Ecstasy (MDMA) is a popular recreational drug with low abuse and dependence liability compared to several other illicit drugs and alcohol, and there is little evidence of long-term harm. A potential health risk is acute hyperthermia, which occurs at an unknown incidence rate and is more prevalent when ecstasy is consumed with heavy exercise at high ambient temperatures or with other substances including alcohol. However, illegal production and trade in the Netherlands have developed into a serious public order and ecological problem, with organized crime related to production and trafficking growing. This review provides a science-based summary to assist debate on future Dutch ecstasy policy to reduce organized crime while maintaining harm reduction.
Problematic or heavy recreational use of nitrous oxide (N2O, laughing gas) can cause serious adverse effects including neurological symptoms and severe paralysis. In Amsterdam, care centers observed these effects among Moroccan-Dutch young adults. Interviews with thirteen excessive users revealed that motives for use include relieving boredom, seeking relaxation with friends, and suppressing psychosocial stress, depression, discrimination, and conflict. A taboo culture involving mistrust, shame, and macho culture around substance use hinders timely medical and psychological treatment. Recommendations include using influencers in media campaigns and outreach youth workers to reduce risks and improve treatment access for this group.