The synthetic psychostimulant and hallucinogen MDMA, also known as “Molly” and the primary component in the club drug “Ecstasy”, has played a uniquely pivotal role in the modern psychedelic renaissance. While the compound has had a troubled history due to prohibition, recent research championed by MAPS has demonstrated the incredible therapeutic potential of MDMA in the treatment of conditions like PTSD.
These findings are certainly compelling and the fact that phase 3 trials exploring MDMA are currently underway is no doubt historic. However, the reality is that much of the MDMA consumed today is not pure and often adulterated with a host of other compounds, some of which can be dangerous. In the modern-day, this presents various harm reduction considerations that must be discussed when exploring this particular psychedelic medicine and its therapeutic potential. This guide will explore the neuropharmacology of MDMA, discuss its clinical promise as a mental health medicine, offer various safety and harm reduction considerations and provide deep, evidence-based insight into this powerful psychedelic medicine.
What is “Molly” or MDMA?
MDMA or “Molly”, short for “molecular”, refers to 3,4-methylenedioxymethamphetamine, a derivative of amphetamine and a member of the phenethylamine family of chemicals. It is normally sold on the black market in a tablet or capsule form as ecstasy or crystal or powder form as “Molly”. Oftentimes, the latter is sold under the pretense of being “pure” or unadulterated, however, this is hardly the case as with many illicit drugs. While the pure molecule is indeed showing great therapeutic potential as a psychotherapeutic pharmacologic intervention, there is still a significant risk that exists when consuming MDMA purchased on the black market.
Risks of Black Market Molly Explored: Common Substituents & Adulterants
While many mistakenly believe Molly does not contain the adulterants found in “Ecstacy”, various epidemiological studies have shown otherwise. In fact, as per DrugAbuse.gov, sometimes samples contained no MDMA at all but contained other synthetic stimulant substituents such as methylone and ethylone, commonly found in “bath salts” and known to be harmful, instead. Countless adulterants have also been found in street Molly, including ketamine, caffeine, the diet drug ephedrine, DXM, heroin, PCP, cocaine, and even powerful synthetic opioids, such as fentanyl, that can easily lead to a fatal overdose.
The fact that more harmful and dangerous substances are being sold under the guise of MDMA or “Molly” opens up serious ethical and harm reduction considerations that will be explored later in this piece. Later in this piece, we will explore MDMA test kits that can help consumers be safer and organizations, such as DanceSafe, that help individuals test their drugs at festivals and concerts.
What Are MDMA’s Effects? Exploring This “Mescaline-Like” Compound With Profound
Classified as a “mescaline-like” drug, MDMA is famous for inducing feelings of empathy, bliss, euphoria, bliss, connectedness. Like other psychostimulants, MDMA increases the release of dopamine and norepinephrine as well as serotonin, like many traditional psychedelics. Users often report sensations of openness, connectedness to others, an overwhelming feeling of love and empathy, allowing patients the ability to dive into traumatic memories more openly and discuss them with potential therapists more freely. Interestingly enough, MDMA is often considered a “mescaline-like” substance (or a blend of mescaline and amphetamine) and was investigated in the infamous MK-ULTRA trials as a potential “truth drug” from the 1940s to 1960s.
Indeed, MDMA’s ability to help PTSD patients in clinical trials make breakthrough progress with their therapists and go into remission is truly remarkable and potentially what MK-ULTRA researchers were attempting to tap into in their notorious research. Its ability to enhance communication is certainly one of the hallmark therapeutic features of this psychedelic medicine and it stands to revolutionize mental health as we currently know it.
How Long Does MDMA Last? Exploring Experience & Excretion of the MDMA Molecule
The MDMA experience, when consumed orally, itself lasts, on average, about three to six hours, depending on dose and other factors. MDMA can also be “plugged” (taken rectally) resulting in a much more rapid onset of effects and the need for much lower dosages than oral doses due to higher bioavailability. A much less common method of administration for MDMA is intravenous (IV) administration, however, the drug can be and is consumed this way as well. The onset of effects are reported, in online “trip report” forums, to be extremely rapid, usually overwhelming, and extremely short-lasting. Neither the rave scene nor the therapy setting seems to have much use for IV MDMA and, as with any injection drug use, is associated with serious health concerns. Overall, the route of administration (ROA) along with several other factors, such as height, weight, metabolic efficiency, and other factors will become relevant in ultimately determining how long MDMA’s acute and post-effects will last for any particular user.
