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Drug and MDMA Interactions Implications for Public Health

Esther Papaseit, Magí Farré, Clara Pérez-mañá

Handbook of Substance Misuse and Addictions January 1, 2022 DOI: 10.1007/978-3-030-67928-6_121-1 via Springer Nature

Summary

Public health efforts must balance preventing illicit drug use with ensuring access to medicines that have abuse potential. Drug interactions for drugs of abuse, unlike those for medicines, are largely underexplored and not part of clinical routine. MDMA (ecstasy, molly) exemplifies this: it is a popular recreational psychostimulant and is being evaluated for treating post-traumatic stress disorder. Understanding inter- and intraindividual factors, modulation factors, and potential interactions is crucial to assess intoxication risk for both recreational users and patients in future MDMA-assisted therapy.

Study at a glance

Characteristics Review Peer reviewed
Topics MDMA
Keywords 3,4-methylenedioxymethamphetamine Drug of abuse Drug/medicine Drug interaction
Key finding Drug interactions with drugs of abuse like MDMA are underexplored, yet understanding them is crucial for both recreational users and patients in MDMA-assisted therapy.

Abstract

Public health focused on drug use is considered a balancing act between preventing illicit use of drugs of abuse and ensuring access to drugs/medicines with abuse potential for a medical condition. Whereas clinically relevant drug interactions for medicines are widely recognized and are included in most pharmacovigilance systems, drug interactions with drugs of abuse are mainly underexplored, and their assessment is not part of clinical routine. An excellent example of this paradigm is 3,4-methylenedioxymethamphetamine (MDMA, ecstasy, or molly), one of the most popular recreative psychostimulants, which is being currently evaluated for the treatment of post-traumatic stress disorder. Considering both aspects of MDMA, as a consolidated recreational drug of abuse and a potential medicine, it is crucial to understand which inter- and intraindividual factors, modulation factors, and potential interactions could lead to risk of intoxication in recreational drug users as well as in patients with possible future MDMA-assisted therapy.

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