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What I've found out about MDMA

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ryg0r
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Posted - 2003/08/04 :  18:45:47  Show profile View artist profile Send a private message
This is a quote from Dj *********. Onya *********. Truely an amazing article. Thi is not mine. I don't take drugs (except for what my doc prescribes)

*********'s definitive guide to MDMA.
-------------------------------------

This post is long. Be warned. I'd also appreciate if this post was made sticky for some time. Funnily enough, its informative.

The drug MDMA is illegal in Australia, possession of which is punishable by a gaol term. Use at your own risk.

I do not deal, nor will I supply to anyone, not even close friends. Never have, never will. Deal at your own risk.

This post will generalise people as "you do this xxx" or "you are this xxx". Whilst a small minority of you are responsible drug users, and therefore exempt from these generalisations, most of you aren't. Like all generalisations, they apply to a specific group.

This post is intended to let you people all know what the real story is with pills. I'm sick and tired of reading absolute trash on this board, when its blatantly obvious that well over 90% of you have little idea, if any, of what you're talking about. I'm sick and crap of seeing the abuse of drugs, and seeing the effect that such a valuable tool can have on people.

YES DRUGS CAN RUIN PEOPLE'S LIVES, but in moderation they're also extraordinarily effective at achieving some things.

I'm going to let you guys in on a whole lot of information I don't think you're ready for.

I'm going to source this information. Unlike you, I've read journal articles. Unlike you, I claim to know what I'm talking about. I've read three books specifically dedicated to MDMA, one of which is the MAPS handbook for the use of MDMA in a theraputic clinical setting, the protocol of which has been approved by the Food and Drug Administration (the FDA) in America for the use of MDMA as a treatment for Post Traumatic Stress Disorder. PTSD currently has no drug treatment that is consistently effective.

This post shall be broken up into the following sections.

1) The risks of taking MDMA. Or - what you can die from.
1a) Hyperthermia
1b) Hyponatremia.
1c) Other reactions
2) A discussion of MDMA neurotoxicity. Or why proper, responsible use is ok.
3) Serotonin receptor downregulation & polydrug use. i.e. why you're all e-tards.
3a) Does MDMA cause long-term psychiatric illness?
4) Theraputic uses of MDMA. In specific, MDMA treatment of depression.
1) Risks

MDMA is remarkably safe.

Current statistics from both the US and the UK put the number of users who die from MDMA each year at approximately 2 in 100,000.

As a comparison, 50 in 100,000 alcohol users will die each year, and 400 in 100,000 tobacco users will die each year. Tobacco is the single biggest preventable cause of death in the 1st world.

Average useage figures from the US and UK put regular users at a usage of around 25 pills per year (one every other weekend). This means that the chance of you dying from a single pill is, on average, about 1 in 2.5 million. Safe partying reduces this risk even more.

To put this into perspective, if you take five rides at a fun fair you run a risk of 1 in 3.2 million of being killed through an accident. Some sports are obviously dangerous, such as parachuting which kills 3 in 1000 participants per year. Even skiing in Switzerland is risky - 1 in 500,000 are killed. If you play soccer, every year you run a risk of 1 in 25,000 of being killed. But if you stay at home instead of going out you still aren't safe, since the risk of being killed through an accident at home is 1 in 26,000 a year!

MDMA in its pure form is significantly safer than alcohol.

The LD50 of MDMA in human users (the dose at which 50% of the test subjects die from overdose) is unestablished, but extrapolation from rat and primate studies suggests it occurs at about 60mg/kg.

Translation: You're going to have to eat about 50 to 60 pills. It's very hard to overdose on MDMA, unless you're seriously stupid.

The main risks occur from mixing drugs, hyperthermia and hyponatremia.

1a) Hyperthermia

Hyperthermia is when your body temperature rises to dangerous levels. Though you may feel temperature changes on Ecstasy, your body temperature actually remains relatively constant.

FACT 1: MDMA does not raise your body temperature, or not by a significant amount.
STUDY 1a: Liechti and Vollenweider, "Acute psychological and physiological effects of MDMA ("Ecstasy") after haloperidol pretreatment in healthy humans", European Neuropsychopharmacology 10 (2000) 289-295.
STUDY 1b: de la Torre et al., "Pharmacology of MDMA in humans", Annals of New York Academy of Sciences (2000).

