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. Author manuscript; available in PMC: 2023 Jan 1.
Published in final edited form as: Addict Res Theory. 2021 Jun 24;30(2):96–103. doi: 10.1080/16066359.2021.1940972

Media coverage about medical benefits of MDMA and ketamine affects perceived likelihood of engaging in recreational use

Joseph J Palamar a, Austin Le a,b
PMCID: PMC9122108  NIHMSID: NIHMS1719765  PMID: 35601078

Abstract

Background:

Research on the efficacy of ketamine in treating depression and 3,4-methylenedioxymethamphetamine (MDMA) in treating post-traumatic stress disorder have been widely covered by the media. Given recent widespread coverage of the efficacy of these drugs, it is important to determine whether such coverage influences prevalence of recreational use. While longitudinal studies would be most ideal for assessing this, to acquire preliminary data, we tested survey items assessing this potential phenomenon in a population known for high prevalence of use of these drugs.

Method:

Adults entering randomly selected nightclubs in New York City (n = 209) were surveyed about drug use. Questions were included to assess their perceived likelihood of recent media coverage about medical benefits associated with use of ketamine and MDMA affecting their own use.

Results:

Two-thirds (66.8%) of participants had ever used ecstasy/MDMA and 22.6% had ever used ketamine. The plurality of participants reported that media coverage about ketamine (46.1%) and MDMA (39.9%) did not affect their likelihood of using. 10.1% and 21.0% of participants reported increased likelihood of using ketamine and MDMA, respectively. 52.3% of those reporting past-month ketamine use and 6.1% of those reporting no lifetime use reported being more likely to use in response to media coverage about ketamine. 28.6% of those reporting past-month ecstasy use and 5.5% of those reporting no lifetime use reported being more likely to use in response to media coverage about MDMA.

Discussion:

Media coverage about the medical benefits of ketamine and MDMA might influence specific subsets of people to use.

Keywords: Ketamine, MDMA, media, nightlife, club drugs, intention to use

Introduction

There has been a recent resurgence of research on medicinal uses of psychedelics and related drugs (Pollan 2018). Much of this attention has been on drugs that are available in natural form, such as psilocybin and ayahuasca (Davis et al. 2021; Zeifman et al. 2021), but attention is also being increasingly directed toward synthetic drugs that have psychedelic or hallucinogenic effects – namely ketamine and 3,4-methylenedioxymethamphetamine (MDMA). As a result, media coverage and public discourse on the medical benefits of using ketamine and MDMA has grown. It has been known for some time that media has the capacity to influence drug use patterns (Fan and Holway 1994; Reis et al. 1994; Lu et al. 2014; Palamar et al. 2020) as well as health-related behaviors in general (Yanovitzky and Blitz 2000; McIntosh and Blalock 2005; Niederdeppe et al. 2017), but it currently remains unknown whether recent press coverage of ketamine and MDMA is affecting individuals’ intentions to use these drugs in a recreational manner.

Ketamine in particular has gained extensive media attention over the past two years. Results from multiple randomized double-blind controlled-placebo trials have found that intranasal non-anesthetic doses of esketamine, an enantiomer of ketamine, has an ultra-rapid antidepressant effect among those with major depression disorder, lasting for at least 28 days (Zheng et al. 2020). On 5 March 2019, the US Food & Drug Administration (US FDA 2019) approved esketamine nasal spray for treatment-resistant depression. Their announcement led to extensive media coverage about the efficacy of treating depression with this dissociative drug. However, major news sources, including Fox News, CBS, ABC, and NBC, commonly referred to ketamine as a party drug, a club drug, or even its street name, ‘Special K’. USA Today and The New York Times – two of the most circulated news sources in the US, also referred to ketamine as a party drug in article titles or subtitles (Bacon 2019; Carey 2019). It is unknown, however, if referring to such drugs as common recreational drugs affects readers’ intention to use in a recreational manner.

