MDMA

What is MDMA?

  • MDMA, also known as “molly” or “ecstasy,” belongs to a family of drugs called entactogens (“touching within”).

  • Names like “molly” or “ecstasy” have taken on common meanings to imply the form that MDMA is in, with “ecstasy” frequently referring to pressed tablets as opposed to capsules or loose crystals. Nonetheless, the desired active chemical these names refer to is still MDMA.

  • The MDMA experience is called “rolling.” Very intense rolls can make someone feel “floored,” where they want to remain sitting or lying down for several hours.

  • MDMA was popularized by use in party (specifically rave) communities, as well as more intimate social environments.

  • Before it was made illegal in 1985, MDMA was a medication introduced to psychotherapy by Dr. Alexander Shulgin. Studies are currently evaluating the effectiveness of MDMA in PTSD treatment. It is on track to be approved by the FDA as a prescription medication in 2023.

  • The circumstances surrounding MDMA’s illegality involve an interesting series of political events in the 1980s. Its history paints a more complex tale of stigma, psychology, counterculture, and the ways that public health has been historically used to condemn “undesirable” demographics.

 

What are the effects?

  • Physical effects of MDMA include enhanced tactile sensation and typical stimulant effects around increased blood pressure and heart rate. Users may also experience dehydration, teeth grinding (bruxism) or jaw locking (trismus), eye wiggles (nystagmus), and difficulty urinating.

  • These effects tend to be most intense during the peak of the roll and fade as the experience ends.

  • Cognitive effects of MDMA include euphoria, feelings of wellbeing, and increased sociability. People also experience heightened feelings of empathy, emotional warmth, openness, and self-acceptance.

  • MDMA is typically swallowed as a tablet or capsule. Effects are typically felt within 20 to 40 minutes, and the peak effects typically last around 90 to 120 minutes. The total duration is about 3-5 hours.

  • Most users say the experience is very pleasant and highly controllable. It is very rare for a roll to be frightening or unpleasant, although under-dosing (doing too little) can feel very uncomfortable, and doing too much can be dangerous.

What is a typical dose?

  • For most people, a standard dose of MDMA is between 80 and 125 mg. Some people naturally require more to feel the desired effects, while others require less.

  • The MDMA experience involves both physical and mental components. The mental component involves “breaking through” into the MDMA headspace, which is typically very soft, loving, and curious. The physical component can involve feelings of lightness, pleasurable thrills, and very sensitized touch.

  • Not taking enough MDMA may produce physical effects but fail to cause you to “break through.” This is often characterized by feeling stimulated, but antisocial or quiet.

  • Taking too much MDMA may cause very intense feelings and sensations that lead a person to be floored for the duration of the experience. This isn’t always high risk, but it can increase the likelihood of adverse effects and worsen the comedown.

  • Needing to take more and more MDMA to feel it properly indicates that you are building a tolerance and may be rolling too frequently.

  • Taking a single redose of 1/3 to 1/2 of the original dose around 90 minutes later can extend the peak of the experience by a few hours. Redosing any more than this will usually only increase side effects, especially the hangover.

 

Be careful!

  • Since MDMA increases core body temperature, overheating is a serious risk. This risk is compounded by being in a hot environment, taking a large dose, mixing with other temperature-raising drugs like cocaine or amphetamine, and/or lots of physical exertion.

  • Severe headache on any stimulant may be a sign of dangerously high blood pressure. Seek medical attention for a severe, splitting headache.

  • The feeling of being dehydrated due to dry mouth and high body temperature can lead people to drink way too much water. Drinking too much or too little water on MDMA can be deadly due to hypernatremia (dehydration) or hyponatremia (over hydration).

  • Aim for about 1-3 cups (6-18 oz) of water per hour, or up to 4 cups (24 oz) if you’re exerting yourself. Electrolyte powders and salty snacks can help prevent hydration-related illness.

  • MDMA works by releasing (and depleting) a chemical in your brain called serotonin. Your brain needs time to replenish its serotonin levels, which is why rolling frequently or on high doses can lead to prolonged feelings of depression or emotional sensitivity.

  • Very high or frequent doses of MDMA can cause neurotoxicity, in which serotonin neurons are damaged. This may be reversible with a long period of abstinence.

  • Although many users experience a pleasant mood the next day, known as an “afterglow,” some people experience sadness, irritability, or emotional exhaustion in the days after taking MDMA (“blues”).

  • It’s typical to feel irritable, restless, easily distressed, or antisocial in the five to seven days following a roll. This may manifest as temper tantrums over minor inconveniences or just feeling more sensitive in general.

  • To minimize the risks of MDMA, space your rolls by a minimum of 3-6 months and try not to increase your normal dose if it still works for you.

  • Many people find it difficult to stick to the 3-6 month rule. Rolling more frequently may or may not impact your day-to-day mental health as time goes on, but keep in mind: the more frequently you roll, the higher your likelihood is of losing the magic sooner in life.

  • At bare minimum, wait a few weeks between rolls. Your serotonin needs time to replenish.

  • It’s natural to develop a tolerance over many years of rolling, but it should happen slowly. Needing to take more and more MDMA over the course of a few sessions is almost always a sign that you’re not spacing enough.

 

More harm reduction tips

  • MDMA is not physically dependence-forming, but it can take on great importance in people’s lives, and some people start compulsively using it every weekend.

  • If taken too frequently, MDMA can stop working. Users report that the “magic” goes away. This can last for many years or even be permanent.

  • There are some supplements that may offer a protective effect against MDMA hangover or toxicity, but nothing replaces spacing your rolls out. Supplements taken before your roll may have some protective effect. Supplements taken after your roll probably won’t do anything except for potentially help with post-roll blues.

  • 5-HTP can help reduce the symptoms of post-roll blues, but should only be taken until a minimum of 8 hours has passed. Do not take 5-HTP before or during your roll, as this could induce mild to moderate serotonin syndrome.

  • Many medications interact with MDMA. Always check individual interactions.

  • While it’s commonly believed that taking SSRIs with MDMA is very dangerous, it’s much more likely that the MDMA simply won’t work at all. Taking lots of MDMA to try and “break through” the blunting effects of SSRIs could become dangerous. Note: Some people may indeed react poorly to this combination, but it usually leads to letdowns as opposed to medical emergencies.