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RAVE Act Backfires, Increases Risks for MDMA Harm

The RAVE Act is a piece of federal legislation enacted in 2003 as part of an attempt to reduce the use of MDMA (Ecstasy, Molly), a stimulant/hallucinogen known for its ability to produce severe or fatal health problems in some users. In a report presented in August 2014 to the Annual Meeting of the American Sociological Association, researchers from the University of Delaware assessed the impact of this legislation on the rate of MDMA-related harm in the U.S. The researchers concluded that the RAVE Act may have had the inadvertent effect of increasing the likelihood of such harm.

MDMA (Ecstasy, Molly)

MDMA is a manmade, illegal substance that simultaneously produces some of the mind- and body-altering effects associated with stimulant drugs and some of the mind- and body-altering effects associated with hallucinogenic drugs. For decades, the primary nickname of the drug has been Ecstasy (a reference to its effects on the mental state of users). However, a new nickname — Molly — has emerged in recent years. Supposedly, MDMA identified as Molly has a higher level of purity than MDMA identified as Ecstasy. However, users, researchers and public health officials have no realistic way to prove or disprove this claim since no reputable labs test batches of MDMA for purity. MDMA produces its drug effects by changing the levels of several key chemicals inside the brain. In addition to feelings of benevolence and euphoria, these effects commonly include sensory hallucinations and the accelerated heart and breathing rates associated with other stimulant substances. Short-term problems linked to MDMA use include dehydration, disrupted sleep patterns, nausea, lightheadedness, a confused mental state and a depressed or anxious mental state. Habitual users can develop additional problems that include persistent sleeping difficulties, persistent alterations in mental/emotional function and the withdrawal symptoms that classically herald the presence of physical drug dependence. When used in large amounts in high-heat environments such as parties or clubs, the dehydration produced by the drug can contribute to potentially lethal cases of elevated body temperature (hyperthermia).

The RAVE Act

The RAVE Act is the common abbreviation for legislation called the Reducing Americans’ Vulnerability to Ecstasy Act. The abbreviation is based on the dance parties or “raves” that first brought MDMA use to the widespread attention of the general public. The RAVE Act makes venue owners legally liable for any use of MDMA on their premises, in addition to making them potentially legally liable for any MDMA-related deaths or other serious or severe outcomes of MDMA use on their property.

Inadvertent Impact on MDMA Users

The authors of the report presented at the Annual Meeting of the American Sociological Association note that, prior to the introduction of the RAVE Act, owners of the venues where raves or similar gatherings occurred commonly took steps to ensure the safety of attendees under the influence of MDMA. Examples of these steps included making sure water was available to combat cases of dehydration and prevent the onset of hyperthermia, as well as assigning staff members to seek out and assist partygoers in obvious or suspected states of distress. In addition, venue owners and promoters often allowed third-party groups to provide assistance for MDMA users and distribute information on the dangers of using the drug. However, the authors note, these practices largely ended when the RAVE Act went into effect. Apparently, this change is closely linked to fears among owners and promoters that their actions might be interpreted as support for criminal activity on their premises. The report’s authors believe that the RAVE Act-inspired change in the conduct of club owners and promoters has significantly increased the likelihood that young people who attend raves or similar gatherings will not receive the short-term treatment they need if they experience hyperthermia or other serious adverse reactions to MDMA use. In some cases, fears of prosecution may even delay or deter efforts to request emergency medical treatment.

Increase in MDMA-Related ER Visits

The federal Substance Abuse and Mental Health Services Administration tracks the number of MDMA-related emergency room visits in the U.S. through a monitoring program called the Drug Abuse Warning Network (DAWN). Information released by DAWN in 2011 (the last year with fully available statistics) indicates that such visits increased by nearly 75 percent in the four-year timespan following the passage of the RAVE Act.

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