An In-Depth Exploration of the Ecstasy Experience: Reviewing the Literature
One 2005 peer-reviewed study explored the subjective effects of MDMA and reported that
“When an average dose of ecstasy (100–125 mg) was ingested orally on an empty stomach, its effects were usually experienced after 20 to 60 minutes, and were often described as a sudden and intense high, a perfect euphoria. However, for some users, this ‘rush’ was far from perfect, as trepidation, tension, stomach tightness, and/or nausea ensued. Following this initial period, users generally reported a relatively stable and enjoyable period that tended to last between 2 and 3 hours. Finally, the “coming down” phase was experienced approximately 3 to 4 hours after ingestion. Ecstasy users reported using other substances such as alcohol, tranquilizers, or marijuana to ease the comedown.”
The above description captures the average timeline of effects most ecstasy or MDMA users experience. Indeed, there are important harm reduction considerations to explore since, as mentioned, ecstasy is often consumed in conjunction with other drugs, especially in this age of fentanyl and its dangerous opioid derivatives that are becoming increasingly prevalent in street drugs.
How Long Does MDMA Stay in Your System?
Since MDMA is still an illicit drug, many consumers wonder how long MDMA will stay in their system. For the individual to answer this question for themselves, various factors must be considered, such as the route of administration (ROA) discussed above. When combining MDMA with other psychedelics, such as LSD in a practice known as “candyflipping”, the duration of the MDMA experience can somewhat differ (or seem that way) for the user. Additionally, many users are concerned about how long the drug will stay in their system. Just like how long the psychedelic journey on MDMA will last, the time in which MDMA stays in your system is also dependent on weight, age, kidney/liver function, metabolic function and other concurrent drug and alcohol use. All of these factors are important considerations here when evaluating how long MDMA will stay detectable in your system.
Exploring the Historic Phase 3 Trials Investigating MDMA for PTSD Treatment
In Nature Medicine this year, one of the top-rated medical journals in the world, Phase 3 data from MAPS trials investigating MDMA for PTSD was released. In this gold-standard clinical trial (meaning it was randomized, double-blind, and placebo-controlled) researchers found that in patients with severe PTSD and common comorbidities, such as dissociation, depression, and a history of alcohol and substance use disorders, that MDMA-assisted psychotherapy was incredibly effective in diminishing PTSD symptoms. Researchers found on the follow-up that 67% of patients no longer qualified for a PTSD diagnosis and 88% had a clinically significant and meaningful reduction in their PTSD symptoms. Such findings have been unheard of in neuropsychiatry, until now.
Read More: Historic MAPS Phase 3 Trial of MDMA-Assisted Psychotherapy for PTSD Produces Successful Results
The researchers showed that MDMA was able to “induce significant and robust attenuation” in PTSD diagnosis criteria compared to placebo with significant reductions across both clinical endpoints. Additionally, it is worth noting the researchers reported that “MDMA did not induce adverse events of abuse potential, suicidality or QT prolongation.” This is an important fact when making the clear distinction between the risks associated with illicit MDMA versus the quality of medicine available to the select patients in these clinical trials.
Is Molly Neurotoxic? Exploring MDMA Toxicity & Adverse Effects
While new research into MDMA demonstrates controlled dosing in a clinically therapeutic setting can be done safely, such variables are hardly controlled for on the black market. As mentioned at the beginning of this article, street “Molly” is contaminated with everything from dangerous opioids like heroin and fentanyl to illicit stimulants like crystal methamphetamine and dissociatives like ketamine. When considering the level of adulteration prevalent in black market MDMA, it would behoove the modern-day consumer to understand many serious risks present in Molly come from this sort of contamination often resulting from the “cut” more than the MDMA itself.
