When someone reaches the stage of addiction to ecstasy, it is very important for them to get proper addiction treatment and have help recovering from the addiction. Fortunately, there are several treatment options available for people struggling with this substance use disorder.
What is MDMA?
MDMA stands for 3,4-methylenedioxymethamphetamine. It’s a synthetic drug that acts as both a stimulant and a hallucinogen. Most people know it by names like ecstasy or molly. While it first became popular in clubs and raves, MDMA use now spans a wider population.
The effects of using the drug usually last 3 to 6 hours. These include heightened energy, emotional warmth, and distorted sensory perception.
The Drug Enforcement Administration classifies MDMA as a Schedule I substance. This means it has a high potential for abuse and no accepted medical use. Still, researchers are looking at its possible role in treating PTSD and anxiety in terminally ill patients.
How is MDMA used?
People take Molly in pill, capsule, or powder form. Pills often come in bright colors with cartoon-like logos. Some users also crush and snort it or smoke it.
Common terms for how users take Molly:
- Bumping: Taking more than one pill
- Stacking: Taking three or more at once
- Piggybacking: Taking several pills in quick succession
- Candy flipping: Mixing MDMA with LSD
“Molly” usually refers to a form of MDMA marketed as pure crystalline powder. However, many capsules sold as Molly are mixed with other substances, such as bath salts, amphetamines, or cocaine.
Effects of Molly use and abuse
People often feel the effects within 45 minutes of taking the drug. These include:
- Feeling more energized and alert
- A heightened sense of well-being and emotional closeness
- Increased openness and extroversion
- Enhanced perception of sights, sounds, touch, and smell
These effects usually peak within 15 to 30 minutes and last around three hours. However, risks increase in certain settings, like crowded events or hot environments.
MDMA can also cause:
- Seizures or, in rare cases, loss of consciousness
- High blood pressure and jaw clenching
- Nausea, vomiting, or faintness
- Panic attacks or confusion
- Overheating, which can lead to kidney failure or brain swelling
- Muscle stiffness, dehydration, and electrolyte imbalance
- Disorganized thinking or mild detachment from reality
- Difficulty driving or reacting to motion
What MDMA does to the brain
MDMA affects how your brain uses three main neurotransmitters:
- Serotonin: controls mood, sleep, and appetite
- Dopamine: linked to pleasure and reward
- Norepinephrine: influences energy and heart rate
When people take Molly, these chemicals flood the brain and block reabsorption.
This overstimulation can damage nerve cells and lead to issues with long-term memory, mood, and focus.
MDMA also raises glutamate levels in the hippocampus, which handles memory. Over time, this may harm neurons and cause emotional or learning problems.
Long-term effects of ecstasy addiction
After the high fades, users often feel a “comedown” with symptoms like:
- Depression, anxiety, or irritability
- Trouble sleeping or concentrating
- Reduced appetite
- Low energy or mood swings
With ongoing use, long-term problems can include:
- Memory and attention issues
- Higher risk of heart or liver problems
- Disrupted sleep and poor cognitive performance
- Impulsive behavior and aggression
- Lasting emotional issues, including paranoia
Some studies show damage to brain cells involved in mood and decision-making after repeated Molly use.
Contamination risks of street molly
Street versions of MDMA, whether in pill, capsule, powder, or liquid form, are often mixed with other substances. Sometimes, they don’t even contain MDMA.
Though sold as pure, many products labeled as Molly contain other drugs meant to mimic or increase MDMA’s effects.
These include:
- Stimulants: methamphetamine, amphetamine, and synthetic cathinone like methylone or ethylone (found in bath salts)
- Dissociatives and anesthetics: ketamine
- Other additives: caffeine, ephedrine, dextromethorphan, heroin, PCP, and cocaine
For example, in 2013, molly sold in Washington and Florida was methylone. By 2015, ethylone had become a common ingredient.
Why MDMA contamination is dangerous
Contaminated Molly use increases several health risks:
- Risk of overdose, especially when mixed with opioids like fentanyl, which can be deadly even in small amounts
- Unexpected symptoms users may experience include side effects they didn’t plan for or understand
- More stress on the body, especially when combined with other drugs or medications like antidepressants
- Harder emergency care, doctors may not know what was ingested, making treatment harder
The bottom line is that using street MDMA carries serious and sometimes fatal risks.
