What does MDMA feel like?

Overview: MDMA, also known as "molly" and "ecstasy," has a rich history, initially developed by Merck in 1912 and gaining popularity in the 1970s. While it became widely used recreationally, there is growing evidence of its effectiveness as a therapeutic aid, particularly for PTSD. MDMA-assisted therapy sessions create a warm and inviting environment to maximize the compound's therapeutic potential, allowing patients to explore their emotions. MDMA primarily releases serotonin and inhibits neurotransmitter reuptake, leading to a 4-6 hour experience of euphoria and enhanced openness. While MDMA is known as a party drug, it fosters social connections and empathy. Safety precautions should be taken when using MDMA recreationally, including substance testing, managing settings, and avoiding risky combinations. Individual factors and careful consideration should guide decisions about MDMA use.

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Brief History and Evolution of MDMA

MDMA (3,4-methylenedioxymethamphetamine), also known as “molly” and “ecstasy,” was first developed by the pharmaceutical company Merck in 1912. However, it wasn’t until the 1970s that MDMA started to gain popularity after its rediscovery by prolific psychedelic chemist Alexander Shulgin. 

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In the 60s, MDMA first became popular on dance floors and recreational settings before making a name for itself therapeutic circles. However, it became a strictly controlled substance in 1985 under the Controlled Substances Act.  

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Though its popularity as a recreational drug has been fairly consistent despite its illegality, lawmakers, doctors, and scientists are considering loosening the controls on MDMA as researchers gather increasing evidence of its effectiveness as a therapeutic aid in the treatment of PTSD and other psychological conditions. 

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MDMA-Assisted Therapy: Maximizing the Therapeutic Environment

MDMA-assisted therapy sessions are carefully conducted in warm and inviting environments that prioritize aesthetics, aiming to amplify the therapeutic impact of the compound. Instead of the impersonal and sterile atmosphere commonly associated with hospital settings, these spaces are designed to evoke a sense of comfort and visual appeal.

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By creating a homey and aesthetically pleasing ambiance, the therapeutic potential of MDMA is maximized, providing a more nurturing and conducive environment for healing and personal growth. 

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Following the informed consent process and initial consultations, each patient enters their treatment session where they are comfortably positioned and provided with eyeshades and a thoughtfully curated playlist. The music begins with soothing melodies and gradually progresses towards emotionally evocative tunes.

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During the session, patients are encouraged to turn inward, exploring their emotions and inner experiences. A dedicated male and female co-therapy team is present throughout, offering unwavering support and reassurance.

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It is important to note that the therapists refrain from actively conducting therapy during the MDMA experience. Instead, there exists a delicate balance between introspection and therapeutic conversation, which is guided by the patient's preferences and the therapists' expertise. Following the subsiding effects of MDMA, the focus shifts more towards engaging in meaningful therapeutic discussions. 

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Some of the reported positive effects experienced during MDMA therapy include:

• Light euphoria
• Decreased fear and anxiety
• Enhanced perception
• Intensification of feelings
• Increased imagination and association abilities
• Increased thoughtfulness
• Better ability to recall and face traumatic memories
• Suppression of social fears
• Enlargement of empathy, trust, and feelings of connectedness
• Greater desire for interaction
• Improved self-esteem and self-image

These effects may last for approximately 4 to 6 hours.

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In a therapeutic setting, MDMA can induce feelings of safety from which the exploration of deep emotional wounds and communication of one’s innermost private feelings with therapists becomes less frightening.

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Indeed, several randomized controlled studies have found that MDMA produces significantly better therapeutic outcomes than placebo in the treatment of post traumatic stress disorder (PTSD) on a Clinician-Administered-PTSD Scale (CAPS). These promising results prompted the US Food and Drug Administration to grant “Breakthrough Therapy” designation to MDMA-assisted psychotherapy for the treatment of PTSD in 2017. 