Study 1a reported no temperature increase. Study 1b reported a temperature increase of less than half a degree Celsius.

Temperature rises are caused by speed, meth, etc.

I will also mention at this point that neurotoxicity does not occur without temperature rises. I'll refer to this later on.

If you’re out dancing, however, the extra energy Ecstasy gives you can let you dance much longer than you normally would. You can become dehydrated, and overheated. If you become dehydrated your body has a much harder time keeping your temperature down.

What happens when the temperature in your body rises?
To put it simply, you start dying. If you increase someone's temperature enough they'll die.Proteins denature, the kidneys and liver fail, muscle breakdown starts occuring, enzymes fall apart.

Hyperthermia on MDMA is easily avoided. Drinking a small amount of water helps, as does access to ventilation and TAKING A BREAK. The biggest problem for MDMA users is marathon dancing sessions of 1+ hours without a break. A break of 10 mins every hour returns the body temperature to approximately normal. If you want to cool off, pour some water over yourself. Don't drink heaps.

Why? Hyponatremia.

1b) Hyponatremia.

If you drink too much water, your body can’t get rid of it fast enough. Your sodium levels (electrolyte levels) in your blood become lower and lower, and your tissues start to swell as water moves into them under osmotic pressure. This is a real problem for your brain, because it doesn’t have anywhere to swell “to”. It can cause death if your brain expands enough as cells get crushed and die.

Hyponatremia means, literally, low sodium levels.

MDMA seems to know you want to dance, and it releases an anti-diuretic hormone , which tells your kidneys not to get rid of as much water, so you stay hydrated.

Anna Wood died because she drank some an estimated 8 to 11 litres of water in an hour. If you try this, you’ll probably die as well. She forced herself to because she thought water was an antidote to MDMA. It’s not.

What’s the solution? Drink reasonably. 500mL an hour is PLENTY. Sports drinks are fantastic, because they replace lost sodium in your blood.

1c) Other reactions and interactions.

There is a statistically remote chance of you dying from liver failure from taking MDMA. There is no predictor for this, and the it seems to be less than one in 2 million users. Accurate figures are not available.

MDMA has a known interaction with protease inhibitors, namely the new generation of HIV drugs. They raise MDMA plasma levels to dangerous concentrations (eat one pill and your blood levels will be raised to the level of up to 10 pills. It's VERY dangerous). People have died from this.

Don't drink alcohol and eat pills. Not only is alcohol a diuretic (it dehydrates you), but being drunk and dumb isn't a survival advantage if something goes wrong.
2) MDMA Neurotoxicity

It doesn't happen at recreational doses, as far as I'm concerned.

Firstly, overheating, often of life-threatening proportions, is necessary to create neurotoxicity.

STUDY 2a: Yuan et. al., "Effect of depleting vesicular and cytoplasmic dopamine on MDMA neurotoxicity",
Journal of Neurochemistry, Vol 80:960-969, 2001.

That's my source.

CHANGES ARE REVERSIBLE
YES, MDMA DOES CAUSE NEUROLOGICAL CHANGES.

These changes are, however, explained entirely by neuroadaptation to the presence of a large amount of serotonin, and have been shown to be FULLY REVERSIBLE UPON QUITTING.

STUDY 2b: Semple et al., "Reduced in vivo binding to the serotonin transporter in the cerebral cortex of MDMA ("ecstasy") users", British Journal of Psychiatry, Vol 175, 63-69 (1999)
STUDY 2c: Buchert et al., "Long-Term Effects of "Ecstasy" Use on Serotonin Transporters of the Brain Investigated by PET", Journal of Nuclear Medicine 2003; 44:375-384.
STUDY 2d: Reneman et al., "Cortical serotonin transporter density and verbal memory in individuals who stopped taking MDMA: Preliminary findings", Archives of General Psychiatry, 2001:58(10):901-906.
STUDY 2e: Reneman et al., "Effects of dose, sex, and long-term abstention from use on toxic effects of MDMA (ecstasy) on brain serotonin neurons", Lancet, 2001;358(9296):1864-1869.

I would note that study 2c is the largest ever conducted of its kind. It was conducted by the German version of the FDA.

All of these studies share one thing in common. There are changes in your brain after you have taken MDMA.