Although most media attention in recent years has focused on medical use of ketamine, the potential medical benefits of MDMA – also known as ecstasy, or Molly when in powder or crystalline form – have also been discussed relatively widely over the past five years. MDMA was first used as an adjunct to psychotherapy in the US in the 1970s, but such use was halted when the US Drug Enforcement Administration (US DEA) classified the drug as a Schedule I controlled substance in 1985 in response to increased popularity in recreational use (Climko et al. 1986). However, in the past decade, research has investigated the drug’s efficacy in treating post-traumatic stress disorder (PTSD), and randomized, double-blind phase II trials have determined that MDMA in combination with psychotherapy were effective at reducing PTSD symptoms among veterans and first responders (Mithoefer et al. 2018). Consequently, the efficacy of MDMA in treating PTSD has been covered somewhat extensively by the media in recent years (Phillips 2018). However, similar to ketamine, many major media outlets, including The New York Times, Fox News, CBS, and PBS, have referred to MDMA as ecstasy – the ‘street’ name of the drug – in article titles. The most recent large cluster of coverage occurred in early 2020 when the Multidisciplinary Association for Psychedelic Studies (MAPS) – the leading funder of MDMA research – acquired approval from the FDA to expand access to MDMA-assisted psychotherapy to treat PTSD (MAPS 2020).

To our knowledge, no studies have yet investigated whether the recent increase in media coverage on the medical benefits associated with ketamine and MDMA use have influenced recreational or nonmedical use of these synthetic drugs. Estimates of use of these two drugs have remained relatively stable in the US in recent years. For example, an estimated 2.0% of high school seniors (12th graders) in the US used ecstasy in 2018 and in 2019, and an estimated 1.0% if individuals age ≥18 in the US used in these years (Center for Behavioral Health Statistics and Quality 2020; Miech et al. 2020). Estimated past-year use of ketamine use has also remained stable at 0.7% among high school seniors in 2018 and in 2019 (Miech et al. 2020). Among electronic dance music (EDM) party attendees in New York City, prevalence of ecstasy use, while relatively stable, is significantly higher, hovering between 25.0 and 28.5% from 2016 to 2019, while ketamine use nearly tripled from 5.9% in 2016 to 15.3% in 2019 (Palamar and Keyes 2020).

Continued examination of trends in use based on repeated cross-sectional surveys may help determine whether trends in use are influenced by increasing media coverage, but national drug surveys are lagged. Longitudinal studies investigating potential changes in drug use behavior in relation to shifts in media coverage would be most ideal when trying to determine effects of coverage on use. Given the current lack of data from such high-quality designs, to acquire preliminary information on the potential influence of media coverage affecting use, we added questions to our rapid drug survey to acquire preliminary information regarding whether such coverage may influence intentions to use.

This study focuses on EDM party attendees as this population reports higher prevalence of use of party drugs such as ketamine than non-attendees in population studies (Palamar et al. 2015). Given that our study is cross-sectional in nature and not longitudinal, we asked a portion of participants from our parent study whether recent media coverage about the medical benefits of ketamine and MDMA affect their perceived likelihood of using the drugs recreationally. We believe self-reported perceived likelihood of use is important as a similar construct – intention – is the most proximal predictor of engaging in a behavior such as drug use according to the Theory of Planned Behavior and the Theory of Triadic Influence (Ajzen 1985; Flay et al. 2009). Longitudinal studies have also confirmed that intention to use ecstasy strongly predicted later use (Umeh and Patel 2004; Ramchand et al. 2013; Palamar et al. 2018). Intentions to engage in a behavior do not always translate into that behavior (Ajzen 1987), but this is an important concept to examine. In this study, we examine intentions among EDM party attendees to use ketamine and ecstasy in response to media coverage about benefits, and we examine correlates of reporting that one is more likely to use in order to inform prevention and harm reduction efforts where warranted.

