About MDMA

MDMA, commonly known as ecstasy (E) or molly, is a psychoactive drug primarily used
recreationally. Effects include altered sensations, increased energy, empathy, and pleasure,
which last 4-6 hours.
MDMA acts primarily by increasing the activity of the neurotransmitters serotonin, dopamine,
and noradrenaline in parts of the brain. Following use people often feel depressed and tired.
In 2016, about 21 million people between the ages of 15 and 64 used ecstasy (0.3% of the world
population). This was broadly similar to the percentage of people who use cocaine or
amphetamines, but lower than for cannabis or opioids.
 Comparison between users:
USER X: USER Y: USER Z:
oDrug: •MDMA •MDMA, Weed •MDMA, Weed, LSD
oUsage: •Twice over 1 year •4-5 times over 2 years •Almost every weekend until rehab
oFirst time:•1 year ago •2 years ago •2 years ago
oReason: • •Wanted to try due to
Believes that one should try •N/A
everything possible that documentaries about artists who
wouldn’t kill oneself. tried MDMA to increase
creativity.
oImpact on •None. Injury healing unaffected,
body and •None. Injury healing unaffected. says smoking weed helped relieve •Changes in weight, physical
health: appearance, psychology
headaches, joint pain etc.
oLast •N/A
usage: •N/A •March 2019
Mode of Action
MDMA is readily absorbed from the gastrointestinal tract. Onset of action is within 30 minutes
and peak serum levels occur after one to three hours
The primary mode of action is as an indirect serotonergic agonist, increasing the amount of
serotonin released into the synapse. It acts on the serotonin transporter and is transported into
the nerve terminal. This promotes release of serotonin through the serotonin transporter by a
process of transporter-mediated exchange. Whilst within the terminal, MDMA interferes with
the storage of serotonin within the vesicles and thus increases the amount of serotonin available
to be released.
MDMA is also able to enhance release of dopamine and noradrenaline . It is presumed that
MDMA's effects on dopamine and noradrenaline release are mediated in a similar manner to
the serotonin release.
 Long term Short term Users X,Y,Z

• Damage to brain and • Depression

loss of • Anxiety X: None
memory(cerebral • Restlessness
cortex and • Irritability Y: None
hippocampus) • Sleep Disturbances
• Loss of sensation • Paranoia Z: Changes in weight, physical
• Kidney failure • Muscle Tension appearance, psychology
• Hemorrhaging • Involuntary teeth
• Psychosis clenching
• Cardiovascular • Blurred Vision
collapse
• Convulsions
MDMA: a stressor on the immune system
Has immunosuppressive activity and increases susceptibility to infectious diseases
o Suppresses neutrophil phagocytosis
o Suppresses production of TNF-α
o Suppresses production of IL-1β
o Increases production of IL-10 ( an immunosuppressive cytokine)
o Suppresses circulating lymphocyte numbers, with CD4+ cells being the main target

Note: These are not the direct consequences of the drug, but due to the Serotonin release in the
CNS
Summary
o Correlation vs Causation

o Adulteration-87% of MDMA analyzed b/w 2009

and 2013 had 0% MDMA. The fake molecules are
sometimes more harmful than the drug itself

o Rehabilitation