Common Questions About the Club Drug Ecstasy/MDMA

MDMA (3,4-methylenedioxymethamphetamine) is an illegal, synthetic, psychoactive drug that acts as both a stimulant and a hallucinogen - stimulating the user while producing distortions in time and perceptions.

It has been described as a combination of the stimulant amphetamine and the hallucinogen mescaline.

Although MDMA is widely known as Ecstasy, and more recently known as Molly, research has shown that many of the pills that are sold in clubs and on the street as Ecstasy contain not only MDMA but a number of other drugs or drug combinations that can be harmful.

Therefore, some of the effects that users experience while taking Ecstasy may be due to the ingredients added to MDMA during the manufacture of the pills or capsules.


What Is the Scope of MDMA Abuse in the U.S.?

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MDMA Use Has Declined Among Youngsters. © Getty Images

It is difficult to determine the exact scope of the use of MDMA because it is often used in combination with other substances, and does not appear in some traditional data sources, such as treatment admission rates. MDMA does, however, appear to be a drug that has increased in popularity and become more widespread, particularly among people under the age of 25.

In 2014, more than 17 million persons aged 12 or older reported using Ecstasy at least once in their lifetimes, according to the National Survey on Drug Use and Health.

The number of current users in 2002 was estimated to be 676,000. Two years later, the number of current (use in past month) users in 2004 was estimated to be 450,000. The initiation of Ecstasy use in the U.S. had been rising steadily since 1992, with 1.8 million new users in 2001.

The Drug Abuse Warning Network, maintained by the Substance Abuse and Mental Health Services Administration, reported that mentions of MDMA in drug abuse-related cases in hospital emergency departments were 22,498 for 2011. The majority of patients who came to emergency departments mentioning MDMA as a factor in their admissions during that time were aged 18–20.

NIDA’s Monitoring the Future (MTF) survey, an annual survey used to track drug abuse trends among adolescents in middle and high schools across the country, reported that between 2001 and 2005, annual ecstasy use decreased by 52 percent in 8th-graders, 58 percent in 10th-graders, and 67 percent in 12th-graders. Rates of lifetime MDMA use decreased significantly from 2004 to 2005 among 12th graders.

In 2005, 8th-graders reported a significant decrease in perceived harmfulness in using MDMA occasionally. The MTF data also show that MDMA use extends across many demographic subgroups. Among 12th-graders in 2005, for example, 3.9 percent of Whites, 3.0 percent of Hispanic students, and 1.4 percent of African-Americans reported using MDMA in the year prior to the survey.

While the rates of MDMA use may be declining in high school students, the drug is still easy to get, and its use remains prevalent. The MTF data also show that MDMA use extends across many demographic subgroups.


Who Is Abusing MDMA?

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Who Uses MDMA?. © Getty Images

When MDMA first hit the scene it was popular mostly with adolescents and young adults involved in the nightclub lifestyle or weekend-long dance parties known as raves. But, over the years, as the drug became known as Ecstasy, its popularity began spreading to other segments of the population in urban, suburban and rural areas.

Now widely known as Molly, the drug has become popular among college students. One thing is clear, throughout all areas of the country, MDMA is easily obtained. 


What Are the Effects of MDMA?

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Effects of Ecstasy Are Both Good and Bad. © Getty Images

Ecstasy has gained popularity because of the pleasurable effects it produces within the first hour after the drug is taken. But, those positive feelings can come with a price. MDMA can cause a wide variety of negative health effects and unpleasant side-effects.

It is possible to overdose on MDMA. Do you know what the symptoms of an Ecstasy overdose are like? They can be severe and sometimes even life-threatening. 


What Does MDMA Do to the Brain?

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MDMA Can Negatively Affect the Brain. © Getty Images

Ecstasy, also known as Molly, acts by increasing the activity of three chemical messengers of brain cells - the serotonin, dopamine, and norepinephrine systems. Because MDMA affects neurotransmitter activity in the brain, it can disrupt the regulation of mood, sleep, pain, emotion, appetite, and other behaviors.

Because Molly triggers the release of excessive amounts of these neurotransmitters, they can become depleted and contribute to the negative behavioral aftereffects that users often experience for several days after taking MDMA, researchers report. 


Is Ecstasy / MDMA Addictive?

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Is Ecstasy Addictive?. © Getty Images

Because Ecstasy affects some of the same neurotransmitters systems in the brain that are affected by other addictive drugs, some people who use MDMA can become addicted to the drug. One survey of youth and young adult users of Molly found that 43% met the diagnostic criteria for chemical dependence on the drug. 


What Do We Know About Preventing MDMA Abuse?

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MDMA Prevention Efforts Are Social. © Getty Images

Because social context and networks seem to be an important component of MDMA use, the use of peer-led advocacy and drug prevention programs may be a promising approach to reduce MDMA use among adolescents and young adults.

High schools and colleges can serve as important venues for delivering messages about the effects of MDMA use. Providing accurate scientific information regarding the effects of Ecstasy is important if society hopes to reduce the damaging effects of this drug.

Education is one of the most important tools for use in preventing MDMA abuse.


Are There Effective Treatments for MDMA Abuse?

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There Are No Specific Treatments for MDMA. © Getty Images

There are no specific treatments for MDMA abuse. The most effective treatments for drug abuse and addiction are cognitive behavioral interventions that are designed to help modify the patient's thinking, expectancies, and behaviors, and to increase skills in coping with life's stressors.

Drug abuse recovery support groups may be effective in combination with behavioral interventions to support long-term, drug-free recovery. There are currently no pharmacological treatments for dependence on MDMA.

Antidepressant medications might be helpful in combating the depressive symptoms frequently seen in MDMA users who have recently become abstinent.

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  2. National Institute on Drug Abuse. MDMA (Ecstasy) Abuse Research Report: What is the scope of MDMA use in the United States?. Updated September 2017.

  3. National Institute on Drug Abuse. MDMA (Ecstasy) Abuse Research Report: What are the effects of MDMA?. Updated September 2017.

  4. National Institute on Drug Abuse. MDMA (Ecstasy) Abuse Research Report: What are MDMA’s effects on the brain?. Updated September 2017.

  5. Cottler LB, Leung KS, Abdallah AB. Test–re‐test reliability of DSM‐IV adopted criteria for 3,4‐methylenedioxymethamphetamine (MDMA) abuse and dependence: a cross‐national studyAddiction. 2009;104(10):1679-1690. doi:10.1111/j.1360-0443.2009.02649.x

  6. National Institute on Drug Abuse. MDMA (Ecstasy) Abuse Research Report: How can MDMA use be prevented?. Updated September 2017.

  7. National Institute on Drug Abuse. MDMA (Ecstasy) Abuse Research Report: How are MDMA use disorders treated?. Updated September 2017.