Overview of Ecstasy Use and Abuse
- MDMA, or Ecstasy, is a stimulant and a hallucinogenic drug that produces euphoria, enhanced sensory perception, improved mood, and increased sociability and empathy in users.
- Ecstasy is sold as a tablet, or as capsules or powder. It often contains additives and adulterants such as caffeine, ketamine, and methamphetamine.
- Molly, which is promoted as a safer, purer alternative to Ecstasy, may contain even more dangerous additives than MDMA.
- Though it is not considered as addictive as other drugs of abuse, people can build tolerance and develop compulsive patterns of Ecstasy use.
- Signs of Ecstasy use and abuse include an irregular sleep schedule, grinding teeth, profuse sweating, and heightened sensitivity to sensory stimuli (e.g., music and light).
What Is Ecstasy?
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MDMA, or 3,4-methylenedioxymethamphetamine, is the active ingredient in Ecstasy and affects the brain in a number of ways. It acts both as a stimulant and as a psychedelic.
MDMA is a synthetic drug that can be derived from safrole oil, an essential oil of the sassafras tree. Much of the MDMA seized in the U.S. is manufactured in Canada and the Netherlands.13
Despite contradictory evidence, MDMA is considered addictive. Recovery is still needed as with other addictions such as cocaine or heroin. No approved medications specifically treat MDMA addiction.
Common street names for MDMA include:
- Disco Biscuits.
- Love Drug.
- Scooby Snacks.
- Thizzle, or thizz.
MDMA vs. Molly
In recent years, MDMA has been rebranded as Molly and marketed as a gentler, safer form of the drug. People buy Molly with the hopes of obtaining the “pure” powdered or crystalline form of MDMA. The term is slang for “molecule” or “molecular.”
Molly is most often sold in a capsule or as a powder. The Drug Enforcement Administration (DEA) has also seen Molly applied to blotter paper, like LSD, and in injectable form.
Is Molly Safer?
Molly is not supposed to have all the dangerous adulterant substances that were in the older form of MDMA known as Ecstasy. In reality, Molly may contain even more dangerous additives and has become a toxic mixture of lab-created chemicals.
Between 2009 and 2013, the DEA analyzed 143 samples of seized Molly and found MDMA in only 13% of samples. Molly is now thought to be as contaminated as Ecstasy once was. It is not a safe alternative to using Ecstasy.19
How Is It Used?
It is commonly ingested orally, but it can be snorted or injected.
Ecstasy is frequently sold in tablet form, though it is occasionally sold in capsules or as a powder. It is most commonly ingested orally, though it can be snorted and, rarely, injected.
A standard recreational dosage of MDMA can range from 50 mg to 150 mg. MDMA generally takes 30-45 minutes to take effect with effects lasting 4-6 hours. 13
It is hard to pinpoint the specific composition of each dose of MDMA, which is one reason why it can be particularly dangerous. It may contain varying levels of MDMA along with innumerable additive chemicals.
MDMA is rarely used alone, and it’s common for users to mix it with other substances such as:
- LSD. 13
- Ketamine (a dissociative anesthetic)
- Acetaminophen (the active ingredient in Tylenol)
- Ephedrine (a banned, stimulant alkaloid chemical)
- Dextromethorphan (DXM) 20
Ecstasy causes a number of effects that users find pleasurable, such as elevated mood and increased empathy, as well as side effects such as teeth grinding, sweating, and increased heart rate.
Life-threatening effects include extremely high body temperature, brain swelling, and seizures.
Effects of Ecstasy include:
- Increased extraversion.
- Increased sex drive.
- Elevated mood.
- Enhanced sensory perception.
- Dilated pupils.
- Increased sweating.
- Loss of appetite.
- Lack of muscle coordination.
How It Affects the Brain
MDMA increases the activity of at least 3 neurotransmitters, or chemical signaling chemicals, in the brain – serotonin, dopamine, and norepinephrine.
