MDMA ("Ecstasy," "Molly") Facts

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MDMA (3,4-methylenedioxymethamphetamine), commonly referred to as ecstasy or molly, is a drug that is sold either as a pressed pill taken orally, or as a powder that is snorted or swallowed. MDMA’s effects resemble those of both stimulants and psychedelics. A typical dose of 100 to 125 mg lasts four to six hours.

Facts

  • People who use MDMA describe themselves as feeling open, accepting, unafraid and connected to people around them. Typically used in social settings, especially among the rave and dance club cultures, MDMA’s effects are stimulated by visuals, sounds, smells and touch. Some people experience nausea at the outset, but after about forty-five minutes, most people report feelings of relaxation and clarity. MDMA causes dilation of the pupils and, often, sensitivity to light. People using MDMA experience heightened sensations and want to intensify these feelings by dancing, talking and touching.
  • Most of MDMA’s potential harms derive from the setting of its use. Although few adverse effects have been reported, hyperthermia – a dangerously high increase in body temperature – is the most common problem related to ecstasy. Hyperthermic reactions result from physical exertion (such as dancing) in an overheated environment without replenishing fluids, which is why users take breaks and consume fluids like water or Gatorade. Overdoses are extremely rare. 
  • Because MDMA is illegal – and, therefore, unregulated – it is impossible know what a “dose” contains. In fact, many drugs sold as “ecstasy” or “molly” are not MDMA. Besides MDMA, ecstasy pills may contain varying levels of MDA (methylene-dioxyamphetamine), other stimulants such as caffeine, or anesthetics such as Ketamine or dextromethorphan (DXM) – which can significantly amplify potential harms. Testing kits are available to detect if pills contain MDMA or another drug, but cannot determine potency or purity.
  • Research evaluating MDMA’s therapeutic and medical applications has shown promising results. MDMA-assisted psychotherapy combines traditional psychotherapy with the administration of MDMA. Because of MDMA’s unique effect of diminishing fear and enhancing interpersonal trust, it is an ideal adjunct medicine to psychotherapy, and it has been administered to over 500 human subjects in clinical trials without a single serious adverse event. A seminal study published in 2010 found that PTSD patients who received MDMA-assisted psychotherapy reported overwhelming reductions in the severity of their symptoms – reductions which were sustained, on average, for more than three years. Such findings have been replicated by other studies, and additional research is underway in the U.S., Canada, Israel, U.K. and Australia.
  • MDMA was initially popularized by psychotherapists and other mental health practitioners in the late 1970s and early 1980s. After MDMA was placed in Schedule I in 1985, a lawsuit challenging this designation won a favorable ruling from the DEA Administrative Law Judge, who concluded that MDMA had "currently accepted medical use" and "acceptable safety" – yet it remains in Schedule I today. In 2002, the RAVE Act (“Reducing Americans’ Vulnerability to Ecstasy”) increased penalties and mandatory minimum sentences.
 
Sources
 
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R. Doblin, “A clinical plan for MDMA (Ecstasy) in the treatment of posttraumatic stress disorder (PTSD),” Journal of Psychoactive Drugs, 34 (2002), pp. 185–194. 
 
Erowid.org, http://www.erowid.org/chemicals/mdma/mdma.shtml. 
 
G. J. Dumont et al., "Increased Oxytocin Concentrations and Prosocial Feelings in Humans after Ecstasy (3,4-Methylenedioxymethamphetamine) Administration," Soc Neurosci 4, no. 4 (2009). 
 
Substance Abuse and Mental Health Services Administration, "Results from the 2011 National Survey on Drug Use and Health," (Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012).” Tables 7.3B, 7.5B and 7.6B. 
 
AR Green et al., "Ecstasy Cannot Be Assumed to Be 3, 4‐Methylenedioxyamphetamine (Mdma)," British J. Pharmacology 166, no. 5 (2012). 
 
Green et al., "Ecstasy Cannot Be Assumed to Be 3, 4‐Methylenedioxyamphetamine (Mdma)." 
 
Holland, Julie, “Minimizing Risk in the Dance Community: An Interview with Emanuel Sferios,” in Ecstasy: The Complete Guide, Julie Holland, ed. ( Vermont: Park Street Press, 2001); http://www.dancesafe.org. 
 
