Addiction Drug Use Hallucinogens What Is Ecstasy (Molly)? Also called MDMA, ecstasy is a hallucinogenic and stimulant drug By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial process Updated on April 18, 2023 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by David Susman, PhD Medically reviewed by David Susman, PhD David Susman, PhD is a licensed clinical psychologist with experience providing treatment to individuals with mental illness and substance use concerns. Learn about our Medical Review Board Print Willy turner / Wikimedia Commons Table of Contents View All Table of Contents Signs Identification Therapeutic Uses Impact Addiction How to Get Help History Ecstasy, also commonly known by its slang name "molly," is a synthetic drug known primarily for its hallucinogenic and stimulant effects. It's known to impart feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception. The chemical name for ecstasy is 3,4-methylenedioxymethamphetamine (MDMA). It is a derivative of amphetamine and has a similar structure to methamphetamine ("meth"). While ecstasy was initially used primarily in nightclubs and raves, its use has now spread to a wider range of populations. According to a 2021 survey by the National Institute on Drug Abuse, 0.8% of the U.S. population over the age of 12 reported using ecstasy in the previous 12 months. Addiction to Methamphetamines Signs of Ecstasy Use According to the National Institute on Drug Abuse, MDMA causes a range of effects including: Anxiety Attention problems Confusion Decreased libido Depression Impulsiveness Insomnia Irritability Memory problems Reduced appetite The effects of MDMA typically last for three to six hours. However, in some cases, you may continue to feel the side effects of molly the day after you take it. The symptoms may persist for up to a week or more, especially if MDMA is mixed with other drugs such as marijuana. If you experience lasting effects after taking ecstasy, be sure to seek help from a medical professional as soon as possible. How to Recognize Ecstasy Ecstasy is usually found in tablet or capsule form, but it can also be swallowed as a liquid or snorted as a powder. Tablets: Ecstasy typically comes in a tablet form that's often imprinted with graphic designs or commercial logos.Powder: Ecstasy known by the popular nickname molly (which is slang for "molecular") is often used for the supposedly "pure" crystalline powder form of MDMA. However, molly is often combined with other substances like synthetic cathinone (bath salts), according to the National Institute on Drug Abuse. Unlike other recreational drugs such as cocaine and nicotine, which are derived from plants, ecstasy is synthesized by altering the structure of the amphetamine molecule. Because of the way it's made, its purity can vary substantially, and other compounds can be easily combined into the same tablet. Ecstasy additives and contaminants often include methamphetamine, caffeine, ephedrine, and ketamine. Potential Therapeutic Uses for Ecstasy Though known today mainly as a recreational drug, ecstasy has been used off-label in medical contexts. Ecstasy was explored as a therapeutic drug in the 1970s, as some psychotherapists believed it opened people up and enhanced their potential for empathy and understanding of one another. This use was interrupted by the criminalization of MDMA. Ecstasy was classified as a Schedule I drug in 1985, which means that the substance has a high potential for abuse and is not approved by law to treat medical conditions. However, there has been renewed interest in the medical use of MDMA alongside psychotherapy to treat conditions such as anxiety disorders—specifically social anxiety disorder (SAD) and post-traumatic stress disorder (PTSD). One study found that the use of medical MDMA in autistic adults with social anxiety disorder helped reduce social anxiety symptoms such as perceived social threat, self-criticism, and shame. Ongoing clinical trials suggest that ecstasy is a promising treatment for chronic post-traumatic stress disorder (PTSD). Results of a Phase 3 trial found that 88% of participants who received MDMA-assisted therapy experienced a meaningful reduction in PTSD symptoms, with 67% no longer qualifying for a PTSD diagnosis after treatment. It is important to note, however, that this research is still in the early stages. More research is needed to fully understand the effectiveness of medical MDMA. The medical use of MDMA is highly regulated and only administered by healthcare professionals in regulated settings. In 2017, the Food and Drug Administration granted MDMA breakthrough therapy status due to the preliminary evidence of its efficacy in the treatment of PTSD. This status helps expedite the development and review of substances for the treatment of serious conditions. This does not mean that ecstasy is available as a treatment, but it may increase the speed at which the drug becomes gains approval and becomes available to treat certain conditions. What MDMA-Assisted Therapy Could Do for PTSD and Cost of Healthcare Impact of Ecstasy Ecstasy works by influencing the activity of three chemicals in the brain: dopamine, norepinephrine, and serotonin. These chemicals play a role in a number of different functions in the body including energy levels, mood, emotions, and sleep. The immediate impact of ecstasy begins within about 45 minutes of taking a dose. People typically experience an increased sense of well-being and emotional warmth. Other effects include feeling greater empathy toward others and enhanced sensory perception. The Effects of Ecstasy (MDMA) on the Brain Addiction, Overdose, and Withdrawal While ecstasy affects many neurotransmitters in the brain that are impacted by other addictive drugs, research has not determined whether MDMA is addictive, notes the National Institute on Drug Abuse. One study