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What is Molly? 5 Things You Didn’t Know About MDMA

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On the street you’ll hear her referred to as Molly—as if she were a real person and not a drug. Molly is a street name for MDMA (3,4-methylenedioxy-methamphetamine), a popular rave drug used at nightclubs and music festivals to alter mood and perception.1 People may see Molly as a drug that helps them let loose, connect to others, and dance all night, but there are many facts about the substance of which users may be unaware.

She’s More Than 100 Years Old

MDMA (also known as ecstasy) is a synthetic substance that’s been around more than 100 years old. The substance was first synthesized in 1912 by a German pharmaceutical company attempting to create an appetite suppressant.2 It did not become illegal in the United States until 1988, when it was categorized as a Schedule I drug after illicit use started to become popular in the college “rave” and nightclub scene.2,3

You Never Know How Pure She Is

Many use the term Molly to refer to a supposedly pure form of MDMA, while reserving the term ecstasy for tablets thought more likely to be cut with other synthetic substances.1 In reality, many of the powders sold on the street as pure MDMA often contain other drugs and ingredients that you may not be aware of.1

According to The National Institute on Drug Abuse (NIDA) and the Center for Substance Abuse Research, much of the MDMA seized by police contains other substances including:1,2

  • Ketamine.
  • PCP.
  • DXM.
  • Cocaine.
  • Methamphetamine.
  • Synthetic cathinones (“bath salts”).
  • Ephedrine.
  • Pseudoephedrine.
  • Caffeine.
  • Various over-the-counter (OTCs) medications.

How do you know if you or a loved one may be addicted? Find out here.

She May Hold Some Therapeutic Potential

Despite it being classified as a Schedule I drug, some research has indicated that MDMA may have certain therapeutic benefits.1 For instance, one randomized controlled study of MDMA-assisted psychotherapy in the treatment of PTSD showed that 83% of those given MDMA showed improvement in PTSD symptoms compared to only 25% of those given a placebo.The drug was also used as a therapy aid for psychotherapy and marriage counseling in the 1970s, prior to it becoming a controlled substance in the late 1980s.1,2

She Isn’t All Raves and Empathetic Understanding

While MDMA may have therapeutic potential as well as popularity as a “fun” rave drug, it comes with many risks and adverse effects that you should be aware of. Some potential short-term side effects of MDMA that may occur while you are under the influence include:1,3

  • Anxiety and/or paranoia.
  • Sleeplessness.
  • Teeth clenching (involuntary).
  • Muscle cramps and tension.
  • Elevated blood pressure, body temperature, breathing rate, and heart rate.
  • Severe dehydration (especially when mixed with alcohol).
  • Cold chills.
  • Sweating.
  • Nausea.
  • Blurred vision.
  • Vertigo/fainting.
  • Sexual dysfunction.
  • Hallucinations.
  • Tremors.

When the drug wears off, the euphoric high and feelings of love and understanding quickly fade and often leave the user feeling dark and depressed. Many people refer to this phenomenon as “Suicide Tuesday,” even though the symptoms usually last longer than a day and can endure for a week or longer in some people.6

Withdrawal or “comedown” symptoms may include:1

  • Depression.
  • Irritability.
  • Sleep disturbances.
  • Anxiety.
  • Aggression.
  • Impulsive behavior.
  • Cognitive problems.
  • Memory issues.
  • Decreased appetite.
  • Loss of libido.

There are several long-term risks associated with prolonged or frequent use of MDMA. When you take a dose of MDMA, several neurotransmitter systems are impacted. The associated surge in serotonin activity is thought to underly a temporary elevation in mood, a heightened sense of perception, and more empathy toward others.1,2

However, as the drug wears off, serotonin activity drops, and levels become relatively depleted. This temporary depletion of active serotonin may be the cause of any post-MDMA depression.

Other potentially persistent adverse effects of MDMA include:1,2

  • Sleep problems.
  • Severe anxiety.
  • Paranoia.
  • Confusion.
  • Cognition and memory problems.
  • Death.

She Can Kill You

While it is a rare occurrence, it is possible to die from a single night of MDMA use. Large doses of MDMA can affect your body’s ability to regulate its own temperature.2 Taking too much MDMA can lead to a spike in body temperature, which has the potential to exacerbate muscle brakdown (rhabdomyolysis) and may be additionally associated with kidney, heart, and other organ failure, and in rare cases, even death.1,2

Most deaths related to MDMA do not occur from an overdose on the drug itself, but from a result of heatstroke after dancing all night with no water and becoming severely dehydrated.2

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Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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