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If You Had to Legalize One Drug Besides Weed Which One Would You Choose?

Question by Jake: If you had to legalize one drug besides weed which one would you choose?
Your choices are:
mdma
heroin
dmt
or…
ghb

and tell me why?

Best answer:

Answer by Mathieu
Firstly are you talking about legal for medical use (like morphine or amphetamine) or legal for recreational use (like alcohol)?

In general you would have to determine what risks a drug has (physical harm, abuse potential, harm to community and individual) and benefits the drug has (medical use).

GHB is already a prescription drug called Xyrem (sodium oxybate). It uses the name sodium oxybate to avoid the stigma of GHB. And I certainly support the legality of Xyrem when treating narcolepsy especially with cataplexy. I would not want this to be available for recreational use largely due to the fact that mixing it with alcohol or prescription benzodiazepines (Xanax, Valium, Ativan) or barbiturates (Seconal, Butisol, Phenobarbital) is very likely to result in death without immediate medical assistance. Almost all, if not all, GHB deaths have been from respiratory depression associated with alcohol and other drugs. In terms of abuse, physical harm, and harm to society it is fairly safe (more so than alcohol or smoking).
Information about it is at www.xyrem.com

DMT is not something I would legalize because it has no significant medical value however compared to other drugs its abuse potential is low, it really needs to be taken with a MAOI-A which is a reversible inhibitor of monoamine oxidase like minaprine. Due to the additional requirement of obtaining an MAOI (which is a type of antidepressant) the abuse potential is reduced. There are also potential risks when using an MAOI.

It is becoming more and more evident that MDMA is actually a very safe drug, more so than marijuana, alcohol, or tobacco when it is pure. Most MDMA used recreationally is NOT pure and death from using ecstasy is almost always a result of other substances in the tablet or prescription drug interactions. Use of MDMA with an MAOI is often lethal without very rapid medical attention. Medically MDMA has been used in psychotherapy and it was actually very effective.

Heroin (diacetylmorphine) is the big stand out of the group, it is the “hard” drug and heroin is almost universally considered the most dangerous drug of abuse. However heroin does indeed have a well known medical use as an analgesic (pain killer). Heroin, used under the name diamorphine is a legal medication in The United Kingdom and it is used much in the same way as morphine is used. Many countries such as Canada have allowed limited access programmes to permit people with severe pain (typically from cancer or AIDS) that is not well controlled with other opioids to use heroin. In countries where heroin is used medically it is typically only used in hospitals other in-patient heath care facilities, under significant supervision, and diversion is extremely rare. Also dozens of studies have shown that use of full (aka pure) opioid agonists like morphine, oxycodone, oxymorphone, hydromorphone, fentanyl, or methadone have the SAME risks of physical harm, harm to society, and risk of addiction. For example IV heroin addicts are not able to distinguish a difference when another opioid is used in equivalent amounts. Additionally oxymorphone, hydromorphone, and especially fentanyl are more potent than heroin. Heroin is a prodrug meaning it has no pharmacological actions instead it breaks down into the active substance which is primarily morphine. Heroin is for all intensive purposes morphine but heroin enters the brain a bit faster, then it turns into morphine for a faster, “bigger” high. However when an equal amount of morphine is given there is no difference in the high.

Having said all of that I would say I want heroin made legal for medical use. The reason being that it has a very significant medical use and despite all the hysteria about heroin it is no more dangerous as legal opioids. In fact methadone and dextropropoxyphene are both prescription and both have absurdly high mortality rates. Dextropropoxyphene has been withdrawn from medical use in The UK and a FDA board has recommended it be withdrawn in the US because it is only slightly more effective than Aspirin, it is always abused in very large amounts, it is cardiotoxic, and mortality is highly disproportionate to use.

If it was a drug for recreational (and potentially medical) use I would say MDMA simply because it has some medical use and recreational use of it is safer than any of the other drug you list. MDMA is the only drug I have ever herd people talk about what a positive experience it was, sometimes life changing, without leading to any abuse or negative consequences.

Answer by Jefferson
For medical use, I think MDMA should be legalized. The Multidisciplinary Association for Psychedelic Studies (http://www.maps.org) is currently sponsoring FDA approved studies testing the efficacy of MDMA as an adjunct to psychotherapy for treating post traumatic stress disorder. So far the results are very promising. It seems to offer a long term solution to the problem, helping people deal with the underlying causes, rather than requiring patients to remain on medication for extended periods of time.

Regarding non-medical use, I would still say MDMA. Most of the problems associated with Ecstasy use are the result of tablets adulterated with substances other than MDMA. If there were some kind of regulation and quality assurance that ecstasy tablets contained only MDMA, many of these problems would be nonexistent. Research has shown that MDMA itself is relatively safe with a low to moderate potential for addiction, while the substances often contained in “Ecstasy” tablets are far more dangerous. That, and I also just really like MDMA and would like to see it legalized 🙂