Street names include Molly, Ecstasy, X, Superman, and XTC, among many others.
Developed in 1914 as an appetite suppressant, MDMA gained popularity in the 1980s with young adults at large music festivals and all-night dance parties or raves.
The user experiences feelings of euphoria, increased energy, intimacy and emotional warmth, sensitivity to touch, and a distortion of time and of the senses.
Ecstasy is frequently taken with other illegal drugs, and pills sold as MDMA on the street often contain additives. These factors can contribute to serious, and sometimes fatal, health effects.
MDMA can also be addictive, and research suggests that long-term cognitive problems may develop in some users.
A Global Drugs Survey in 2014 found that over 20 percent of American respondents had used MDMA in the previous year.
Another survey published in the same year showed that 1 percent of people aged 19 to 28 years in the United States (U.S.) had used the drug within the last month.
Here are some key points about MDMA. More information is in the main article.
- MDMA is perceived as a safe party drug, but its effects can be lethal
- Tablets sold as pure ecstasy often contain highly toxic additives.
- MDMA can interfere with the body's ability to regulate temperature, and it can raise the heart rate to a dangerous level.
- The adverse after-effects of ecstasy can be felt for a week or more.
What is MDMA?
MDMA is an illegal psychoactive substance that is often taken in pill form.
MDMA (3,4-methylenedioxy-methamphetamine) is a synthetic drug that was used legally in the 1970s for use in psychotherapy treatment, despite a lack of data to support its efficacy.
The nickname "Molly" is short for "molecular." It often refers to the powder form of the drug, which may be sold in capsules.
A synthetic drug is one manufactured in a laboratory environment rather than coming from a natural source.
The substance then began illegally circulating for recreational use.
In 1985, the Drug Enforcement Administration (DEA) labeled MDMA a Schedule I substance, or a drug with high abuse potential and of no recognized medicinal use.
MDMA is mainly taken by swallowing a capsule or tablet, but it can also be snorted or smoked as a powder.
The user will feel the effect within an hour, and it can last up to 6 hours. Users commonly take a second dose as the first wears off.
MDMA has many of the same physical effects as other stimulants such as cocaine and amphetamines.
These include increased heart rate and blood pressure, decreased appetite, and increased energy.
MDMA functions by increasing production of serotonin, dopamine, and norepinephrine.
These are the brain's neurotransmitters, and they influence mood, sleep, and appetite.
Serotonin also triggers the release of other hormones that can cause feelings of attraction and intimacy. As a result, users may become more affectionate than usual, and feel a connection with complete strangers.
The effects last for 3 to 6 hours, but people who take a moderate amount may experience withdrawal-type side effects for a week after.
- confusion, irritability, anxiety, and depression
- impulsiveness and aggression
- decreased interest in sex
- memory and attention problems
- reduced appetite
These effects may be due to MDMA alone, or to the combination of MDMA use with other drugs.
Other substances can be mixed with MDMA
Not all the effects are predictable because so-called pure "ecstasy" can contain other unwanted drugs or chemicals. Being illegal, there is no government regulation over production.
As a result, people using MDMA could also unwittingly be using:
- synthetic cathinones such as mephedrone, the psychoactive ingredient in another drug, known as "bath salts."
These harmful substances can be particularly dangerous when mixed with MDMA. When users buy MDMA from dealers on the street, they do not know what they are taking.
Ingesting other substances, such as marijuana or cocaine, along with MDMA greatly increases the danger of adverse reactions.
Deaths have been linked to some fatal batches of MDMA.
Adverse effects and risks
MDMA can drastically increase the heart rate. This can, on occasion, be fatal.
People use MDMA because it enhances feelings of alertness, euphoria, and physical and mental powers.
However, there are also some common adverse effects, as well as some severe risks and possible long-term damage.
Common adverse effects include:
- Jaw clenching or teeth grinding
- restlessness, insomnia, irritability, and anxiety
- sweating, thirst, and nausea
- increased heart rate
More serious, and potentially fatal, conditions can arise under certain circumstances.
MDMA causes an increase in heart rate, blood pressure, and body temperature.
These stimulant effects, combined with prolonged physical activity, a hot environment, and other drugs, can result in unpredictable and serious physical complications.
Deaths from MDMA use mostly result from hyperthermia, or a sudden increase in body temperature, cardiovascular collapse, or significant dehydration.
Warning signs that suggest a potentially fatal event after MDMA use include:
- excessive thirst and profuse sweating
- muscle cramping
- shaking chills
- little to no urine output
- blurred vision
These can lead to liver, kidney, or heart failure, and even death.
These signs indicate an emergency. Seek immediate medical attention if the above are experienced following MDMA use.
MDMA causes a surge of serotonin, after which the body will experience a depletion of this "feel-good" neurotransmitter.
The brain can take days or weeks to replenish the serotonin. Side effects of moderate use can persist for a week after using it.
Animal studies show that MDMA in moderate to high doses can damage nerve cells in the brain.
Due to the altered sense of reality caused by MDMA use, people who have taken it can make poor, risky, or even dangerous decisions without concern for the consequences.
The often-added impurities, combined with the physical rigor of an all-night dance party experience, makes taking any form of MDMA significantly dangerous.