That said, it’s also worth noting that the stimulant properties of MDMA made it the perfect party drug for the rave scene, providing users with excess energy and the ability to dance for many hours. Unsurprisingly, MDMA consumed in this context is often consumed concurrently with alcohol, magnifying potential adverse reactions. Naturally, dehydration and neurotoxicity became a bigger risk to this population of users compared to those receiving it in a therapy/research setting (often taken lying down on a couch with a blindfold on with a therapist). MDMA itself is also neurotoxic at certain dosage ranges and, currently, several players, including PharmAla Biotech are developing MDxx analogs that are significantly less neurotoxic to address this potential treatment concern.
Unfortunately, the black market is only expected to become more pervasive and, until a safe and regulated supply chain for these compounds can be established, “safe MDMA” use in the modern day is more complex than something like cannabis, for instance, and requires more harm reduction measures than other substances. One highly recommended harm reduction method is the MDMA test kit.
MDMA Test Kits: An Appeal to Rational Harm Reduction in the Age of Modern Prohibition
A 2019 peer-reviewed study published in Drug & Alcohol Review exploring the prevalence of MDMA test kits in an electronic dance music scene in NYC found that such kits can be effective in helping users detect adulterants and informing harm reduction efforts. Indeed, the study found that most ecstasy users reported they would be less likely to use again if they found out what they consumed contained bath salts or speed. Readers will recall earlier in this article that both are common substituents/adulterants found in street “Molly”. As such, organizations like DanceSafe and The Zendo Project are working actively to further psychedelic harm reduction efforts for the masses. We at Microdose appreciate their efforts to make MDMA safer for the world at large.
Concluding Thoughts on MDMA as an Emerging Psychedelic Medicine and Still Popular Party Drug
From its roots in early works of Shulgin to its continued prevalence as a party drug and now emerging mental health medicine, MDMA has played a pivotal role in the modern psychedelic renaissance. While some players in the sector are already developing the next generation of MDMA and MDxx therapeutics, organizations like MAPS have already advanced the molecule well into successful phase 3 clinical trials. Indeed, there are still serious safety concerns present in black market MDMA use that are explored in this piece. However, MDMA has also shown to be quite safe and extremely efficacious in recent clinical trials into the treatment of difficult to manage conditions, such as PTSD. What’s more, is the treatment is seemingly curative. The future certainly seems much brighter due to MDMA-assisted psychotherapy.
The synthetic psychostimulant and hallucinogen MDMA, also known as “Molly” and the primary component in the club drug “Ecstasy”, has played a uniquely pivotal role in the modern psychedelic renaissance. While the compound has had a troubled history due to prohibition, recent research championed by MAPS has demonstrated the incredible therapeutic potential of MDMA in the treatment of conditions like PTSD.
These findings are certainly compelling and the fact that phase 3 trials exploring MDMA are currently underway is no doubt historic. However, the reality is that much of the MDMA consumed today is not pure and often adulterated with a host of other compounds, some of which can be dangerous. In the modern-day, this presents various harm reduction considerations that must be discussed when exploring this particular psychedelic medicine and its therapeutic potential. This guide will explore the neuropharmacology of MDMA, discuss its clinical promise as a mental health medicine, offer various safety and harm reduction considerations and provide deep, evidence-based insight into this powerful psychedelic medicine.
What is “Molly” or MDMA?
MDMA or “Molly”, short for “molecular”, refers to 3,4-methylenedioxymethamphetamine, a derivative of amphetamine and a member of the phenethylamine family of chemicals. It is normally sold on the black market in a tablet or capsule form as ecstasy or crystal or powder form as “Molly”. Oftentimes, the latter is sold under the pretense of being “pure” or unadulterated, however, this is hardly the case as with many illicit drugs. While the pure molecule is indeed showing great therapeutic potential as a psychotherapeutic pharmacologic intervention, there is still a significant risk that exists when consuming MDMA purchased on the black market.
Risks of Black Market Molly Explored: Common Substituents & Adulterants
While many mistakenly believe Molly does not contain the adulterants found in “Ecstacy”, various epidemiological studies have shown otherwise. In fact, as per DrugAbuse.gov, sometimes samples contained no MDMA at all but contained other synthetic stimulant substituents such as methylone and ethylone, commonly found in “bath salts” and known to be harmful, instead. Countless adulterants have also been found in street Molly, including ketamine, caffeine, the diet drug ephedrine, DXM, heroin, PCP, cocaine, and even powerful synthetic opioids, such as fentanyl, that can easily lead to a fatal overdose.