A. C. Parrott, "Mdma in Humans: Factors Which Affect the Neuropsychobiological Profiles of Recreational Ecstasy Users, the Integrative Role of Bioenergetic Stress," J Psychopharmacol 20, no. 2 (2006). 
 
A. C. Parrott, "Mdma and Temperature: A Review of the Thermal Effects of 'Ecstasy' in Humans," Drug Alcohol Depend 121, no. 1-2 (2012); A. C. Parrott, "Mdma (3,4-Methylenedioxymethamphetamine) or Ecstasy: The Neuropsychobiological Implications of Taking It at Dances and Raves,” Neuropsychobiology 50, no. 4 (2004); A. Parrott et al., "Mdma Can Increase Cortisol Levels by 800% in Dance Clubbers," J Psychopharmacol 27, no. 1 (2013). 
 
G. Rogers et al., "The Harmful Health Effects of Recreational Ecstasy: A Systematic Review of Observational Evidence," Health Technol Assess 13, no. 6 (2009). 
 
A. C. Parrott et al., "Ecstasy/Mdma Attributed Problems Reported by Novice, Moderate and Heavy Recreational Users," Hum Psychopharmacol 17, no. 6 (2002); M. J. Baggott, "Preventing Problems in Ecstasy Users: Reduce Use to Reduce Harm," J Psychoactive Drugs 34, no. 2 (2002). 
 
S. de Sola et al., "Auditory Event-Related Potentials (P3) and Cognitive Performance in Recreational Ecstasy Polydrug Users: Evidence from a 12-Month Longitudinal Study," Psychopharmacology (Berl) 200, no. 3 (2008); Grob, C. 2000. Deconstructing Ecstasy: The politics of MDMA research. Addiction Research 8 (6): 549-88. 
 
M. Baggott and J. Mendelson, “Does MDMA Cause Brain Damage?” In Ecstasy: The Complete Guide, edited by Julie Holland, MD. Vermont: Park Street Press. 
 
J.H. Halpern et al., "Residual Neurocognitive Features of Long-Term Ecstasy Users with Minimal Exposure to Other Drugs," Addiction 106, no. 4 (2011); A. C. Parrott et al., "Dancing Hot on 
 
Ecstasy: Physical Activity and Thermal Comfort Ratings Are Associated with Memory and Other Psychobiological Problems Reported by Recreational Mdma Users," Hum Psychopharmacol 21, no. 5 (2006). 
 
John E. Fisk et al., "Modelling the Adverse Effects Associated with Ecstasy Use," Addiction 106, no. 4 (2011). 
 
David J Nutt, Leslie A King, and Lawrence D Phillips, "Drug Harms in the Uk: A Multicriteria Decision Analysis," The Lancet 376, no. 9752 (2010); David Nutt et al., "Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse," ibid.369, no. 9566 (2007). 
 
R. Doblin, “A clinical plan for MDMA (Ecstasy) in the treatment of posttraumatic stress disorder (PTSD): partnering with the FDA,” J. Psychoactive Drugs, 34 (2002):185-94. 
 
Multidisciplinary Association of Psychedelic Studies, http://www.mdmaptsd.org. 
 
M. C. Mithoefer et al., "The Safety and Efficacy of {+/-}3,4-Methylenedioxymethamphetamine-Assisted Psychotherapy in Subjects with Chronic, Treatment-Resistant Posttraumatic Stress Disorder: The First Randomized Controlled Pilot Study," J Psychopharmacol 25, no. 4 (2011): 439-52. 
 
M. C. Mithoefer et al., "Durability of Improvement in Post-Traumatic Stress Disorder Symptoms and Absence of Harmful Effects or Drug Dependency after 3,4-Methylenedioxymethamphetamine-Assisted Psychotherapy: A Prospective Long-Term Follow-up Study," ibid.27, no. 1 (2013). 
 
“A Randomized, Triple-Blind, Phase 2 Pilot Study Comparing 3 Different Doses of MDMA in Conjunction with Manualized Psychotherapy in 24 Veterans, Firefighters, and Police Officers with Chronic, Treatment-Resistant PTSD”, 2012, http://www.maps.org/research/mdma/MP8_amend4_final_7Feb2012web.pdf. 
 
Christina M. Sheerin et al., “A New Appraisal of Combined Treatments for PTSD in the Era of Psychotherapy Adjunctive Medications,” J Contemp Psychother (2012) 42:69–76.  

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