MDMA usage statistics
MDMA use is relatively low across the general population, but certain groups face a higher risk.
Prevalence in the United States:
- About 0.9% of people aged 12 and older used MDMA in the past year, based on 2015–2020 data.
- In 2014, over 17 million people had tried MDMA at least once in their lifetime, up from 11 million in 2004.
- Monthly use in 2014 was estimated at 660,000 people, up from 450,000 a decade earlier.
- Lifetime use among Americans 12 and older reached over 18 million by 2014.
Trends among adolescents:
- In 2016, 2.7% of 12th graders, 1.8% of 10th graders, and 1% of 8th graders reported past-year MDMA use.
- By 2021, past-year use dropped to 1.1% for 12th graders, 0.7% for 10th graders, and 0.6% for 8th graders.
- Among people aged 19–30, 2.6% reported past-year use in 2021.
Demographics of use:
- MDMA is most commonly used by males aged 18 to 25.
- People aged 12–34 had higher odds of use compared to those aged 35–49.
- Bisexual women and people identifying as Asian, Black, or multiracial had increased odds of use.
- Use was more likely among those with some college education and less likely among those who were married.
- Gay and bisexual individuals were more likely to use MDMA and report related harm than heterosexual individuals.
Connection to other substances:
- MDMA users often reported using cannabis, LSD, cocaine, ketamine, GHB, and methamphetamine.
- There’s also a link between MDMA use and misuse of prescription painkillers, stimulants, sedatives, and alcohol use disorder.
Other key stats:
- In 2011, emergency rooms reported 22,498 MDMA-related visits, mostly among 18- to 20-year-olds.
- In 2015, 3,510 people entering treatment for a substance use disorder listed MDMA as a contributing factor.
Addiction Treatment for MDMA use disorder
There are no FDA-approved medications for treating MDMA addiction, but that doesn’t mean people can’t recover. A treatment program can help address Molly use and its effects.
Options include:
- Therapy with medical support: Talk therapy is a key part of treating Molly’s addiction, especially when paired with medical help.
- Brain-focused treatment: Some researchers are working on ways to repair the brain systems affected by MDMA use.
- Medications under study: These include dextromethorphan, dextrorphan, ketoprofen, rilmenidine, and even ginger for its possible protective effects in lab tests.
General help for substance addiction
If you or someone you care about is struggling with drug use or withdrawal symptoms, help is available. You can:
- Call the SAMHSA National Helpline at 1-800-662-HELP (4357)
- Visit FindTreatment.gov to find local support
- Call or text 988, or go to 988lifeline.org to speak with a counselor
You can also get support at home. Modern Recovery offers online addiction treatment with therapy, recovery coaching, and mental health support.
It’s a flexible option to help with long-term recovery and serve as aftercare following rehab.
Get started on your journey to recovery
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Sources
1. National Institute on Drug Abuse. MDMA (Ecstasy/Molly) [Internet]. 2024 Apr 19 [cited 2025 Mar 20]. Available from: https://nida.nih.gov/research-topics/mdma-ecstasy-molly
2. Mustafa NS, Abu Bakar NH, Mohamad N, Mohd Adnan LH, Md Fauzi NFA, Thoarlim A, et al. MDMA and the Brain: A Short Review on the Role of Neurotransmitters in Neurotoxicity. Basic Clin Neurosci [Internet]. 2020 Jul 1;11(4):381–8 [cited 2024 May 15]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878040/
3. National Institute on Drug Abuse. MDMA (Ecstasy) Abuse [Internet]. Last Updated September 2017 [cited 2024 May 15]. Available from: https://www.drugabuse.gov/publications/research-reports/mdma-ecstasy/mdma-ecstasy-abuse
4. Yang KH, Kepner W, Nijum A, Han BH, Palamar JJ. Prevalence and Correlates of Past-Year Ecstasy/MDMA Use in the United States. J Addict Med. 2023 Jun 16;17(5):592–597. doi: 10.1097/ADM.0000000000001188. PMCID: PMC10593986. PMID: 37788615.