Method

Procedure

A multi-stage sampling design was used to survey participants in this study. Each week, parties were randomly selected from an extensive weekly list (at the design stage), and then attendees entering randomly selected parties were surveyed (MacKellar et al. 2007). Although party selection was random, in order to conserve resources, we aimed to survey as many eligible individuals as possible rather than every nth individual (Parsons et al. 2008). Each week, a party selection list was constructed based on parties listed on popular EDM ticket websites and nightclubs that consistently held EDM parties on specific nights. Random selection of parties was conducted using R 3.5 software (R Core Team 2019). Recruitment typically occurred on 1–2 nights per week on Thursday through Sunday. To be eligible, individuals must have been about to enter the randomly selected party and report being age ≥18. Those about to enter parties were approached by a recruiter, and, if eligible, were asked if they were willing to take a university survey about drug use. Those interested in participating provided informed consent (on a page which preceded the first page of the survey) and then self-administered the anonymous survey on a tablet. The survey typically took about 10 minutes to complete. The parent study surveyed 1109 participants in 2019–2020, but the portion of the study in this analysis focuses on the 209 participants surveyed outside of 15 parties from November 2019 through February 2020 as these individuals were also queried about intention to use psychedelics in response to media coverage. The survey response rate was 75.3%. This study was approved by the New York University Langone Medical Center institutional review board.

Measures

Participants were asked about their age, sex, race/ethnicity, educational attainment, sexual orientation, and frequency of past-year EDM party attendance. With respect to drug use, they were asked whether they had ever used ketamine or ecstasy (MDMA, Molly) and when they had last used. Response options were never, in one’s lifetime but not in the past 12 months, in the past 12 months but not in the past 30 days, and in the past 30 days. They were also asked about use of other drugs including cannabis, powder cocaine, and LSD. Later in the survey, it was stated at the top of a page that, ‘Studies have been finding that use of drugs like ketamine and MDMA in medical settings has been effective at reducing depression and/or anxiety in patients.’ Below this statement participants were asked, ‘Does increasing media coverage about the medical benefits of ketamine affect whether you’d use (recreationally) in the future?’ Answer options were ‘No, it has no effect’, ‘I’m more likely to use’, ‘I’m less likely to use’, and ‘I don’t know’. They were then asked the same question regard to MDMA and provided with the same answer options.

Statistical analysis

We first described participant characteristics and estimated likelihood of using ketamine and MDMA in response to media coverage. We then compared recency of use of the corresponding drug according to whether or not participants reported a higher likelihood of use. This was done via Rao-Scott chi-square. We then fit all demographic and drug use characteristic variables as independent variables into two multivariable models to determine correlates of reporting increased likelihood of using (1) ketamine and (2) MDMA, in response to media coverage. Specifically, all independent variables were fit into generalized linear models using Poisson and log link to generate adjusted prevalence ratios (aPRs) for each variable. The same variables were entered into both models with exception of recency of ketamine and ecstasy use. The model in which ketamine use likelihood was the outcome included a variable indicating how recently ketamine was used (compared to ‘never used’), and the model with MDMA use likelihood as the outcome contained a similar variable but for ecstasy use recency.

In order to make estimates more generalizable to the EDM party-attending population, we calculated and utilized sample weights. These weights were based on the proportion of party attendees who completed a survey (out of the number of passersby counted entering the party on the night of survey) and each surveyed individual’s reported frequency of EDM venue attendance (Jenness et al. 2011). This was done because those attending venues with a higher proportion of party attendees surveyed and those attending venues more frequently are believed to have a higher likelihood of being sampled (MacKellar et al. 2007). In addition to use of weights, parties were accounted for as strata when specifying the complex survey design. Data were analyzed using Stata 13 SE (StataCorp 2013) and survey commands were used to generate estimates (Heeringa et al. 2010).