- Serotonin plays an important role in mood, sleep, pain perception, and appetite. Excessive release of serotonin causes the mood-elevating effects experienced by MDMA users.
- Dopamine is a key player within the brain’s pleasure and reward centers.
- Norepinephrine is partly responsible for the increases in heart rate and blood pressure typically seen with MDMA ingestion. 1,4
Signs and Symptoms of Addiction
If you or someone you love is experiencing these symptoms, contact a treatment support specialist at 1-888-319-2606
Signs of an Ecstasy addiction may include:
- Taking Ecstasy in larger amounts or over a longer period than was intended.
- Persistent desire or unsuccessful efforts to cut down or control Ecstasy use.
- Great deal of time spent on activities necessary to obtain Ecstasy, use it, or recover from its effects.
- Craving, or a strong desire or urge to use Ecstasy.
- Recurrent Ecstasy use resulting in a failure to fulfill major role obligations at work, school, or home.
What to Look For
The following are signs that someone may be using or abusing Ecstasy:
- Grinding teeth
- Profuse sweating
- Irregular sleep schedule
- Attending dance parties or nightclubs regularly
- Sensitivity to music and light
How Addictive Is MDMA?
Scientists know that the drug affects the same neurotransmitters (serotonin, dopamine, and norepinephrine) in the brain as other addictive drugs.
Experiments have revealed that animals will self-administer MDMA (an important indicator of a drug’s dependency potential), but to a lesser extent than other drugs of abuse such as cocaine.7 Extensive evidence also demonstrates user tolerance to MDMA (requiring higher doses of a drug to achieve the same initial high).
The first study characterizing MDMA as addictive appeared in 1999 and described 3 cases in which criteria for dependence (addiction) were met.8,9
Overdoses from MDMA are extremely rare and are usually linked to mixing illicit or prescriptions drugs with Ecstasy, or from dehydration, rather than a direct result of MDMA itself.
Call 911 or visit an emergency room if you observe symptoms of MDMA overdose in yourself or someone else.
Symptoms of Ecstasy overdose include:13, 14, 15
- Extreme nausea.
- High body temperature.
- High blood pressure.
- Panic attacks.
- Loss of coordination.
Addiction Treatment Options
People who develop a problem with their Ecstasy use have several options to get help.
- Inpatient drug treatment programs. Inpatient or residential programs are live-in programs where you spend your day learning about addiction, going to groups and 12-step meetings, and working with a therapist on the root causes of your addiction.
- Dual diagnosis programs. Dual diagnosis recovery centers are specifically designed to treat substance abuse disorders as well as mental health or medical conditions. People who have abused Ecstasy may have an underlying mental health problem or may have developed one in association with their Ecstasy abuse.
- Outpatient rehabilitation programs. Outpatient drug recovery programs involve similar therapeutic interventions to that of inpatient or residential recovery centers, but do not require living at a rehab center. You attend groups or therapy sessions and receive medical care certain days of the week for a few hours at a time.
- 12-step programs. Twelve-step programs are free programs where people recovering from addiction share their stories and receive support from others. Narcotics Anonymous is a popular 12-step program that people with Ecstasy addiction may benefit from.
How Do I Know Which Program Is Right for Me?
The same treatment program won’t work for every person. It depends on what you’re comfortable with and what you feel you need. It helps to learn about the treatment process for Ecstasy addiction and what to pay attention to when seeking a program.
Cost and Paying for Treatment
The cost of Ecstasy addiction treatment will depend on whether you attend an inpatient or outpatient program, how long you stay, what kind of amenities the program offers and whether or not you have insurance.
Some people choose to finance the cost of their recovery using credit cards, loans, crowdsourcing or other means.
If you aren’t sure what your insurance will cover, or you don’t have insurance, you can get more information below:
- Call 1-888-319-2606 Who Answers? find out what your insurance will cover and what your treatment options are.
- If you’re looking for rehab programs without insurance, call the Substance Abuse and Mental Health Services Administration’s toll-free helpline.
