The Situation

Every year, millions of Americans report taking recreational drugs such as MDMA (a.k.a. ecstasy or molly) [1]. Large portions of ecstasy/molly users are unknowingly using drugs containing other substances such as “bath salts” or methamphetamine. In fact, studies of ecstasy-using nightclub and dance festival attendees have found that about half of ecstasy users who test positive for these adulterant drugs did not know they used them. [2, 3].

While there were more than 10,000 drug-related deaths involving cocaine and other psychostimulant drug use in 2016 alone [4], many more users may struggle with negative consequences ranging from dehydration to psychosis. Knowledge among the medical community and potential users about how to identify and address these risks is limited and inconsistent - with potentially tragic consequences. GPFF is committed to saving lives by supporting education, appropriate treatment and overall awareness of the dangers related to recreational drug use.

+ What is MDMA/ecstasy/molly?

  • MDMA is a synthetic drug that has both stimulant and hallucinogenic effects.
  • Use can increase energy, distort perception, and enhance feelings of empathy and sensory experiences.
  • MDMA is the name for the pure chemical compound, but it is also known as molly (when in powder or crystal form) or ecstasy (when in pill form). However, a lot of molly and ecstasy actually contains little to no MDMA.

+ How many people use ecstasy/molly in America?

  • Recreational ecstasy use was popularized in the 1980s in nightclub scenes, and use became widely associated with all-night dance parties in the 1990s and in the early 2000s. Although use has decreased since the early 2000s, the drug is still quite prevalent and used in a wide range of settings.
  • 1.2 million people ages 18-25 are estimated to have used ecstasy/molly in the past year1
  • 19.2 million people ages 12+ are estimated to have ever used ecstasy/molly in their lifetime.1
  • These numbers are likely higher as many people under-report drug use on surveys.
  • Between 2005 and 2011 there was a 128% increase in ecstasy/molly-related ER visits among young people under age 21 in the US.5

+ What are the potential side-effects of using ecstasy/molly?

  • Drugs sold as ecstasy and molly are commonly adulterated with other drugs such as methamphetamine, “bath salts”, cocaine, or ketamine. In addition there is concern that ecstasy and molly are becoming contaminated by fentanyl. However, even “pure” MDMA may be equally dangerous.
  • “Adulterated” drugs are intentionally modified to mimic the effects of MDMA because they are less costly or more available.
  • “Contaminated” drugs are unintentionally combined with other substances (i.e., when a manufacturer is not using clean conditions).
  • In addition, illicit manufacturers are creating ever-more high-potency drugs, sometimes competing to produce the strongest products.
  • Because MDMA is a Schedule I controlled substance in the US, the ability to possess and legally study its impact is limited.
  • However we do know that any use of MDMA may cause adverse psychiatric and physical symptoms such as panic attack, depression, suicidal ideation, increase in body temperature, sleeplessness and dehydration.
  • MDMA also releases serotonin which creates a sense of well-being. However, this temporarily depletes serotonin levels, causing many people to experience negative after-effects, sometimes referred to as ‘Blue Monday’ and ‘Suicide Tuesday’ following weekend use.
  • There is an opportunity to increase awareness among the medical community regarding treatment for these negative outcomes as well as research on the use and adverse outcomes associated with ecstasy/molly.

+ References

  1. Substance Abuse and Mental Health Services Administration, Reports and Detailed Tables From the 2017 National Survey on Drug Use and Health (NSDUH), in HHS Publication No. SMA 18-5068, NSDUH Series H-5. 2018, Center for Behavioral Health Statistics and Quality: Rockville, MD.
  2. Palamar, J.J., et al., Detection of "Bath Salts" and Other Novel Psychoactive Substances in Hair Samples of Ecstasy/MDMA/"Molly" Users. Drug and Alcohol Dependence, 2016. 161: p. 200-5.
  3. Palamar, J.J., et al., Hair testing to assess both known and unknown use of drugs amongst ecstasy users in the electronic dance music scene. Int J Drug Policy, 2017. 48: p. 91-98.
  4. Seth, P., et al., Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants - United States, 2015-2016. MMWR Morb Mortal Wkly Rep, 2018. 67(12): p. 349-358.
  5. Substance Abuse and Mental Health Services Administration, Ecstasy-Related Emergency Department Visits by Young People Increased between 2005 and 2011; Alcohol Involvement Remains a Concern. 2013.