The fact that more harmful and dangerous substances are being sold under the guise of MDMA or “Molly” opens up serious ethical and harm reduction considerations that will be explored later in this piece. Later in this piece, we will explore MDMA test kits that can help consumers be safer and organizations, such as DanceSafe, that help individuals test their drugs at festivals and concerts.
What Are MDMA’s Effects? Exploring This “Mescaline-Like” Compound With Profound
Classified as a “mescaline-like” drug, MDMA is famous for inducing feelings of empathy, bliss, euphoria, bliss, connectedness. Like other psychostimulants, MDMA increases the release of dopamine and norepinephrine as well as serotonin, like many traditional psychedelics. Users often report sensations of openness, connectedness to others, an overwhelming feeling of love and empathy, allowing patients the ability to dive into traumatic memories more openly and discuss them with potential therapists more freely. Interestingly enough, MDMA is often considered a “mescaline-like” substance (or a blend of mescaline and amphetamine) and was investigated in the infamous MK-ULTRA trials as a potential “truth drug” from the 1940s to 1960s.
Indeed, MDMA’s ability to help PTSD patients in clinical trials make breakthrough progress with their therapists and go into remission is truly remarkable and potentially what MK-ULTRA researchers were attempting to tap into in their notorious research. Its ability to enhance communication is certainly one of the hallmark therapeutic features of this psychedelic medicine and it stands to revolutionize mental health as we currently know it.
How Long Does MDMA Last? Exploring Experience & Excretion of the MDMA Molecule
The MDMA experience, when consumed orally, itself lasts, on average, about three to six hours, depending on dose and other factors. MDMA can also be “plugged” (taken rectally) resulting in a much more rapid onset of effects and the need for much lower dosages than oral doses due to higher bioavailability. A much less common method of administration for MDMA is intravenous (IV) administration, however, the drug can be and is consumed this way as well. The onset of effects are reported, in online “trip report” forums, to be extremely rapid, usually overwhelming, and extremely short-lasting. Neither the rave scene nor the therapy setting seems to have much use for IV MDMA and, as with any injection drug use, is associated with serious health concerns. Overall, the route of administration (ROA) along with several other factors, such as height, weight, metabolic efficiency, and other factors will become relevant in ultimately determining how long MDMA’s acute and post-effects will last for any particular user.
An In-Depth Exploration of the Ecstasy Experience: Reviewing the Literature
One 2005 peer-reviewed study explored the subjective effects of MDMA and reported that
“When an average dose of ecstasy (100–125 mg) was ingested orally on an empty stomach, its effects were usually experienced after 20 to 60 minutes, and were often described as a sudden and intense high, a perfect euphoria. However, for some users, this ‘rush’ was far from perfect, as trepidation, tension, stomach tightness, and/or nausea ensued. Following this initial period, users generally reported a relatively stable and enjoyable period that tended to last between 2 and 3 hours. Finally, the “coming down” phase was experienced approximately 3 to 4 hours after ingestion. Ecstasy users reported using other substances such as alcohol, tranquilizers, or marijuana to ease the comedown.”
The above description captures the average timeline of effects most ecstasy or MDMA users experience. Indeed, there are important harm reduction considerations to explore since, as mentioned, ecstasy is often consumed in conjunction with other drugs, especially in this age of fentanyl and its dangerous opioid derivatives that are becoming increasingly prevalent in street drugs.
How Long Does MDMA Stay in Your System?
Since MDMA is still an illicit drug, many consumers wonder how long MDMA will stay in their system. For the individual to answer this question for themselves, various factors must be considered, such as the route of administration (ROA) discussed above. When combining MDMA with other psychedelics, such as LSD in a practice known as “candyflipping”, the duration of the MDMA experience can somewhat differ (or seem that way) for the user. Additionally, many users are concerned about how long the drug will stay in their system. Just like how long the psychedelic journey on MDMA will last, the time in which MDMA stays in your system is also dependent on weight, age, kidney/liver function, metabolic function and other concurrent drug and alcohol use. All of these factors are important considerations here when evaluating how long MDMA will stay detectable in your system.
