I feel like the summary in the introduction is somewhat at odds with the content? You say
Unfortunately the evidence is very strongly on the side of “dangerous”. Retrospective studies of long term users show cognitive deficits not found in other drug users, while animal studies show brain damage and inconsistent cognitive deficits.
But then you also say that
Retrospective user studies look bad but results seem pretty confounded. The studies comparing MDMA users to users of other street drugs give inconsistent results, as some say MDMA users do worse than other drug users and some say they only do worse if they also combine the use with alcohol.
Only some animal studies show actual cognitive defects and the ones that do use doses that are crazy high. Possibly this works to simulate long-term use but it’s also possible that it doesn’t because the brain will heal between doses.
Controlled human studies don’t show much, MAPS claims no significant cognitive defects though it’s suspicious that they don’t share some of their data.
I do agree that this is reason to be concerned and that you might want to avoid MDMA because of this, but this sounds to me like “suggestive but inconsistent and often low-quality evidence” rather than “very strong evidence”.
I feel like the summary in the introduction is somewhat at odds with the content? You say
But then you also say that
Retrospective user studies look bad but results seem pretty confounded. The studies comparing MDMA users to users of other street drugs give inconsistent results, as some say MDMA users do worse than other drug users and some say they only do worse if they also combine the use with alcohol.
Only some animal studies show actual cognitive defects and the ones that do use doses that are crazy high. Possibly this works to simulate long-term use but it’s also possible that it doesn’t because the brain will heal between doses.
Controlled human studies don’t show much, MAPS claims no significant cognitive defects though it’s suspicious that they don’t share some of their data.
I do agree that this is reason to be concerned and that you might want to avoid MDMA because of this, but this sounds to me like “suggestive but inconsistent and often low-quality evidence” rather than “very strong evidence”.