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Transcript
MDMA (3,4-methylenedioxy-N-methylamphetamine) is an empathogenic drug of the
phenethylamine and amphetamine classes of drugs. MDMA has become widely known as "ecstasy"
(shortened to "E", "X", or "XTC"), usually referring to its street form, although this term may also
include the presence of possible adulterants. The UK term "Mandy" and the US term "Molly"
colloquially refer to MDMA that is relatively free of adulterants. Although recently, "Molly" is no
longer essentially MDMA, but potentially a host of other related serotonergetic compounds, such as
Methylone and Butylone.. [3] [4]
MDMA can induce euphoria, a sense of intimacy with others, diminished anxiety, and mild
psychedelia. Many studies, particularly in the fields of psychology and cognitive therapy, have
suggested MDMA has therapeutic benefits and facilitates therapy sessions in certain individuals, a
practice for which it had been formally used in the past. Clinical trials are now testing the
therapeutic potential of MDMA for post-traumatic stress disorder, anxiety associated with terminal
cancer[5][6] and addiction.[7]
MDMA is criminalized in most countries. Some limited exceptions exist for scientific and medical
research. For 2008, the UN estimated between 10 and 25 million people globally used MDMA at
least once in the past year. This was broadly similar to the number of cocaine, amphetamine, and
opioid users, but far fewer than the global number of cannabis users.[8] It is taken in a variety of
contexts far removed from its roots in psychotherapeutic settings, and is commonly associated with
dance parties (or "raves") and electronic dance music.[9]
Regulatory authorities in several locations around the world have approved scientific studies
administering MDMA to humans to examine its therapeutic potential and its effects.[10]
Medical use
See also: Effects of MDMA on the human body
MDMA has been indicated as possibly useful in psychotherapy, facilitating self-examination with
reduced fear.[11][12][13] Indeed, some therapists, including Leo Zeff, Claudio Naranjo, George Greer,
Joseph Downing, and Philip Wolfson, used MDMA in their practices until it was made illegal.
George Greer synthesized MDMA in the lab of Alexander Shulgin and administered it to about 80
of his clients over the course of the remaining years preceding MDMA's Schedule I placement in
1985. In a published summary of the effects,[14] the authors reported patients felt improved in
various mild psychiatric disorders and experienced other personal benefits, especially improved
intimate communication with their significant others. In a subsequent publication on the treatment
method, the authors reported one patient with severe pain from terminal cancer experienced lasting
pain relief and improved quality of life.[15] In the United States, no research on MDMA was allowed
at all, from 1985 until 1992, when the FDA approved Dr. Charles Grob to conduct human
studies.[16]
In the year 2000, Doctor Jose Carlos Bouso performed the first clinical trial of MDMA for use in
treating Post Traumatic Stress Disorder.[17] Since 2009, two randomized, controlled trials of
MDMA-assisted psychotherapy for post-traumatic stress disorder were published. Although small,
these trials are consistent with earlier results. The patients treated with two or three sessions of
MDMA-psychotherapy showed greater improvement than the ones treated by placebopsychotherapy[18] or placebo-inactive dose of MDMA.[19] This improvement was generally
maintained on a follow-up several years later.[20]
Recreational use
Tablets containing MDMA
Small doses of MDMA are used as an entheogen to enhance prayer or meditation by some religious
practitioners.[21]
MDMA is often considered the drug of choice within the rave culture and is also used at clubs,
festivals and house parties. In the rave environment, the sensorial effects from the music and setup
such as lasers are often highly synergistic with the drug. The psychedelic amphetamine quality of
MDMA lends it to variable reasons as to why it appeals to users in the "rave" setting. Some users
enjoy the feeling of mass communion from the inhibition-depressing effects of the drug, while
others use it as party fuel because of the drug's stimulatory effects.[22]
MDMA is occasionally known for being taken in conjunction with psychedelic drugs, such as LSD
or psilocybin mushrooms, or even common drugs such as cannabis. As this practice has become
more prevalent, most of the more common combinations have been given nicknames, such as
“candy flipping” for MDMA combined with LSD, “hippy flipping” for MDMA with psilocybin
mushrooms, or “kitty flipping” for MDMA with ketamine.[23] The term “flipping” may come from
the subjective effects of using MDMA with a psychedelic in which the user may shift rapidly
between a more lucid state and a more psychedelic state several times during the course of their
experiences. Many users use mentholated products while taking MDMA for its cooling sensation
while experiencing the drug’s effects. Examples include menthol cigarettes, Vicks VapoRub,
NyQuil,[24] and lozenges.
