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What is MDMA (Ecstasy/Molly)?

MDMA (3-4 methylenedioxymethamphetamine) is a synthetic, psychoactive drug with a chemical structure similar to the stimulant methamphetamine and the hallucinogen mescaline.

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.

It is known commonly as Ecstasy and Molly.

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 does MDMA (Ecstasy/Molly) 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.

How is MDMA used?

MDMA is most often available in tablet or capsule form and is usually ingested by mouth. 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.

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

Recently, the FDA designated MDMA-assisted psychotherapy for PTSD as a Breakthrough Therapy and ongoing MDMA studies can be found on clinicaltrials.gov.

What are the effects of MDMA (Ecstasy/Molly) use?

MDMA stimulates the release of the neurotransmitters such as serotonin from brain neurons, producing a high that lasts from 3 to 6 hours, but its length can be variable based on the user. The drug’s rewarding effects vary with the individual taking it, the dose, purity, and the environment in which it is taken. Repeat doses are often used in the sane day or night.

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 dangerous is MDMA (Ecstasy/Molly)?

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.

Is MDMA (Ecstasy/Molly) use popular?

Compared to other drugs like marijuana or alcohol, the use of MDMA (Ecstasy, Molly) is much lower.

The National Institute on Drug Abuse (NIDA) regularly looks at trends of illicit drug use in the U.S. in middle and high school-aged children, teens, and adults.

• In the 2019 Monitoring the Future results, researchers found that past year use of MDMA in 12th graders was at 2.2% (2.2 of every 100) survey respondents, 1.70% of 10th graders and 1.1% of 8th graders.
• From the 2018 National Survey on Drug Use and Health: Trends in Prevalence of MDMA, people age 18 to 25 years appeared to be the groups with the highest use at 3.1%, but this figure was down from 3.5% in 2017.
• In the past year, 0.9% of those surveyed 12 years or older reported past-year use.