Ecstasy (Molly) Abuse, Addiction, And Treatment Options

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

March 18, 2019

Ecstasy (MDMA), or Molly, is a drug that has been abused for many years. Made popular in dance- and nightclubs in the 1980s, Ecstasy was once a well-known party drug.

Currently, Ecstasy abuse does not get a lot of national attention due to the alarming rates of abuse for other, more potent drugs. Yet Ecstasy abuse still exists, and people who abuse this drug experience adverse side effects, including addiction.

What Is Ecstasy (Molly)?

Ecstasy is an illicit (illegal) drug of abuse. Because the drug is illegally produced and sold, any use of it is considered abuse.

Ecstasy is chemically similar to hallucinogens and stimulants. Hallucinogens, like LSD, cause altered perceptions of reality including hallucinations, while stimulants work to excite the central nervous system.

Ecstasy abuse leads to:

• feelings of warmth
• increased energy and alertness
• pleasure (euphoria)
• distortions of time and sensory perceptions

How Do People Abuse Ecstasy?

Ecstasy is most commonly taken as a pill or capsule, but can also be abused in liquid form, or crushed into a powder and snorted.

“Molly” typically refers to the pure crystal form of MDMA. When sold on the street, Ecstasy can be found mixed with other substances. Like other illicit drugs, those buying Ecstasy cannot guarantee the purity of the drug.

Signs And Symptoms Of Ecstasy Abuse

In addition to feelings of warmth, pleasure, and increased energy and alertness, ecstasy comes with changes which signal abuse.

Signs and symptoms of ecstasy abuse include:

• greater tactile “touch” sensations
• having energy/alertness during unusual times
• a higher sense of self-esteem
• increase in sociability
• increased empathy
• jaw clenching/teeth grinding

Reasons People Abuse Ecstasy

People who abuse ecstasy may be in search of the drug’s perceived positive effects, like warmth, pleasure, and lowered inhibitions. Ecstasy can lead individuals to be more outgoing in a social setting, which is why it is so popular for nightclub use.

Many people also abuse the drug for its ability to produce extreme emotions and perception of self-confidence.

For those who seek an extreme high, ecstasy may be abused in combination with other drugs. Polydrug abuse, or abuse of more than one substance, can lead to enhanced side effects of each substance with unpredictable combined effects.

How Ecstasy Abuse Leads To Addiction

Ecstasy is not a highly addictive drug. However, the effects of ecstasy can be addicting. In other words, while ecstasy does not lead to a physical dependence on the drug, the effects produced by ecstasy can cause a person to develop a mental reliance (addiction).

There are three main chemical messengers in the brain responsible for feelings of pleasure: dopamine, serotonin, and norepinephrine. Ecstasy affects all three feel-good chemicals.

With time and repeated or regular abuse, ecstasy can disrupt the natural process of chemical production in the brain. This means the brain comes to rely on ecstasy to produce these feelings, forming an addiction.

The effects of addiction cause a person to change behavior, experience changes to emotion and eventually change lifestyle.

Addiction essentially hijacks a person’s brain, leading them to engage in behaviors they may not otherwise engage in.
A person may become secretive about their ecstasy use, begin lying about whereabouts or other details, and may begin stealing money to buy ecstasy. They may become irritable or obsessive if they can’t obtain ecstasy and cravings may seem unbearable.

If a person struggles with addiction to another substance, the effects of ecstasy addiction are only worsened.

Effects Of Ecstasy Abuse

Ecstasy abuse can lead to a number of adverse side effects. Side effects of substance abuse can manifest in many different ways, including emotional, physical, psychological, and behavioral.

