3,4-methylenedioxy-methamphetamine (MDMA) is a synthetic drug that alters mood and perception (awareness of surrounding objects and conditions). It is chemically like both stimulants and hallucinogens, producing feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception.
MDMA was initially popular in the nightclub scene and at all-night dance parties, but the drug now affects a broader range of people who more commonly call the drug Ecstasy or Molly.
How do people use MDMA?
People who use MDMA usually take it as a capsule or tablet, though some swallow it in liquid form or snort the powder. The popular nickname Molly, often refers to the supposedly “pure” crystalline powder form of MDMA, usually sold in capsules.
Some people take MDMA in combination with other drugs such as alcohol or marijuana.
How does MDMA affect the brain?
MDMA increases the activity of three brain chemicals:
- Dopamine—produces increased energy/activity and acts in the reward system to reinforce behaviors
- Norepinephrine—increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems
- Serotonin—affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust. The release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.
Other health effects include:
- muscle cramping
- involuntary teeth clenching
- blurred vision
MDMA’s effects last about 3 to 6 hours, although many users take a second dose as the effects of the first dose begin to fade. Over the course of the week following moderate use of the drug, a person may experience:
- impulsiveness and aggression
- sleep problems
- memory and attention problems
- decreased appetite
- decreased interest in and pleasure from sex
Other health effects of MDMA
High doses of MDMA can affect the body’s ability to regulate temperature. This can lead to a spike in body temperature that can occasionally result in liver, kidney, or heart failure or even death.
In addition, because MDMA can promote trust and closeness, its use—especially combined with sildenafil (Viagra®)—may encourage unsafe sexual behavior. This increases people’s risk of contracting or transmitting HIV/AIDS or hepatitis.
Dr Greenwood notes that some people do show signs of drug dependence and withdrawal with regular molly use.
A qualified addiction professional can help you manage these symptoms and recover.
Dr Greenwood advises that the following behaviors are associated with an MDMA use disorder:
- Noticeable change in personality or behavior
- Inability to perform normal daily routines
- Strong urges or compulsion to use molly even with negative effects
- Life revolves around molly (talking about how to get it, use it, etc.)
- Giving up other commitments, including work and social life, for molly
- Withdrawal symptoms (mood swings, depression, anxiety, etc.)
Treatment for MDMA use disorder
Treatment for MDMA use disorder involves management of withdrawal symptoms, reducing cravings for the drug, and preventing relapse.
The Food and Drug Administration (FDA) hasn’t approved any medications to treat MDMA use disorder. But several medications are being tested.
Molly can cause dependence. People who regularly and heavily use it may develop an addiction to it. Research is ongoing to learn whether molly changes brain chemistry in the long term.
Certain factors can make a person more prone to substance misuse. Genetics and social, emotional, and environmental factors can all play a role.
If you’re concerned about molly use, Dr Greenwood recommends that you contact a trained healthcare professional for guidance and help.