Ecstasy Use and Abuse
What is MDMA?
MDMA is the official scientific name for ecstasy or Molly. It’s the main ingredient in the drug known as 3,4- methylenedioxymethamphetamine.
Being chemically similar to stimulants and hallucinogens, it can create feelings of increased pleasure, energy, empathy, and can alter time perception. People often compare it to a cross between a stimulant and a hallucinogen.
As MDMA is an illegal substance and unregulated, drugs that are sold as “ecstasy” or “Molly” could range from being pure MDMA to being mixed with other substances. In some cases, they might not contain MDMA at all.
The MDMA Drug
The MDMA drug became popular in the nightclub scene in the late 1990s and early 2000s. The drug now affects a large number of people who often call it “Molly” or “Ecstasy.”
Some people take it in the form of a tablet or a capsule. Others swallow it in liquid form or snort its powder form. They often mix it with other drugs or take it together with alcohol or marijuana.
History of MDMA
MDMA was first discovered in 1912 by a German chemist called Anton Kollisch. He was trying to create drugs that could prevent uterine bleeding. The drug was rediscovered in 1976 by the chemist Alexander Shulgin who wanted to study its therapeutic benefits.
However, his efforts came to a roadblock when the U.S. federal government designated MDMA as a Schedule I drug in 1985. The reason for the classification was the growing popularity of the substance as a recreational drug. Schedule I drugs are defined as drugs with no currently accepted medical use and a high potential for abuse.
What is Ecstasy?
Ecstasy is the slang name for MDMA. It’s a synthetic psychoactive drug that produces a euphoric high in the user and mild hallucinations if taken in larger doses.
Widely known as a party drug, ecstasy is a popular club drug that young people abuse due to its ability to enhance feelings of euphoria, sociability, and empathy.
Ecstasy comes in a tablet form and is often imprinted with a commercial logo or graphic design. The designs and logos allow users to share their experiences with different pills online and on social media.
The drug also comes in different sizes, shapes, and colors. People usually swallow the pill, but it can also be snorted or injected.
Studies report that nearly 1 out of 10 college students have tried the drug, and ecstasy users have a higher rate of polydrug abuse than other groups . People who try ecstasy typically try other drugs later on, such as marijuana, cocaine, amphetamines, and heroin.
Illicit laboratories around the globe make ecstasy. The biggest portion of MDMA that enters the U.S. is produced in the Netherlands and Canada. The production can be linked to Chinese drug traffickers who are importing the necessary ingredient for ecstasy from China called MDP2P. The Drug Enforcement Agency (DEA) has also discovered several laboratories on U.S. grounds.
What is Molly?
“Molly” is another widely used slang term for drugs that contain MDMA. It’s thought by many that it’s pure MDMA sold in the form of capsules. The name comes from the word “molecular” and refers to the supposedly pure crystalline powder form of MDMA. The DEA has reported that only 13% of the Molly they have seized contained MDMA.
People who buy Molly may not get MDMA, but other drugs such as “bath salts.” Bath salts are synthetic cathinones that act as cheap substitutes for drugs such as MDMA. People who take these substitutes experience powerful cravings and more aggressive reactions. Studies discovered that four out of ten users who believed they were taking Molly tested positive for synthetic cathinone.
According to the National Institute on Drug Abuse (NIDA) and the Center for Substance Abuse Research, the MDMA tested by authorities contained other substances including:
Taking other drugs in addition to MDMA, such as alcohol or cocaine, is highly dangerous and can put users at a higher physical risk.
Molly vs. Ecstasy
Molly and ecstasy are both slang terms that are used to describe drugs that contain MDMA. While they are both made from MDMA, but there’s a slight difference in what they represent.
The term ecstasy is used to describe MDMA in the form of a pill or tablet. Molly is the term people use when they’re referring to MDMA in the form of a powder or crystal.
Both drugs may be mixed with other substances, such as:
One survey of 268 users from the U.S., Australia, and the U.K. discovered that ecstasy abuse is not specific to gender, employment status, or education level. However, the age group that has the highest rates of use are young adults aged 18-25.
In 2012, over 16 million Americans reported having tried ecstasy. In 2013, that number grew to almost 18 million.
Moreover, according to the UN Office on Drugs and Crime, the number of ecstasy users is nearly 9 million worldwide.