Subjective effects
The primary effects attributable to MDMA consumption are predictable and fairly consistent among
users. In general, users begin reporting subjective effects within 30 to 60 minutes of consumption,
hitting a peak at about 75 to 120 minutes, reaching a plateau that lasts about 3.5 hours.[25] This is
followed by a comedown of a few hours. After the drug has run its course, many users report
feeling fatigue.
The following subjective effects of MDMA were statistically significant in a placebo-controlled
trial, using Altered States of Consciousness rating scale: derealization, depersonalization, altered
perception of space and time, positive basic mood, mania-like experience, anxious derealization,
thought disorder, fears of loss of thought or body control, visual hallucinations or pseudohallucinations, synesthesia, changed meaning of percepts, facilitated recollection or imagination. On
an Adjective Mood rating scale, the following measurements were significantly increased: self-
confidence, heightened mood, apprehension-anxiety, thoughtfulness-contemplativeness,
extroversion, dazed state, sensitivity, and emotional excitation.[25]
After-effects
Effects reported by some users once the acute effects of MDMA have worn off include:

Psychological
o Anxiety and paranoia
o Depression[31][32][33][34]
o Irritability[32]
o Fatigue[33][34]
o Impaired attention, focus, and concentration, as well as drive and motivation (due to
depleted serotonin levels)[31]
o Residual feelings of empathy, emotional sensitivity, and a sense of closeness to
others (afterglow)

Physiological
o Dizziness, lightheadedness, or vertigo[34]
o Loss of appetite[31]
o Gastrointestinal disturbances, such as diarrhea or constipation
o Insomnia[31]
o Aches and pains, usually from excessive physical activity (e.g., dancing)[31][33]
o Exhaustion[32][34]
o Jaw soreness, from bruxism[34][35][36]
A slang term given to the depressive period following MDMA consumption is Tuesday Blues (or
"Suicide Tuesday"), referring to the low mood that can be experienced by midweek from depleted
serotonin levels following MDMA use on the previous Friday or Saturday when raves or dance
concerts were frequently scheduled. Some users reported consuming 5-HTP, L-tryptophan and
vitamins the day after use can reduce the depressive effect by replenishing serotonin levels
(magnesium supplements are also used prior to or during use, in an attempt to prevent jaw/muscle
clenching).[37]
Purity and dosage of "ecstasy"
MDMA powder
Another concern associated with MDMA use is toxicity from chemicals other than MDMA in
ecstasy tablets. Due to its near-universal illegality, the purity of a substance sold as ecstasy is
unknown to the typical user. The MDMA content of tablets varies widely between regions and
different brands of pills and fluctuates somewhat each year. Pills may contain other active
substances meant to stimulate in a way similar to MDMA, such as amphetamine, mephedrone,
methamphetamine, ephedrine, caffeine, all of which may be comparatively cheap to produce and
can help to boost overall profits. In some cases, tablets sold as ecstasy do not even contain any
MDMA. Pills may include a variety of non-psychoactive substances as well, such as paracetamol,
ibuprofen, talcum powder, etc.[88]
A number of deaths have been attributed to para-methoxyamphetamine (PMA), a hallucinogenic
amphetamine, being sold as ecstasy.[89][90] PMA is unique in its ability to quickly elevate body
temperature and heart rate at relatively low doses, especially in comparison to MDMA. Hence,
users believing they are consuming two 120-mg pills of MDMA could actually be consuming a
dose of PMA that is potentially lethal, depending on the purity of the pill. Not only does PMA
cause the release of serotonin, but it also acts as a monoamine oxidase inhibitor. When combined
with an MDMA or an MDMA-like substance, serotonin syndrome can result.[91] Combining MAO
inhibitors with certain legal prescription and over-the-counter medications can also lead to
(potentially fatal) serotonin syndrome.
History
-MDMA was first synthesized in 1912 by Merck chemist Anton Köllisch.
-In the early 1980s clubbers started using MDMA in Ibiza’s discos