ADVISORY WARNING: In recent years, common MDMA substitutes have emerged, such as PMA/PMMA (“Death”). These substances are highly toxic, extremely dangerous, and easily lead to death. It is strongly recommended to avoid them.
What is MDMA?
MDMA is a synthetic substance that alters mood and perception. MDMA is also known as ecstasy or Molly. The popular nickname Molly, which is slang for molecular, often refers to the supposedly “pure” powder form of MDMA. MDMA is not classified a psychedelic in the strict scientific sense, but it is often grouped alongside psychedelics because of its therapeutic properties and potential for deep inner work.
What is the MDMA experience like?
MDMA can be consumed as a capsule or pill, swallowed as a liquid, or snorted in powder form. MDMA’s effects last anywhere from three to six hours. MDMA can produce stimulant effects such as an increase in energy and enhanced libido. Its strong effects on mood include feelings of peacefulness, acceptance, and empathy.
A brief history of MDMA
MDMA was initially synthesized by a German company in 1912 and was first utilized in psychotherapy in the 1970s. The FDA recently gave MDMA-assisted psychotherapy for PTSD a “Breakthrough Therapy” designation. Currently, many researchers continue to study MDMA’s value in psychotherapy, especially for treating PTSD and as part of couple’s therapy.
MDMA Safety
MDMA is not formally classed as a psychedelic, and interacts with different neurological systems in comparison to psychedelics. As such, it requires special attention regarding safety considerations. There are physical and psychological risks attached to the use of MDMA.
Physical safety
Physiologically, numerous adverse effects can occur after ingesting MDMA, even at lower doses. These include heightened blood pressure, nausea, increased heart rate, jaw clenching, chills, sweating, tremors, hot and cold flushes, jaw clenching, urinary urgency, hyperreflexia, nystagmus (repetitive, uncontrolled eye movements), and insomnia.
When higher doses of MDMA are consumed, the effects described above can intensify and become severe. Overdoses on MDMA can result in death, and there are many recorded cases of fatal overdoses (Rigg & Sharp, 2017). MDMA can also trigger serotonin syndrome, resulting in seizures, muscle rigidity, and other severe symptoms.
MDMA interacts adversely with many other drugs and substances, including some natural supplements (Papaseit, Perez-Mana, Torrens et al, 2020). MDMA should never be combined with alcohol, MAOIs, 5-HTP, St. John’s Wort, heart or blood pressure medications, amphetamines, cocaine or any other stimulant.
Psychological safety
Psychologically and emotionally, some users report an unpleasant comedown from MDMA, including fatigue, depression, and anxiety (Sharifimonfared & Hammersley, 2019). It is important to eat and sleep well before and after consuming MDMA, and to keep well-hydrated during a session. There is also some evidence to show that pure MDMA produces far fewer negative effects during the comedown phase. However, as “ecstasy”, MDMA has often been mixed with other substances, such as methamphetamine, ephedrine, cocaine, bath salts, or dextromethorphan. For this reason, it is recommended that only pure MDMA be consumed, and trustworthy sources should always be used.
There is no evidence that MDMA is addictive, although chronic use resembles addictive substance abuse patterns (National Institute on Drug Abuse, 2017). When adulterated and mixed with other drugs, such as methamphetamines, addiction to impure forms of MDMA can occur.
MDMA Science
Pharmacology
MDMA (3,4-methylenedioxy-methamphetamine) engages with three of the brain’s neurotransmitters: serotonin, dopamine, and norepinephrine (noradrenaline). The substance’s ability to increase dopamine levels lead to sensations of euphoria and increased energy. Increases in norepinephrine/noradrenaline can cause blood pressure and heart rate to increase, creating a stimulant effect. Finally, increased serotonin levels are responsible for intense feelings of emotional closeness, empathy, and acceptance.
Therapeutic Use
The benefits of MDMA go beyond temporary feelings of well-being and euphoria. Recent studies indicate that the drug has significant potential to treat anxiety, depression, trauma, PTSD, and feelings of disconnection (Sessa, 2017). MDMA decreases activity levels in the limbic system of the brain. It also reduces communication between the prefrontal cortex and temporal lobe, parts of the brain that are responsible for emotional responses and emotional control (Wong, 2014). Individuals who suffer from anxiety generally have increased activity in these same areas, so the evidence suggests that MDMA can potentially be used to treat mood disorders (Feduccia, Holland & Mithoefer, 2017).
MDMA also increases communication between the hippocampus and amygdala in the brain. Among individuals who suffer from PTSD, communication is reduced in these same areas, which points towards the action through which MDMA may effectively treat PTSD (Sessa, 2017).