Short-Term Side Effects Of Ecstasy (Molly) Abuse

• aggression
• anxiety
• blurred vision
• chills
• depression
• irritability
• lack of appetite
• muscle cramps
• nausea
• sleep troubles

Long-Term Side Effects Of Ecstasy Abuse

• increased body temperature for lengthy periods of time
• extreme anxiety
• insomnia
• memory loss
• fatigue
• lethargy
• severe depression

Dangers Of Ecstasy Abuse

One of the greatest dangers of ecstasy abuse is that it can lead to extremely high body temperatures, surpassing the body’s ability to regulate its temperature.

Failure to regulate body temperature can result in organ damage and/or failure, which can be fatal.

At high doses, ecstasy can lead a person into a psychotic state in which they experience hallucinations.

Hallucinations may be severe enough to lead to a severely confused state or delusions. In turn, this may lead a person to become aggressive or manic.

While Ecstasy leads to an intense high, the high is followed by an intense low, or crash. This crash is characterized by a period of extreme anxiety and depression, sleep troubles, and lack of appetite, all of which can greatly affect a person’s health.

Finally, ecstasy may be laced with other substances. Because ecstasy is an illicit drug, it is always produced and sold illegally and buyers cannot guarantee the purity of the drug. Ecstasy may contain dangerous substances or more potent drugs, making each use of it a risk.

Mixing Ecstasy And Other Drugs

Mixing Ecstasy with other drugs can be dangerous for a few different reasons. First, when mixing Ecstasy with another stimulant, the effects of each drug may become enhanced. While a person may be chasing this combined effect, it can have dangerous consequences.

Ecstasy raises body temperature and other functions, like heart rate. All stimulants also work to increase heart rate. When combining ecstasy and other stimulants, such as cocaine, a person’s heart rate, blood pressure, or body temperature may rise to dangerous levels.

Combining ecstasy with a drug that has opposing effects, such as a depressant like alcohol or heroin, can be dangerous as well. Because the drugs have opposing effects, ecstasy may work to mask the effects of alcohol or heroin and vice versa.

This means a person will likely not be able to feel the full effects of each drug, may take more of each substance, and will experience greatly increased risk of overdose.

Risk Of Ecstasy Overdose

Ecstasy may not be the most potent illegal drug available, but it still results in many emergency-department visits each year, particularly for the age group of 25- to 34-year-olds.

Ecstasy overdose can be dangerous when combined with potent substances, like alcohol, opioids, heroin, or benzodiazepines. Because of the drug’s hallucinogenic properties, ecstasy can also lead to dangerous psychotic states which can land a person in emergency care.

Signs and symptoms of ecstasy overdose can include:

• chest pain
• cardiac arrest, including heart failure
• dilated pupils
• dry mouth/locked jaw
• dehydration, leading to fatigue

Ecstasy Addiction Treatment Programs

Many rehab programs offer treatment for ecstasy abuse and addiction. Which type of program works best for each individual will depend on the severity of ecstasy abuse, how long they abused the drug, if they have any co-occurring disorders, and any other treatment needs.

Because ecstasy abuse can lead to psychosis, the best rehab programs for ecstasy addiction will have a strong therapy and/or counseling component.

Residential Treatment For Ecstasy Addiction

Those struggling with ecstasy addiction may benefit most from an intensive program, like residential or inpatient treatment.

Such programs allow individuals to seek care within a rehab facility for an extended period of time, such as 30 to 90 days. Here, individuals can receive ongoing medical care, medications when needed, and attend therapy and courses during the day.

Most intensive inpatient programs have individuals attending various therapy, counseling, and educational course sessions 15 to 30 hours per week.

Upon completing a residential rehab program, individuals who struggle with ecstasy addiction should be well-equipped to manage addiction, prevent relapse, and enter recovery.

Continuing Care For Ecstasy Addiction

As with other addictions, ecstasy addiction requires a carefully laid plan for continuing care. Addiction often requires long-term management, which helps a person avoid substance use triggers, manage cravings, and engage in a lifestyle free from substance abuse.

Continuing care for ecstasy addiction can be found in many forms, such as outpatient therapy and counseling, 12-step support groups, and rehab program alumni networks.