Exploring the Historic Phase 3 Trials Investigating MDMA for PTSD Treatment
In Nature Medicine this year, one of the top-rated medical journals in the world, Phase 3 data from MAPS trials investigating MDMA for PTSD was released. In this gold-standard clinical trial (meaning it was randomized, double-blind, and placebo-controlled) researchers found that in patients with severe PTSD and common comorbidities, such as dissociation, depression, and a history of alcohol and substance use disorders, that MDMA-assisted psychotherapy was incredibly effective in diminishing PTSD symptoms. Researchers found on the follow-up that 67% of patients no longer qualified for a PTSD diagnosis and 88% had a clinically significant and meaningful reduction in their PTSD symptoms. Such findings have been unheard of in neuropsychiatry, until now.
Read More: Historic MAPS Phase 3 Trial of MDMA-Assisted Psychotherapy for PTSD Produces Successful Results
The researchers showed that MDMA was able to “induce significant and robust attenuation” in PTSD diagnosis criteria compared to placebo with significant reductions across both clinical endpoints. Additionally, it is worth noting the researchers reported that “MDMA did not induce adverse events of abuse potential, suicidality or QT prolongation.” This is an important fact when making the clear distinction between the risks associated with illicit MDMA versus the quality of medicine available to the select patients in these clinical trials.
Is Molly Neurotoxic? Exploring MDMA Toxicity & Adverse Effects
While new research into MDMA demonstrates controlled dosing in a clinically therapeutic setting can be done safely, such variables are hardly controlled for on the black market. As mentioned at the beginning of this article, street “Molly” is contaminated with everything from dangerous opioids like heroin and fentanyl to illicit stimulants like crystal methamphetamine and dissociatives like ketamine. When considering the level of adulteration prevalent in black market MDMA, it would behoove the modern-day consumer to understand many serious risks present in Molly come from this sort of contamination often resulting from the “cut” more than the MDMA itself.
That said, it’s also worth noting that the stimulant properties of MDMA made it the perfect party drug for the rave scene, providing users with excess energy and the ability to dance for many hours. Unsurprisingly, MDMA consumed in this context is often consumed concurrently with alcohol, magnifying potential adverse reactions. Naturally, dehydration and neurotoxicity became a bigger risk to this population of users compared to those receiving it in a therapy/research setting (often taken lying down on a couch with a blindfold on with a therapist). MDMA itself is also neurotoxic at certain dosage ranges and, currently, several players, including PharmAla Biotech are developing MDxx analogs that are significantly less neurotoxic to address this potential treatment concern.
Unfortunately, the black market is only expected to become more pervasive and, until a safe and regulated supply chain for these compounds can be established, “safe MDMA” use in the modern day is more complex than something like cannabis, for instance, and requires more harm reduction measures than other substances. One highly recommended harm reduction method is the MDMA test kit.
MDMA Test Kits: An Appeal to Rational Harm Reduction in the Age of Modern Prohibition
A 2019 peer-reviewed study published in Drug & Alcohol Review exploring the prevalence of MDMA test kits in an electronic dance music scene in NYC found that such kits can be effective in helping users detect adulterants and informing harm reduction efforts. Indeed, the study found that most ecstasy users reported they would be less likely to use again if they found out what they consumed contained bath salts or speed. Readers will recall earlier in this article that both are common substituents/adulterants found in street “Molly”. As such, organizations like DanceSafe and The Zendo Project are working actively to further psychedelic harm reduction efforts for the masses. We at Microdose appreciate their efforts to make MDMA safer for the world at large.
Concluding Thoughts on MDMA as an Emerging Psychedelic Medicine and Still Popular Party Drug
From its roots in early works of Shulgin to its continued prevalence as a party drug and now emerging mental health medicine, MDMA has played a pivotal role in the modern psychedelic renaissance. While some players in the sector are already developing the next generation of MDMA and MDxx therapeutics, organizations like MAPS have already advanced the molecule well into successful phase 3 clinical trials. Indeed, there are still serious safety concerns present in black market MDMA use that are explored in this piece. However, MDMA has also shown to be quite safe and extremely efficacious in recent clinical trials into the treatment of difficult to manage conditions, such as PTSD. What’s more, is the treatment is seemingly curative. The future certainly seems much brighter due to MDMA-assisted psychotherapy.