'Never drop without your significant other, cause that way lies ruin': The boundary work of couples who use MDMA together

Psychedelics as a tool for a more connected and sustainable world? Considering the importance of rituals, boundaries, and commitment

Despite the surge of interest in psychedelic research in the past decade, largely due to the promise of psychedelics for improving mental health outcomes, there has been comparatively little discussion about the social and environmental consequences of psychedelic drug use. While there is growing evidence to suggest psychedelics could foster a greater connection to the natural world and improve social relationships, such positive repercussions are far from guaranteed. In this commentary, we focus on LSD, psilocybin and especially MDMA, and outline three insights we came to see as crucial to creating beneficial outcomes: 1) the importance of setting and rituals, 2) the establishment of boundaries, and 3) understanding the long-term commitment required. These insights are grounded in the history of psychedelics, which is intimately intertwined with ritualised use, yet the process of commercialisation of these substances threatens to strip away important contextual factors. Creating boundaries around when, how and with whom psychedelics are used have been found to protect recreational users from harm and could also be instrumental in steering commercial interests to align with socio-environmental goals. Finally, far from being a 'quick fix' for social or environmental problems, the use of psychedelics requires sustained engagement to integrate the insights obtained. Whereas we remain optimistic about the transformative potential of psychedelics for social relationships and the environment, we also emphasise the need for a more cautious, considered approach if we are to harness the benefits and minimise the challenges of psychedelic drug use.

Evenings with Molly: Adult Couples' Use of MDMA for Relationship Enhancement

Within the modern resurgence of psychedelics as medicinal agents for a range of conditions, the story of MDMA (Ecstasy, Molly) has been re-narrated from a dangerous street drug to a breakthrough mental health therapy. Even still, the story of MDMA remains incomplete within a binary discourse of deviant recreational use versus psychotherapeutic-medical use. The present research aimed to uncover an emerging model of MDMA use grounded in the experiences of adult couples using MDMA privately and in the context of their committed relationships. Eight adult couples who self-reported active MDMA use were recruited for confidential in-depth interviews exploring questions related to drug, set, and setting as a general framework for understanding their private experiences with MDMA. A general inductive coding process was used to arrive at four overarching themes: Conscious Use, A Tool for Exploring, Planned Recovery, and Difficult Experiences. Couples reported making purposeful decisions about MDMA use, collaborating together on becoming physically and emotionally "set" for their drug experience. Couples described positive effects on communication, intimate bonding, and providing a relationship "tune up," among other durable changes to the relationship. An emerging cognitive-relational model of "evenings with Molly" contrasts with existing models of use by suggesting the possibility of informed, non-problematic adult use of the drug for cognitive and relational enhancement. With a small, homogenous sample reporting generally positive experiences with MDMA self-administration, findings from this study cannot be generalized. It remains unknown what proportion of the total MDMA user population might align with the non-problematic adult use of MDMA explored in this study. Additional focused investigations might examine the prevalence and varieties of non-clinical use among adults in order to arrive at rational, science-based regulatory frameworks.

Reprint of: Pharmacosex: Reimagining sex, drugs and enhancement

BACKGROUND

The use of drugs in sexual contexts is receiving closer attention in the media, public health bodies and communities than ever before. However, research to date is most often concerned with the sex-related drug use of lesbian, gay, bisexual, transgender and queer (LGBTQ) populations, and particularly men who have sex with men (MSM) engaging in 'chemsex'. Against a backdrop dominated by public health and medical science perspectives, this article seeks to move beyond prevailing sex on drug discourses characterised by risk and harm, or pleasure. Drawing on an expansive notion of enhancement, we explore intersections between drug consumption and sex via the concept of 'pharmacosex': the ways in which wider populations experiment with a range of illicit drugs that modify and enhance their sex lives in the context of broader processes of the pharmaceuticalisation of sexuality.

METHODS

Drawing on two empirical studies comprising a virtual ethnography and 45 interviews with participants across a range of gender and sexual identities who regularly combine sex and drugs, this article contributes to the growing body of research that attends to the materiality of drug consumption practices in relation to the historical and social contexts from which they emerge.

RESULTS

Our participants reported variegated and complex modes of enhancement in relation to a wide range of psychoactive substances. Participants described enhanced emotional connectedness, bodily sensations, disinhibition and desire, but they also discussed how sex enhances drug experiences. As important but currently neglected in research literature were the therapeutic dimensions of drug-taking reported, which cannot be neatly distinguished from purely hedonic motivations. While enhancement was also experienced by participants in more challenging ways in relation to shame, regret, risk and/or harm, these experiences simultaneously afforded space for the emergence of innovative practices of risk-management, safety and care.

CONCLUSION

This study exposes the diversity of practices and meanings sex-related drug use hold for participants, but also demonstrates the paucity of biomedical conceptions of sexual enhancement limited to stamina, function and libido, and the need for a more expansive approach. The study also raises questions about the extent to which contemporary discourses of self-improvement have come to 'inhabit' sexuality in the twenty-first century, and the role drugs might play in this context. By shifting the gaze from pathology to enhancement and exploring the plurality of practice, we can better understand the motivations for engaging in sex-related drug use, thereby circumventing knee-jerk counterproductive enforcement and policy responses.

Pharmacosex: Reimagining sex, drugs and enhancement

BACKGROUND

The use of drugs in sexual contexts is receiving closer attention in the media, public health bodies and communities than ever before. However, research to date is most often concerned with the sex-related drug use of lesbian, gay, bisexual, transgender and queer (LGBTQ) populations, and particularly men who have sex with men (MSM) engaging in 'chemsex'. Against a backdrop dominated by public health and medical science perspectives, this article seeks to move beyond prevailing sex on drug discourses characterised by risk and harm, or pleasure. Drawing on an expansive notion of enhancement, we explore intersections between drug consumption and sex via the concept of 'pharmacosex': the ways in which wider populations experiment with a range of illicit drugs that modify and enhance their sex lives in the context of broader processes of the pharmaceuticalisation of sexuality.

METHODS

Drawing on two empirical studies comprising a virtual ethnography and 45 interviews with participants across a range of gender and sexual identities who regularly combine sex and drugs, this article contributes to the growing body of research that attends to the materiality of drug consumption practices in relation to the historical and social contexts from which they emerge.

RESULTS

Our participants reported variegated and complex modes of enhancement in relation to a wide range of psychoactive substances. Participants described enhanced emotional connectedness, bodily sensations, disinhibition and desire, but they also discussed how sex enhances drug experiences. As important but currently neglected in research literature were the therapeutic dimensions of drug-taking reported, which cannot be neatly distinguished from purely hedonic motivations. While enhancement was also experienced by participants in more challenging ways in relation to shame, regret, risk and/or harm, these experiences simultaneously afforded space for the emergence of innovative practices of risk-management, safety and care.

CONCLUSION

This study exposes the diversity of practices and meanings sex-related drug use hold for participants, but also demonstrates the paucity of biomedical conceptions of sexual enhancement limited to stamina, function and libido, and the need for a more expansive approach. The study also raises questions about the extent to which contemporary discourses of self-improvement have come to 'inhabit' sexuality in the twenty-first century, and the role drugs might play in this context. By shifting the gaze from pathology to enhancement and exploring the plurality of practice, we can better understand the motivations for engaging in sex-related drug use, thereby circumventing knee-jerk counterproductive enforcement and policy responses.