MDMA became a popular rave or club drug with younger people due to its reputation as a drug that can enhance sociability, empathy, and feelings of euphoria as well as its hallucinogenic properties. These effects have been substantiated by a number of research studies, including a 2014 article in the journal Psychopharmacology. MDMA’s abuse reached its peak in the late 1990s and early 2000s.The National Institute on Drug Abuse (NIDA) reports that initially the powder and tablet forms of MDMA were 30-40 percent MDMA, and the rest of the substance consisted of cutting agents, such as lactose, to increase profits for dealers. NIDA reports that substances being sold as MDMA currently are probably even less pure, and a number of other drugs are now often substituted for the MDMA in the drug, such as bath salts (synthetic cathinones), methamphetamine (crystal meth), cocaine, ketamine, the synthetic hallucinogenic para-methoxyamphetamine, and over-the-counter medications.
Today, use of the drug has significantly decreased since its peak use in the 1990s and early 2000s; however, it is still a significant and dangerous drug of abuse in either its diluted or purer forms.
Molly’s mechanism of action is primarily focused on three neurotransmitters:
NIDA reports on some of the other short-term and long-term effects of MDMA use. These include:
The development of a substance use disorder as a result of MDMA abuse would be labeled a hallucinogen use disorder under the current diagnostic scheme. According to APA, the signs of a hallucinogen use disorder include:
Some sources suggest that chronic use of MDMA may result in a mild level of physical dependence, demonstrating withdrawal from MDMA is not a diagnostic criterion for a hallucinogen use disorder because most hallucinogenic drugs do not result in the development of physical dependence. A formal diagnosis of a hallucinogen use disorder can only be made by a licensed mental health clinician.
The use of Molly results in a number of other nonclinical signs and symptoms that may be indicative that the individual is developing an issue with abuse of the drug. Some of these include:
The group at the greatest risk to abuse MDMA includes those 16-24 years old. Treating adolescents and young adults with substance use disorders is a delicate matter, and it is suggested that treatment providers for these individuals have special training in dealing with the issues that occur in this group.The treatment approach generally consists of various components, outlined below.