MDMA (3,4-methylenedioxy-methamphetamine) is exclusively used in the United States as an illicit recreational drug. It’s a synthetic drug with properties of both psychedelics and stimulants. It’s often taken in party settings because the drug lifts your mood and increases “emotional warmth,” as the National Institute on Drug Abuse (NIDA) puts it.
The increased empathy and social euphoria you feel makes it a popular drug to take in social settings. As an illicit drug, it’s called Molly, and when it’s mixed with stimulants, it’s called ecstasy.
MDMA can have profound effects on some important chemicals in the brain, including dopamine, norepinephrine, and serotonin. These chemicals are tied to reward, motivation, mood, and energy levels. MDMA can affect your heart rate and blood pressure, sexual arousal, mood changes, empathy, and feelings of excitement, all through its interaction with these chemicals. These chemicals are also tied to substance use disorders.
Your reward center is designed to work with these feel-good chemicals to learn to encourage activities that produce positive feelings. The goal of the reward center is to continually encourage you to seek out life-sustaining activities, such as eating a warm meal. MDMA can cause your brain to mistake it for one of these important activities, and it will encourage the use of the drug again in the future.
NIDA says that the research into the addiction potential of MDMA is mixed. However, it does show signs of potentially causing a substance use disorder. Still, it may not be as addictive as other stimulants like cocaine. Learn more about MDMA addiction and how it can be treated.
Addiction is often identified by compulsive use of a drug despite consequences. If you experience things like strained relationships, health issues, or financial problems as a result of MDMA use, and you continue to use, you may have a severe substance use disorder. Other signs and symptoms can include:
MDMA doesn’t commonly cause severe substance use disorders; if it does happen, it can be treated. When you enter an addiction treatment program, you’ll undergo a medical and clinical assessment process to determine your needed level of care. It’s unlikely that MDMA withdrawal will cause life-threatening symptoms, so the highest levels of care, like detox, may not be necessary.
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However, if you have other medical needs that might be complicated by MDMA withdrawal, you may go through medical detox. If you don’t need detox, but you do have high-level medical or psychological needs, you may enter an inpatient or residential treatment program.
Once you can live by yourself, you may move on to an intensive outpatient or outpatient treatment program. Through these levels of care, you will go through a personalized treatment program that you create with the help of your therapist. You’ll meet with medical and clinical professionals weekly to go through therapies and assess your progress.
MDMA can cause severe adverse effects. In high doses, it can increase your body temperature in a way that’s similar to a fever. High temperatures can be fatal if they last for too long, and if you encounter them on the drug, it’s important to seek medical attention.
Moderate doses can also cause you to sweat, which can lead to dehydration. MDMA can also cause you to retain water in a way that impairs your ability to hydrate properly while on the drug. Drinking too much water can lead to hyponatremia, or water intoxication, which can be dangerous.
MDMA is an illicit, human-made drug. This means that any time you buy it, you’re getting it from unregulated black market sources. A wide variety of designer drugs are marketed and sold as Molly, even though they are chemically different and may have different effects and side effects. In some cases, the drugs can be more potent and dangerous.
For instance, bath salts are sometimes sold as MDMA, and they can cause deadly overdoses and frightening hallucination-inducing highs.
American Psychiatric Association. (2017, January). What Is Addiction? Retrieved from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
American Society of Addiction Medicine. (n.d.). What is the ASAM Criteria? Retrieved from https://www.asam.org/resources/the-asam-criteria/about
Baggott, M. J., Garrison, K. J., Coyle, J. R., Galloway, G. P., Barnes, A. J., Huestis, M. A., & Mendelson, J. E. (2016). MDMA Impairs Response to Water Intake in Healthy Volunteers. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4923534/
National Institute on Drug Abuse. (2016, February). 8: Medical detoxification. Retrieved from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification
National Institute on Drug Abuse. (2018, June). MDMA (Ecstasy/Molly). Retrieved from https://www.drugabuse.gov/publications/drugfacts/mdma-ecstasymolly