These changes appear to be entirely reversible upon quitting. Once you stop taking MDMA, your brain returns to normal. The harder you have hit the drug, the longer it takes, but the period is in the region of 1 to 2 months.

Think you've been hitting it hard? Study 2c involved users with a lifetime average of 827 pills. No, that's not a typo. 827 pills. That's a fairly hardcore study group, and if you expect to find brain damage that's where it would be. There is none.

A dose of 2mg/kg would get most users absolutely plastered off MDMA. Studies which find neurotoxicity often involve doses of 50mg/kg, supplied 4 times a day for 4 days.
I.e. the equivalent of you eating 50 or 60 pills every 6 hours for 6 days.

Swedish groups have concluded that 1.5mg/kg produces no neurotoxicity.

STUDY 2f: Vollenweider et al., "Effects of MDMA on 5-HT uptake sites using PET and [11C](+)McN-5652 in
humans", Conference of the German Society for Psychiatry, Psychotherapy and Neuromedicine (2000).

BLOOD FLOW

Measurements of cerebral blood flow have been done both retrospectively and prospectively (on human volunteers). Both studies found no long term changes in cerebral blood flow. The thing you might have heard about on Oprah (a girl who had “holes” in her brain) has been conclusively disproved; it was Oprah misreading a (very technical) PET scan.. Ecstasy does not put holes in your brain.

STUDY 2g: Gamma et al., "No Difference in Brain Activation During Cognitive Performance Between Ecstasy (3,4-MDMA) Users and Control Subjects: A [H2 15O]-PET study", Journal of Clinical Psychopharmacology, Vol 21, No 1 (2001).
STUDY 2h: Chang et al., "Effect of ecstasy (MDMA) on cerebral blood flow: a co-registered SPECT and MRI study", Psychiatry Research: Neuroimaging Section 98 (2000) 15-28.

Both these studies demonstrate this.


MDMA DOES NOT CAUSE PARKINSONS

The following two studies investigated dopamine levels in Ecstasy users, as dopamine has been linked to Parkinsons and other such diseases. These two studies found no such changes. It should be noted that serotonin is a primarily serotonogenic drug, and does not involve the dopamine system of the brain to anywhere near as much drugs such as Ritalin or Dexadrine, both available upon prescription in Australia and reviewed by the TGA for safety.

STUDY 2i: Semple et al., "Reduced in vivo binding to the serotonin transporter in the cerebral cortex of MDMA ("ecstasy") users", British Journal of Psychiatry, Vol 175, 63-69 (1999).
STUDY 2j: Reneman L, Booij J, Lavalaye J, de Bruin K, Reitsma JB, Gunning B, den Heeten GJ, van Den Brink W "Use of amphetamine by recreational users of ecstasy (MDMA) is associated with reduced striatal dopamine transporter densities: a [123I]beta-CIT SPECT study-- preliminary report" Psychopharmacology (Berl) , 2002; 159(3):335-340.

Additionally drugs which have a much larger dopamine generating effect, including methamphetamine, have been reviewed in huge long term studies (including ones in both Japan and Germany, where soldiers were all given methamphetamine to help them fight), all of which conclude methamphetamine does not cause Parkinsons. If this doesn't, there is no known pharmacological method for MDMA to cause Parkinson's.

SUMMARY
-------

I'm not going to go into the theory of how high doses cause MDMA neurotoxicity. Nor am I going to go into a discussion of how you can substantially reduce tolerance or recovery time, because that is possible. It is possible to reduce the recovery time from MDMA by up to 50-70%, and also to minimise tolerance. I'm not going to talk about that because I think it would promote a lot of you to go and dump every weekend.

If you aren't aware of these methods, dumping more than once every 2-4 weeks (differs from person to person) will BUILD A TOLERANCE FOR YOU.

NO, PILLS AREN'T GETTING WORSE. YOUR BRAIN IS...

3)SEROTONIN RECEPTOR DOWNREGULATION AND POLYDRUG USE.

Why do you build a tolerance?
It has to do with what happens in your brain. Your brain adapts to extreme levels of neurotransmitters. It's a way of maintaining homeostasis, so your brain keeps working.

