A relatively recent hypothesis for the neurotoxicity associated with MDMA is that it causes the brain to over-heat (see: 1, 2, 3). This would make the sorts of environments in which people take it particularly hazardous (hot raves, nightclubs, warm baths, and wild sex).
I really hope this is the core main reason for MDMA’s long-term deleterious effects.
Because then the damage would be completely preventable! In particular, I would point you to the athletic performance-enhancing technology developed at Stanford in 2012 that uses rapid thermal exchange devices (aka. “the cooling glove”*) in order to cool your blood and allow you to compete at a higher level. This is an extremely efficient method to keep the temperature of your whole body (including your brain!) within a healthy range.
Sadly, the device is likely to get banned for athletic purposes (it would be, some say, an unfair advantage if some teams have access to the cooling glove and others don’t). Sports are, of course, completely inconsequential, so the fact that the device is likely to get banned for this application shouldn’t matter. Yet it does, because as a result many people seem to be losing interest in this line of research.
Maybe, I would posit, the device could be resurrected as part of a modern harm-reduction strategy. Imagine night-clubs with a chill-out space stocked with dozens of cooling gloves. Party for 30 minutes, cool down for 10 minutes, repeat. If this could allow people to take MDMA once every month for the rest of their lives without enduring the brain damage that doing this usually causes… wouldn’t that be wonderful? I would expect it to also be highly beneficial for the benevolence of culture and the overall mental health of our society.
And this is all to say: Who would have known… that “being cool” was the key to partying for the rest of your life? Cool it down and party it up!
*For a skeptical take on the device, see: Better Than Steroids? The hype behind Stanford’s magic “cooling glove” for athletes. And a comeback article that extends its use to more serious applications: Cooling glove developed by Stanford researchers helps athletes and patients.