Is XTC more harmful than alcohol?

The popular party drug XTC is used more and more every year. The Trimbos Institute writes that in 2018, 2.8% of the population had used XTC at least once. In 2019, this rose to 3.4%. In 2020, this percentage slightly decreased (to 3.1%) because almost no festivals took place, but the expectation is that in 2021 and 2022 XTC use will increase again when partying can fully resume.

We often hear discussions about whether using an XTC pill might be less harmful than a night of heavy drinking. Therefore, I have looked for interesting facts and data about both types of drugs to summarize it for you. I want to mention here that I do not want to encourage you to use one because it is less ‘harmful’ than the other. This is simply an article to enrich your knowledge to be well prepared in a conversation about XTC and alcohol.

Damage from XTC and alcohol

First of all, I want to explain the risks of both substances. Much research is still being done on the long-term negative effects of XTC. With alcohol, it is a different story because alcohol has been consumed for centuries and is, of course, legal.

After using XTC, you may experience short-term risks such as dehydration, overheating, damage to the liver, kidneys and other organs, heart problems, depressive symptoms, water poisoning, overexertion of your body, and the Tuesday dip. Long-term risks include brain damage, memory problems, concentration problems, and possible depression. These are, of course, risks that may occur, but generally, the lower the dose and frequency, the smaller the chance of the mentioned risks.

Alcohol carries risks in the short term such as alcohol poisoning, blackouts, passing out, coma, disinhibition, decreased reaction speed, lowered testosterone, poor sleep, and the well-known hangover. In the long term, the risks of alcohol are much more harmful. You can suffer damage to the liver, stomach lining, and brain. Additionally, it increases the risk of mouth cancer, throat cancer, larynx cancer, and esophageal cancer. Other risks include reduced fertility, risk of psychosis, weight loss, weight gain, and social problems. The dangerous thing is that with alcohol these risks can already arise from a few glasses per week, which may sound very innocent.

Ranking of drugs

What caught my interest is a report from the RIVM (National Institute for Public Health and the Environment) published in 2009 called Ranking of Drugs. The ranking of 19 different types of soft and hard drugs was determined based on how toxic the substance is in the short and long term, how addictive it is, and what the societal damage is. Remarkably, alcohol ended up in 3rd place and XTC (MDMA) in 13th place. From this report alone, you can conclude that alcohol is more harmful than XTC.

It should be noted that this report is from 2009 and is therefore outdated. Nowadays, XTC pills have become much stronger, writes Van der Gouwe from the Trimbos Institute. This increases the average dosage of MDMA per person, which can affect how toxic the substance is.

Addiction susceptibility

The Ranking of Drugs report took into account how addictive a certain type of drug can be, which I want to elaborate on. XTC is addictive, many people want to experience the feeling they had again, but stopping this drug is not very difficult for most people. The feeling caused by XTC cannot be experienced every day. You have to wait a few days until your serotonin level has risen again to experience the positive effects of XTC. This means you are less likely to become addicted to XTC quickly.

With alcohol, it is a different story. Unfortunately, there are no recent estimates of how often alcohol addiction occurs in the Netherlands, but from the most recent data from 2007 to 2009, it was found that alcohol dependence occurs in 0.7% of adults. However, many people who have used XTC want to use it again because the positive effect is so strong compared to drinking a few glasses of alcohol. If this happens within a short period (about two months), it can be harmful to your brain and the typical XTC ‘love’ feeling diminishes. Overall, alcohol is more addictive, but you should not forget that excessive use of XTC also carries risks.

Incidents

It is often mentioned informally that you can die from a bad XTC pill and that therefore alcohol is a safer substance. There is some truth to this, but it is important to have the correct data to make a comparison with alcohol.

The article Recreational ecstasy use in the Netherlands from 2020 analyzed several interesting studies worldwide to reach a conclusion about the safety of XTC. Fatal XTC incidents are not registered in the Netherlands, but because this is done in England and Wales, an estimate can be made of the number of fatal XTC incidents in the Netherlands. This number comes to a maximum of 37 MDMA-related deaths per year. The report describes that based on this data, XTC is not a safe drug and that its use poses a health risk that should not be underestimated. But calculated per user or per pill, the risk of XTC is relatively low and the number of fatal incidents per user is comparable to that of alcohol.

I want to mention here that comparing these data is very difficult. The cause of death is often not directly due to a bad pill but can also be in combination with other types of drugs or an overdose. This also applies to excessive alcohol use. Additionally, XTC is currently an illegal substance. If the use of XTC is legalized, a maximum strength per pill can be set. Arguments for legalizing XTC even mention that the government could produce XTC pills. This would lead to fewer ‘bad’ pills in circulation and the exact ingredients would be known, resulting in fewer health incidents. These are, of course, assumptions. To minimize the risks of XTC yourself, you should always have your pill tested beforehand.

Dosage

When you take the recommended amount of XTC, you can experience the desired effects for a few hours. The feeling caused by XTC can really take you to another world. After a few hours, this effect ends and it is recommended to wait at least two months before using XTC again.

Alcohol is easier to dose. You could drink 1 to 2 glasses of alcohol every day without really feeling major effects in the short term. The Nutrition Center advises drinking a maximum of 1 glass of alcohol per day. With a maximum of 0.5 per mille (about 2 glasses) alcohol in your blood, you may even drive as an experienced driver. With XTC, no dosage is recommended for driving. This is of course also because XTC is an illegal substance, but as I mentioned, XTC can cause a stronger effect at a lower dose compared to alcohol.

In conclusion

The question ‘Is XTC more harmful than alcohol?’ is therefore difficult to answer because they are two completely different types of substances with different proportions, but when someone asks you the question, you are now well prepared with the correct facts and data about both substances. If you make sure not to exceed the recommended amounts, you can perfectly take a pill now and then and enjoy a nice glass of alcohol here and there!

Are you curious about tips against an XTC hangover or the Tuesday dip? Check this page!

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