MDMA (3,4-methylenedioxy-N-methamphetamine) is an empathogenic drug of the phenethylamine and amphetamine classes of drugs. MDMA has become widely known as “ecstasy” (shortened to “E“, “X“, or “XTC“), usually referring to its street pill form, although this term may also include the presence of possible adulterants. The term “molly” or “mandy” colloquially refers to MDMA in powder or crystalline form, usually implying a higher level of purity.
MDMA can induce euphoria, a sense of intimacy with others, and diminished anxiety. Many studies, particularly in the fields of psychology and cognitive therapy, have suggested that MDMA has therapeutic benefits and facilitates therapy sessions in certain individuals, a practice for which it had formally been used in the past. Clinical trials are now testing the therapeutic potential of MDMA for post-traumatic stress disorder (PTSD) and anxiety associated with terminal cancer.
MDMA is criminalized in most countries (though some civil society initiatives—such as the Global Commission on Drug Policy—consider educating the public about the drug more important than curtailing supply) and its possession, manufacture, or sale may result in criminal prosecution. Some limited exceptions exist for scientific and medical research. For 2008 the UN estimated between 10–25 million people globally used MDMA at least once in the past year. This was broadly similar to the number of cocaine, amphetamine and opioid users, but far fewer than the global number of cannabis users. It is taken in a variety of contexts far removed from its roots in psychotherapeutic settings and is commonly associated with dance parties (or “raves”) and electronic dance music.
Regulatory authorities in several locations around the world have approved scientific studies administering MDMA to humans to examine its therapeutic potential and its effects.
There have long been suggestions that MDMA might be useful in psychotherapy, facilitating self-examination with reduced fear. Indeed, some therapists, including Leo Zeff, Claudio Naranjo, George Greer, Joseph Downing, and Philip Wolfson, used MDMA in their practices until it was made illegal. George Greer synthesized MDMA in the lab of Alexander Shulgin and administered it to about 80 of his clients over the course of the remaining years preceding MDMA’s Schedule I placement in 1985. In a published summary of the effects, the authors reported patients felt improved in various mild psychiatric disorders and experienced other personal benefits, especially improved intimate communication with their significant others. In a subsequent publication on the treatment method, the authors reported that one patient with severe pain from terminal cancer experienced lasting pain relief and improved quality of life.
Recently, two randomized controlled trials of MDMA-assisted psychotherapy for PTSD were published. Although small, these trials are consistent with earlier results. The patients treated with 2-3 sessions of MDMA-psychotherapy showed greater improvement than the ones treated by placebo-psychotherapy or placebo-inactive dose of MDMA. This improvement was generally maintained on a follow-up several years later.
Small doses of MDMA are used as an entheogen to enhance prayer or meditation by some religious practitioners.
MDMA is occasionally known for being taken in conjunction with psychedelic drugs, such as LSD or psilocybin mushrooms, or even common drugs such as cannabis. As this practice has become more prevalent, most of the more common combinations have been given nicknames, such as “candy flipping” for MDMA combined with LSD, “hippy flipping” for MDMA with psilocybin mushrooms, or “kitty flipping” for MDMA with ketamine. The term “flipping” may come from the subjective effects of using MDMA with a psychedelic in which the user may shift rapidly between a more lucid state and a more psychedelic state several times during the course of their experience. Many users use mentholated products while taking MDMA for its cooling sensation while experiencing the drug’s effects. Examples include menthol cigarettes, Vicks VapoRub, NyQuil, and lozenges.
The primary effects attributable to MDMA consumption are predictable and fairly consistent among users. In general, users begin reporting subjective effects within 30–60 minutes of consumption, hitting a peak at approximately 75–120 minutes, reaching a plateau that lasts about 3.5 hours. This is followed by a comedown of a few hours. After the drug has run its course, many users report feeling fatigue.
The following subjective effects of MDMA were statistically significant in a placebo-controlled trial, using Altered States of Consciousness rating scale: derealization, depersonalization, altered perception of space and time, positive basic mood, mania-like experience, anxious derealization, thought disorder, fears of loss of thought or body control, visual hallucinations or pseudo-hallucinations, synesthesia, changed meaning of percepts, facilitated recollection or imagination. On an Adjective Mood rating scale, the following measurements were significantly increased: self-confidence, heightened mood, apprehension-anxiety, thoughtfulness-contemplativeness, extroversion, dazed state, sensitivity and emotional excitation.
In January 2001, an overview of the subjective side-effects of MDMA was published by Liechti, Gamma, and Vollenweider in the journal Psychopharmacology. Their paper was based on clinical research conducted over several years involving 74 healthy volunteers. The researchers found that there were a number of common side-effects and that many of the effects seemed to occur in different amounts based on the sex of the user. The top side-effects reported were difficulty concentrating, jaw clenching, grinding of the teeth during sleep, lack of appetite, and dry mouth/thirst (all occurring in more than 50% of the 74 volunteers). Liechti, et al., also measured some of the test subjects for blood pressure, heart rate, and body temperature against a placebo control but no statistically significant changes were seen.
A study from Johns Hopkins Medical School in 2008 found a slight but significant correlation of cognitive deficiency in MDMA users, but admitted that this data may be confounded by other illicit drug use. The significant finding of the article was the serotonergic neurotoxicity in stacked doses and a lasting decrease in serotonin reuptake (SERT) binding. In rats, high doses and in high temperatures, serotonergic neurotoxicity is limited and dopaminergic neurotoxicity occurs. However, rats may not be a generalizable model for human neurotoxicity studies.
However, a 2011 study carried out by Harvard Medical School and published in the journal Addiction found no signs of cognitive impairment due to ecstasy use, and that it did not decrease mental ability. The report also raised concerns that previous methods used to conduct that research on ecstasy had been flawed, and the experiments overstated the cognitive differences between ecstasy users and nonusers.
Effects reported by some users once the acute effects of MDMA have worn off include:
- Anxiety and paranoia
- Impaired attention, focus, and concentration, as well as drive and motivation (due to depleted serotonin levels)
- Residual feelings of empathy, emotional sensitivity, and a sense of closeness to others (afterglow)
- Dizziness, lightheadedness, or vertigo
- Loss of appetite
- Gastrointestinal disturbances, such as diarrhea or constipation
- Aches and pains, usually from excessive physical activity (e.g., dancing)
- Jaw soreness, from bruxism
A slang term given to the depressive period following MDMA consumption is Tuesday Blues (or “Suicide Tuesday”), referring to the low mood that can be experienced midweek by depleted serotonin levels following MDMA use on the previous Friday or Saturday when raves or dance concerts were frequently scheduled. Some users report that consuming 5-HTP, L-Tryptophan and vitamins the day after use can reduce the depressive effect by replenishing serotonin levels (magnesium supplements are also used prior to or during use, in an attempt to prevent jaw/muscle clenching).
Molly Drug Facts and Information was brought to you on behalf of WIKI: http://en.wikipedia.org/wiki/MDMA
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