Due to the controversial nature of this topic and the target audience (young people) it is important that the reader reads the complete answer and not
simply one paragraph or a few sentences. Taking one part of the answer out of context can lead to a misinterpretation of the intended message.
Paul Dillon speaks to thousands of students across Australia providing information on alcohol and drugs, particularly in relation to looking after
themselves and their friends. Some young people make contact with him to ask questions that they did not feel comfortable asking in front of their peers.
The Real Deal on Drugs allows young people to ask questions about drugs and provides them with access to accurate and up-to-date information.

Why do ecstasy users 'connect' with other people when they use the drug?

How come human beings bond while 'rolling' on MDMA? I was with some friends a few weeks back and while rolling, I connected deeply with someone I usually don't talk to. It's a strange feeling to have such a connection after a trip.

A deep connection with someone when taking MDMA (ecstasy) is not unusual. Users of the drug often describe a combination of feeling energetic and yet calm, as well as an enhanced sense of closeness with other people. The usual social defences are weakened and communicating with strangers is no longer taboo. These effects have been recognised for a long time – both on the dance floor and in therapeutic settings.

Alexander Shulgin, an American research chemist, experimented with MDMA in the 1960s and found it produced 'emotional openness' and empathy and made those using the drug feel in tune with each other and facilitated communication. As a result, a handful of psychotherapists used the drug in couple's therapy and as a means to help address post-traumatic stress disorders during the 1970s in the US. During the last decade, research into how MDMA and its unique effects could potentially be used therapeutically has been renewed. Clinically-controlled studies in the US and Switzerland continue to be carried out, particularly in relation to the treatment of PTSD.

So how does MDMA cause this effect?

There is no straightforward answer but most experts agree that MDMA works by increasing levels of dopamine and oxytocin in the brain, which affect emotions, empathy and pleasure. At the same time, MDMA 'tricks' the brain into releasing serotonin (the 'feel-good' neurotransmitter) and then also prevents it from being re-absorbed. As a result, the level of serotonin in the synapse – a part of the brain that allows information from one neuron to flow to another neuron - increases, producing the 'loved-up' euphoria associated with MDMA.

Some experts, however, are sceptical about serotonin explaining this unique effect. Other drugs, including pharmaceutical products, cause a big release of serotonin but they don't cause anything like the euphoric effect of MDMA. We still have a lot to learn about this drug.

Please remember, using MDMA does involve risk. The main reasons why it can cause problems or even deaths are as follows:

  • adulterants – drugs sold as ecstasy may contain little or no MDMA. Ecstasy may contain other substances some of which may be more harmful than MDMA
  • heatstroke – using the drug in a hot environment (like a nightclub) can cause body temperature to dangerous levels, which can result in death
  • water intoxication – MDMA affects the kidneys, preventing the body from getting rid of fluids. Water is retained in the body and the pressure can lead to coma and death  
  • heart failure – the stimulant effects of MDMA have caused death in vulnerable users, particularly those with undiagnosed heart problems
  • MDMA overdose – the increase in the strength of ecstasy may have caused fatal overdoses among some users i.e., the 'dose' taken is 'over' the safe amount

All drugs, whether they be legal, illegal or pharmaceutical, are potentially dangerous. Things can, and do, go wrong - no matter what the substance. Although taking MDMA can lead to some positive effects for many users (such as the feelings of being 'connected' to others), there are risks those people thinking about taking the drug also need to consider. 
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Can I be affected (or get stoned) if someone around me is smoking cannabis?

Every time I believe someone is using cannabis near me, I become anxious and fearful that I may experience the same effects of the drug, as has the user. Is this fear irrational? Furthermore, can the effects of being merely exposed to the smoke of cannabis cause noticeable or even negligible effects to the developing brain?

It sounds as though you are someone who has never used a drug like cannabis and you have no intention of ever doing so. If that is the case, it is no surprise that being around those using the drug could worry you. In most parts of the world cannabis is still an illegal drug and being around people who are breaking the law can often result in problems for you, even if you're not actually involved. But as far as the risk of being affected by cannabis due to exposure to the drug by others smoking around you ('passive cannabis smoking'), from what we know from current research it should not be a major concern.

Just being in a room where people are smoking and the smell of cannabis is in the air is not sufficient to cause effects and you should not be worried about such levels of exposure. If you are in a very confined space that is not well ventilated, it is possible, however, to experience mild intoxication from inhaling the smoke of others. Even then, the effect would be at much lower levels. An effect is more likely to be experienced when the newer, stronger strains of cannabis are smoked as they contain higher levels of THC (the chemical that produces the high) that can be found in side-stream and exhaled smoke. Realistically, however, this is a situation that can, and should be, avoided.

The simplest thing to do if you suspect someone is smoking or vaping cannabis near you and that you may be exposed to smoke or vapour is to move away, or excuse yourself politely if you know the person. If you don't feel comfortable about being honest with them and telling them about your concerns, say that you are allergic to the smoke/vapour or you're worried about the smell of the smoke getting onto your clothes or into your hair. Alternatively, simply make an excuse to leave the room when they're using the drug. Even though the risk of being affected by the drug is low, if being around someone who is smoking the drug causes you to become anxious, avoid the situation when you can - it's just not worth the worry!
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How do I know when I can safely put a drunk person to bed?

I have a question that I have thought of about taking care of a drunk friend. One of the things I recall you saying is to try to make sure they don't fall unconscious and try to keep them awake if you possibly can. Some of the people I have looked after have wanted to go to bed, so I was wondering when is it a safe time for a drunk person to be put to bed and go to sleep without me watching them anymore?

The practice of putting someone to bed to 'sleep it off' has been around for as long as alcohol has been consumed and most times the worst thing that happens is that the person wakes up the next morning feeling a little worse for wear or covered in their own vomit. That is not always the case, however, with some drunk people being sick through the night and ending up choking on their own vomit, or others simply stopping breathing due to the depressant effects of alcohol.

The reality is that many drunk people will want to go to bed, particularly if they have been feeling unwell for a while. There are three simple tests that a person looking after a drunk friend can use to see whether you are able to put them to bed and be reasonably sure that they will be safe:

  • Can the person walk? Just a few steps, not a marathon - if they can't walk, they still need to be monitored closely. Putting them to bed at this time is not advised
  • Can they talk? They don't need to have a quality conversation but you need to know that can speak and let you know where they are, preferably in a language you can understand!
  • Can they answer a question? The best question to ask them is something like "What is your full name?" If they don't know what their name is, once again, it is not a good idea to put them to bed!
If they can pass these simple tests, you should be able to put them to bed. It is important, however, that you make sure you put them into bed in the recovery position (you can look at this YouTube video from St John Ambulance if you don't know how to do this), and then put a folded pillow behind their back to ensure that they don't roll back over through the night. Once you have, it is still important to monitor them for at least 30mins to an hour, ensuring that they are breathing steadily, that they haven't vomited or rolled over onto their back.

The major issue with looking after drunk people is that you can never be sure when they actually had their last drink, so you can't know with any certainty that this is as 'drunk' as they'll get. With that in mind, if you are considering put a drunk friend to bed, another good trick is to quickly take their pulse and then wait 10-15 minutes and take it again, making sure that it is now either steady or getting stronger (faster). If it is dropping that means there is still alcohol making its ways to the brain and putting them to bed is potentially very dangerous.

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