MDMA: Everything You Need to Know

Do you know what MDMA is? The effects and medical potential may surprise you. Here's everything you need to know.

The Complete Guide to MDMA

Overview

3,4-Methylenedioxymethamphetamine (MDMA) is a common recreational drug. It is also known as Molly or Ecstasy, and to a lesser extent, Mandy or Adam. MDMA is also beginning Phase 3 trials with the US FDA for the treatment of PTSD.

“MDMA’s risk profile is low enough to justify further explorations in clinical trial settings. However, this only applies to carefully designed research contexts with screened adult subjects, and does not apply to any other use of MDMA.”1

What is MDMA?

MDMA is a drug that can make people feel euphoric and empathetic. Molly is the street name for powder or crystal MDMA, often sold in capsules. Ecstasy is the street name for pill form of MDMA.

Rabbi Zalman Schachter-Shalomi publicly compared psychedelics to a sacrament. Of MDMA he would later say for publication, “I felt the great delight of loving the universe and being loved by the universe.”2

Brother David Steindl-Rast told the Los Angeles Times the MDMA experience was “like climbing all day in the fog and then suddenly, briefly seeing the mountain peak for the first time. There are no shortcuts to the awakened attitude, and it takes daily work and effort. But the drug gives you a vision, a glimpse of what you are seeking.”2

Molly vs Ecstasy vs MDMA

MDMA is the official chemical name for the pure chemical compound - in an ideal world, Molly would be 100% pure MDMA. Molly is a street name for MDMA in powder form, often contained in clear capsules. “Molly” doesn’t mean pure. Ecstasy is a street name for MDMA in pill/tablet form.3

Caution: Drugs sold as MDMA, Molly or Ecstasy are often impure. 87% of “Molly” analyzed by the DEA between 2009 and 2013 contained 0% MDMA, instead mostly containing “bath salts.”4

Quick MDMA Info

Topic Info
Safety in research Yes, safe in research5
Chemical name 3,4-Methylenedioxymethamphetamine
Street names Molly, Ecstasy, X, Mandy
Risks 1. Fake MDMA 2. Overheating 3. Drinking too much water
Desirable effects (~3-7 hours) Eurphoria, feelings of authenticity, empathy for others
Side effects (~3-7 hours) Dry mouth, anxiety, thirst
Medical use PTSD treatment combined with therapy

Is MDMA safe?

MAPS states “in laboratory studies, pure MDMA has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses.”5 MDMA seems to be about as safe as skydiving, and a regulated environment would likely make MDMA safer. Regulation could reduce the risk of fake MDMA.6 MDMA appears to be safer than most other illegal drugs, though all drugs can be harmful under specific circumstances.7 MDMA is safer if you follow harm reduction guidelines.

“Nonhuman animal studies have shown MDMA (structurally similar to some classical hallucinogens, but with a substantially different pharmacological mechanism of action) to have neurotoxic effects at high doses, although MDMA has been judged to be safe for human administration in the context of several therapeutic and basic human research studies.”8

Advocates of MDMA-assisted psychotherapy stress the differences between heavy recreational drug users and patients who are carefully screened and take the medication two or three times in a supervised setting. Statistics from emergency room visits or reports of deaths attributed to Ecstasy are troubling, but they often involve users who may be simultaneously drinking alcohol and ingesting other illicit drugs. Those behind the new wave of studies point out that more than a thousand people have received MDMA in research settings without any serious problems. “There is little reason to fear,” says Rick Doblin of MAPS, the psychedelic research sponsor, “that normal therapeutic (or recreational) doses of MDMA will result in harmful functional or behavioral consequences.”9

Impure MDMA

Unfortunately, your “MDMA”, “Molly” or Ecstasy is probably not pure MDMA. This 2005 paper found that 61% of tested ecstasy tablets contained other drugs. And a massive 46% contained 0% MDMA.10

87% of “Molly” analyzed by the DEA between 2009 and 2013 contained 0% MDMA, instead mostly containing “bath salts.”4 😔

These other substances that are mixed in with MDMA can have worse side effects than pure MDMA - as the image above makes clear. Most illicit drugs have a greater risk of serious harm than MDMA, and so getting impure MDMA substantially increases your risks. And given that illegal drugs have no regulation, impure MDMA is a very frequent risk.4

From our page on MDMA’s Side Effects

MDMA can be dangerous

About 2.66 million people used ecstasy in the US in 2015.11 12 Harm reduction expert Emanuel Sferios estimated that there are around 20 ecstasy related deaths per year in the US.