found that ecstasy use is associated with changes in the dopamine and serotonin systems that are linked to increased impulsivity and substance use disorders. Addiction is defined by the American Society of Addiction Medicine as continued use despite harmful consequences. Reports also suggest that people who use ecstasy exhibit such symptoms as well as other markers of addiction including tolerance, drug cravings, and withdrawal. Are Psychedelics Addictive? Risks of Ecstasy While people who use ecstasy experience increased feelings of euphoria and alertness, taking the drug also has a number of adverse impacts including: Disorganized thoughts Feelings of detachment Increased anxiety Increased heart rate Irritability Nausea Poor appetite Sweating and hot flashes Ecstasy Overdose Overdose is rare but can be life-threatening. Ecstasy overdose symptoms can include faintness, panic attacks or extreme anxiety, high blood pressure, and seizures. When ecstasy use is followed by vigorous physical activity, it can lead to a potentially dangerous rise in body temperature known as hyperthermia. Another significant danger is the fact that people who take ecstasy don't really know what they are actually ingesting. In one study, researchers found that only 60% of samples tested contained any MDMA at all and many were mixed with so-called "fake cocaine," a substance typically made with synthetic cathinone. In nearly 25% of the samples, the researchers were unable to identify what was actually in the tablets. How to Get Help While there are no specific treatments for ecstasy addiction, the National Institute on Drug Abuse suggests that cognitive behavioral therapy (CBT) is the most effective option. This type of intervention helps change how people think and behave in order to support addiction recovery. CBT also teaches people coping skills so people can better manage the stress that contributes to substance use. There are currently no FDA-approved medications to treat ecstasy addiction. Twelve-step recovery programs and support groups can also be helpful, particularly when used in conjunction with cognitive behavioral interventions. History of Ecstasy MDMA was initially developed in 1912 as a pharmaceutical compound that could be used in the preparation of other pharmaceuticals, and it was patented in 1914. But once the drug's hallucinogenic properties were discovered, further development was stopped for several decades. Ecstasy was one of several drugs tested in a military context decades after. It was then re-synthesized, first by Gordon Alles, then by Alexander Shulgin, who tested it on himself, his wife, and his friends. Shulgin went on to develop a range of new compounds, with varying effects and risks, including MDMA and PMMA (paramethoxymethamphetamine), many of which ended up as versions of street ecstasy. It was many years after this that MDMA eventually appeared on the streets as a recreational drug. An earlier version of ecstasy, MDMA became popular as a recreational drug during the 1960s and 1970s. In the 1980s, MDMA became fashionable as a party drug in the nightclub and rave scene and its use grew among college students, "yuppies," and in the gay community. However, due to concerns about the health risks associated with ecstasy, it was made illegal in the United Kingdom in 1977, way ahead of its popularity in that country. Molly was made illegal in the United States in 1985, at which time it was classified by the Drug Enforcement Administration (DEA) as a Schedule I drug, according to the Controlled Substances Act. For a few years, in an attempt to circumvent the law, different versions of ecstasy were synthesized, which was the basis of the designer drugs movement. This production was eventually outlawed but re-emerged as a problem around the year 2000 with the popularity of homemade crystal meth. 14 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Institute on Drug Abuse. What is the scope of MDMA use in the United States? National Institute on Drug Abuse. What are the effects of MDMA?. National Institute on Drug Abuse. What is MDMA?. Meyer JS. 3,4-methylenedioxymethamphetamine (MDMA): current perspectives. Subst Abuse Rehabil. 2013;4:83–99. doi:10.2147/SAR.S37258 Luoma J, Lear MK. MDMA-assisted therapy as a means to alter affective, cognitive, behavioral, and neurological systems underlying social dysfunction in social anxiety disorder. Front Psychiatry. 2021;12:733893. doi:10.3389/fpsyt.2021.733893 Mitchell JM, Bogenschutz M, Lilienstein A, et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med. 2021;27(6):1025-1033. doi:10.1038/s41591-021-01336-3 Danforth AL, Grob CS, Struble C, et al. Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study. Psychopharmacology (Berl). 2018;235(11):3137-3148. doi:10.1007/s00213-018-5010-9 Feduccia AA, Jerome L, Yazar-Klosinski B, Emerson A, Mithoefer MC, Doblin R. Breakthrough for trauma treatment: Safety and efficacy of MDMA-assisted psychotherapy compared to paroxetine and sertraline. Front Psychiatry. 2019;10:650. doi:10.3389/fpsyt.2019.00650 Food and Drug Administration. Frequently asked questions: Breakthrough therapies. National Institute on Drug Abuse. Is MDMA addictive? Schenk S, Aronsen D. Contribution of impulsivity and serotonin receptor neuroadaptations to the development of an MDMA ('ecstasy') substance use disorder. Curr Top Behav Neurosci. 2017;34:17-32. doi:10.1007/7854_2015_421 American Society of Addiction Medicine. Definition of addiction. Saleemi S, Pennybaker SJ, Wooldridge M, Johnson MW. Who is 'Molly'? MDMA adulterants by product name and the impact of harm-reduction services at raves. J Psychopharmacol (Oxford). 2017;31(8):1056-1060. doi:10.1177/0269881117715596 National Institute on Drug Abuse. How are MDMA use disorders treated? By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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