ACCEPTANCE
The following factors suggest that MDMA will achieve a marijuana-like acceptance.

The Declining Salience of the Drug Abuse Problem

As recently as April 1990, 30% of Americans cited drug abuse as the "most important problem facing the country." By September 1992, only 6% named drug abuse as the number one problem. This means that it will be difficult to open another front in the War on Drugs. To wage war on MDMA will require that public outrage be whipped up once again, that tough laws be passed and enforced, and that a number of people not of the conventional criminal type be prosecuted and jailed. Faced with such tasks, would-be opponents of MDMA may simply lose heart and give up.

The Low Incidence of Adverse Reactions to MDMA

A review conducted by the present author showed that adverse reactions to MDMA averaged less than 20 per year from all emergency rooms reporting to the nationwide Drug Abuse Warning Network (DAWN) system. The rate of such reporting to DAWN has not increased significantly since then. In other words, of the millions of individual uses of MDMA, only a handful of serious problems have been reported. This dearth of "MDMA horror stories" leaves potential opponents without the ammunition needed to mount of campaign of suppression.

Substantial Numbers of Articulate Proponents

By contrast to users of crack cocaine or heroin, a major portion of MDMA users are apparently from the educated middle class, the sort of young people who wake up one morning with Ph.D.'s or M.D.'s or powerhouse jobs in the media. Many of them will write persuasive articles or essays on the virtues of MDMA, moderately used. Thus, would-be MDMA opponents will have to challenge a formidable academy of proponents.

Widespread "Safe MDMA Use" Campaigns

A number of campaigns are currently under way to educate MDMA users about safe use. A typical example is the set of flyers, done in the style of "rave" invitations, prepared by the San Francisco AIDS Foundation and the Haight-Ashbury Free Clinics. Readers are advised to be sure of their source of X, to use small amounts, to be well rested, to drink plenty of fluids, and to avoid alcohol. Campaigns of this sort are likely to reduce further the already rare frequency of adverse reactions.

REJECTION
By contrast, the following factors indicate that MDMA will receive an increasingly hostile rejection, much as occurred with LSD two decades ago.

The Emergence of an Abuser Subpopulation

MDMA feels good. This simple fact will inspire many young people- especially those without a full repertory of rewarding activities in their lives- to use more of it, more often. The very low incidence of adverse reactions to MDMA in past years may simply be due to moderate use by a population of educated middle-class users (i.e., the "cognoscenti"). In the near future, there may be many more low socioeconomic status users, and there may also be much greater supply of the drug. These factors could combine to increase greatly the rate of adverse reactions.

Concentration of MDMA Use in Unpropitious Settings

MDMA use spreads in a different way now than it did five or ten years ago. It is likely that the most common site for initiation into the use of MDMA is the "rave" scene. The setting of the rave- late at night in a noisy crowd of strangers, with the likelihood of food and sleep deprivation- is the polar opposite to the setting recommended by MDMA cognoscenti: well rested, during the daytime, in a calm environment, with a few trusted friends. Thus, MDMA is being widely used under the very conditions most likely to engender bad experiences or trips.

The Innumeracy of the Public

Statistics indicate that the fatality rate per mile traveled is many times higher for automobile travel than for airplane travel. Yet people are more often fearful of traveling by air than by car. The reason is that (rare) airplane crashes receive spectacular media coverage, while (common) automobile accidents are hardly covered at all. This numeric illiteracy, or innumeracy, on the part of the public means that they pay much more heed to rare, spectacular disasters than to common, mundane ones. In similar manner, a few newsworthy MDMA tragedies- users attempting to "fly" from high buildings, for example- may galvanize public attention far more than the commonplace mortality of heroin or alcohol abusers. This would ease the task of MDMA's opponents.

The Endurance of Puritanism

The English historian Thomas Macaulay noted that "the Puritans objected to bear-baiting not because of the pain endured by the bear, but because of the pleasure enjoyed by the spectators." This Puritan theme- incomprehension of, or even hostility to, pleasure for pleasure's sake- remains strong in American culture. It has a modern echo in the 35-year-old yuppie's disapproval of the pleasure taken by the 20-year-old in simple idleness, "chillin' out." Because MDMA use lacks an established leisure-cultural framework, such as that represented by the cocktail bar, the racquetball court, the playhouse or the baseball stadium, resistance to it may be easily mobilized: "aimless, destructive pleasure-seeking behavior." Indeed, the Puritan aspect of American culture makes legitimization of euphorogenic drugs an unlikely prospect.

CONCLUSION
Ecstasy is at the crossroads. Youth culture in general, and the rave scene in particular, are creating tens of thousands of new users every month. The American public's view of this phenomenon in mid-1995, I am certain, will be very unlike the near-indifference that prevails at the time of this writing (June 1993). Given the strong and apparently equal forces pulling in each direction, I am loath to predict how things will change, but I am confident the change will be striking.

Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world.
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.

-- W.B. Yeats