The Essential Guide To

MDMA

(Ecstasy, E, X, XTC, Rolls, Beans, Adam, Molly)

mdma pills

3,4-Methylenedioxymethamphetamine
C11H15NO2

 

Disclaimer: MDMA is a potentially illegal substance, and we do not encourage or condone the use of this substance where it is against the law. However, we accept that illegal drug use occurs, and believe that offering responsible harm reduction information is imperative to keeping people safe. For that reason, this guide is designed to ensure the safety of those who decide to use the substance.

1. OVERVIEW

MDMA, commonly known as ecstasy, is primarily a recreational drug that causes euphoric feelings, increased empathy with others, and enhanced sensations. Sounds and colors are often experienced more intensely, making MDMA a popular recreational drug at raves and music festivals.

It is most commonly taken as an oral tablet that comes in a variety of shapes and colors, but it can also be snorted or smoked.

MDMA can be deadly when combined with other drugs (especially PMA/PMMA), and can also be deadly on its own at high doses. Currently, it is in Phase III clinical trials for use as a therapeutic aid in the treatment of PTSD.

2. HISTORY & STATS

BRIEF HISTORY

A common myth perpetuated by both the scientific community and media outlets is that MDMA was first synthesized and patented by the German pharmaceutical company Merck as an appetite suppressant.

Merck did synthesize the drug in 1912, but the appetite suppressant story is an urban legend. Instead, it was developed as a potentially life-saving blood clotting medicine.

Very little, if any, testing was done in the early years after its first synthesis. It wasn’t until 1927 that Merck revived interest in the drug. A chemist named Max Oberlin predicted that MDMA might mimic adrenaline since the chemicals shared a similar molecular structure. Not long after these initial studies, however, the prices of a chemical precursors skyrocketed and testing was put on hold.

It is not exactly known when the first human trials with MDMA were conducted, but the US military is known to have tested it and other drugs on humans in the 1950s.

The first “recipe” for MDMA was published in a polish-language scientific journal in 1960 and tablets began popping up in seized contraband in the 1970s.

Dr. Alexander Shulgin first read about MDMA in the early 1970s at which point he synthesized it and tested on himself, becoming the first person to officially record ecstasy use in a human subject in 1978.[1] In the 1980s, it started to be used in psychotherapy and was said to increase patient self-esteem and facilitate therapeutic communication.[2]

While Shulgin is often called “the Godfather of Ecstasy”, the real creator of MDMA was a German scientist named Anton Kollisch, who died in 1916 never knowing the legacy he left.

Since 1985, MDMA has been listed as a schedule I drug in the United States, making it effectively illegal for all uses, but some limited clinical trials have been approved and conducted in recent years. In 2011, a federal court sided with the ACLU who argued that punishments for MDMA possession and use were based on outdated science which led to overly severe prison sentences,[3] but other courts have upheld the previous sentencing laws.

CURRENT USAGE

The annual National Survey on Drug Use and Health found that MDMA had been used at least once by 13.1% of people between the ages of 18 and 25, and 6.5% of people age 26 and over. Full results from the survey are below.

Time PeriodAges 12 or OlderAges 12 to 17Ages 18 to 25Ages 26 or Older
Lifetime6.80%1.40%13.10%6.50
Past Year1.00%0.80%4.10%0.50
Past Month0.20%0.10%0.90%0.10%

 

These trends appear to be holding relatively steady:

18 to 25 Year Olds26 Years Old and Over
Time Period201320142015201320142015
Lifetime12.8012.0013.106.406.406.50
Past Year4.003.504.100.500.500.50
Past Month0.900.800.900.100.100.10

 

Its appearance in published reports and literature reached a peak in the early- to mid- 2000s and has fallen quite a bit since then:

Interest in MDMA

Google search interest over the past decade or so has slowly but steadily increased before plateauing the past few years:

3. PHARMACOLOGY

RECEPTOR INTERACTIONS

MDMA affects the brain by increasing activity levels of three different neurotransmitters: dopamine, norepinephrine (noradrenaline), and serotonin.[4]

Increases in dopamine account for euphoric effects as well as increased energy, while physical effects such as increased heart rate and blood pressure are caused by increases norepinephrine/noradrenaline. Its effects on the serotonin system cause characteristic changes in mood, appetite, sexual arousal, and sleep cycles. Spikes in serotonin after taking MDMA likely account for feelings of emotional closeness and empathy that are commonly reported by users.

