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MDMA Experience Survey
I would like to ask you a few questions regarding your experiences with MDMA (Ecstasy). All responses are collected anonymously!
There are about 30 multiple choice questions and 3 short answer questions, but this survey should take no longer than 10 minutes to fill out.
The purpose of this survey is conducting early stage scientific study of combined effects of MDMA and substances.
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詳細
* 必須の質問です
What is your age?
*
12-17 years old
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-65 years old
65 years old or older
What is the highest degree or level of school you have completed? If currently enrolled, highest degree received.
*
Some high school, no diploma
High school graduate, diploma or the equivalent (for example: GED)
Some college/university credit, no degree
Trade/technical/vocational training
Associate degree
Bachelor’s degree
Master’s degree
Professional degree
Doctorate degree
What environment do you live in?
*
Urban
Suburban
Rural
Have you ever consumed cannabis in any form?
*
Yes
No
I don't know
Have you ever taken MDMA, X, molly, ecstasy?
*
Yes
No
I don't know
Have you ever taken MDA, sally, sass?
*
Yes
No
I don't know
Have you ever taken classic psychedelics (mushrooms, LSD, 2C-B)?
*
Yes
No
I don't know
Have you ever taken novel psychedelics or research chemicals?
*
Yes
No
I don't know
How often do you consume cannabis?
*
Every day
Few times per week
Once a week
Few times per month
Once a month
Few times a year
I do not
How often do you consume alcohol?
*
Every day
Few times per week
Once a week
Few times per month
Once a month
Few times a year
I do not
How often do you consume psychedelics? (e.g. LSD, mushrooms)
*
Every week
Few times per month
Once a month
Few times a year
Once a year
Once every few years
I do not
How often do you consume MDMA, X, molly, ecstasy?
*
Every week
Few times per month
Once a month
Few times a year
Once a year
Once every few years
I do not
How often do you consume MDA, sally, sass?
*
Every week
Few times per month
Once a month
Few times a year
Once a year
Once every few years
I do not
Do you consume MDMA, X, molly, ecstasy in pill or powder/crystal form?
Pill
Crystal/powder
Both
選択を解除
Do you test your substances before consuming them?
Yes
More often than not
Less often than not
No, I trust my dealer
選択を解除
What setting do you usually consume MDMA, X, molly, ecstasy in?
Club, rave or concert
House party
Small gathering or alone
その他:
What is the average first dose of MDMA, X, molly, ecstasy do you consume? If you consume pills, please describe the pill or the dosage in the "other" field.
80-100mg
100-120mg
120-150mg
150-200mg
200mg+
その他:
選択を解除
What is the average second dose of MDMA, X, molly, ecstasy do you consume? If you consume pills, please describe the pill or the dosage in the "other" field.
80-100mg
100-120mg
120-150mg
150-200mg
200mg+
I do not redose
その他:
選択を解除
What is the average third dose of MDMA, X, molly, ecstasy do you consume?
80-100mg
100-120mg
120-150mg
150-200mg
200mg+
I do not redose
その他:
選択を解除
How often do you dose more than 3 times in one session?
Always
More often than not
Less often than not
Never
選択を解除
Have you consumed MDMA, X, molly, ecstasy in combination with other substances? (At the same time or within 30 minutes from each other) - check all that apply
Yes, LSD or mushrooms
Yes, MDA, sally or sass
Yes, cannabis
Yes, cocaine
Yes, amphetamines
Yes, alcohol
No
Have you consumed other substances after MDMA, X, molly, ecstasy effects have worn off (~2:30-3hrs after last dose)
Yes, LSD or mushrooms
Yes, MDA, sally or sass
Yes, cannabis
Yes, cocaine
Yes, amphetamines
Yes, alcohol
Yes, benzodiazepines (Xanax, Valium, alprazolam, diazepam)
No
Have you ever experienced any of these effects of combining MDMA (Ecstasy) and cannabis/psychedelics?
Yes, dizziness
Yes, anxiety
Yes, visual hallucinations
Yes, auditory hallucinations
No
If you have answered NO to the last question - thank you for your time! Hit submit! If you have answered YES, HALLUCINATIONS to the last question - please proceed to the next questions!
What time of the day did you consume your first dose of MDMA when said hallucinations happened?
回答を入力
What time of the day did you consume your last dose of MDMA when said hallucinations happened?
回答を入力
How much cannabis did you consume coming down from MDMA? Describe: a joint? A piece of wax, or hash? Split among 3-4 people? Edible? Do you know exact THC dose?
回答を入力
Have you experienced any of this under these circumstances: you have consumed MDMA and dosed more than once. After your “roll” was over you have consumed cannabis, and after some time you have experienced:
Open-eye visual hallucinations
Closed-eye visual hallucinations
Auditory hallucinations
Disorientation
Not being able to think straight
Not being able to tell between people’s identities
Aggression
Loss of motor control
Loss of self-realization
Ego death
Bad trip
Seizure
その他:
Describe your hallucinations if you had any:
Patterns
Beings
Scenes
Closed-eye visuals
Open-eye visuals
その他:
Describe the vividness of hallucinations:
Very subtle
1
2
3
4
5
6
7
8
9
10
What I saw seemed to be real
選択を解除
Please describe your experience(s) in detail, emphasizing on the visuals:
回答を入力
Thank you for getting through this survey!
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