MDMA, also known as ecstasy and/or molly, has remained a popular recreational drug for decades, mainly due to its euphoric and stimulating high. Although it has gained popularity through recreational use in more recent times—especially within the rave scene—MDMA has a long history of research and psychotherapy in the United States. Today, MDMA fast tracking to possible rescheduling in the United States due to extremely promising research regarding its therapeutic value.
Table of Contents
What is MDMA
MDMA, short for 3,4-methylenedioxymethamphetamine, is a popular drug that acts as both a psychoactive and a stimulant. It is a derivative of amphetamine, and a member of the phenethylamine family. This explains the production of an energizing effect in the user, while also causing enhanced enjoyment, empathy, feelings of connection to others, and enhanced sensory enjoyment. When purchased, it typically comes in tablet or powder form.
MDMA has many nicknames including:
- Ecstasy or E
- XTC or X
- Malcolm X
- Molly (short for “molecular”)
- Mandy (more popular name in the UK)
- The Love Drug
- Happy pill
Molly and ecstasy both refer to the same chemical: MDMA. When sold in tablets, it is commonly referred to as ecstasy. When sold in powder form (which usually comes in capsules) it is referred to as Molly. MDMA is occasionally sold in crystalline form as well, which is also referred to as Molly, or other slang names.
Pure MDMA powder does not stay in a pressed pill form easily, so ecstasy usually contains other ingredients to maintain its shape. These other ingredients can be active and harmful (MDMA is notorious for being impure), so the user should take extra precautions when/if buying. Additionally, MDMA often gets cut with other stimulants, which can cause harmful interactions.
The drug has developed many other slang names, mainly due to its effect on the user. For example, it is called “the love drug” or “the happy pill” because of the users’ enhanced feelings of affection and euphoria.
MDMA stands for 3,4-methylenedioxymethamphetamine, a derivative of amphetamine, which is why it produces some stimulant effects. It is a member of the larger group of ring-substituted phenethylamines. Phenethylamines without ring substitution usually behave solely as stimulants. However, the ring substitution in MDMA causes additional psychoactive effects, yet it is still less hallucinogenic than it’s homolog, methylenedioxyamphetamine (commonly known as MDA).
MDMA’s half-life is 6-7 hours. For synthesis, there are four principal precursors to manufacture MDMA: safrole, isosafrole, piperonal, and 3,4-methylenedioxyphenyl-2-propanone (PMK).
Forms & Ways of Consumption
MDMA is typically sold in tablet or powder form. Users can consume it orally; although some occasionally consume it intranasally. MDMA is measured in milligrams. A standard dose is between 80-160mg, although lower doses have been used in therapy. When taken, it affects the brain by increasing the levels of the neurotransmitters dopamine, norepinephrine, and serotonin.
MDMA is commonly sold in the tablet form. Most high quality tablets contain somewhere in the range of 80-150mg of the drug itself. However, pure MDMA powder cannot stay in pill form when pressed, so it is commonly mixed with other ingredients to bind the powder together. The onset of effects from tablets takes anywhere from 20 to 60 minutes. Once the onset of effects starts, the user will start to experience euphoria, an increase in energy, increased empathy/connection to others, and enhanced sensations. These feelings typically last for 3 to 5 hours.
Snorting MDMA powder can cause the effects to come on faster, and may cause a shorter, but more intense peak. It reaches the brain faster because the nasal membrane allows the bloodstream to absorb the drug quicker. This method also allows some of the drug to avoid being broken down by the liver.
Because snorting causes the effects to come on faster and more intense, the risks associated with the drug increase. The user could experience extreme damage and/or irritation to their nasal cavity, as snorting any powder can cause lasting effects.
Dissolving MDMA powder in a beverage produces a similar onset to tablet form, taking 20-60 minutes for effects to start.
What does it look like?
Ecstasy tablets are usually small round tablets that range in color, and often have a small icon pressed into them (such as a happy face, a heart, a number, or logo).
MDMA crystals look like a blackish/white crystal, which easily breaks off into powder.
MDMA powder is usually a white or off-white powder made out of MDMA crystals.
MDMA was first synthesized in Germany in 1912, but it wasn’t until the 70s that its therapeutic potential was discovered through use in psychotherapy. It was particularly productive in helping with marriage counseling. The drug quickly became popular for recreational use because of its euphoric/empathetic effects on the user.
Much like other psychedelics, after a rushed introduction to the public, the government quickly made it illegal and placed it on the Schedule I list.