TOXICOLOGY

Potentially fatal neurological complications can occur following MDMA ingestion, likely due to short-term hypertension and dehydration that is induced by the drug. Necrosis of liver and heart tissue has also been reported in individuals where death was associated with the use of amphetamine derivatives.[5]

Many fatal cases are due to abnormally high doses, prior healthy complications, a “bad batch” of MDMA, or a combination of all of these. It’s also particularly difficult to tell exactly how much of role MDMA plays in adverse reactions in many cases because users are more likely to have used multiple drugs.[6] Like with any substance, it should be used in moderation, as heavy users tend to experience more complications than occasional users.[7]

Clinical studies with pure MDMA have been conducted on over 1100 individuals without the occurrence of severe adverse effects.[8]

4. EFFECTS

Most tablets available for recreational use contain between 80 and 150 mg of MDMA.[9] At this dose level, the onset of effects occur approximately 20 to 60 minutes after taking the drug, and the characteristic effects (euphoria, increased empathy, increased energy, enhanced sensations) typically last for 3 to 5 hours.

MDMA usually produces a relaxed, euphoric state, including emotional openness, empathy, reduction of negative thoughts, and a decrease in inhibitions. Sounds and colors can also appear more intense.

Some adverse physiological effects can occur after ingesting MDMA and include elevated blood pressure and heart rate, nausea, chills, sweating, tremor, jaw clenching, hyperreflexia, urinary urgency, muscle aches or tension, hot and cold flushes, nystagmus, and insomnia. At higher doses, these physiological changes can result in severe adverse reactions.

Hyperthermia is one of the most common physiological reactions reported by users, and some studies have found body temperatures as high as 43°C (normal body temp: 37°C). Secondary complications from increased body temperature are a risk, especially when taking higher doses of MDMA.

5. MYTHS

Ecstasy will make me drink so much water that I’ll die

Although one of the most famous ecstasy-related deaths was caused by overhydration, MDMA itself will not make you drink yourself to death. The victim in this infamous case thought that by drinking a large amount of water, they would counteract an unpleasant ecstasy experience. Unfortunately, MDMA also makes it harder for the body to process water, meaning she died from water retention.

This doesn’t mean you should avoid drinking water on ecstasy. Taking a very high dose of ecstasy can cause an inability to regulate your hydration, so you should make sure you’re drinking water regularly. This is especially if you’re dancing or exerting yourself.

The main cause of ecstasy-related deaths is a lack of education. People don’t know how to take the drug safely, and end up increasing their health risks. When used responsibly, it is a relatively safe drug.

Ecstasy is a clubbing drug only

Although MDMA is very popular for use in clubs due to its enhancement of music and dance, that doesn’t mean it’s exclusively a clubber’s drug. Many people take it in a spiritual or therapeutic context. It can be used for various forms of personal and relationship development, and clinical trials are using it to treat sufferers of post-traumatic stress disorder.

Ecstasy eats away at your brain

There is no evidence that moderate use of MDMA (less than 100mg every few weeks) can cause damage to your brain.

Frequent, high dose use can cause heart problems and memory problems. Additionally, it’s relatively easy to overdose on MDMA if it’s combined with other drugs, especially PMA/PMMA. Overdoses can be lethal.

So although sensible use is relatively safe, it can be harmful in large amounts.

6. THERAPEUTIC USE

PTSD

MDMA was recently approved for use in a Phase 3 clinical trial in the US to treat posttraumatic stress disorder (PTSD).[10] [11] This is one of the last phases of testing before a drug is legally approved for therapeutic use. The trials are being funded by MAPS.

MDMA-assisted therapy for PTSD involves only a few administrations of the drug alongside guided professional therapy. The drug used in these trials is pure, with dosages strictly controlled – unlikely the typical use of recreational ecstasy.

Patients who have undergone this therapy typically have a particularly treatment-resistant form of PTSD (many of them are war veterans). They report that MDMA-assisted therapy helped them approach their past trauma with a greater sense of acceptance, warmth, and compassion for themselves, allowing them greater opportunity to cope and heal.

ANXIETY

Preliminary results from a few studies suggest MDMA is also a promising treatment for social anxiety in individuals with autism.[12] In a clinical setting, it can be used to shift a patient with social anxiety towards openness and encourage introspection. Early results suggest this is accomplished with infrequent or even single doses, eliminating the need for frequent administration of the drug, thereby mitigating the possible adverse side effects and many of the costs associated with longer-term, more involved therapies.

This same mechanism appears operate in treating patients with life-threatening illnesses who experience clinical anxiety as well.[13]

7. PERSONAL GROWTH

Opinions vary among spiritual leaders and guides, but MDMA is sometimes cited as an tool that can be used for spiritual growth. Some spiritual teachers laud its ability to induce feelings of oneness, interconnectedness, empathy, compassion, warmth and kindness towards others, and, importantly, a lack of self-consciousness. States such as these are often catalysts for spiritual epiphanies and further spiritual and personal development.

As one Benedictine monk put it:

“MDMA always propels me into an intimate space in conversation. There is a special quality to this conversation. One feels a heaviness, a sense of the weight of the moment, of something profound, of the seriousness of life itself. It is a space that is inner, without masks, without pretense, utterly open and honest. It is not an erotic intimacy, but a philosophical and mystical intimacy. Does this make any sense? One has the consciousness that this is an inner communication rarely achieved in ordinary discourse. There really are no adequate words to express this state of awareness, only to say, that it is essential in my experience.”