Results

Sample characteristics are presented in Table 1. Two-thirds (66.8%) of participants had ever used ecstasy and 22.6% had ever used ketamine. Estimates of how media coverage of the medical benefits of ketamine and MDMA affect participant’s perceived likelihood of future use are presented in Figure 1. With respect to ketamine, the plurality (46.1%) reported that media coverage has no effect on their decision to use, while a tenth (10.1%) reported being more likely to use, 18.8% reported being less likely to use, and a quarter (25.0%) reported not knowing if coverage would affect their decisions to use. With regard to ecstasy, the plurality (39.9%) reported that media coverage has no effect on their decision to use, 21.0% reported being more likely to use, 19.7% reported being less likely to use, and 19.3% reported not knowing if coverage would affect their decisions to use. Figure 2 presents estimates of participants self-reporting a higher likelihood of use according to recency of use. Among those who have never used ketamine, 6.1% reported an increased likelihood of use owing to media coverage of medical benefits. These estimates increased with recency of use. 24.1% of those who used ketamine in their lifetime reported a greater likelihood to use owing to media coverage, as did 44.2% of those reporting past-year use and over half (52.3%) of those reporting past-month use (ps<.001). Among those who have never used ecstasy, 5.5% of participants self-reported an increased likelihood of use (initiation), and these estimates increased along with recency of use, with 28.7% of those reporting lifetime use, 40.7% of those reporting past-year use, and 28.6% of those reporting past-month use (ps<.001).

Table 1.

Sample characteristics (n = 209).

Weighted % n
Age
 18–24 years 30.5 68
 25–29 years 43.2 75
 ≥30 years 26.2 66
Sex
 Male 59.5 142
 Female 40.5 67
Race/ethnicity
 White 35.8 102
 Black 7.4 23
 Hispanic 35.2 34
 Asian 13.1 25
 Other/mixed 8.6 25
Education
 High school or less 10.5 30
 Some college 18.8 46
 College degree 70.7 133
Sexual orientation
 Heterosexual 76.2 124
 Gay/lesbian 10.9 42
 Bisexual 8.7 31
 Other sexuality 4.2 12
Ecstasy/MDMA use
 Lifetime use 66.8 152
 Lifetime, not past year use 35.2 58
 Past-year, not past month use 18.8 50
 Past-month use 12.7 44
 Never used 33.2 57
Ketamine use
 Lifetime use 22.6 91
 Lifetime, not past year use 11.7 31
 Past-year, not past month use 5.1 22
 Past-month use 5.8 38
 Never 77.4 118
Other past-year drug use
 Marijuana 72.7 167
 Powder cocaine 45.7 108
 LSD 19.8 69
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Figure 1.

Figure 1.

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Estimates of how media coverage of the medical benefits of ketamine and MDMA affect likelihood of future use.

Figure 2.

Figure 2.

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Estimates of reporting higher likelihood of ketamine and MDMA use according to recency of use.

Table 2 presents estimates of self-reported likelihood of using according to demographic and drug use characteristics. With all else being equal, compared to those ages 18–24, those ages 25–29 were less likely to report increased likelihood of using ketamine in response to media coverage (aPR = 0.25, 95% CI: 0.11–0.60), and compared to white participants, those identifying as Hispanic were less likely to report increased likelihood (aPR = 0.01, 95% CI: 0.00–0.07). Compared to those identifying as heterosexual, those identifying as gay/lesbian (aPR = 0.28, 95% CI: 0.11–0.70) or bisexual (aPR = 0.12, 95% CI: 0.03–0.57) were less likely to report increased likelihood of using ketamine, and compared to those who have never used ketamine, those reporting past-year but not past-month use (aPR = 3.75, 95% CI: 1.22–11.52) and those reporting past-month use (aPR = 8.50, 95% CI: 3.40–21.24) were more likely to report increased likelihood of using again.

Table 2.

Participant demographic and drug use characteristics in relation to reporting increased likelihood of using ketamine and MDMA in response to media coverage about medical benefits.

