesting, or they wouldn't have limited themselves to a giving a one-sentence summary of his history with the other drugs. I suppose it was heavily edited for length, which is tragic and ludicrous given the cost of storing and presenting a few kilobytes of data these days.

Also, if this is supposed to be data for further study, I'm not sure why they decided that in the limited space available it was less important to report the actual raw data they collected than to summarize general knowledge from other sources, such as:

All ecstasy misusers would develop a (mild-degree, in most cases) serotonin syndrome after acute drug intake, which is characterized by enhanced physical activity, hyperthermia and sweating, increased muscle rigidity, rhabdomyolysis, hyperreflexia, trismus, jaw-clenching, myoclonus, tremor, and nystagmus.4

This case report should be summarized and read to high school students as part of their health class.

Maybe not the best idea. While the report clearly shows the irreversible damage caused by MDMA (as do many other reports), it does conclude with "Contrary to results of other neuroimaging observations, Mr. A’s brain scan did not show any gross cerebral abnormalities, especially at the hippocampal level," and over eager students might take away the wrong lesson.

Not sure... I think it's too extreme a case to show, most students would rationalize that by thinking 'but I'm only taking one it's not like I'm taking 40 000 pills'

Definitely not. Telling kids about the clearly very extreme cases just gives them an easy reason to dismiss what you're telling them.

Yes. Don't become a pharmacy.

That doesn't mean that a pill here or there will have the same effect. Considering how many different drugs he was on, we don't know that it was even the MDMA.

Let's keep in mind that this was five times the previous known lifetime dosage of anyone else.

Right, "Let this be a lesson to you, kids: Unless you're Pacman, you're probably cool."

May I take this opportunity to remind that the only drug known to be relatively safe is caffeine.

Not unless you back it up with evidence.

Pure caffeine powder can be almost instantly fatal if handled without gloves and respiratory protection. There are no safe drugs, only safe quantities.

And conversely, cocaine can be made into a healthy tea: http://en.wikipedia.org/wiki/Coca_tea

I believe you mean nicotine...I have observed friends taking 10 kilograms of food grade caffeine microballs and weighing and bagging in 500 mg doses to distribute at a hacker convention, with no adverse effects.

Food grade caffeine granules are both diluted and granulated to prevent machine material handling errors from becoming deadly at food packaging plants. The powdered stuff is quite dangerous.

The info I have is that the granules are mainly to ease mechanical processing. Given that ld50 of anhydrous caffeine USP is above 100mg per kilo of body weight, I do not think a few grams, especially through skin, would be much risk. The msds advises gloves, due to it being a skin irritant, but that is for constant exposure.

Fine powders are a fire safety and explosion risk, of course, especially in automated storage and processing environments....flour, non dairy creamer, aluminum powder, etc are great fun.

If there is any info to the contrary I would be very interested.

"Given that ld50 of anhydrous caffeine USP is above 100mg per kilo of body weight, I do not think a few grams, especially through skin, would be much risk."

Fine water-soluble powders are absorbed quickly when inhaled, producing a very high peak concentration in the blood that supplies the heart. If it is enough to stop the heart from beating, you die, even if dose averaged over the whole body is reasonable.

By just about any definition of the word "drug" (except common-use, which isn't acceptable as it changes rapidly), water is also a drug.

People drown in water. Choke on water. There's water poisoning if you have too much of it.

Then you don't know a lot about drugs. Caffeine can be extremely dangerous in certain quantities. The only drug I know of that has no effective toxicity is cannabis, but that has other possible long term issues.

If you were to refine cannabis down to pure THC, I'm sure it'd have a toxicity level as well. Cannabis, like iceberg lettuce, doesn't have a toxicity level because of chemicals contained in it. And cannabis, like iceberg lettuce, could have stuff extracted out of it which would be toxic in large amounts at high concentrations.

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