MDMA and blood donation

How much time should elapse between taking MDMA and donating blood?

Hi DoctorX,
Some days ago I went to donate blood in my local community center (they do this several times a year). However, when I said I had used MDMA two weeks earlier, they told me they could NOT use my blood.

Does this make any sense to you?

It was this really old fashioned looking rectal-exam type head nurse who looked «not amused», so it could very well be prejudice on her part. Should I simply not mention it next time?

Originally posted in SR 2.0 6/4/14 . Reviewed 14/2/23

No, it doesn´t make any sense at all.

The time and speed it takes for a given substance to be  eliminated from the body depends on  factors related to pharmacology.

And the most important of these is the «elimination half-life»: the time it takes for the body to eliminate half of the drug (t1/2). The t1/2 for MDMA is 9 hours.

100% of a drug is eliminated between 7 and 10 elimination half-lives.

For instance, the t1/2 for MDMA is 9 hours: and 100% of the drug is eliminated between 7 and 10 elimination half-lives, which is between 63 and 90 hours after use.

Two weeks after use, not a single molecule of the dose consumed will remain.

The WHO Clinical Guideline on Donation recommends that people with a history of intravenous drug use should not donate blood. This is a reasonable precautionary principle (possibility of undetected blood-borne viruses).

Regarding recreational drug use, the guideline states:

«There is no documented evidence that a donor’s recent ingestion of a «recreational» drug or alcohol has caused harm to the recipient of his or her blood. As in the case of prescribed medication,(…)  the recipient of the blood receives a very small residual amount,. This is unlikely to have any adverse effects».

And it only recommends discarding the donor in the case of obvious signs of intoxication at the time of donation, which also seems reasonable

Rejecting a blood donor solely on the basis of having consumed MDMA two weeks earlier is not justified on clinical grounds.

So, in a nutshell,

  • Rejecting a blood donor solely on the basis of having consumed MDMA two weeks earlier is not justified on clinical grounds.
  • Whether the nurse looks old-fashioned, dull, or has a face like the one you describe is not very important. That is all her problem. What is serious is the ignorance and prejudice that many health workers have towards drug users.
  • Technically, I can’t recommend  «don’t say anything» next time. If a health professional refuses your blood donation, you have the right to request a written explanation based on official guidelines. You could submit a written complaint to the hospital. And you could provide the documentation attached to this post.
  • Donating blood is an act of generosity. while you have the right to follow up on any mistreatment, you are not required to make extraordinary efforts.

Oxycodone, benzos and alcohol risks

How much Xanax and Oxycontin would be fatal when consumed together with alcohol and how much alcohol would cause problems? I know that drinking increases it greatly but I want to know if I can at least have a few, or does it all depend on height and weight?

Originally posted in SR 2.0 . Reviewed 12/2/23

Benzodiazepines, alcohol or oxycodone are rarely fatal in overdose because they do not produce respiratory depression (or do so in extraordinarily high doses). But the risk increases when combining two substances, and even more mixing all three

It is very difficult to know exactly what is the dose above which the risk is elevated. They are drugs with different pharmacological properties. Weight, sex, age and tolerance are also factors to be considered.  Low-dose combinations probably does not  increase the risk of death, but uncomfortable adverse effects (such as amnesia) are very likely to occur.

In a series of 575 deaths attributed to oxycodone in Sweden between 2006-2018, the most commonly detected drugs were benzodiazepines (70%) and alcohol (50%). Another similar study found the same association between the three substances, with alprazolam (Xanax, Trankimazin). In this series, these appeared as   as the benzodiazepine most associated with oxycodone poisoning deaths.

There are anecdoticar reports of cases of death caused by  the combination of oxycodone and clonazepam at high doses


Expiry of benzodiacepines

Hey DoctorX,
What is the best method of storing pills (Xanax, Valium, ect)..?
Also how long does it take for them to start loosing thier potency..?

Originally posted in SR 2.0 9/6/14 . Reviewed 11/2/23

Benzodiacepines can be stored in «normal» conditions. There is no need for frigdes or special containers (unless you live in a ecuatorial or tropical country).

In a environment of 10-25ºC, no extreme humidity and no direct sunlight, they will keep their quality for several years. A noticeable lose of potency will occur 5-10 years after production.

LSD and chest pain

Are LSD and chest pain related?

Hey Doc, i have a question about some (presumably) LSD and chest pain i took:

So i got it from a reputable SR vendor  and tried out a single 100-125 ug tab. Only experience with drugs before this (except alcohol and tobacco) is weed a single time. I ate probably both too much and the wrong things (meat) before the trip, but i haven’t read that this could cause these pains.

In fact, the experience went pretty well. However, i had for some time this persistent ache in my leftmost chest. During the trip i took notes and described it as a warm feeling like my chest muscles/heart was slowly melting down across the chest. A week later i microdosed 25 ug and had that same feeling. It was a single, short stab of pain in that area as well. Not too extreme but strong enough to worry me.

It tasted only slightly metalic, not bitter as i’ve read NBOMES do, but mostly sort of sour, and the taste lingered slightly throughout the trip.

So, I hope it was just have been panic attacks (the first time was just fuck-all overwhelming, and i accidentally swallowed the microdose after some time and thought it wouldn’t work, so that trip wasn’t entirely expected either), but i’d like to hear a qualified view on it.

Originally posted in SR 2.0 7/6/14 . Reviewed 11/2/23

It is impossible to know what has happened without knowing the content of the substance.

Chest pain is a possible symptom of a panic attack after taking psychedelics, but it is usually accompanied by psychological symptoms (anxiety, fear, etc.). Chest pain of cardiac origin tipically is «tightness radiating to the left arm» and accompains with nausea and vomiting.

In fact, LSD does not produce noticeable cardiovascular effects. A few psychedelics currently available in the market (NBOMEs, bromodragonfly, DO-X) are  active in microgram doses. There substances are sometimes counterfeits of LSD. And all these substances have considerable organic toxicity, which is absent in LSD.

LSD blotters or drops fluoresce if placed under a black light (the type of light used in some nightclubs). The technique is a bit rudimentary but it allows at least to rule out certain counterfeits. So, a Drug Checking Service is the ideal option, if available.


Speed and depression

Are speed and depression linked?

Dear DoctorX,

I´ve wanted to know if somebody has a depression on the base of drugs like speed nearly 2 till 3 gramm a day,
after a few years u can lose this drug- induced depression or it´s changed the hole personalitiy as u think you ´re the same as before?

Originally posted in SR 2.0 7/6/14 . Reviewed 11/2/23

The prolonged and high-dose consumption of stimulants, such as speed, can lead to psychological problems during use and in the weeks and months following withdrawal. The withdrawal symptoms of stimulants can cause depression.

Depression and other mental health issues are rarely caused by a single factor but rather by a combination of factors. It is unlikely that depression lasting for years is solely due to prolonged stimulant use. There are likely to be other contributing factors.

On the other hand, some individuals may use illegal drugs as a means of self-medicating for mental health problems or life’s challenges. However, this approach is not usually effective in the long term.

In reality, drugs, including both legal psychotropics and controlled substances, cannot cure depression. Antidepressants can provide individuals with the means to cope with their problems, but no pill can heal the problems of the brain, psyche, spirit, or soul