Ecstasy, otherwise known as MDMA, is a synthetic drug that performs as a stimulant and hallucinogen. Individuals who use it usually feel extremely energized, experience distortions in time and perception, and receive enhanced enjoyment from sensory experiences. Ecstasy has also been described as an entactogen, which is a drug that can artificially increase self-awareness and empathy, although the temporary state also has many side effects.

Ecstasy is often used to refer to MDMA in the tablet or capsule form, which is the most common way to consume the drug. After studying samples from around the world, researchers have determined that many ecstasy tables contain different concentrations of MDMA, but they also have found a number of other drugs within the tablets that can be harmful. Adulterants found in ecstasy tablets purchased on the street have included methamphetamine, the anesthetic ketamine, caffeine, the diet drug ephedrine, the over-the-counter cough suppressant dextromethorphan, heroin, phencyclidine (PCP), and even cocaine.

Molly is another form of ecstasy that has become more popular in recent year. It is slang for “molecular” and refers to the crystalline powder form of MDMA. Molly is usually sold as powder or in capsules. Some people believe that Molly does not contain contaminants often found in ecstasy tablets, but that is not true. In fact, chemical analyses of drugs sold as Molly and seized by the U.S. Drug Enforcement Administration (DEA) have shown that they often contain other types of drugs and may not contain any MDMA at all. For example, according to the National Institute on Drug Abuse, epidemiologists from Washington state and Florida reported in 2013, substances that were being sold as Molly were actually methylone, a synthetic stimulant commonly found in “bath salts.”

Effects of MDMA

The National Institute on Drug Abuse explains that MDMA can cause trouble sleeping, a increased lack of appetite, trouble concentrating on a certain task, depression, heart disease, and impulsivity. In addition, the use of MDMA during a 2-year period of time is actually associated with decreased cognitive function. Some of these side-effects may not be directly caused by MDMA, but may instead be related to some of the other drugs that are often used in combination with MDMA. Drugs like cocaine, alcohol, or marijuana can also have these side-effects.

Users of ecstasy may often experience the intoxicating effects of the drug within about 45 minutes or so after taking a single dose. The effects can cause the person to feel an enhanced sense of well-being, become more extroverted, emotional, increased empathy toward others, and an enthusiasm to discuss emotionally-charged memories. In addition, people report enhanced sensory perception as a trademark of this drug’s experience. Ecstasy can also cause a number of acute adverse health effects. Although fatal overdoses on MDMA are rare, they can be life threatening with symptoms that include high blood pressure (hypertension), faintness, panic attacks, and in severe cases, a loss of consciousness and seizures, according to the National Institute on Drug Abuse. The institute also explains that MDMA can arouse various other adverse side-effects such as involuntary jaw clenching, lack of appetite, mild detachment from oneself (depersonalization), illogical or racing thoughts, restless legs, nausea, hot flashes or chills, headache, sweating, and muscle or joint stiffness.

Is Ecstasy Addictive?

According to the National Institute on Drug Abuse, research hasn’t definitively answered whether MDMA is addictive, but it has been proven that it affects many of the same neurotransmitter systems in the brain that are targeted by other addictive drugs. It has been shown in experiments that animals will self-administer MDMA. This is a telling indicator of a drug’s addictive potential. Data from both humans and animals suggest that the regular use of MDMA does produce adaptations in the serotonin and dopamine systems that are associated with substance use disorder and related behaviors, such as increased impulsivity.

The current treatments that are most effective for patients with an ecstasy use disorder 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 so that the individual does not turn to ecstasy to cope. Recovery support groups may also be effective in conjunction with behavioral interventions to help with recovery over time.

Although there are currently a number of medication targets that show promise in animal models and in some early clinical trials, there are currently no FDA-approved medications to treat MDMA use disorder.