Drinking too much alcohol can cause brain damage13 - and taking too much MDMA at once can do the same.14 This may also be the case with taking MDMA too often.15

MDMA can be low-risk is certain contexts

“MDMA has been administered to more than 750 human subjects in clinical studies with only one single serious adverse event occurring as a result of the drug.”1 In this patient, “full recovery occurred 1 day after MDMA administration.”16

Side effects of MDMA (Molly/Ecstasy) relative to other drugs7

Relative side effects of MDMA

See this page for more info on side effects relative to other drugs.

What are the effects of MDMA?

Side effects during use (perhaps ~7 hours)

“MDMA has been administered to more than 750 human subjects in clinical studies with only one single serious adverse event occurring as a result of the drug.”1 In this patient, “full recovery occurred 1 day after MDMA administration.”16

  • Dry mouth
  • Difficulty concentrating
  • Anxiety
  • Feeling cold
  • Impaired balance/gait
  • Heavy legs
  • Jaw clenching/tight jaw
  • Lack of apppetite
  • Perspiration
  • Thirst
  • Restless legs

Long-term side effects

“I am slightly reassured,” Baggott said, “that we haven’t seen an obvious epidemic of mental health problems despite thirty years of widespread MDMA use. But we absolutely still need to consider potential neurotoxicity when considering giving MDMA to people.”9

MDMA researcher Matthew Baggott: “To the best of my understanding, doses around 1.5-1.7 mg/kg MDMA (roughly 100 to 125 mg MDMA) are unlikely to cause long-lasting serotonin changes. Studies by MAPS have looked for changes in mental abilities after people participated in their studies, with some participants receiving 125 mg followed by 62.5 mg, and have not found any changes.”

For more info on the side effects of MDMA, see this page.

Short-term desirable effects, lasting for 3-4 h

  • Everything is perfect - with you and with the world
  • Euphoria (extreme happiness)
  • Empathy + increased ability to connect with others
  • A feeling that you are more able to be yourself / be authentic

Long-term desirable effects

  • Anecdotal reports that MDMA is effective in dealing with past trauma (and scientific support of MDMA helping PTSD in clinical settings)
  • Increased bonds with friends
  • A strengthened or enhanced romantic relationship17

“I have a friend,” Michael says, “who works with MDMA. He says there’s nothing you can get with MDMA that you can’t get without MDMA. You just might not get to it in this lifetime.”9

Greer continued to track the long-term psychological impact of the session for up to two years for some subjects. “It is reasonable to conclude,” he wrote, “that the single best use of MDMA is to facilitate more direct communication between people involved in a significant relationship. Not only is communication enhanced during the session, but afterward as well.” 9

For more info on how MDMA (Molly/Ecstasy) makes you feel, see this page.

Does MDMA have medical uses?

See this article and this article about clinical research into medical uses for MDMA. MAPS aims to make MDMA a prescription treatment for PTSD by 2021. Dr Bronner’s has generously donated, though millions more in funding is needed.

“MDMA is a psychotherapy tool par excellence,” Wolfson said. “It allows us to work with people with an open mind and an open heart in conversation for prolonged periods of time.”9

Why is MDMA as a treatment for PTSD important?

“Since 2009, more U.S. soldiers have died from suicide than combat.”9 18

Taking MDMA (Molly/Ecstasy)

Read our guide on how to take MDMA (and Molly or Ecstasy) the RollSafe way, to reduce unnecessary risks if you decide to use Molly. 😍

How to take MDMA (Molly/Ecstasy)

As a preview, see the checklist below.