The number of emergency room visits due to ecstasy has increased by 1200% since ecstasy became the drug of choice at clubs and parties.
Immediate Effects on the Brain
Ecstasy increases the brain’s production of three chemicals: dopamine, serotonin, and norepinephrine.1 Increased levels of these neurotransmitters can cause changes in the brain.
Higher levels of dopamine can lead to increased energy.
Larger amounts of serotonin can produce an elevated mood, empathy, and emotional closeness.
Higher levels of norepinephrine can increase one's heart rate and blood pressure.
Ecstasy and Molly are known to produce feelings of happiness, friendliness, and well-being. They can increase one’s sense of sound and smell. For this reason, they’re commonly abused at dance clubs and raves.
Other common immediate effects of ecstasy include:
However, when the drug wears off, the feelings of euphoria and increased energy quickly fade. As a consequence, there is increase feelings of depression and hopelessness. People call this phenomenon “Suicide Tuesday” which is the depressive period that follows a weekend use of party drugs.
Ecstasy Side Effects
As ecstasy is an illegal drug, its production and sale are not regulated. As a consequence, drugs that are sold as ecstasy are usually never pure and are often mixed with other substances. Even worse, some drugs may not even contain MDMA at all or contain dangerous substances.
When an individual takes a fake pill and has a dangerous reaction to it, the medical staff will not know what type of drugs were ingested or in what amount. In other words, it’s difficult to predict the side effects and offer appropriate treatment.
The most common short-term side effects of ecstasy use include:
- Increased heart rate
- Increased body temperature
- Teeth grinding
- Muscle tension
- Blurred vision
- Impaired judgment
Although there’s not much evidence to support the long-term effects of ecstasy use, it’s speculated that there may be a lasting impact on mood, cognition, memory, and sleep.
Also, dangerous and even fatal cases of hyponatremia (low sodium levels) have been reported in MDMA users. People who take ecstasy often drink water in large quantities to avoid dehydration. However, by doing so, they lose excessive amounts of electrolytes through sweating.
Taking a large quantity of MDMA can lead to a spike in body temperature. This has the potential to exacerbate muscle breakdown and may be associated with kidney, heart, and other organ failures.
During a night of partying, a person may take between 50 mg to 700 mg of ecstasy. The risk of life-threatening side effects increases by taking higher doses of the drug.
The risk of ecstasy overdose depends on a range of factors. Many of the drugs sold as ecstasy commonly don’t contain MDMA but something more dangerous. They may contain bath salts or PMA (paramethoxyamphetamine). PMA creates similar feelings as MDMA, although the onset is longer. This drug also has a lower fatal dose, so people may try to take more to experience the feeling they get from MDMA. As a result, an overdose is a serious possibility.
Even if the person uses pure MDMA, the drug can be risky in the wrong conditions. Recently, there have been many reports of deaths at festivals related to drugs. Many things can influence drug overdoses, and music festivals can be an ideal combination of risk factors.
Severity of Overdose
The severity of the overdose can depend on:
- Purity of the drug
- Amount taken
- How the drug was taken
- Combination with other drugs
- Pre-existing health issues
- Physical tolerance
- Access to water and support
Effects of Overdose
When someone overdoses on ecstasy, it means that they took more than the recreational dose. Some of the effects of ecstasy overdose can include:
All of these side effects can lead to heatstroke or worsen an underlying heart condition, both of which are fatal.
How Long Does Ecstasy Stay in Your System?
The high ecstasy produces usually lasts from three to five hours. It depends on a range of factors, such as gender, weight, the amount taken, and how it was taken. In some cases, its effects can last up to eight hours.
Research suggests that MDMA reaches its maximal blood concentration in around two hours if taken by mouth. Larger doses may take longer to leave the system. A regular dose ranges from 50 to 160 milligrams.
Detection times also depend on the time a person last used the drug. If a person took multiple doses over a short period, this could lengthen the detection window.
Ecstasy can be detected in urine tests one to three days after using it. The drug enters the bloodstream and is carried to the liver. It’s then broken down and removed from the body.
The drug is detectable in blood tests one to two days after the last use. In saliva, it can be detected one to two days after ingestion. In hair, ecstasy is detectable for up to about three months.
Can MDMA Be Used to Treat PTSD?
