Adolescent patients with both post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) reported more frequent past-year use of MDMA (ecstasy) than those with SUD alone or with traumatic experiences but no current PTSD. No such differences appeared for tobacco, alcohol, cannabis, or stimulants. The link between PTSD and higher MDMA use was partly explained by using the drug to cope with mental health symptoms. This suggests a specific coping mechanism for MDMA, possibly due to its unique psychoactive effects, rather than a general pattern of self-medication across all substances.
Among adolescent psychiatry outpatients with substance use disorder, attenuated psychotic symptoms were linked to MDMA (ecstasy) use and trauma history, but not to cannabis use. In a sample of 46 adolescents, 35% reported using MDMA in addition to cannabis. Statistical analysis showed that MDMA use and trauma history were each associated with more psychotic-like symptoms, while cannabis use, gender, and birth complications were not. The authors suggest that cannabis may increase psychosis risk only after longer use or when combined with other factors like trauma. Clinicians should screen for psychotic symptoms in adolescents who use both MDMA and cannabis.