Ketamine Ecstasy/MDMA
Not more likely to use Weighted % More likely to use Weighted % aPR (95% CI) Not more likely to use Weighted % More likely to use Weighted % aPR (95% CI)
Age
 18–24 years 84.4 15.6 1.00 67.2 32.8 1.00
 25–29 years 96.2 3.8 0.25 (0.11–0.60) 92.2 7.8 0.19 (0.06–0.56)
 ≥30 years 85.9 14.1 0.83 (0.37–1.85) 71.0 29.0 0.53 (0.26–1.11)
Sex
 Male 88.0 12.0 1.00 78.4 21.6 1.00
 Female 92.7 7.4 0.53 (0.18–1.53) 79.8 20.2 1.01 (0.40–2.57)
Race/ethnicity
 White 82.5 17.5 1.00 79.9 20.1 1.00
 Black 96.0 4.0 0.23 (0.05–1.14) 86.0 14.0 0.93 (0.19–4.51)
 Hispanic 99.8 0.2 0.01 (0.00–0.07) 74.2 25.8 1.80 (0.70–4.58)
 Asian 86.7 13.3 1.08 (0.39–2.96) 78.0 22.0 1.02 (0.21–4.96)
 Other/mixed 79.6 20.4 0.70 (0.33–1.50) 90.4 9.6 0.42 (0.11–1.54)
Education
 High school or less 95.6 4.4 1.00 95.6 4.4 1.00
 Some college 89.3 10.7 1.42 (0.29–7.02) 82.7 17.3 4.44 (1.04–18.88)
 College degree 89.2 10.8 2.57 (0.75–8.84) 75.5 24.5 4.50 (1.19–17.08)
Sexual orientation
 Heterosexual 89.5 10.5 1.00 79.7 20.3 1.00
 Gay/lesbian 85.2 14.8 0.28 (0.11–0.70) 70.6 29.4 1.28 (0.48–3.38)
 Bisexual 96.7 3.3 0.12 (0.03–0.57) 85.4 14.6 0.62 (0.11–3.45)
 Other sexuality 94.6 5.4 0.37 (0.06–2.19) 75.1 24.9 1.16 (0.31–4.28)
Recency of use
 Never 94.0 6.1 1.00 94.5 5.5 1.00
 Lifetime, not past year 94.8 5.2 0.67 (0.10–4.58) 82.0 18.0 4.53 (0.95–21.50)
 Past-year, not past month 64.9 35.1 3.75 (1.22–11.52) 51.1 48.9 6.20 (1.43–26.92)
 Past month 47.7 52.3 8.50 (3.40–21.24) 71.4 28.6 4.40 (1.01–19.15)
Past-year other drug use
 Marijuana 88.9 11.1 0.98 (0.27–3.55) 75.5 24.5 1.55 (0.51–4.76)
 Powder cocaine 89.0 11.0 0.64 (0.27–1.54) 77.7 22.3 1.09 (0.47–2.55)
 LSD 78.9 21.1 1.35 (0.56–3.25) 67.5 32.5 2.52 (1.23–5.18)
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aPR: adjusted prevalence ratio; CI: confidence interval.

Row percentages are presented when comparing whether participants report an increased likelihood of using ketamine or MDMA in light of seeing media coverage about medical benefits. Recency of use applies to recency of use of the drug being asked about; specifically, recency of use refers to ketamine use in the ketamine-related columns and it refers to MDMA use in the MDMA-related columns. 10.1% of participants reported increased likelihood of using ketamine and 21.0% reported increased likelihood of using MDMA.

With respect to ecstasy use (Table 2), compared to those ages 18–24, those ages 25–29 were less likely to report increased likelihood of using in response to media coverage (aPR = 0.19, 95% CI: 0.06–0.56), and compared to those reporting an education of high school diploma or less, those with some college (aPR = 4.44, 95% CI: 1.04–18.88) or a college degree or higher (aPR = 4.50, 95% CI: 1.19–17.08) were more likely to report increased likelihood of using ecstasy in response to media coverage. Compared to those who have never used ecstasy, those reporting past-year but not past-month use (aPR = 6.20, 95% CI: 1.43–26.92) and those reporting past-month use (aPR = 4.40, 95% CI: 1.01–19.15) were more likely to report increased likelihood of using again. In fact, 48.9% of those reporting past-year but not past month use reported intention to use. Finally, those reporting past-year LSD use were also more than twice as likely to report increased likelihood of using ecstasy (aPR = 2.52, 95% CI: 1.23–5.18).

