Substance Use & Misuse, 46:1675–1689, 2011 Copyright C ⃝ 2011 Informa Healthcare USA, Inc. ISSN: 1082-6084 print / 1532-2491 online DOI: 10.3109/10826084.2011.610398 ORIGINAL ARTICLE Negotiating Ecstasy Risk, Reward, and Control: A Qualitative Analysis of Drug Management Patterns Among Ecstasy-Using Urban Young Adults Elyse Ona Singer and Jean J. Schensul Institute for Community Research, Hartford, Connecticut, USA This paper is based on qualitative in-depth interviews conducted from 2008 to 2009 with 118 ethnically di- verse Ecstasy users from the greater Hartford area, CT, USA. Participants were urban, primarily Black and Hispanic, aged 18 to 36, and had limited higher ed- ucation compared with samples in previous Ecstasy research. Interviews focused on personal background, history of Ecstasy and other drug use, and recent sex- ual events. In this paper, we examine: participants’ negotiation of perceived risks and benefits of Ecstasy use, behavioral strategies employed to minimize risks, and the relationship of risk–benefit analysis, motiva- tion for use, frequency of use, and polydrug use to par- ticipants’ sense of control over their Ecstasy use. We conclude with recommendations for intervention ap- proaches and suggestions for future research. Keywords Ecstasy, young adult, risk, beneit, use management, perceived control, addiction, intervention, urban, polydrug use INTRODUCTION Over the past decade, MDMA (3,4-methylenedioxy- methamphetamine, commonly known as “Ecstasy”) has attracted considerable research attention as a high-risk il- legal drug used in electronic dance events and other so- cial milieus with potentially serious consequences (Boot & McGregor, 2000; Brown & Kiyatkin, 2004; Butler & Montgomery, 2004; Reneman, Booij, Schmand, Brink, & Gunning, 2000). Much of the literature on Ecstasy focuses on public health risks associated with its use. At the same time, a number of social science researchers have explored The authors would like to express gratitude to several people for their assistance in the development of this paper. A special thanks to Merrill Singer, Ph.D., for help with conceptualizing and editing the paper. We appreciate Dr. Kristin Kostick’s careful attention to editing. Thanks to members of the MDMA research team Sari Fromson, Chavon Hamilton, Christina Kraweck, Lwendo Moonzwe, and Noelle Bessette, and study coordinator Elsie Vasquez-Long. Lastly, thanks to the participants for sharing their stories. Address correspondence to Elyse Ona Singer, Institute for Community Research, Two Hartford Square West, 146 Wyllys Street, Hartford, CT 06106-5128; E-mail: esinger@wustl.edu 1 NIDA (National Institute on Drug Abuse) grant number R01 DA0203939: MDMA and STD/HIV risk among hidden networks of ecstasy-using young adults. users’ own understandings of risks associated with Ec- stasy consumption (Carlson, Falck, et al., 2004; Carlson, McCaughan, et al., 2004; Hunt, Evans, & Kares, 2007; Kelly, 2005; Panagopoulos & Ricciardelli, 2005; Shewan, Dalgarno, & Reith, 2000), which are to some degree dif- ferent from those portrayed by public health experts. As with other drugs, however, users also cite considerable beneits associated with Ecstasy (Beck & Rosenbaum, 1994; Hunt & Evans, 2008) that continue to draw the at- tention of youth even as the contexts within which the drug is used and the demographics of users have shifted in re- cent years (Eiserman, Diamond, & Schensul, 2005). Some researchers have explored risk and beneit per- ception and negotiation among Ecstasy users (Allot & Redman, 2006; Kelly, 2005; Shewan et al., 2000). Other researchers (Orbell, Blair, Sherlock, & Conner, 2001; Panagopoulos & Ricciardelli, 2005) have mentioned but not examined in detail how Ecstasy users feel they can control their use, or the risks they perceive to be associ- ated with it, as a means of negotiating its management and improving its positive effects. The ability of users to make sound decisions about the drugs they use, including when, where, and how they use them, and their perceived con- trol over drug management are central factors in the devel- opment of effective preventive and harm reduction inter- ventions (Hunt, Moloney, & Evans, 2009). In the current paper, based on indings from a study of self-identiied current urban Ecstasy users in Hartford, CT, USA, 1 we address these gaps in the Ecstasy literature by examin- ing popular understandings of risks and rewards and their management in relation to perceived sense of agency or control over consumption in an understudied population of urban young adults.