Modern Day Development
In 1912, Anton Kollisch first synthesized MDMA with Merck Pharmaceuticals in Germany while investigating hemostatic substances (an agent that stops bleeding). Two years later, Merck Pharmaceuticals patented MDMA. After World War I, Merck’s US unit was confiscated.
In 1927, almost a decade after World War I ended, a chemist from Merck named Max Oberlin performed the first animal testing with the drug while investigating “adrenaline-like substances.” In 1953, the Army Chemical Center tested MDMA toxicity on guinea pigs, dogs, mice, and rats as part of the MK-Ultra project. These tests determined that the drug was “less toxic” than MDA. In 1965, American medicinal chemist Alexander Shulgin synthesized MDMA, but did not ingest it or try it.
Important Events, Findings, Studies
By 1971, a select amount of people were recreationally using MDMA, and The Bureau of Narcotics and Dangerous Drugs published their first encounter of the drug. This report was provided by the Chicago Police Department Crime Laboratory. The report refers to MDMA as “Methylenedioxymethamphetamine hydrochloride” where “the methylenedioxy linkage appears to be in the 3,4-positions.”
By 1976, Alexander Shulgin began to test it himself and introduce it to others. In September of 1976, Shulgin reported taking 16mg of MDMA and increasing doses until he reached 81mg on September 27th. He later reported the effects in his lab book as “amphetamine-like.”
Introduction into Psychotherapy
It was also in the 1970s that MDMA became extremely popular in the psychedelic therapy community, and began to show measurably positive effects in psychotherapy. It was during this time that it gained its nickname “Adam,” because many therapists felt that it brought their patients into an innocent-like state and helped them communicate more willingly.
Between the years of 1977 and 1981, only eight individuals had to seek emergency room treatment after using the drug recreationally (according to the Drug Abuse Warning Network).
In March of 1985, Esalen in Big Sur California held one of the first conferences on MDMA. Earth Metabolic Design (an organization started by Rick Doblin before he began MAPS) held the conference. Although the DEA Law Judge Francis Young recommended that physicians should be able to administer their patients MDMA, both the non-medical and therapeutic use of it was made illegal following an “emergency classification” under Schedule I in 1985.
Why MDMA is also “ecstasy”?
Michael Clegg was a catholic priest who got to know MDMA during his student years. Clegg was one of the main pioneers responsible popularizing MDMA in the late ’70s and early ’80s — right up it’s ban in the mid ’80’s. He was also selling the substance and making a profit. Clegg came up with the name “ecstasy” because his own experience with this substance, as he stated, was similar to the experience of “ecstasy” described in the bible. There’s currently a television series in production about his life.
First Reported Death
The first report of human deaths caused by MDMA or MDEA (another homolog) was published in 1987. In this report the details of five deaths are recorded, three of which were thought to be caused by arrhythmias in individuals with underlying conditions. One was an accidental death as a result of risky behavior, and officials believed that MDMA was the immediate cause of death in the last patient (although they were unsure). Later that same year, it was removed from Schedule I because of incorrect procedure in the emergency scheduling, but by March of 1988 it was permanently placed in Schedule I, where it remains today.
In 1991, Alexander and Ann Shulgin published PIHKAL, which documented over 250 phenethylamines, including MDMA, mescaline, and 2C-B. In 1992, FDA reviewed a MAPS supported protocol from Dr. Charles Grob for a study of MDMA and it’s potential to treat pain, anxiety, and depression in cancer patients.
By the recommendation of the FDA, Grob’s team postponed the cancer study and first completed a Phase 1 dose-response safety study. Completed in 1995, the study showed no unusual risks, indicating that it could be safely administered within a clinical research context. Between the years of 1994 to 1999, 27 related ecstasy deaths occurred in the United States reported by SAMSA. Ecstasy tablets became notoriously impure and laced with other harmful substances.
Rick Doblin’s Vision
On February 2nd of 2001, a conference called “The State of Ecstasy: The Medicine, Science, and Culture of MDMA” was held in San Francisco. Here, Rick Doblin announced his “Five Years, Five Million Dollars” plan for MAPS to turn MDMA into a prescription medication. Thanks to MAPS today, it is on the fast track to being rescheduled today, as it is showing extremely promising results in phase 3 clinical trials.
Laws and Legal Status
MDMA is illegal in the United States and has been a Schedule I substance since 1985.
It is illegal to buy, sell, or produce MDMA in most countries. However, it is more of a “gray area” in certain countries. In Peru, it is legal to possess up to 250mg, as long as it’s the only drug on you.