☑️ Safer and more enjoyable usage checklist

  • 👨‍⚕️ 1. I have no pre-existing health conditions that make MDMA less safe
  • 💉 2. I'm not taking medicines or supplements that may interact with MDMA
  • 🔬 3. I have tested my MDMA with a reagent test
  • 💊 4. I have my supplements ready
  • 📅 5. I haven't rolled in at least the last ~5 weeks, ideally longer
  • ⚖️ 6. I'm aware of the dosage guideline: your weight in kg + 50 = total dosage in mg for the night. I'm aware that a study found that positive effects are maximized between 81-100 mg.
  • 💦 7. I'll drink 250-500 ml/h (1-2 cups), definitely no more than 500 ml/h (2 cups), and ideally Gatorade instead of water
  • 🔥 8. I'll stay cool to avoid heat stroke
  • 🏠 9. I'll take MDMA in a safe, cool and positive environment
  • 😊 10. I'm aware that MDMA can bring to the surface issues that I may be emotionally struggling with
  • 🚑 11. I know the signs of heat stroke and agree to pay attention to the friends I am rolling with
  • 🎯 12. I know my intention for taking MDMA, even if it is just to have fun, and I will state it out loud to the people I plan to roll with

🚫 The main risks to watch out for

Short-term risks:

  1. Consuming a substance that is not MDMA. Many tablets and powders are fake and/or adulterated with other drugs.4 19 20 10

  2. Heat stroke and/or serotonin syndrome. Like all serotonergic drugs, MDMA increases heat stroke risk due to its effects on the hypothalamus, the part of our brain that helps us regulate body temperature.21

  3. Hyponatremia. Generally caused by drinking too much water. MDMA causes water retention.22 Dancing aerobically in hot environments causes dehydration. Overcompensating by drinking too much water can be fatal.

Long-term risks:

  1. Used too frequently, MDMA can temporarily exacerbate symptoms of depression in people who suffer from clinical depression (Sferios).

  2. High and/or frequent doses of MDMA have been shown to be neurotoxic in laboratory animals. Whether this neurotoxic effect happens in human users is unknown.14 No properly controlled studies have shown cognitive impairments in human users after a period of abstention long enough to rule out temporary effects. Nevertheless, if you are concerned, normal therapeutic doses of SSRI’s like Prozac, taken on the comedown, have been shown to prevent MDMA’s neurotoxic effects in animals.23 24 25 “For reducing risk of neurotoxicity, limiting dose amount and taking supplements may be most important (BM).”

  3. Losing the magic. “Losing the magic” is when people who use MDMA find that over time, they get less and less of the special effects of MDMA. This is unfortunate, especially considering that MDMA is on a path to be used as a prescription medicine to assist therapy.

From side effects.

Extra info

MDMA Myths

Does MDMA put holes in your brain?

MDMA does not put holes in your brain. This myth comes from messages broadcast by anti-drug campaigns in the late 1990s/early 2000s.

Is MDMA (ecstasy) powder purer than ecstasy pills?

Like most illegal drugs, the purity of MDMA changes all the time, so forms that might once have been more reliable cannot be guaranteed to remain so. It is quite easy for drug dealers to mix MDMA powder with any substance that looks like it, so taking MDMA powder does not necessarily mean you are not unknowingly taking other substances mixed with the drug.

Does MDMA (ecstasy) drain your spinal fluid?

No. This myth probably comes from experiments where researchers measured breakdown products of serotonin in the spinal fluid of animals who had taken MDMA. MDMA does not damage your spine.

Does MDMA (ecstasy) cause Parkinson’s disease?

MDMA does not cause Parkinsons. This myth may come from an experiment where researchersaccidentally gave methamphetamine (crystal meth) to laboratory monkeys instead of MDMA. There is a horribly toxic chemical with a four-letter acronym, MPTP, which does cause parkinsonism. It has appeared as an unwanted impurity in a heroin-like (opiate) drug called MPPP, causing the people who took the contaminated drug to ‘freeze up’ by destroying dopamine neurons in the brain, just as Parkinson’s disease does. Neither MPTP or MPPP have any relation to MDMA.

MDMA Myths Source: Professor David Nutt and others at DrugScience.org.uk

Is the MDMA comedown real? Can it be prevented or treated?

MDMA comedowns don’t appear to exist in clinical research!16 This means that the MDMA comedown should be completely preventable by correctly following the RollSafe MDMA guide.

