As we enter the fourth decade of MDMA’s widespread use, new thinking is needed on how to better control production and distribution, and on how to reduce the risks associated with its consumption. There is growing evidence to support reorienting drug policy away from an ideologically driven criminal justice-led model to one rooted in pragmatic health and harm reduction principles. Current policy is not meeting its goal of reducing harms, and greater control of MDMA production, distribution, purchase, and consumption is needed in order to prevent MDMA-related emergencies.
This policy proposal examines the acute, sub-acute, and chronic harms related to MDMA use in detail. We examine the production, distribution, purchase, and consumption of the drug; related risks and harms; and the impact prohibition has on these, as well as the potential impact of alternative policies. Crucially, our evidence shows that most harms associated with MDMA use arise from its unregulated status as an illegal drug, and that any risks inherent to MDMA could be more effectively mitigated within a legally regulated market.
This policy proposal rests on the following five principles which should underpin all evidence-informed drug policy and practice:
Roadmaps to Regulation: MDMA has two overarching interlinked objectives:
The report outlines, for the first time, detailed recommendations for drug policy reform in order to better control the production, distribution, purchase, and consumption of MDMA products. Reform, and the ensuing reduction in MDMA-related harms, will not happen overnight. The changes outlined, which culminate in a strictly-regulated, legal market for MDMA, would need to be phased in gradually and closely monitored throughout, in order to ensure that health and social outcomes are properly evaluated.
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