Mediating MDMA-related harm: preloading and post-loading among Ecstasy-using youth.

Ecstasy use remains a key concern for professionals working in fields related to youth and drug use. At the forefront of these concerns are issues related to neurological dysfunction and depression--both acute and long-term--associated with MDMA use. Ecstasy users have been shown to assess Ecstasy related harms and to engage in a variety of practices to manage these risks. To contend with risk related to neurological dysfunction and depression, some youth have turned to "preloading" and "post-loading": the practice of consuming other substances to mitigate the negative effects of Ecstasy. Drawing upon data from an ethnographic study of club drug use among youth, the author provides a descriptive profile of the practices of preloading and post-loading as well as the motivations underlying these behaviors among New York City area youth. Youth utilize a range of preloading and post-loading practices, yet do not universally share similar practices, attitudes, and knowledge. It is critical to link clinical and behavioral sciences research to further study both the efficacy and safety of these practices.