Pure MDMA , (Molly for sale) commonly known as ecstasy (E) or molly, is a psychoactive drug primarily used for recreational purposes. The desired effects include altered sensations, increased energy, empathy, as well as pleasure. When taken by mouth, effects begin in 30 to 45 minutes and last 3 to 6 hours.
Adverse effects include addiction, memory problems, paranoia, difficulty sleeping, teeth grinding, blurred vision, sweating and a rapid heartbeat. Deaths have been reported due to increased body temperature and dehydration. Following use people often feel depressed and tired. MDMA acts primarily by increasing the activity of the neurotransmitters serotonin, dopamine and noradrenaline in parts of the brain. It belongs to the substituted amphetamine classes of drugs and has stimulant and hallucinogenic effects.
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Pure MDMA is illegal in most countries and, as of 2018, has no approved medical uses. Limited exceptions are sometimes made for research. Researchers are investigating whether MDMA may assist in treating severe, treatment-resistant posttraumatic stress disorder (PTSD) with phase 3 clinical trials to look at effectiveness and safety expected to begin in 2018. In 2017, the FDA granted MDMA a breakthrough therapy designation for PTSD, meaning that if studies show promise, a review for potential medical use could occur more quickly.
What is MDMA
MDMA was first developed in 1912 by Merck. It was used to enhance psychotherapy beginning in the 1970s and became popular as a street drug in the 1980s. MDMA is commonly associated with dance parties, raves, and electronic dance music. It may be mixed with other substances such as ephedrine, amphetamine, and methamphetamine. In 2016, about 21 million people between the ages of 15 and 64 used ecstasy (0.3% of the world population). This was broadly similar to the percentage of people who use cocaine or amphetamines, but lower than for cannabis or opioids. In the United States, as of 2017, about 7% of people have used pure MDMA at some point in their lives and 0.9% have used it in the last year.
Names and forms
Since the 1980s, MDMA has become widely known as “Ecstasy” (shortened to “E“, “X“, or “XTC“), usually referring to its street forms as illicitly pressed pills or tablets. The American term “Molly” and the British equivalent term “Mandy” originally referred to crystal or powder MDMA that was purported to be of high purity and free of adulteration. However, it has since evolved into a generic street term for any number of euphoric stimulants that are sold in powder or crystal form.
MDMA can be found in the following forms:
- Pills are the most common form in which MDMA is sold, and are commonly referred to as Ecstasy. They often contain other substances or adulterants that range from anything from MDA, MDEA, amphetamine, methamphetamine, caffeine, 2C-B or mCPP to synthesis by-products such as MDP2P, MDDM or 2C-H. They can also contain an array random substances such as research chemicals, prescription drugs, over-the-counter drugs, poisons or nothing at all. It is strongly recommended to take harm reduction measures such as using a reagent testing kit when ingesting unknown pills.
The average concentration of MDMA in ecstasy pills, tested in a drug checking program in Zurich, doubled between 2010 and 2018. The percentage of pills containing more than 120 mg MDMA rose from 4% to 73%. In the same period, the rate of pills containing other psychoactive compounds dropped from 53% to 7%.
- Crystals or powder (commonly called Molly) is a white to brownish substance which can be dissolved, crushed, put into gel capsules or edible paper (“parachutes”). It can be administered orally, sublingually, buccally or via insufflation (“snorting” or “sniffing”).
Toxicity And Harm Potential
The short-term physical health risks of MDMA consumption include dehydration, bruxism, insomnia, hyperthermia, and hyponatremia. MDMA generally does not cause any serious or life threatening effects by itself unless it is associated with other extraneous factors such as exposure to prolonged high ambient temperature and humidity, prolonged physical activities, poor intake of water and lack of acclimatization.
Continuous activity without sufficient rest or rehydration may cause the user’s body temperature to rise to dangerous levels, and loss of fluid via excessive sweating puts the body at further risk as the stimulating and euphoric qualities of MDMA may cause the user to become oblivious to their physical condition. Diuretics such as alcohol may exacerbate these risks further due to causing excessive amounts of dehydration. Users are advised to pay close attention to their water intake, drinking neither too much nor too little, and to take care not to overexert themselves to avoid heat-stroke, which can be fatal.
The exact toxic dosage is unknown, but considered to be far greater than its effective dos
Although many psychoactive substances are reasonably safe to use on their own, they can suddenly become dangerous or even life-threatening when combined with other substances. The following list includes some known dangerous combinations (although it is not guaranteed to include all of them). Independent research should always be conducted to ensure that a combination of two or more substances is safe to consume. Some of the listed interactions have been sourced from TripSit.
- 25x-NBOMe – Due to the highly unpredictable and physically straining effects of 25x-NBOMe, combinations with MDMA are strongly discouraged.
- 5-MeO-xxT – 5-MeO tryptamines are considered to be unpredictable and should be mixed with MDMA with care.
- Alcohol – Both MDMA and alcohol cause dehydration and bodily strain. Approach this combination with caution, moderation and sufficient hydration. More than a small amount of alcohol will dull the euphoria of MDMA.
- Cocaine – Cocaine blocks some of the desirable effects of MDMA while increasing the risk of heart attack.
- DOx – The combined stimulating effects of DOx and MDMA can become overbearing, particularly during the come-up phase. Additionally, coming down on the MDMA while the DOx is still active can produce significant anxiety and bodily discomfort.
- GHB/GBL – Large amounts of GHB/GBL may overwhelm the effects of MDMA on the comedown and place the user at risk of sudden loss of consciousness.
- MXE – There have been reports of concerning serotonergic interactions when the two are taken at the same time, but MXE taken to the end of an MDMA experience does not appear to cause the same issues.
- PCP – PCP with MDMA may increase the risk of excessive stimulation, mania, and psychosis.
- Tramadol – Tramadol is well-documented to lower the seizure threshold and this risk is especially elevated when tramadol is taken with MDMA.