Common or street names: Adam, Beans, Clarity, Disco Biscuit, E, Ecstasy, Eve, Go, Hug Drug, Lover’s Speed, Molly, Peace, STP, X, and XTC
What is MDMA?
MDMA (3-4 methylenedioxymethamphetamine) is a synthetic, psychoactive drug with a chemical structure similar to the stimulant methamphetamine and the hallucinogen mescaline. It commonly referred to as Ecstasy or Molly by users.
MDMA is an illegal drug that acts as both a stimulant and psychedelic, producing an energizing effect, as well as distortions in time and perception and enhanced enjoyment from tactile experiences. MDMA is a Schedule I substance under the Controlled Substances Act, which means that the DEA has determined that it has no medical benefit and a high potential for abuse.
MDMA was first synthesized by a German company in 1912, possibly to be used as an appetite suppressant. It has been available as a street drug since the 1980s, and use escalated in the 1990s among college students and young adults. Then, it was most often distributed at late-night parties called “raves”, nightclubs, and rock concerts.
As the rave and club scene expanded to metropolitan and suburban areas across the country, MDMA use and distribution increased as well. MDMA is frequently used in combination with other drugs. Today, the drug is still used by a broader group of people who more commonly call it Ecstasy or Molly.
How is MDMA used?
MDMA is most often available in tablet or capsule form and is usually ingested by mouth or crushed and snorted.
Ecstasy traffickers consistently use brand names, colors and logos as marketing tools and to distinguish their product from that of competitors. The logos may be produced to coincide with holidays or special events. Among the more popular logos are butterflies, lightning bolts, and four-leaf clovers.
It is also available as a powder and is sometimes snorted, taken as a liquid, and it is occasionally smoked but rarely injected. The drug’s effects generally last from 3 to 6 hours.
Users may take several tablets at once or in succession over a period of time. Abusers may also use in conjunction with other psychoactive drugs like LSD. As with many other “party drugs”, ecstasy is rarely used alone and it is frequently combined with alcohol and marijuana.
What are the effects of MDMA use?
MDMA stimulates the release of neurotransmitters, such as serotonin and norepinephrine, from brain neurons producing a high that lasts from 3 to 6 hours, but the length of a high is variable based on the user. The drug’s rewarding effects vary with the individual taking it, the dose taken, purity of the MDMA, and the environment in which it is taken.
MDMA can produce stimulant effects such as an enhanced sense of pleasure and self-confidence and increased energy. Its psychedelic effects include feelings of peacefulness, acceptance, and empathy.
How does MDMA affect the brain?
MDMA exerts its primary effects in the brain on neurons that use the chemicals serotonin, dopamine and norepinephrine to communicate with other neurons.
Serotonin is most likely responsible for the feelings of empathy, elevated mood, and emotional closeness experienced with this drug. Overall, these neurotransmitter systems play an important role in regulating:
- mood
- energy/activity and the reward system
- appetite
- aggression
- sexual activity
- sleep
- sensitivity to pain
- heart rate, blood pressure
Research in animals indicates that MDMA is neurotoxic and may affect the brain. Clinical studies suggest that MDMA may increase the risk of long-term or permanent problems with memory and learning.
How dangerous is MDMA?
Shorter-term health effects include:
- nausea
- muscle cramping
- involuntary teeth clenching
- blurred vision
- chills
- sweating / hyperthermia
Also, there is evidence that people who develop a rash that looks like acne after using this drug may be at risk of severe side effects, including liver damage, if they continue to use the drug.
Because use promotes trust, closeness, empathy, and enhances sexual desire, the risk of unsafe sexual practices may increase, resulting in HIV/AIDS, hepatitis, or other sexually transmitted diseases.
Damage to brain serotonin neurons can occur; serotonin is thought to play a role in regulating mood, memory, sleep, and appetite. Studies are conflicting on MDMA use and its affects on memory and cognition.
Can I get addicted to MDMA?
Research results are controversial on whether MDMA can be addictive. Some people do report signs and symptoms of addiction. Almost 60% of people who use Ecstasy report some withdrawal symptoms, including fatigue, loss of appetite, depressed feelings, and trouble concentrating.
Users may encounter problems similar to those experienced by amphetamine and cocaine users, including addiction. Research has shown that animals will self-administer MDMA, an indicator of a drug’s abuse potential.
Some people who use MDMA do report symptoms of addiction, including continued use despite negative consequences, tolerance, withdrawal, and craving, according to the NIH.
After moderate use of the drug over one week, psychological and physical effects due to withdrawal may include:
- irritability
- depression
- confusion
- agression and impulsiveness
- muscle cramps
- problems with sleep
- anxiety
- memory deficits
- loss of attention
- nausea and decreased appetite
- loss of interest in sex
Can I overdose or die from MDMA use?
MDMA-related fatalities at raves have been reported. The stimulant effects of the drug, which enable the user to dance for extended periods, combined with the hot, crowded conditions usually found at raves can lead to dehydration, hyperthermia (dangerous increase in body temperature), and heart or kidney failure.
Repeated use within a short timeframe can be dangerous because the drug cannot be adequately removed from the body.
Other drugs chemically similar to Ecstasy, such as MDA (methylenedioxyamphetamine, the parent drug of Ecstasy) and PMA (paramethoxyamphetamine) have been associated with fatalities in the U.S. and Australia and are sometimes sold as Ecstasy. These drugs can be toxic to the brain or create additional health risks to the user.
Additionally, the illegal sale of Ecstasy or Molly makes it prone to being “cut” with other illicit and potentially toxic or deadly chemicals. Ecstasy or Molly may contain other substances in addition to MDMA, including:
- ketamine (an anesthetic used mostly by veterinarians that also has PCP-like effects)
- caffeine
- bath salts (synthetic cathinones)
- cocaine
- methamphetamine
While the combination of Ecstasy with one or more of these drugs may be inherently dangerous, users might also voluntarily combine them with substances, such as marijuana, alcohol, or opioids, putting themselves at further risk of physical harm, overdose, or death.
In addition, fentanyl has been increasingly found cut into other street drugs, often unknown by the user and leading to fatalities.
Is there a treatment for MDMA addiction?
There are no specific treatments for MDMA addiction. Therapy is typically directed by a substance use clinic or health care provider and involve supportive care and behavioral and group therapy.
If you need help with a drug addiction concern, you can call the SAMHSA Treatment Locator at 1-800-662-HELP (1-800-662-4357), a confidential and anonymous source of information available 24 hours a day, 7 days a week.
How is MDMA used in medicine?
The DEA considers MDMA an illegal schedule I drug with no recognized medical uses.
Researchers are looking at MDMA use as a possible treatment for:
- Post-traumatic stress disorder (PTSD)
- Anxiety in terminally ill patients
- Social anxiety in autistic adults
- Eating disorders
- Alcohol use disorder
- PTSD and Opioid use disorder (co-occurring)
Recently, the FDA designated MDMA-assisted psychotherapy for PTSD as a Breakthrough Therapy and ongoing MDMA studies can be found on clinicaltrials.gov.