MDMA stimulates serotonin release. I'll try and avoid as much jargon here as I come
(strictly speaking its said that MDMA enters the serotonin axon through the SERT and triggers the release of serotonin into the synaptic cleft by reversing the direction of serotonin reuptake in the SERT, thus expelling serotonin from the vesicles rather than introducing MDMA into the axon).

Intense serotonin release triggers lots of serotonin receptors. This is why you peak.

Your brain doesn't like this. Doing MDMA effectively resets the volume level on your brain's serotonin system. LOUD MUSIC (MDMA) makes your brain turn the volume down.

It does this by retracting neuroreceptors from the post-synaptic cell body. This is a normal response, and not brain damage.
SSRIs (Prozac, Cipramil) etc help depression in this EXACT fashion. By increasing the amount of serotonin available, SSRIs force your brain to retract some serotonin receptors. This is known as downregulation.

I stress: This process is NOT brain damage. It's entirely reversible, though it takes time. SSRIs provide protection against depression for some months after you stop taking them. It can return, however, after the brain returns the receptors to normal.

In a similar way, MDMA triggers downregulation. The receptors will return to normal, but only after some abstinence from the drug. This is what all the studies above ^^^ find.

EXCESSIVE USE
The downregulation theory entirely explains symptoms from excessive use.

If you use pills too much (more than about once every 3-4 weeks) your brain will be downregulating receptors further and further, until they become *too* downregulated.

You may experience short-term memory problems, depression, verbal processing problems (problems with speech or finding words), or other "e-tarded" feelings. That's what you get for hitting it too hard.

The good news is: this is entirely reversible. The above studies confirm this. If you quit the drugs for a period of 1-3 months, your brain will return to normal.

You might not feel like it, but your brain WILL be back to normal. Prospective studies confirm this. The remnant "my brain has been ****ed" feeling is entirely psychological.

Note: this does not apply if you've been dumping 20-30 pills a night. You may very well have caused neurotoxicity.

Quit the drugs for a few months and you'll stop being e-tards.

POLYDRUG USE:

Here's another interesting result. ALL the verbal problems and long term brain problems Ecstasy users encounter are due to other drugs. Primarily: marijuana.

STUDY 3a: Croft et al., "The relative contributions of ecstasy and cannabis to cognitive impairment", Psychopharmacology (2001) 153:373-379
STUDY 3b: Simon and Mattick, "The impact of regular ecstasy use on memory function", Addiction, 2002; 97(12):1523-9.

When marijuana use is accounted for, all verbal problems and memory problems caused by ecstasy disappear. If your memory is ****ed and you smoke pot, there's your problem. It's your pot use that is to blame.


LONG TERM PSYCHIATRIC PROBLEMS

There has been some conjecturing that MDMA causes long term psychiatric illnesses, such as depression or schizophrenia.

STUDY 3c: Lieb R, Schuetz CG, Pfister H, von Sydow K, Wittchen H (2002) "Mental disorders in ecstasy users: a prospective-longitudinal investigation." Drug Alcohol Depend 68: 195-207.

This study is the largest ever of its kind conducted, and one of the most rigorous. It found that, whilst Ecstasy users are more likely to have a DSM-IV disorder than non-ecstasy users, this is almost entirely accounted for by the fact that people with a DSM-IV disorder are morel likely to seek drugs to "self-medicate" their illness.

i.e. drug use does not trigger psychiatric disorders; psychiatric disorders make people seek drugs, to self-medicate.

There is no evidence that MDMA can trigger depression. As you'll see, it can be used in its treatment
THERAPUTIC USE OF MDMA

I'm going to start this section by noting that the FDA in America, as I said above, has approved a trial by

MAPS (http://www.maps.org) for the treatment of PTSD using MDMA. They have reviewed ALL the literature in the field, the review of which can be found at http://www.maps.org/research/mdma/litupdates/
It's a big ****ing document. It reviews every significant study ever done, of which I believe there are about 1000.

Epidemiological studies of depression whos that the lifetime risk for major depression in the adult population ranges from 10 percent to 25 percent for women, and 5 percent to 12 percent for men
Source: American Psychiatric Association 1994.

Many of you may know that depression has a basis in neurochemistry. Low serotonin levels have been correlated with depression, and SSRIs (which boost serotonin levels) alleviate depression.

