What is MDMA?
The drug commonly known as MDMA, Ecstasy or Molly is actually 3,4-methylenedioxy-methamphetamine, a synthetic drug that alters mood and perception (awareness of surrounding objects and conditions). It is chemically similar to 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 (“raves”), but the drug now affects a broader range of people who more commonly call the drug Ecstasy or Molly.
What is the history of MDMA?
MDMA was developed by a German pharmaceutical company in 1912. Originally known as “Methylsafrylaminc,” it was intended as a parent compound to synthesize medications that control bleeding, not to control appetite as is often incorrectly cited.
MDMA gained a small following among psychiatrists in the late 1970s and early 1980s, despite the fact that the drug had not undergone formal clinical trials nor received approval from the U.S. Food and Drug Administration (FDA) for use in humans. Some psychiatrists believed that it enhanced communication in patient sessions and allowed patients to achieve insights about their problems. It was also during this time that MDMA started becoming more widely available on the street.
In 1985, the DEA declared an emergency ban on MDMA, placing it on the list of Schedule I drugs, defined as substances with no currently accepted medical use and a high potential for abuse. MDMA has remained a Schedule I substance since then, with the exception of a brief period of time between 1987 and 1988.
Does MDMA Have Therapeutic Value?
The evidence on MDMA’s therapeutic effects is limited thus far,although research is ongoing in this area. Proponents of MDMA-assisted therapy recommend that it only be used for reactive disorders such as post-traumatic stress disorder because it can worsen some psychiatric conditions.
In the early 1990s, the FDA approved the first human trial exploring whether MDMA could help relieve pain in terminally ill patients, as well as serve as an adjunct to psychotherapy.Results from this study have not been published; however, these early studies helped establish safety parameters for administering MDMA to human participants in controlled, clinical settings.
A small study published in The Lancet Psychiatry looked at the use of MDMA in patients suffering from post-traumatic stress disorder (PTSD). Researchers gave three different doses of MDMA to 22 veterans, three firefighters and one police officer with PTSD. Among the participants, 23% had used ecstasy before. MDMA use was also combined with psychotherapy sessions. A month after the second session, a greater percentage in the high-dose groups no longer met diagnostic criteria for PTSD, compared with the low-dose group.
After one year, 16 of the 26 participants (62%) no longer suffered from PTSD, but two had received a new diagnosis of PTSD. In addition, 12 patients were also taking additional psychiatric medications.
Side effects occurred with all doses, and included: anxiety, headache, fatigue, muscle tension, difficulty sleeping (insomnia), and suicidal thoughts.
However, not all experts were convinced. Long-term safety could not be guaranteed with this small group, and there is a risk of addiction and suicide in a population already at risk for these serious outcomes. Researchers note larger phase 3 studies should be completed, but those with PSTD should NOT use MDMA on their own to try to replicate these results.
Health Hazards of Ecstasy Use
According to drugs.com, this illicit drug can be addictive for some people. A survey of young adult and adolescent users found that 43% met the accepted diagnostic criteria for dependence, as evidenced by continued use despite knowledge of physical or psychological harm, withdrawal effects, and tolerance (or diminished response), and 34% met the criteria for drug abuse.
Almost 60% of people who use ecstasy report withdrawal symptoms, including:
- fatigue
- loss of appetite
- depressed feelings
- trouble concentrating.
Research in animals indicates that this drug, also referred to as MDMA or Molly, is neurotoxic; whether or not this is also true in humans is under investigation. It’s effect on cognition and memory is a concern. The drug can also be lethal on rare occasions.
Effects of Ecstasy Use
Chronic users of ecstasy perform more poorly than nonusers on certain types of cognitive or memory tasks. Some of these effects may be due to the use of other drugs in combination with ecstasy, among other factors. Research indicates heavy ecstasy use may cause persistent memory problems in humans, although studies are conflicting.
Physical Effects:
- In high doses, ecstasy can interfere with the body’s ability to regulate temperature. On rare but unpredictable occasions, this can lead to a sharp increase in body temperature (hyperthermia), resulting in liver, kidney, and cardiovascular system failure, and death.
- Because it can interfere with its own metabolism (breakdown within the body), potentially harmful levels can be reached by repeated drug use within short intervals.
- Users face many of the same risks as users of other stimulants such as cocaine and amphetamines. These include increases in heart rate and blood pressure, a special risk for people with circulatory problems or heart disease, and other symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating.
Psychological Effects:
- Psychological effects can include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during and for days or weeks after taking ecstasy.
Neurotoxicity:
- Research in animals links ecstasy exposure to long-term damage in neurons that are involved in mood, thinking, and judgment. A study in nonhuman primates showed that exposure to the compound for only 4 days caused damage to serotonin nerve terminals that was evident 6 to 7 years later.
- While similar neurotoxicity has not been definitively shown in humans, the wealth of animal research on damaging properties suggests that the chemical is not a safe drug for human consumption.
Hidden Risks and Contaminants:
- Other drugs chemically similar to ecstasy, such as MDA (methylenedioxyamphetamine, the parent drug of ecstasy) and PMA (paramethoxyamphetamine, associated with fatalities in the U.S. and Australia) are sometimes sold as ecstasy. These drugs can be neurotoxic or create additional health risks to the user.
- Ecstasy tablets may be further contaminated with other substances in addition to MDMA, such as: ephedrine (a stimulant); dextromethorphan (DXM, a cough suppressant that has PCP-like effects at high doses); ketamine (an anesthetic used mostly by veterinarians that also has PCP-like effects); caffeine; cocaine; and methamphetamine.
- While the use of this agent by itself or with one or more of these drugs may be inherently dangerous, users might also unknowingly combine them with substances such as marijuana and alcohol, putting themselves at further physical risk.