In recent years, researchers have been investigating how pure MDMA can help patients struggling with post-traumatic stress disorder (PTSD).2
Several trials have discovered that when used in combination with psychotherapy, MDMA can treat PTSD in patients who haven’t responded to any other treatment. Improvements in their condition could be seen many months after treatment. Tests and research have been done using a pure and precisely dosed form of MDMA with the guidance of a medical professional.
Researchers believe that MDMA enables patients to reflect on their difficult memories that they often find too painful to address. In the long run, this could help recovery.
How Does MDMA Affect the Brain?
The effect MDMA has on the brain is not entirely understood. It’s believed that the drug increases the brain’s production of three brain chemicals: dopamine, serotonin, and norepinephrine. It also slows down activity in the amygdala, which is where the brain processes fear. Consequently, this may result in powerful feelings of well-being and social connectedness.
PTSD Clinical Trials
From 2004 to 2017, six controlled phase 2 clinical trials were conducted at five study sites. The MDMA-assisted psychotherapy treatment trials included patients who have PTSD. They received active doses of MDMA or placebo/control doses during their psychotherapy sessions.
Researchers concluded that out of the 72 patients who received MDMA, 54% were in such an improved condition that they no longer fit the diagnosis for PTSD. In 2018, the number of patients who no longer suffered from PTSD had increased to 68%. Only 23% of patients in the control group experienced beneficial effects.3
Seeking FDA Approval
MDMA is still not an approved method for the treatment of PTSD. However, the Food and Drug Administration granted breakthrough therapy status to MDMA-assisted psychotherapy in 2017. Phase 3 clinical trials are now taking place across 16 sites in the United States, Canada, and Israel.
Is Ecstasy Addictive?
It’s difficult to say whether ecstasy is addictive or not. As ecstasy is not regulated, one can never know what’s in the drug they’re buying. Often, ecstasy is mixed with other substances or doesn’t contain MDMA at all. The other drugs that are mixed with ecstasy change the way people react to it. That makes it difficult to predict if an addiction will develop.
Researchers believe that addiction may be possible if there’s regular or heavy use.
There are also cathinone stimulants such as bath salts that are often sold as ecstasy. These drugs create powerful cravings and more potent side effects.
The withdrawal symptoms that happen from chronic use of ecstasy are primarily psychological. MDMA increases the production of dopamine, serotonin, and norepinephrine in the brain. When a person stops using the drug, the levels of these neurotransmitters suddenly drop. It’s common to experience withdrawal symptoms as the brain tries to relearn how to operate properly without it. Withdrawal may include feelings of depression, apathy, hopelessness, and even suicidal behaviors.
Factors that Affect Withdrawal Symptoms
The symptoms vary from person to person. There are several factors at play, including:
Frequency and duration of drug use
A person who suffers from multiple addictions may experience more intense symptoms. An individual who has co-occurring mental health disorders may also experience more challenging symptoms.
MDMA is a popular rave drug that comes in different forms and names. Its two most commonly used slang names are ecstasy (sold as tablets) and Molly (sold as capsules and powder).
The age group that has the highest rates of use are young adults aged 18-25. Young people abuse the drug due to its ability to enhance feelings of euphoria, sociability, and empathy.
Molly is thought by many that it’s pure MDMA sold in the form of capsules. However, the DEA has reported that only 13% of the Molly they have seized contained MDMA.
NIDA and the Center for Substance Abuse Research reported that MDMA is often mixed with other drugs such as ketamine, cocaine, caffeine, PCP, synthetic cathinones, and various over-the-counter medications.
Ecstasy increases the brain’s production of three brain chemicals: dopamine, serotonin, and norepinephrine. When the drug wears off, the feelings of euphoria and increased energy quickly fade. As a consequence, the person might feel depressed and hopeless.
Taking the drug can be risky in the wrong conditions. Many things can influence drug overdoses, and music festivals can be an ideal combination of risk factors. The severity of the overdose depends on the drug, the individual, and the environment.
In recent years, researchers have been investigating how pure MDMA can help patients struggling with post-traumatic stress disorder (PTSD). Several trials have discovered that when used with a medical professional in combination with psychotherapy, MDMA can treat PTSD in patients who haven’t responded to any other treatment.
This information should not replace a visit to a doctor or treatment center. If you are concerned that you might be suffering from an ecstasy addiction or a loved one, ask for professional help today.