Riedlinger (1985) first proposed that MDMA may have a use in treating depression. Riedlinger believed this because MDMA is fast acting (unlike SSRIs, for example, which can take weeks to have an effect) and because it is most effective when administered infrequently (perhaps once a month), rather than the multiple daily dosing required by all other known antidepressants.

It has been hypothesised that interpersonal attitudes interacting with depression are the major cause of suicide:

STUDY 3a: Beck, A. T., G. Brown, and R. A. Steer. 1989. Prediction of eventual suicide in psychiatric patients
by clinical ratings of hopelessness. J Consult. Clin. Psychol. 57(2)309-10.
STUDY 3b: Beck. A. T., R. A. Steer, M. Kovacs, and B. Garrison. 1985. Hopelessness and eventual suicide: A 10-year prospective study of patients hospitalised with suicidal ideation. Am. J. Psychiatry 142:599-63. p268

Many proponents of MDMA argue it can be used in a theraputic setting at theraputic doses (0.5mg/kg - 1mg/kg) to help overcome depression.

Adamson (1985) describves about 50 psychiatric sessions in which he believes MDMA helped people overcome their depression.

STUDY 3c: Adamson, S. ed. 1985 "Through the gateway of the heart: Accounts of experiences with MDMA and other empathogenic substances." San Fransisco: Four Trees
see also:
STUDY 3d: Adamnon, S. and R. Metzner. 1998. "The nature of the MDMA experience and its role in healing, psychotherapy and spiritual practice." Revision 10(4):59-72.

Eisner (1989) also observed this:
STUDY 3e: Eisner, B. 1989. "Ecstasy: The MDMA Story." Berkely, Calif.: Ronin Press.


"The Value of MDMA is that it does not make its users feel better by transporting them into a naive state of bliss. They are aware of the fact that their lives have been burdened by negative thinking, have been based on fears and anxieties. MDMA seems to lend them a different perspective for several hours by minimising their defensiveness and fear of emotional injury."
Source?
STUDY 3f: Greer, G. Using MDMA in psychotherapy. Adv. J. Inst. Adv. Health 2:57-9.
STUDY 3g: Greer, G., and R. Tolbert. 1986. Subjective reports of the effects of MDMA in a clinical setting. J. Psychoactive Drugs 18(4):319-27.
STUDY 3h: Greer, G., and R. Tolbert. 1990. Testing psychotherapies and drug therapies: The case of psychedelic drugs. In: Ecstasy, The clinical, pharmacological and neurotoxicological effects of the drug MDMA, edited by S. J. Peroutka. Boston: Kluwer Academic Publishers.

Metzner, in Adamson's book, is quoted as saying "One therapist has estimated that in five hours of one [MDMA] session clients could activate and process psychic material that would normally require five months of weekly session."

CONCLUSIONS:
When used at THERAPUTIC (not recreational) doses in the right sitting, MDMA can rapidly facilitate the overcoming of depression. A theraputic does is generally considered to be 1/2 an average pill. If your vision is ****ed and your eyes are shaking (nystigmus) you've far exceeded a theraputic dose.

Personally...
On a personal note, I know this, because it's happened to me.I have had clinical depression for some time. I estimate as having it for some 2-3 years before I properly sought treatment, in the form of SSRIs.

I did notice, however, that around pills I was significantly happier than I was around alcohol, though perhaps the effect is even more obvious in retrospect.

I have used MDMA in a proper fashion to help myself overcome a significant part of my depression. Under the influence of MDMA I have been able to work through much of what is troubling me. MDMA is a powerful anxiolytic (a drug that supressed anxiety), and I attest to the fact that careful, controlled MDMA use has made me happier than at any other time in my life that I can remember. These effects are lasting, too.

I am not going to go into how often I use MDMA for this purpose, suffice to say that I am not building a tolerance, nor am I even close to it.

Yes, chronic binging on MDMA does cause depression, reversible after quitting the drug for several months. I feel however, that low does of MDMA have helped me overcome much of what is troubling me. I am on a much lower dose of my antidepressants than I was originally, because I no longer need it now. Im looking forward to the day when I've worked through enough of my issues to the point that I no-longer need SSRIs as a backup.

As a side note: combining SSRIs and MDMA is safe, though you'll get no effects. SSRIs prevent 70% to 90% of the effects of the pill. I'm not going to go into how I manage to avoid that problem, because it's very finicky.

