The name ecstasy is associated with the drug 3,4-Methylenedioxymethamphetamine, also called Molly or MDMA. Although the substance was developed to be a psychiatric medication, it is now listed by the Drug Enforcement Administration (DEA) as a Schedule I substance, meaning it has no acceptable medical use.
Popularity of ecstasy, specifically, peaked in the early 2000s, and more recently, purer versions of MDMA have taken ecstasy’s place. Because it creates a sense of euphoria that increases the pleasure of social settings and touch, ecstasy is often found in larger social settings like nightclubs, raves, or music events.
What Is Ecstasy, and How Is It Abused?
Ecstasy is a drug with both stimulant and hallucinogenic effects. It is chemically similar to amphetamines, but it also produces psychedelic effects. Because the drug increases sensations of emotional warmth, changes the perception of time and surroundings, increases energy, creates mild dissociation, and induces a sense of pleasure, ecstasy was originally used in clinical settings to help patients work with psychologists on very difficult personal issues. However, the drug is so intoxicating and reinforcing that, in larger doses, it can be dangerous.
In appearance, the primary MDMA product is a white or whitish crystalline powder. This substance is most often pressed into tablets with bright colors and cartoon-like logos and then sold as ecstasy. The drug may also be crushed and snorted, or mixed into drinks like soda, juice, or alcohol.
In high-energy social settings, a tablet or snort of ecstasy takes effect within 20-40 minutes after it is ingested. Initially, the drug’s effects include exhilaration, heightened sensory experiences, and nausea. After 60-90 minutes, effects from ecstasy peak, including hallucinations, empathy, muscle tension, and excitement. While ecstasy’s effects may last up to six hours, many of the later effects may be negative, including:
- Anxiety and paranoia
- Extreme relaxation
- Severe dehydration
- Increased body temperature and heat exhaustion
- Raised blood pressure
- Increased breathing rate
- Rapid heartbeat
- Feeling faint
- Blurry vision
- Rapid quivering of the pupils, called nystagmus
Coming down from ecstasy can leave one exhausted, even feeling “burned out,” for up to two days. The drug’s effects and intense comedown experience are due to how the substance binds to receptors in the brain. Three neurotransmitters associated with mood – dopamine, serotonin, and norepinephrine – are suddenly released in large amounts when the drug enters the brain. After ecstasy’s effects wear off, the brain has difficulty producing these neurotransmitters, which can lead to temporary depression, exhaustion, and reduced pleasure.
Unlike some other drugs like meth or cocaine, few people who take ecstasy will binge on the drug. What is riskier is the association between social setting and ecstasy; the tablets may contain other drugs, including meth, and social settings may encourage people taking ecstasy to consume other drugs, like alcohol, opiates, or marijuana.
Who Abuses Ecstasy, and What Are the Risks?
Adolescents and young adults are the primary age groups who abuse ecstasy. This is predominantly due to the popularity of raves, nightclubs, music festivals, and large dance parties with teenagers and young adults. The National Institute on Drug Abuse (NIDA) reports that most people who consume ecstasy are white, non-Hispanic, although the popularity of ecstasy is spreading to other ethnic groups in urban areas.
The Drug Abuse Warning Network (DAWN) found that, between 2005 and 2011, there were surges of people under the age of 21 requiring emergency room treatment due to ecstasy abuse and overdose. In 2005, there were 4,460 admissions; by 2011, that number increased to 10,176 admissions, with a peak of 11,316 admissions in 2010. The surge represented a rise of 128 percent. On average, 33 percent of those admissions for ecstasy also involved alcohol use, although the patients were under the legal drinking age of 21.
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Because most people who consume this drug are young, their brain development and long-term health may be impacted. Lasting effects from consistent ecstasy abuse include:
- Sleep trouble, including insomnia
- Cravings for the drug
- Intense anxiety
- Possible serotonin depletion
- Memory loss and trouble forming new memories
- Sudden death
While many of the health risks associated with ecstasy come from the MDMA chemical itself, many other effects may be associated with adulterants, especially other intoxicating drugs that are mixed into the ecstasy tablets. Drugs often found mixed into these tablets include:
- Over-the-counter cough medicine, including the ingredient dextromethorphan
- Synthetic cathinones, or bath salts
Some of these adulterants are also addictive. When mixed with another potent intoxicant, any intoxicating drug can cause a rapid overdose that is difficult to treat. Too much of any of these substances may lead to sudden death.
More general signs of ecstasy abuse include frequent exhaustion, staying up all night, spending too much money or asking for money frequently, obsessing about specific social events where the drug might be present, and other behavioral changes.
Treatment for Ecstasy Abuse
Even unadulterated ecstasy can be addictive, and it is important to understand the treatment process to overcome abuse of this drug. While there are no specific drugs or pharmacological treatments that can ease withdrawal symptoms associated with ecstasy, a physician can soften the detox process with over-the-counter painkillers, nausea treatments, and other remedies.
Attending an evidence-based rehabilitation program that offers psychotherapy – most often, Cognitive Behavioral Therapy – is the best treatment approach after detox has been safely completed. NIDA’s Principles of Effective Treatment recommend remaining in a rehabilitation program for at least 90 days, which helps a person put behavioral changes into regular practice. Long-term care, therapy, social support, and complementary therapies also help to maintain sobriety.