Interestingly, in MAPS sponsored MDMA clinical research, depressed mood in days 1-7 following MDMA use was observed in 13% of patients in the placebo condition, and 13% of patients in the 100-125 mg condition! Refer to page 77 of 143.16

Anecdotal reports indicate that MDMA comedowns are strongly related to:

  • Impure MDMA / fake MDMA
  • Unsafe dosages
  • Not waiting long enough between MDMA uses
  • Lack of sleep
  • Other unhealthy actions / other drug use

Read more on the effects the following day, and preventing and treating the comedown.

MDMA Alternatives

If using one of these classic psychedelics, like LSD or shrooms, we strongly recommend reading the acid/shrooms/psychedelics guide Tripsafe.

Actively recruiting MDMA clinical studies

View the studies here.

Email [email protected] to advertise your study here for free.

Disclaimer

Do not consume any drugs without consulting a medical professional. This is for informational purposes only.

Full Disclaimer

Organizations we recommend supporting

MAPS

Donate to MAPS to make MDMA a medicine

Do you contribute to any Patreon campaigns? If so, please email [email protected] and say that you’d love to contribute to them on Patreon.

Other organizations

👽 Tripsafe.org, guides for LSD and Shrooms

❤️ Datewell.org, a romantic relationship guide

🔥 )‘( BurnerList.org, a more useful version of the burning man shopping checklist

Things to learn next

How Does Molly Make You Feel?

What Are MDMA’s Side Effects?

How to take MDMA

About MDMA for PTSD

What is Ecstasy?

What is Molly?

References


  1. http://www.mdmaptsd.org/faq.html [return]
  2. http://www.amazon.com/exec/obidos/ASIN/0147516374/0781-20 [return]
  3. http://www.sciencedirect.com/science/article/pii/S0376871605003716 [return]
  4. http://www.newsweek.com/2015/04/03/college-kids-are-unknowingly-rolling-bath-salts-316550.html [return]
  5. http://www.maps.org/research/mdma?pk_campaign=Newsletter-November2016-WebVersion&pk_kwd=text-research-learn-more-mdma [return]
  6. Side Effects of MDMA (Molly/Ecstasy) [return]
  7. Nutt, D. J., King, L. A., & Phillips, L. D. (2010, November 01). Drug harms in the UK: A multicriteria decision analysis. The Lancet, 376(9752), 1558-1565. doi:10.1016/s0140-6736(10)61462-6 [return]
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3056407/ [return]
  9. Book: Changing Our Minds [return]
  10. Pharmacological content of tablets sold as “ecstasy”: Results from an online testing service [return]
  11. http://data.worldbank.org/indicator/SP.POP.0014.TO.ZS?locations=US [return]
  12. https://www.drugabuse.gov/drugs-abuse/mdma-ecstasymolly [return]
  13. https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm [return]
  14. https://dancesafe.org/drug-information/is-mdma-neurotoxic/ [return]
  15. https://www.mdmawiki.org/wiki/The_MDMA_3_Month_Rule [return]
  16. MDMA Investigator’s Brochure (2016) [return]
  17. http://www.huffingtonpost.com/2015/05/01/mdma-therapy_n_7181200.html [return]
  18. https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/healing-invisible-wounds-an-action-plan.shtml [return]
  19. http://www.slate.com/blogs/crime/2013/10/25/molly_mdma_the_club_drug_is_dangerous_but_not_for_the_reasons_you_d_think.html [return]
  20. https://teens.drugabuse.gov/blog/post/have-you-seen-molly-even-if-you-think-so-you-may-have-been-fooled [return]
  21. https://www.drugabuse.gov/publications/teaching-packets/neurobiology-ecstasy/section-ii/6-short-term-adverse-effects [return]
  22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923534/ [return]
  23. http://onlinelibrary.wiley.com/doi/10.1038/sj.bjp.0704230/full [return]
  24. https://www.ncbi.nlm.nih.gov/pubmed/14627999 [return]
  25. http://www.sciencedirect.com/science/article/pii/S0028390800001064 [return]
  26. https://www.vice.com/en_us/article/the-last-interview-with-alexander-shulgin-423-v17n5 [return]

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