MDMA can be used in many different sets and settings to invoke spiritual development — from sitting quietly and introspecting, to meditating in groups, to therapy, even rolling at raves can have a spiritual quality if the user approaches it with the right intentions.

MDMA could also be a useful tool for building or repairing relationships. Alexander Shulgin, the ‘godfather’ of ecstasy, has written frequently on its potential use as a therapy for couples. The emotional intimacy produced by ecstasy could be the key to understanding our relationships and perhaps finding the places that need work.

Other resources:

8. FAQ

Can it be detected in a drug test?

MDMA is structurally close enough to amphetamines that it can return a positive result in standard urine drug screens up to 5 days after use. It is also detectable in hair samples for up to 90 days.[14]

How do I know if I have MDMA?

Testing kits can be purchased online, allowing you to test the purity and concentration of your pills. Making sure that you are actually ingesting MDMA, at sensible doses, is a crucial part of safe drug use.

How do I take MDMA?

Ecstasy is most commonly ingested as an oral tablet. In powder form, MDMA crystal can be ingested orally or insufflated (snorted). Many people mix the crystal into their drinks to avoid the bitter taste.

Effects will take up to an hour to appear. Don’t redose too frequently. Don’t mix with other drugs.

Can I microdose with MDMA?

Some people have reported microdosing with MDMA, however it’s possible that long-term use can be toxic. MDMA depletes your serotonin levels, and microdosing could leave you with a long hangover.

MDMA should probably only be used once a month at most, to avoid any dangers of long-term neurotoxicity.

Does it produce tolerance?

MDMA depletes serotonin levels, so users often experience a ‘hangover’ lasting up to a few days, during which they may feel depressed or mentally exhausted. Therefore, it will produce a tolerance lasting several days.

It’s best to avoid taking MDMA more than once a month, as long-term use can be neurotoxic and effect memory and mood.

Can I mix it with other drugs?

MDMA should not be mixed with other drugs, as some combinations can be very dangerous. Avoid DXM, tramadol and MAOIs, as these combinations can be fatal. Since MDMA affects your kidneys and liver, it’s best to avoid alcohol. It’s safest to take ecstasy without any other drug, and drink plenty of water if you’re dancing.

9. Footnotes

[1] Shulgin, A. T., & Nichols, D. E. (1978). Characterization of three new psychotomimetics. The Pharmacology of Hallucinogens. New York: Pergamon.

[2] Green, A. R., Mechan, A. O., Elliott, J. M., O’Shea, E., & Colado, M. I. (2003). The pharmacology and clinical pharmacology of 3, 4-methylenedioxymethamphetamine (MDMA,“ecstasy”). Pharmacological Reviews, 55(3), 463–508.

[3] ACLU. Court Rejects Harsh Federal Drug Sentencing Guideline as Scientifically Unjustified.

[4] NIDA. MDMA (Ecstasy/Molly).

[5] Green, A. R., Mechan, A. O., Elliott, J. M., O’Shea, E., & Colado, M. I. (2003). The pharmacology and clinical pharmacology of 3, 4-methylenedioxymethamphetamine (MDMA,“ecstasy”). Pharmacological Reviews, 55(3), 463–508.

[6] Gouzoulis-Mayfrank, E., & Daumann, J. (2006). The confounding problem of polydrug use in recreational ecstasy/MDMA users: a brief overview. Journal of Psychopharmacology, 20(2), 188–193.

[7] Parrott, A. C., Sisk, E., & Turner, J. J. D. (2000). Psychobiological problems in heavy “ecstasy”(MDMA) polydrug users. Drug and Alcohol Dependence, 60(1), 105–110.

[8] Danforth, A. L., Struble, C. M., Yazar-Klosinski, B., & Grob, C. S. (2016). MDMA-assisted therapy: a new treatment model for social anxiety in autistic adults. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 64, 237–249.

[9] Green, A. R., Mechan, A. O., Elliott, J. M., O’Shea, E., & Colado, M. I. (2003). The pharmacology and clinical pharmacology of 3, 4-methylenedioxymethamphetamine (MDMA,“ecstasy”). Pharmacological Reviews, 55(3), 463–508.

[10] Ecstasy Could Soon Double as a Prescription Drug for PTSD Patients. (2016, November 30). Fortune Magazine.

[11] Philipps, D. (2016, November 29). F.D.A. Agrees to New Trials for Ecstasy as Relief for PTSD Patients. The New York Times.

[12] Danforth, A. L., Struble, C. M., Yazar-Klosinski, B., & Grob, C. S. (2016). MDMA-assisted therapy: a new treatment model for social anxiety in autistic adults. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 64, 237–249.

[13] Mithoefer, M. C., Grob, C. S., & Brewerton, T. D. (2016). Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. The Lancet Psychiatry, 3(5), 481–488.

[14] Erowid MDMA Vault : Drug Testing.

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