How to Legalize MDMA, With the Help of Pharmacies and Nightlife Spaces

December 6, 2019

On December 5, the Beckley Foundation, a British research organization focused on psychedelics and drug policy, called for tightly regulated legalization of MDMA. Its new report, “Roadmaps to Regulation: MDMA” recommends the rescheduling, decriminalization and legalization of MDMA over two phases. It also details how this would protect people from the harms of unregulated drug supplies and criminal enforcement, and encourage clinical research into the drug’s therapeutic uses.

“Rescheduling MDMA is crucial,” said Amanda Feilding, executive director of the Beckley Foundation. “In this report we have outlined realistic policy proposals designed specifically for both the therapeutic and recreational use of MDMA. The report offers a comprehensive guide to those wishing to develop an evidence-based position on this increasingly pressing issue.”

The plan represents a bolder, more ambitious and detailed approach to MDMA regulation than many drug policy reform organizations have allowed themselves to imagine.

The report comes as the United Kingdom struggles with record-high deaths associated with MDMA, or “ecstasy.” In 2018, 92 deaths in the country were linked with the drug—a number about 64 percent higher than in 2017 and the highest for 25 years. Nearly all victims were under 30.

The US has good reason to reconsider its approach, too. Over 17 million Americans reported having ever used MDMA in 2013, according to the National Survey on Drug Use and Health. Users were disproportionately young, between 18-25 years old. While there has been no known crisis of MDMA-involved fatalities this year, deaths and hospitalizations do happen, and it would be smart to think proactively about preventing future harms.

While MDMA remains a Schedule I drug in the US—the most restricted category, with no officially accepted medical use—its medical value may open the door to legalization here, as has been seen with cannabis. Clinical studies of MDMA-assisted psychotherapy for post-traumatic stress disorder are currently taking place in the US, as well as Canada and Israel. Randomized trials sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS) are in their third and final stage after receiving “breakthrough therapy” designation from the US Food and Drug Administration (FDA). Should the completion of these trials produce favorable data, MAPS believes that the FDA will approve the medication for legal use.

But while the Beckley Foundation’s researchers have certainly taken inspiration from their American counterparts, their proposals go several steps further.

The first phase detailed in “Roadmaps” recommends that the UK government reschedule MDMA from the highly restrictive Schedule 1 category to Schedule 2, as designated by the country’s 2001 Misuse of Drugs Act.

Doing this would open the door to more scientists and clinicians researching MDMA. As Filter has reported, this is already taking place in limited instances, such as Dr. Ben Sessa’s study into MDMA therapy for people with alcohol use disorder.

“The more widely taken up any practice is, the more desirable it is to have a fully developed understanding of its health impacts,” the report reads. “Moving MDMA into Schedule 2 will reduce the political, bureaucratic and cost barriers to scientific research associated with a Schedule 1 status […] the wider community of scientists who seek to investigate MDMA’s mechanisms of action and effects will be able to do so unimpeded.”

The report proposes that MDMA should be sold through licensed “MDMA product outlets,” specifically pharmacies.

But Parliament must simultaneously decriminalize personal use and possession of MDMA, the researchers urge. “Decriminalization would free the criminal justice system from a significant burden,” they write. “Police resources could be re-diverted to other priorities such as violent crime, and there would be a pronounced reduction in the need for stop-searches, which are justified by suspicion of drug possession in as much as 82 percent of cases in some police forces.”

The report emphasizes that going even further, and decriminalizing all drugs, would help prevent racial and ethnic minorities from being disproportionately targeted by discretionary drug enforcement.

The report’s second phase sets out the path to fully legalizing MDMA. The researchers recommend that the UK government build a strict, state-regulated legal market for the drug. The goals would be to ensure that people who want it can have a safe supply, with known dosage and purity, and that legal, tax-paying businesses divert revenues from the illicit market.

The report proposes that MDMA should be sold through licensed “MDMA product outlets,” specifically pharmacies. Advertising and promotion would be discouraged or banned, and prices would be set to be competitive with the illicit market. Purchasers would have to be over 18, and pharmacists and sellers would be trained to give them harm reduction education and resources.

In fact, consumers could only purchase MDMA after obtaining a “personalized license,” under the proposals. Obtaining such a license would require a person demonstrating to a pharmacist that they have adequate knowledge about the drug and its potential risks.

The researchers also recommend creating “adult-only MDMA-friendly nightlife spaces” where people can use recreationally. These clubs might even sell MDMA on-site, according to the proposals, provided they have trained harm reduction staff.

Brits are already warming up to the necessity of harm reduction practices for MDMA. This summer, a non-profit organization called the Loop—with blessing from the government’s Home Office—offered drug checking services at seven music and arts festivals. Over 8,000 partiers took advantage of this to check their drugs before consumption; they discovered that MDMA doses were often far higher than “advertised,” were often adulterated with other drugs like cocaine or ketamine, and often didn’t contain any MDMA at all. Similar harm reduction interventions are taking place around the world to keep people safer.

The Beckley Foundation’s plan represents a bolder, more ambitious and detailed approach to MDMA regulation than many other drug policy reform organizations have allowed themselves to imagine. Its vision synthesizes bits and pieces from many different drug policy reforms with demonstrated positive outcomes—from Portuguese drug decriminalization to European safe consumption spaces to Uruguayan cannabis shops to Dutch weed cafés.

The researchers concede that no change will be perfect, and that transitioning may bring some negative as well as positive consequences. But to continue as we are, they argue, is far more dangerous.

“Right now, on a weekly basis, around two people in the UK will die having introduced unregulated MDMA products into their bodies,” they write. “Without a more fundamental change to our approach to MDMA, we risk letting down current and future generations of citizens. Let us not have another wasted decade.”


Image of illicit MDMA pill from the Loop via Twitter.

Alexander Lekhtman

Alexander is an editorial fellow at Filter.

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