Discussion

Over the past decade, the scientific literature has seen a surge in research investigating the benefits of using ketamine and MDMA therapeutically to treat depression and PTSD, respectively. Efficacy of findings from clinical trials has been positive (Mithoefer et al. 2018; Zheng et al. 2020), which has led to rather extensive media coverage on the medical benefits of using these drugs (Phillips 2018; Scutti 2018; Carey 2019; Huzar 2020). It is currently unknown whether such media coverage has influenced recreational use of these drugs. Given the current lack of longitudinal or repeated cross-sectional national data to thoroughly examine whether changes in prevalence have been occurring, we included questions on our rapid drug survey asking participants about their perceived likelihood of changing use of these drugs in response to such media coverage. Our study sought to determine whether such media coverage has affected the perceived likelihood of engaging in recreational or nonmedical use of ketamine and MDMA.

Previous studies have demonstrated that increased media coverage about drugs can have a significant impact on the prevalence or intention to use said drugs (Lu et al. 2014; Palamar et al. 2020). For example, the salient drop in cocaine use in the late 1980s has been meaningfully attributed to anti-cocaine coverage by the press (Fan and Holway 1994), while successes in the commercial sector have established that widespread exposure through mass media certainly has the capacity to induce behavior change in large groups of people (DeJong and Winsten 1990). Likewise, it has been found that coverage of celebrity endorsements of screening for breast cancer or BRCA gene testing has led to significantly increased rates of screening in the general population (Chapman et al. 2005; Desai and Jena 2016). For these reasons, it is plausible that a potentially unintended consequence of increased media coverage on the medical benefits of MDMA and ketamine use is a possible increase in the prevalence of recreational use. Findings from our study suggest that the plurality of respondents (EDM party attendees) do not anticipate that media coverage on the medical benefits of ketamine and MDMA will increase the likelihood of them using these drugs recreationally in the future.

Potentially important findings arise when we further explore the data in terms of recency of use. Attendees who used either ketamine or ecstasy/MDMA in the past month (or past year but not the past month) were much more likely to indicate a greater likelihood of using recreationally in the future as a result of media coverage. In fact, 52.3% of those reporting past-month use reported being more likely to use again in response to media coverage. It is possible that these individuals, especially those who used in the past month, were already exposed to and influenced by the recent media coverage of these drugs and intend to use again for the same reason. Alternatively, it is possible that these individuals are already experienced with these drugs and, consequently, were more likely to use again independent of media coverage. Indeed, previous drug use has been found to be among the strongest predictors of intention to use (Palamar 2020b), so it is unsurprising that use and more recent use were robust correlates of reporting higher likelihood of future use. However, given that our survey specifically probed for likelihood of future use as a direct effect of media coverage, we speculate that the perceived medical benefits of use reported in news media plays a role as an additional reason for continued recreational use among this population.

In contrast, only 6% of those who reported having never used ketamine or ecstasy/MDMA indicated that they were more likely to use (or rather, initiate use of) either drug in response to media coverage on potential medical benefits. Therefore, it appears that the recent wave of media coverage may not pose an imminent concern for increased initiation of recreational ketamine or MDMA use, though there may be an exception for users of certain other drugs. More specifically, our findings demonstrate that those who used LSD in the past year were more than twice as likely to indicate that they were more likely to use MDMA recreationally in the future as a result of recent media coverage. This relates to findings from a recent study investigating the relationship between LSD use and first use of ecstasy among a comparable sample of EDM party attendees. That study found that that people who used ecstasy who had also recently used LSD were found to be more likely to introduce ecstasy to someone else and to report intention to use again in the future (Palamar 2020a). As such, there appears be an important link between use of LSD and initiation of ecstasy among EDM party attendees that may be compounded by perceived medicinal benefits associated with MDMA use.

