2. Introduction
• MDMA (3,4-methylenedioxy-methamphetamine), popularly known as
ecstasy or, more recently, as Molly, is a synthetic, psychoactive drug
that has similarities to both the stimulant amphetamine and the
hallucinogen mescaline.
• an illegal drug that acts as both a stimulant and psychedelic,
producing an energizing effect, as well as distortions in time and
perception and enhanced enjoyment from tactile experiences.
3. Physical & chemical properties
• The free base of MDMA is a colorless oil that is insoluble in water. The
most common salt of MDMA is the hydrochloride salt; pure MDMA
hydrochloride is water soluble and appears as a white or off-white
powder or crystal.
4. History
• MDMA was first synthesized by a German company in 1912, possibly
to be used as an appetite suppressant. MDMA has been available as a
street drug since the 1980s. Its use escalated in the 1990s among
college students and young adults. It is most often distributed at late-
night parties called "raves", nightclubs, and rock concerts. As the rave
and club scene expanded to metropolitan and suburban areas across
the country, MDMA use and distribution increased as well. MDMA is
frequently used in combination with other drugs. However, it is rarely
consumed with alcohol, as alcohol is believed to diminish its effects.
5. Statistics
• According to the National Institute on Drug Abuse (NIDA), Ecstasy use and
abuse has been rising in recent years, especially among middle school and
high school adolescents.
• In 2010, 7.3 percent of high school seniors reported using Ecstasy at least
once in their lives, as did 6.4 percent of 10th graders and 3.3 percent of
8th graders.
• In 2009, about 760,000 Americans over the age of 12 reported using
MDMA in the past month.
• About 5.7 percent of Americans over the age of 12, or 14.2 million people,
reported using MDMA or Ecstasy at least once in their lives.
• In 2009, about 1.1 million Americans said that they used Ecstasy for the
first time in the past year, a significant rise over the prior year when there
were 894,000 self-reporting first-time users.
6. Pharmacokinetics
• MDMA reaches maximal concentrations in the blood stream between
1.5 and 3 hr after ingestion. It is then slowly metabolized and
excreted, with levels of MDMA and its metabolites decreasing to half
their peak concentration over the next several hours. Sixty-five
percent of MDMA is excreted unchanged in the urine (in addition, 7%
is metabolized into MDA) during the 24 hours after ingestion. MDMA
is known to be metabolized by two main metabolic pathways: (1) O-
demethylenation followed by catechol-O-methyltransferase(COMT)-
catalyzed methylation and/or glucuronide/sulfate conjugation; and
(2) N-dealkylation, deamination, and oxidation to the
corresponding benzoic acid derivatives conjugated with glycine.
7. How Is MDMA Abused?
• MDMA is taken orally, usually as a capsule or tablet. The popular term
Molly (slang for “molecular”) refers to the pure crystalline powder
form of MDMA, usually sold in capsules. The drug’s effects last
approximately 3 to 6 hours, although it is not uncommon for users to
take a second dose of the drug as the effects of the first dose begin to
fade. It is commonly taken in combination with other drugs.
8. Effects on Brain
• MDMA acts by increasing the activity of three neurotransmitters,
serotonin, dopamine, and norepinephrine. The emotional and pro-
social effects of MDMA are likely caused directly or indirectly by the
release of large amounts of serotonin, which influences mood (as well
as other functions such as appetite and sleep). Serotonin also triggers
the re-lease of the hormones oxytocin and vasopressin, which play
important roles in love, trust, sexual arousal, and other social
experiences. This may account for the characteristic feelings of
emotional closeness and empathy produced by the drug
9. • The surge of serotonin caused by taking MDMA depletes the brain of
this important chemical, however, causing negative after effects—
including confusion, depression, sleep problems, drug craving, and
anxiety—that may occur soon after taking the drug or during the days
or even weeks thereafter.
• Some heavy MDMA users experience long-lasting confusion,
depression, sleep abnormalities, and problems with attention and
memory, although it is possible that some of these effects may be due
to the use of other drugs in combination with MDMA (especially
marijuana).
11. Short term effects
• Impaired judgment
• False sense of affection
• Confusion
• Depression
• Sleep problems
• Severe anxiety
• Paranoia
• Drug cravings
• Muscle tension
• Faintness and chills or swelling
• Involuntary teeth clenching
• Blurred vision
• Nausea
12. Long term effects
• Long-lasting brain damage affecting thought and memory
• Damage to portions of the brain that regulate critical functions such
as learning, sleep and emotion
• Degenerated nerve branches and nerve endings
• Depression, anxiety, memory loss
• Kidney failure
• Hemorrhaging
• Psychosis
• Cardiovascular collapse
• Convulsions
• Death
13. Dependence and withdrawal
• Some studies indicate repeated recreational users of MDMA have
increased rates of depression and anxiety, even after quitting the
drug. Other meta analyses have reported possibility of impairment of
executive functioning. Approximately 60% of MDMA users
experience withdrawal symptoms, including, but not limited to:
fatigue, loss of appetite, depression, and trouble
concentrating. Tolerance is expected to occur with consistent MDMA
use.
14. Treatment
• There are no specific treatments for MDMA abuse. The most effective
treatments for drug abuse and addiction are cognitive behavioral
interventions that are designed to help modify the patient's thinking,
expectancies, and behaviors, and to increase skills in coping with life's
stressors. Drug abuse recovery support groups may be effective in
combination with behavioral interventions to support long-term,
drug-free recovery. There are currently no pharmacological
treatments for dependence on MDMA.
