MDMA (3,4-methylenedioxy-methamphetamine), popularly known as ecstasy or, more recently, as Molly, is a synthetic, psychoactive drug that has similarities to both the stimulant amphetamine and the hallucinogen mescaline. It produces feelings of increased energy, euphoria, emotional warmth and empathy toward others, and distortions in sensory and time perception.
MDMA was initially popular among White adolescents and young adults in the nightclub scene or at “raves” (long dance parties), but the drug now affects a broader range of users and ethnicities.
How Is MDMA Abused?
MDMA is taken orally, usually as a capsule or tablet. The popular term Molly (slang for “molecular”) refers to the pure crystalline powder form of MDMA, usually sold in capsules. The drug’s effects last approximately 3 to 6 hours, although it is not uncommon for users to take a second dose of the drug as the effects of the first dose begin to fade. It is commonly taken in combination with other drugs. For example some urban gay and bisexual men report using MDMA as part of a multiple-drug experience that includes cocaine, GHB, methamphetamine, ketamine, and the erectile-dysfunction drug sildenafil (Viagra).
How Does MDMA Affect the Brain?
MDMA acts by increasing the activity of three neurotransmitters, serotonin, dopamine, and norepinephrine. The emotional and pro-social effects of MDMA are likely caused directly or indirectly by the release of large amounts of serotonin, which influences mood (as well as other functions such as appetite and sleep). Serotonin also triggers the re-lease of the hormones oxytocin and vasopressin, which play important roles in love, trust, sexual arousal, and other social experiences. This may account for the characteristic feelings of emotional closeness and empathy produced by the drug; studies in both rats and humans have shown that MDMA raises the levels of these hormones.
The surge of serotonin caused by taking MDMA depletes the brain of this important chemical, however, causing negative after effects—including confusion, depression, sleep problems, drug craving, and anxiety—that may occur soon after taking the drug or during the days or even weeks thereafter. Some heavy MDMA users experience long-lasting confusion, depression, sleep abnormalities, and problems with attention and memory, although it is possible that some of these effects may be due to the use of other drugs in combination with MDMA (especially marijuana).