Although possession is illegal in the Netherlands, small amounts are likely to be ignored by the police.
Absorption of MDMA happens through the gastrointestinal tract and metabolized by the liver (mainly by the enzyme cytochrome P450 2D6) to an active metabolite called methoxyamphetamine. It is a serotonergic drug. The neurotransmitter serotonin (or 5-HT) is synthesized in 5-HT neurons and stored in synaptic vesicles. They then release 5-HT into the synaptic cleft in response to the activation of the 5-HT neurons. 5-HT is pumped back into the neuron through the reuptake pump where it is stored in the synaptic vesicles. When ingested, it blocks the reuptake of 5-HT.
MDMA’s primary mode of action is an indirect serotonergic agonist, meaning it increases the amount of serotonin in the synapse. MDMA can also exaggerate the release of dopamine and norepinephrine (noradrenaline) in a similar manner to the way it affects serotonin release.
Overall, MDMA affects 5-HT similarly to the way amphetamines affect dopamine (by inhibiting reuptake and causing the release of 5-HT). However, it has micromolar potency for the serotonin 5-HT2 (the psychedelic site), muscarinic M1, alpha-2 adrenergic (the cardiovascular site), and histamine H1 receptors. Many classic psychedelics (LSD, psilocybin, mescaline) seem to have agonist properties at the 5-HT2 receptor, so it is possible that the “psychedelic” effects occur because of the activity at this receptor. Some of the cardiovascular effects (increased heart rate, etc.) may be due to MDMA’s activity at the alpha-2adrenergic receptor.
Before we can discuss whether or not MDMA is toxic, we first need to define what makes a substance toxic. Toxicity is defined based on the levels of exposure required for a substance to cause harm to a human or animal. The level of toxicity is measured based on the dose required to cause harm to a human. Even water can be toxic in too high of a dose and lethal snake venom can be non-toxic in a small enough dose. LD50 is a common measurement of toxicity, which measures the lethal dose for half of the tested organisms.
When the government first started performing animal tests in the 70s, they gave exorbitant amounts of the drug to animals and deemed it neurotoxic. Since then, extensive evidence has been released showing that this is not the case. Considering the large amount of users internationally, serious acute adverse effects seem to be rare. The main thing to look out for is the danger of becoming dehydrated (especially because it is so popular in the rave scene). Additionally beware increased heart rate (especially if you have pre-existing heart conditions).
Risks associated with possible long-term brain damage are more difficult to research. Government studies in animals have shown that MDMA can cause long-lasting decreases in the neurotransmitter serotonin (keep in mind these are the same government studies in which animals were administered gross, frequent quantities). For these reasons, the phenomena such as the “three-month rule” were developed for individuals interested in trying ecstasy more than once. This rule says that users should wait at least three months between each dose in order for their serotonin levels to become normal again. The true long-term effects from exposure are still unknown.
MDMA can and does produce adverse neurotoxic effects at some large and repeated doses. These adverse effects include decreases in concentration of serotonin (5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA). These effects suggest that the drug causes either a type of “down regulation,” meaning the neuron is making and keeping less of the serotonergic markers, or that permanent loss of serotonergic axons is happening.
The latter option (permanently lost axons) would fit better into “neurotoxicity”, and be cause for more alarm because it is a permanent effect rather than down regulation, which is more of an active adaptation to drug effects. However, we don’t know which of these effects MDMA causes in the brain. This is because factors like diet and lifestyle can affect serotonin levels. This “down regulation” may happen because MDMA rapidly inactivates the enzyme TPH and, thus, decreases serotonin levels until TPH activity returns to normal.
Neurotoxic or Not?
As is the case for most other drugs, the extent of assumed “neurotoxicity” is dose-dependent. The only long-term changes that have been reported in rats were observed after they were administered doses equal to approximately 5 to 10 times higher than those known to be psychoactive in humans. The main finding that these animal studies show is that “binge” use of ecstasy carries a greater risk than a single dose.
One important thing about potential MDMA neurotoxicity is MDMA’s relationship with SSRIs. SSRIs clock the SERTs (a type of monoamine transporter protein which transports serotonin from the synaptic cleft back to the presynaptic neuron). Because of this, many researchers believe that SSRIs can reduce the ability of MDMA to cause neurotoxicity, but they also reduce MDMA’s ability to effect an individual. In conclusion, someone who regularly takes SSRIs may experience less neurotoxicity from MDMA, but will also not experience the normal effects of MDMA.