There's my 2c. I may add more soon. I'll happily take questions. Someone make this sticky
Also:

I don't want to brag, but some of you will (or already have) raise the question as to what my marks are like.
I'm in 2nd year combined Science/Law at UNSW majoring in Physics.
I have a High Distinction average. I have straight High Distinctions in Physics and Maths. I also pull this off while being involved in the uni revues. I've analysed my marks quite comprehensively, and pills have improved my uni marks, by making me happier. Of particular note is that since helping myself my physics marks have raised even higher than the rest. I have a raw assessment mark in Quantum Mechanics of 100%, and topped the 2nd year Physics Lab.

Yeah its hard not to hit MDMA hard, its a very enticing drug...

Once again, this isn't mine, its from *********.

-=[ryg0r]=-


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K-Hole
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Posted - 2003/08/05 :  02:18:09  Show profile  Send a private message  Visit K-Hole's homepage
spme good infomation there, read all thw way though, learnt a few things, ive never actually taken a pill, but this infomation told me a lot so, when it comes to my time(if ever), ill know its proper safe etc.

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milo
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Posted - 2003/08/05 :  16:25:56  Show profile View artist profile  Send a private message  Visit milo's homepage
very informative, i read it all the way through as well... now, for something like this for all the other stuff they put in pills...



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ryg0r
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Posted - 2003/08/05 :  16:38:05  Show profile View artist profile  Send a private message
Yeah, I found it very useful, incase I ever take one too. Not that I will, but I'll know what to look out for, how much to drink, etc, etc...

-=[ryg0r]=-


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rezzna
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Posted - 2003/08/06 :  03:12:22  Show profile  Send a private message
its a position ive maintained for some time now and this has only boosted it. pills are bad, mdma powder (or compressed) is the way forward

"don't worry about it, if i were you i wouldn't remember me either"


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strychnine
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Posted - 2003/08/06 :  04:29:57  Show profile  Send a private message  Visit strychnine's homepage
As much as I like work as a DJ, and as informative as I feel this little diatribe of his is, I'm still disappointed at the way that he reminds the rest of the world what a pretentious, snobby twat he is:

quote:
Originally written by :
I'm going to source this information. Unlike you, I've read journal articles. Unlike you, I claim to know what I'm talking about. I've read three books specifically dedicated to MDMA, one of which is blah blah f***ing blah because I am so much f***ing smarter than everyone else blah.


Again, though, the piece is very informative and I suggest that everyone read it. You shouldn't let the fact that the author thinks the sun shines out of his ass dissuade you from learning and benefitting from his research.

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pacman
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Posted - 2003/08/06 :  05:11:43  Show profile  Send a private message  Visit pacman's homepage
quote:
Originally posted by strychnine:
As much as I like work as a DJ, and as informative as I feel this little diatribe of his is, I'm still disappointed at the way that he reminds the rest of the world what a pretentious, snobby twat he is.



hahahahahaha lmao.

so true (and funny)!

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skid
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Posted - 2003/08/06 :  06:08:45  Show profile  Send a private message
word i read all this
haha u even sourced it and shit at uni level...haha being 1st year uni i hate it....can't copy and paste into assessments
yeah also u threw in some biology terms and i understood them hehe
nah serzly it was a good read...
just wondering...if its safer than most ppl say it is... then y is it illegal to do ecstacy?? haah not being cheeky man

btw i got mix off cpx radio from ages ago...haha still listen to it



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ktm018
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Posted - 2003/09/12 :  21:15:54  Show profile  Send a private message
That is a very good report how ever it doesn't answer wat I need 2 know.. how do I get effects from ecstasy while on an SSRI... please help me I am on cipramil.. I hate 2 drink cause it makes me suicidel and I like to pill wit my friends.. please help



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TypeR
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Posted - 2003/09/13 :  02:25:04  Show profile  Send a private message  Visit TypeR's homepage
you don't want to be asking questions like that.

don't stand and stare, just kick your legs in the air


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Posted - 2003/09/15 :  00:34:21  Show profile View artist profile  Send a private message
Things are deemed illegal by the people in power.

If you REALLY wanted to do legal drugs, move to holland. I hear they're cheaper too.

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