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Unpleasant Side Effects Experienced in MDMA-assisted Therapy 

Though a 2017 study found MDMA to be safe overall in physically and mentally healthy individuals at a dose of 125 mg (a common recreational dose) in a controlled setting, there are some potentially unpleasant side effects to be aware of.

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The most frequently reported side effects of MDMA include:

• Dry mouth
• Loss of appetite
• Difficulty concentrating
• Cold feet
• Perspiration
• Jaw clenching
• Restless legs
• Dizziness
• Hot flushes

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The Science of MDMA: Neurotransmitters, Hormones, and Subjective Effects

Despite structural similarities to amphetamine, a stimulant, and mescaline, a classic psychedelic, MDMA is distinct from these kinds of drugs and falls into a class of substances known as entactogens. The tendency of entactogens to promote emotional closeness, bonding, and empathy distinguishes them from other drug classes. 

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MDMA primarily releases serotonin, while also releasing norepinephrine and dopamine. MDMA inhibits the reuptake of these neurotransmitters, facilitating a 4-6 hour experience typically characterized by bodily euphoria and enhanced openness.

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MDMA also stimulates the release of the hormones oxytocin, vasopressin, and prolactin. The release of these hormones and neurotransmitters is thought to be responsible for the pleasant subjective effects of MDMA.

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Unlike substances such as psilocybin-containing “magic mushrooms” or LSD, the way MDMA works in the brain means that typical psychedelic effects like visual distortions are less prevalent. However, it is worth noting that a minority of users may still experience visual effects, possibly attributable to MDMA's psychedelic metabolite MDA (3,4-methylenedioxyamphetamine). When MDMA is metabolized in the body, it can produce MDA, which may contribute to these reported visual effects.

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Exploring MDMA's Recreational Appeal

MDMA is a prosocial drug. People are more inclined to talk, open up, dance, cuddle, and generally enjoy the company of other people under the influence of MDMA. 

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Due to its various effects, MDMA has become widely known as a party drug. In addition to its emerging role as a potential therapy adjunct, MDMA is often used recreationally for its energizing, stimulating, euphoric, and music-enhancing properties.

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People consume MDMA at concerts, nightclubs, and festivals to enhance their experience, and even in the comfort of their homes to foster empathy and a heightened sense of connection with others.

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When considering the use of MDMA in social settings, it is crucial to prioritize safety and minimize the risk of negative experiences.

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Precautions for MDMA Use: Substance Testing and Risk Awareness

One key precaution is to always test the substance to confirm its authenticity as MDMA. A study conducted in 2017, which examined data from the harm-reduction organization DanceSafe, revealed that only 60% of the 529 samples initially believed to be MDMA actually contained MDMA. Therefore, it is essential to verify the substance before consumption to ensure its purity and avoid potential harm.

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In addition, it is important to recognize that club or concert settings with a more chaotic atmosphere carry higher risks compared to controlled and intimate experiences with friends. In such situations, it is highly advisable to have a trusted friend present who can provide assistance if needed.

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Moreover, taking regular breaks from dancing to cool down and ensuring proper hydration are crucial for recreational users. However, it is important to be cautious and avoid overconsumption of water. Striking a balance between staying hydrated and not overdoing it is essential for maintaining well-being in these environments.

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Mixing MDMA with other substances or medications can also increase the likelihood of experiencing dangerous adverse effects. Furthermore, individuals with certain medical conditions such as heart problems are generally advised against using MDMA as it increases heart rate, and may produce cardiac arrhythmias (irregular heartbeat) such as tachycardia and ventricular fibrillation.

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The nature of an MDMA experience can vary greatly due to individual differences, set and setting, the dose taken, and the presence of other substances. It is important for individuals to consider these factors and approach MDMA use with caution. 

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Like any mind-altering substance, the use of MDMA should be approached cautiously, taking into account both the potential advantages and risks associated with its consumption. While the effects of MDMA may be appealing to many, it is essential to recognize that these effects can vary significantly depending on various individual and environmental factors.

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Ultimately, the decision to use MDMA is a personal one that necessitates thoughtful consideration, informed by the latest research and medical advice.