MDMA and Alcohol
Mixing ecstasy with alcohol can be very dangerous, and cause severe dehydration. Furthermore, MDMA’s stimulant effects can hide alcohol’s sedating effects, causing an individual to drink more and become dangerously drunk. Basically, an individual could feel more sober than they actually are. A study done in 2002 found that the concentration of MDMA in each individual’s blood increased 13% after they drank alcohol. Research on rodents also suggests that mixing alcohol and MDMA may negatively affect the heart by placing unnecessary stress on it.
MDMA and MAOIs
MDMA and MAOIs do not mix! If you are not sure if you are taking prescription MAOIs, you should know that Nardil, Parnate, Marplan, Eldepryl, and Aurorix/Manerix fall under this category. Ayahuasca brew also contains MAOIs in the form of harmine and harmaline.
Mixing MDMA and MAOIs can cause a potentially fatal condition called “serotonin syndrome”. A number of people have died from the result of taking MDMA and MAOIs.
Other Drug Interactions
MDMA taken with other drugs that metabolize through the same liver enzyme known as CYP2D6, can interact. If you combine MDMA with a drug metabolized by the same liver enzyme, both drugs will take longer to metabolize. In turn, the user will feel like they took a higher dose of each drug.
CYP2D6 also metabolizes Ritonavir (also mentioned below). Other drugs metabolized by CYP2D6 include codeine, opiate derivatives, and DXM. DXM is commonly found in impure ecstasy tablets. Also note that CYP2D6 also metabolizes Prozac.
Never take MDMA with a protease inhibitor. If you are using the protease inhibitor Ritonavir, do not take MDMA. This may be a life-threatening combination, and is known to be fatal.
Avoid other stimulants (prescription or recreational) when taking Ecstasy. This can cause increased heart rate, blood pressure, and body temperature risks.
A small number of MDMA users have reportedly experienced seizures after taking moderate doses of pure MDMA. The cause of this is unknown, but it is important to remain aware that MDMA can affect everyone differently.
MDMA and Psychological Conditions
Like all psychedelics, do not take MDMA if predisposed to any mental health conditions (especially schizophrenia and psychosis). MDMA can possibly exacerbate the symptoms of depression when used recreationally. However, current clinical trials indicate that MDMA can help drastically with conditions such as PTSD.
MDMA and Physical Conditions
Do not use MDMA if you have pre-existing heart conditions, a history of heart ailments, high blood pressure, glaucoma, liver/kidney disorders, or hypoglycemia.
Besides the above mentioned interactions, there are two main things to be cautious of when taking MDMA. The first is remaining hydrated, and the second is purity. Because of the drug’s propensity to increase the user’s heart rate, users can get extremely dehydrated and overheated. Making it very important to stay hydrated during use.
It is very rare to find completely pure ecstasy in US. Even if someone promises what you are buying is pure, it is very likely not purely MDMA. Some use a series of harmful substances to cut MDMA in the black market. For more information on laboratory tested ecstasy pills click here. To read more about at home pill testing kits, how to use them, and other questions, please click here.
Can you overdose on MDMA?
Consuming a higher than an appropriate dose of MDMA, can happen, but overdosing is extremely uncommon. One of the few cases of a pure MDMA overdose states that an individual took 2.3 grams of MDMA at once — almost twenty times a normal dose. According to the community, most overdoses occur because of consuming impure MDMA, or consuming a substance that isn’t even MDMA at all.
MDMA affects the brain by increasing the levels of the neurotransmitters dopamine, norepinephrine, and serotonin. Because of this, users normally experience multiple positive effects:
- Mood lift/euphoria
- Increased willingness to communicate
- Decreased fear, anxiety, and insecurities
- Feelings of love, passion, connection, and comfort
- Decreased pain perception
- Feelings of love and empathy
- Increased awareness of the senses
Common Side Effects
Note: higher and more frequent doses may cause a high likelihood of negative effects.
- Decreased appetite
- Visual distortion
- Jaw clenching
- Desire to move the mouth
- Unintended emotional bonding
- Muscle tension
- Erectile dysfunction
- Increase in body temperature
- Sadness while/after coming down
- Post-trip crash or a post-trip afterglow, when the user experiences feelings of euphoria and clarity after tripping
- Hangover causing depression and/or fatigue possible/controversial neurotoxicity
Dependence on MDMA is a sign of overtaking it.
A general rule of thumb in the community is no more than once every 3 months.
