MDMA

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MDMA, officially known as 3,4-Methylenedioxymethamphetamine and affectionately dubbed ‘Molly’ or “Mandy”, is a drug that’s popular in both the party scene and psychopharmaceutic research. Unlike classical psychedelics (like magic mushrooms or LSD) MDMA is not a hallucinogen. Rather, it’s an entactogen or empathogen. Entactogens are a type of psychedelic that produce a sense of euphoria, oneness and emotional openness.

MDMA is still popular in the rave scene, even though it’s been illegal in most countries for decades. However, recently more and more studies have been done to research the therapeutic potential of MDMA. The current expectation is that MDMA will be approved for PTSD treatment in the USA as soon as in 2021.

History

MDMA was first discovered by German scientist Merck as early as 1912. Back then, it was intended as a medicine to control bleeding. MDMA eventually was patented in 1914. In the years that followed both the research and application of the drug were very limited. In 1927 and 1959 Merck studied the pharmacological effects of MDMA, but not with humans.

In the 1950’s, during the Cold War, the CIA investigated the possibilities to use MDMA for warfare in the project MK-Ultra but failed. Years later, in de 60’s, researcher Alexander Shulgin synthesized MDMA, though it took him over a decade to discover the therapeutic possibilities. In 1977 Shulgin finally offered the compound to Leo Zeff PhD. Zeff used MDMA in psychotherapy and eventually introduced it to other therapists.

In the 80’s the drug spread from therapy to the party scene, leading to abuse. Eventually in 1985 MDMA got outlawed as part of the “War on Drugs” under the Controlled Substances Act as a Schedule 1 drug: a drug with high potential for abuse and no real medicinal value. The laws did little to prevent abuse: going underground Molly remained a popular party drug. In fact, it was abused even more due to little control over the sold substances and poor education on side-effects.

In the mean time research on MDMA proved its therapeutic value, showing very promising results in treatment of PTSD and finally granting it the status of “breakthrough therapy” by the FDA.

Production of MDMA

The first thing you need to know about MDMA is that it can be consumed either as crystals or as a pill. In the case of a pill MDMA is also known as Ecstasy or XTC. Please note many XTC-pills contain other substances as well as MDMA (and not all crystals that are sold as MDMA are actually MDMA).

Unlike for instance mescaline or DMT, MDMA is not (yet) found in nature. That means it has to be chemically manufactured. According to the 2016 EU Drug Markets Report “MDMA is primarily produced from piperonyl methyl ketone (PMK), which can also be produced from safrole (or oils rich in safrole) and piperonal.”

While in some countries consumption of MDMA is decriminalized, the production is currently illegal. Production is also dangerous and leads to chemical waste, often disposed of in nature, causing environmental harm.

Pharmacology

MDMA is an indirect serotonergic agonist. That means it increases the amount of serotonin in our brains. It does so both by releasing and inhibiting the re-uptake of presynaptic serotonin. MDMA is also able to enhance the release of dopamine and norepinephrine, though these effects are less notable.

You’ll usually first begin to notice the effects of MDMA about 30 minutes after consumption. The half-life (so the speed with which the substance decreases by half) is approximately seven hours, though an alkaline urine can increase it to as much as 31 hours.

Tolerance to MDMA builds quickly and it’s recommended you give your brain three months in between consumption to allow tolerance to fully disappear and your brain to restore itself from possible toxic effects.

Effects

Effects of MDMA vary greatly and depend on the user, set and setting. However, with the wide range of different effects there are also some common denominators.

The main effect of MDMA is probably caused by the increase in serotonin and is noticeable on an emotional level: it promotes feelings of empathy, unity, love, affection, relaxation. MDMA may also influence your social behavior, making you feel more communicative, confident in social interactions and even more sexual.

On a physical level MDMA is often perceived as a stimulant and leads to enhanced senses, especially when it comes to touch.

On a more negative side, MDMA can increase body temperature, heart rate and blood pressure and lead to dehydration. Psychologically when you use MDMA you can become anxious or paranoid, though this too seems to depend on the set and setting of your experience.

The effects above all apply to the actual experience, but MDMA also has potential after-effects. The best-known is the serotonin dip, also known as the Tuesday dip, a consequence of low levels of serotonin in your brain. Long-term there is consistent evidence of negative consequences for MDMA-users who consume high amounts of the substance in the course of their life, but there is no evidence of structural changes in the brain for moderate users.

Consumption of MDMA

MDMA is used both recreationally and therapeutically. In both cases users either consume a pill or some MDMA crystals.

The average dosage of MDMA – assuming you haven’t built any tolerance – is somewhere between 60 and 150 mg (depending on your sensitivity for the substance), with a different suggestion being “your weight in kg + 50mg “. In therapeutic use, 125mg is sometimes followed up by a booster dose of 60mg 2,5 hours later.

Please note that when taking MDMA as a pill, different pills will have different potency, which is why it’s impossible to determine the average dose in amount of pills.

Safety

MDMA is one of those drugs that most often show up in the news with negative, sometimes even fatal, incidents, mostly in the rave scene. However, when used therapeutically, there have been no such issues. So why does recreational MDMA use lead to so many negative headlines? There are a few reasons.

First and foremost, there is misidentification. Unfortunately, all too often what is sold as MDMA is not actually MDMA. This is especially the case with pills, which sometimes contain byproducts of all kinds and sometimes don’t contain any MDMA at all. Testing your pills or crystals with a test kit (or, if your country offers them, free test labs) you’ll ensure you consume exactly what you want to consume.

Second, quite often people don’t just stick to one dosage. They will take higher dosages (and higher still in order to combat built-up tolerance) and mix MDMA with other substances, such as amphetamines or LSD. Especially in uncontrolled environments, such as parties, this can lead to a variety of negative side-effects, which are mostly unstudied and unpredictable, but in any case include potential issues with your heart and blood pressure.

Third, as mentioned one of the effects of MDMA is dehydration, including a dry mouth. Many people attempt to combat this by drinking large amounts of water. When left unchecked, this can actually lead to the opposite effect: death by water intoxication.

MDMA and research

MDMA is a drug that’s most researched for therapy applications. The MAPS foundation has provided funding for different studies, including studies researching the effect of MDMA on war veterans with PTSD. The results were remarkable, showing a large decrease in symptoms and leading to a lot of media attention. Because of the enormous potential, FDA granted MDMA “Breakthrough Therapy” status. This status ensures faster drug development. MAPS explains: “By granting Breakthrough Therapy Designation, the FDA has agreed that this treatment may have a meaningful advantage and greater compliance over available medications for PTSD.“

Other research on MDMA includes research of MDMA as treatment for social anxiety in autistic adults and anxiety associated with life-threatening illness.

Trivia

  • Early adopters of MDMA therapy called the drug Adam. They felt it reflected the way patients on MDMA became more open and innocent.
  • MDMA allegedly reached European and Indian nightclubs and raves through the followers of Osho, Sannyasins.
  • MDMA has shown remarkable effects in group therapy, leading to more connection and openness between participants.

Resources

Research on MDMA by MAPS

MDMA precursors

Mixmag: “We went undercover in a Chinese MDMA factory”

Adulterants in MDMA

Wikipedia: Alexander Shulgin

Book: Alexander Shulgin – PIHKAL, a Chemical Love Story