Those identifying as a sexual minority (e.g. gay, lesbian, bisexual or other sexual minority identity) were less likely to report a higher likelihood of future recreational ketamine use due to media coverage. As is the case with people already experienced with drugs, identifying as a sexual minority is known to be a strong correlate of drug use (Griffin et al. 2019). However, our findings suggest that any potential future drug use among this population may occur independently of any perceived medical benefits from use as reported by the media.

When considering educational attainment, our study found that those with either some college experience or a college degree were much more likely to report a greater likelihood of using MDMA recreationally in the future owing to media coverage. Perhaps relatedly, a recent study estimated that the percentage of ecstasy users in the US with college degrees or more than doubled between 2007 and 2014 (Palamar et al. 2017). One potential explanation behind our findings may be that those with college educations are more seeking of and exposed to various media outlets. A recent Pew Research study found that the plurality of Americans with at least a college degree (44–49%) obtain news primarily through news websites/apps, print, or radio (versus social media for those with less educational attainment) (Mitchell et al. 2020). Consequently, it is possible that they may be more inclined to use MDMA recreationally in the future, and perhaps in a manner that has compounded the growth in prevalence of use among those with college degrees or higher seen in the past decade.

Limitations

A limitation of this study is the relatively small sample size, but we were still able to detect clear associations. This study was also only conducted over a relatively short period of time (from November 2019 through February 2020), but this was a period in which medical benefits of use were covered somewhat extensively by the media. This recruitment period was before negative press about ketamine beginning in June 2020 about Elijah McClain, who died after being administered a large dose of ketamine by an emergency medical technician during his arrest a year earlier (Yancey-Bragg 2020). While intentions to use a drug such as ecstasy are highly predictive of later use (Orbell et al. 2001; Umeh and Patel 2004; Vervaeke et al. 2008; Ramchand et al. 2013; Palamar et al. 2018), we must keep in mind that intentions to engage in a behavior do not always translate into that behavior (Ajzen 1987). Longitudinal studies examining drug use behavior over time would be needed to determine whether media exposure influences actual behavior. Other limitations include that we did not define media coverage for participants, we did not provide examples, we did not specifically refer to positive or negative coverage, and we did not ask participants about their extent of exposure to such media coverage. Although, the reader should be reminded that we mentioned to participants that science has been determining clinical benefits of use, so ‘positive’ effects were indeed implied in our questions. We are unsure how participants would have responded if we mentioned ‘negative’ coverage. It is possible that some participants were not exposed to this information at all, aside from this information being provided to them on the survey. In addition, we did not gauge perception of drug safety on its own or in clinical settings. We were also not able to explore the mechanisms that drive intention to use or not use. For example, we do not know whether media coverage increased participant knowledge of these drugs or reduced perception of stigma or harm associated with use. Finally, this study was conducted in a population known for its high prevalence of recreational use of ecstasy and ketamine. More research is needed to determine how media coverage effects intentions to use among more general populations.

Conclusions

While more advanced study designs are needed, results from this initial analysis suggest that media coverage about the medical benefits of ketamine and MDMA appears to influence intentions of specific subsets of people to use in a recreational manner, but it does not appear to have a great influence among those who have never used these drugs. More studies are needed, however, focusing on ‘negative’ media coverage – such as news about the death of Elijah McClain. As media coverage and public discourse about ketamine and MDMA continue, it is important to maintain scientific and trustworthy information about the effects, benefits, and potential dangers associated with use of these drugs. Medical information about these drugs is based on information from healthy research participants tested in controlled environments by medical personnel. Individuals with a high likelihood of recreational use should be properly educated not only about drug effects, but also about potential risky behaviors and environments that can make these drugs riskier to use.

Funding

This work was supported by the National Institute on Drug Abuse (R01DA044207).

Footnotes

Disclosure statement

The authors declare no conflict of interest.

Ethical approval

This study was approved by the authors’ institutional review board and all participants provided informed consent before participating.

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