Records show MDMA use both therapeutically and recreationally for decades. As more progressive technology continues in development, and as more awareness of its benefits and risks spread, MDMA use can continue in safer and more effective ways.
MDMA is extremely popular for recreational use due to it’s stimulating, euphoric effects. It is especially popular in the rave/dance/music festival scene.
Although MDMA is still a Schedule I substance, MAPS has a goal of making MDMA available for prescription by 2021. MDMA is currently in phase 3 trials for its medical potential to help patients who have experienced past traumas. For more information on this topic, see the “Current Studies and Research” section.
Ecstasy was very popular in psychotherapy use in the 70s and 80s. Since then, it has made a comeback in therapeutic/medical use through government-funded research, specifically in alliance with MAPS.
Some individuals use MDMA for spiritual experiences because of its tendency to make the user feel more open, connected, and willing to communicate. There is currently no research on spiritual experiences and MDMA. However, many individuals and groups have recorded their mystical/spiritual experiences. These recordings found here.
Although MDMA remains a popular drug today for recreational use, the most astonishing developments occur within the research of MDMA-assisted psychotherapy.
MDMA is very popular for recreational use. The Global Drug Survey of 2019 reported that 49.2% of participants had used MDMA at least once, and 33.0% of participants had used it within the last 12 months of responding.
Where a person buys it and in what quantity will alter the trending price of MDMA. A single tablet may cost up to $50, but 10-20$ is more common. In higher quantities, MDMA will usually sell for $100-$125 per gram. MDMA powder, or “Molly,” has gained popularity over tablets, because many individuals believe that MDMA powder is purer than tablets. However, this belief cannot be verified.
Psychedelic experiences influence many artists. One of the more notable examples is Alex Grey, whose MDMA experiences have greatly influenced his art (find his work here).
More importantly, MDMA is currently being accepted as a therapy tool. The FDA has approved phase three trials for MDMA-assisted psychotherapy. Researchers are aiming for it to be available as a prescription medication by 2021.
Current Studies & Research
Within the current renaissance of psychedelic research, MDMA is showing among the most promising results in trails. Because of extraordinary results, the FDA has granted MAPS permission for phase three trials of MDMA-assisted psychotherapy for PTSD. This research involved a $26.9 million dollar plan to make MDMA into an FDA-approved prescription medicine by 2021. MAPS, founded by Rick Doblin, is the only organization funding clinical trials of MDMA-assisted psychotherapy for PTSD, social anxiety in autistic adults, and anxiety associated with life-threatening illnesses.
In this psychotherapy, psychiatrists administer MDMA only a few times in order to show results. This is in contrast to medications prescribed as an ongoing basis, and may cause extremely negative side effects for years.
MDMA is effective in treatment because it helps the individual feel more comfortable, safe, and communicative while talking through traumas. Current drugs prescribed for a condition like PTSD only manage the symptoms. Therefore, MDMA is a possible permanent solution.
Around the World
Most research is currently going on inside the United States. MDMA is still popular for recreational use internationally, although it is illegal in most countries around the world.
How does MDMA Show Up in my body?
MDMA is detectable 1-5 days after use. This time period depends on the amount taken, your metabolism, and other factors. If an individual has taken MDMA they will test positive for both amphetamines and methamphetamines. It will show up in a hair drug test for about 90 days.
Does MDMA Go Bad?
MDMA is a phenethylamine. In general, phenethylamines are quite stable molecules, and will stay stable for years or even decades. MAPS has a supply of MDMA for research manufactured by Dr. David Nichols and stored in Purdue University. In 1994, Dr. Nichols tested this supply eight years after originally synthesized, and it showed no signs of deterioration.
What Does MDMA Taste Like?
MDMA is extremely bitter, like any other alkaloid.
What Does MDMA Smell Like?
MDMA has no distinct smell to humans.
This MDMA guide is for educational purposes only. While it is our belief that choosing to consume psychedelics is an inalienable human right, many psychedelic substances are currently illegal in the United States.
Our substance guides provide the public with the most accurate and reliable information about psychedelic substances that currently exist. We have compiled research, scientific studies as well as experiences and thoughts from the psychedelic community. We do not include all the scientific research and studies. Rather, we curate each our guides to reflect the most relevant insight backed by the most credible evidence. That being said, we are just at the beginning of studying these substances.Everyday we are learning something new. Knowledge is power! Have a bite. If you have relevant information or updates concerning the research and studies of psychedelic substances, please reach out to [email protected]. We appreciate your contribution. –RS