- Extent of use: More than 18 million people age 12 or older report using Ecstasy at some point in their lifetime, which corresponds to almost 7% of all illicit drug users in 2015. Over 2.5 million, or 1% of illicit drug users, report use within the last year, and 557,000 of those report use within the last month.16
- Teen MDMA use: Among 8th graders in 2015, 2.3% report having used Ecstasy – 1.4% report use in the last year, and 0.5% report use in the last month.17 Tenth graders show slightly higher rates of use, with 3.8% reporting lifetime use, 2.4% reporting past-year use, and 0.9% reporting past-month use.17 Twelfth graders have the highest rates, with almost 6% reporting use at any point, 3.6% reporting use in the past year, and 1.1% reporting use in the past month. All grades showed increases in use rates compared to 2014, but they have demonstrated a general decrease in use rates over the last 5 years.17
- Emergency room visits: MDMA, or Ecstasy, was involved in more than 22,000 visits to emergency departments in 2011.18
Find Treatment for MDMA Addiction
Treatment options are available for those suffering from an addiction to MDMA. If you or someone you love is struggling with MDMA abuse, call 1-888-319-2606 Who Answers? to speak with a treatment support specialist.
. Hall AP, Henry JA. Acute toxic effects of ‘Ecstasy’ (MDMA) and related compounds: overview of pathophysiology and clinical management. Br J Anaesth 2006; 96 (6): 678-685.
. Barrett PJ, Taylor GT. ‘Ecstasy’ ingestion: a case report of severe complications. J R Soc Med 1993; 86: 233-4.
. Ellis AJ, Wendon JA, Portmann B, Williams R. Acute liver damage and ecstasy ingestion. Gut 1996; 38: 454-458.
. Green AR, Mechan AO, Elliott JM, O’Shea E, Colado MI. The pharmacology and clinical pharmacology of 3,4-methyldioxymethamphetamine (MDMA, ‘Ecstasy’). Pharmacol Rev 2003; 55: 463-508.
. Kalant H. The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ 2001 Oct 2; 165 (7): 917-928.
. Wish ED, Fitzelle DB, O’Grady KE, Hsu MH, Arria AM. Evidence for significant polydrug use among ecstasy-using college students. J Am Coll Health 2006 Sep-Oct; 55 (2): 99-104.
. Degenhardt L, Bruno R, Topp L. Is ecstasy a drug of dependence? Drug Alcohol Depend 2010 Feb 1; 107 (1): 1-10.
. Jansen KL. Ecstasy (MDMA) dependence. Drug Alcohol Depend 1999 Jan 7; 53 (2): 121-124.
. Parrott AC. Chronic tolerance to recreational MDMA (3.4-methylenedioxymethamphetamine) or ecstasy. J Psychopharmacol 2005 Jan; 19 (1): 71-83.
. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2015). Monitoring the Future national survey results on drug use, 1975-2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, 599 pp.
. Substance Abuse and Mental Health Services Administration (SAMHSA). 2015. Results from the 2014 National Survey on Drug Use and Health: Volume I. Summary of National Findings. Rockville, MD: Office of Applied Studies, SAMHSA.
. Drug Enforcement Administration. Drug fact sheet: Ecstasy or MDMA.
. National Institute on Drug Abuse. (2006). MDMA (Ecstasy) Abuse.
. U.S. National Library of Medicine. (2014). Serotonin Syndrome. Medline Plus.
. Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51).
. Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E. & Miech, R. A. (2016). Monitoring the Future national survey results on drug use, 1975-2015: Volume 2, College students and adults ages 19-55. Ann Arbor: Institute for Social Research, The University of Michigan.
. Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. HHS Publication No. (SMA) 13-4760, DAWN Series D-39. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.
. Kasnic, D. “College Kids Are Unknowingly Rolling on Bath Salts” Newsweek, March 25, 2015.
. Cole, C. et al. (2010). Cut: A Guide to Adulterants, Bulking agents and other Contaminants found in illicit drugs. Liverpool John Moores University Centre for Public Health.
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