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Newmeyer JA. 
“Some considerations on the prevalence of MDMA use”. 
J Psychoactive Drugs. 1986;18(4):361-2.
The epidemiologist faces two problems when attempting to gauge the prevalence of MDMA use. First, users are still rather uncommon. This means that a general survey of Americans will fred only a few percent, at most, who have used the drug. Even if these few tell the truth about their usage, such a small number in a survey sample will lead to large statistical uncertainty as to the actual percentage of users in the population. Second, the consensus of anecdotal evidence is that MDMA is generally safe; that is, users rarely seem to suffer any untoward consequences. This means that that the traditional indicators of illicit drug use--such as emergency room admissions, overdose deaths, treatment program admissions and arrests--will not reflect much in the way of MDMA's actual usage.
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