Dear Alice,

Me and my friends are users of X. We know that it's illegal and not good for you, but it's only a once in a while thing. My question is that I know there are different types of X pills that you can take. We have been getting motorolas and I know a friend told me that mitsubishis are really bad to take. I was wondering the differences between the pills and the differences between triple and double stacked pills......

Thank you,
curious X

Dear Curious X,

It's great that you're asking questions about different types of substances and how they affect the body when making decisions about what to use. MDMA, which has the chemical name 3,4-methylenedioxy-methamphtamine, and street names ecstasy, E, or X, is a mood elevator that aims to produce a euphoric state. It's usually sold in pill or capsule form, and may cause rushes of exhilaration, often accompanied by nausea. It can act as a stimulant, and may cause hallucinations when taken in higher doses. There are some forms of ecstasy that are stamped with a popular logo or brand name, and "Motorolas" are a common type. Double or triple stacked pills take on their name because they supposedly contain two or three times as much MDMA as regular doses. To further complicate it all, MDMA is often substituted with paramethoxymethamphetamine (PMMA) and the structurally related, paramethoxyamphetamine (PMA), and “Mitsubishis” are one of the pills that contains these substances. PMMA and PMA produce stimulant effects, but because they’re slower to take effect, people may think nothing is happening and take more, leading to a potential overdose. Because there's no regulation or quality control of illegal drugs such as Mitsubishis and Motorolas, it’s wise to be cautious because, as with any street drug, it's not always clear that you’re getting the substance you’re expecting in the potency you desire. 

A pressed MDMA pill often has a stamped symbol on the front that's meant to signify its contents, and while some symbols have a "good" reputation, there can be significant variations amongst pills with the same stamp based on regional differences. Because the pills might contain drugs other than MDMA including ketamine, coocaine, PCP, methamphetamine, and as previously mentioned, PMA and PMMA, there may be additional health risks associated with taking E that may be hard to pin down. So even if you always buy Motorolas, you can't be sure that the one you’re taking is identical to the ones you've taken before. Other common street names for MDMA are: Adam, Clarity, Eve, Lover's Speed, Peace, Uppers, Europa and RDJ, Louis Vuitton, Mercedes, Lacoste, Blue Dolphin, Crown, and Christmas trees, and many of these names are based the pill's stamped symbol. It’s worth noting that overdoses of PMMA or PMA may occur from just one pill. Common street names of PMMA or PMA include Death, Dr. Death, Pink Ecstasy, Red Mitsubishi, Killer, Chicken Powder, Chicken Yellow, Jumbo, Mitsubishi, and Superman.

That being said, whether you're using ecstasy that has PMMA in it or not, there are still some potential risks associated with its use. It has been associated with psychological effects, such as anxiety and depression. Further, it has been associated with physical side effects such as nausea and increased heart rate and blood pressure. For more information on how ecstasy may affect the body, you can read these Go Ask Alice! Q&As Ecstasy's side effects — Are any permanent? and When Ecstasy is no longer ecstasy: Coming down. It can also be helpful to be aware of the signs of an overdose from MDMA, PMA, and PMMA, which include vomiting, convulsions, seizures, high body temperature, kidney failure, and coma. Someone experiencing an overdose requires the immediate help of a medical professional.

While you mention only taking E from time to time, it might be beneficial to consider why you and your friends use it and how to mitigate risks associated with use. Have you considered other options for enjoying activities without it? Have you thought through how you might handle the situation if an unwanted effect occurs? Ultimately it'll be up to you and your friends to each determine what level of risk is acceptable. Hopefully this response has provided you with some knowledge to better make those determinations for yourself.

Alice!

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