Ecstasy is a drug that’s well known for being used for recreational purposes. Most often it is taken as a pill at clubs, outdoor festivals, and house parties and is an associated part of the rave EDM (electronic dance music) culture.
Officially called methylenedioxymethamphetamine or MDMA, it is also known as E, Molly, Adam, eckies, disco biscuits, the love drug, and a variety of other nicknames. It is an illegal synthetic drug classified as an empathogen.
This means it increases feelings of compassion and empathy towards other people (whether they are on the drug or not). It is also a stimulant because it speeds up the central nervous system and it often causes hallucinations.
Ecstasy pills come in a vast variety of colors and shapes. A typical pill will usually have a logo stamped on it such as a dove, smiley face, crown, dolphin, skull, a star, or multinational company logos. It can also be in powder form or crystals.
Ecstasy’s initial effects are usually felt after 20 to 30 minutes and then last for three to six hours. The comedown can last a couple of days, due to the drug but also that users have often not slept for a night.
Is ecstasy dangerous?
As the pills are illegally produced, the strength and what else is added to the MDMA is normally not known by the user. Ecstasy is classified as a Schedule I drug, meaning it has a high potential for misuse. Deaths have been related to ecstasy use, often due to heatstroke and dehydration or in fact drinking too much liquid.
Because users have heard of the dangers of heatstroke they are aware to drink lots of liquid. But there have been some recorded deaths of excessive water intake, from a condition called dilutional hyponatremia.
Some people on ecstasy have also died from heart failure. Ecstasy causes significant rises in heart rate and blood pressure that the majority of people can cope with – but some people have died and have an undiagnosed heart condition.
Due to it being illegal it is difficult to ascertain the number of deaths caused solely by ecstasy use, although compared to alcohol, tobacco, and other drugs such as cocaine and heroin it remains very low. As an illegal drug, it has also not really been looked at over the decades to study how it could help people struggling with mental health conditions.
But this is starting to change – with some promising results from recent research showing that ecstasy could have immense benefits for a great many people.
What is the history of ecstasy?
MDMA was first synthesized in 1912 by German chemist Anton Köllisch while working for the pharmaceutical company Merck. He was actually looking to develop a substance to stop abnormal bleeding. So when Köllisch detailed the effects of MDMA, the company was not interested in MDMA at the time.
However, over the next few decades researchers working on developing other products returned to look at MDMA to see if it could play a part. A paper published in Poland in 1960 was the first scientific paper on MDMA.
By the end of the 1960s, first reports were heard of MDMA being used as a recreational drug. This was in the western states of America. By the early 1970s MDMA use had spread to Chicago. Its use continued to rise and travel throughout much of America.
Meanwhile, in 1976 American chemist and psychopharmacologist Alexander Shulgin synthesized MDMA and tried it. He reported on it at a conference in Maryland later that year. Soon afterward he published a report on MDMA’s psychoactive effects.
Shulgin was especially interested in MDMA’s disinhibiting effects and believed it had the potential to help people in therapy sessions. Believing MDMA allowed users to strip away old negative habits and perceive the world with clarity, Shulgin nicknamed the drug “window”.
He started to give MDMA to friends and others who he thought could benefit from it. This included a psychotherapist called Leo Zeff in 1977. Zeff was so impressed with MDMA’s effects that he took to traveling around the US and Europe to train psychotherapists in the use of MDMA for therapy. Zeff called the drug “Adam”, because he thought MDMA put users in a state of innate and instinctive innocence.
Psychotherapists using MDMA in their therapy sessions saw that MDMA took away the fear of opening up that many of their clients previously had. Now they would openly share their true thoughts and deep feelings.
Depression and substance addictions were treated successfully to some extent with MDMA. But it was seen to be especially useful in couples counseling, with some therapists starting to call the drug “empathy”.
By 1980, MDMA’s recreational use was on the rise and it was still legal. One person who tried it was Michael Clegg, a former Catholic priest turned businessman.
Clegg was so impressed with the effects – that he said was like seeing God – that he decided he had to produce and sell it. He called the drug “ecstasy” as a more apt way of describing it and to market it on the party scene.
By 1984 it is said that Clegg’s laboratory in California was producing one million ecstasy pills a month. Yet it still could not keep up with the burgeoning demand.
This relentless rise in its use had not gone unnoticed by the law. In 1982, the Drug Enforcement Agency (DEA) had started investigating MDMA so that they could present enough evidence to make it illegal.
Therapists who were using it as an effective therapeutic treatment protested. They wanted the drug to be classified as a Schedule III substance, which would mean that professionals could continue to use it for therapy.
But in 1985, MDMA was listed in the USA as a Schedule 1 controlled substance under the Controlled Substances Act, making it an illegal drug. That means that it is considered to have “no currently accepted medical use and a high potential for abuse”.
It was soon also made illegal around most of the Western world. But despite its new illegality, the use of ecstasy continued to spread.
Then in 1987, a new “scene” started in England. A group of young people returned from the Spanish island of Ibiza where they had partied every night and all night at clubs. Back then licensing laws in England meant that nightclubs closed at 2am.
But this group in London put on illegal all-night clubs and parties, at which they also started playing house music – a new and developing musical style back then – from Detroit and Chicago. “Acid house” was one such style and this young crowd discovered while on ecstasy that they could dance and party all night to this new sound that seemed to come from the future.
Word of mouth traveled swiftly and before long this scene spread throughout the United Kingdom and beyond. Ecstasy was increasingly associated with clubs and as largely outdoor events known as “raves” got bigger with tens of thousands going to just one event, so the use of ecstasy grew dramatically.
Today, recreational use of ecstasy is still extensive. According to the National Institute on Drug Abuse (NIDA) in 2020 around 2.6 million people in the US reported using ecstasy in the past year.
What does ecstasy actually do to you?
MDMA increases the brain’s release of the “happy hormones” known as serotonin, dopamine, norepinephrine, and oxytocin. It also reduces activity in the brain’s fear-processing center called the amygdala.
Dopamine controls the brain’s reward center, playing a key role in how we feel pleasure; and norepinephrine controls the body’s functions of wakefulness/sleepiness as well as stress levels. In particular, serotonin is boosted. Sometimes also nicknamed the “feel-good chemical”, it creates and enhances strong feelings of connection, trust and empathy.
Users on ecstasy say they feel:
- Loss of any social inhibitions
- Heightened senses, perhaps especially touch and hearing
- Increased energy
- A complete sense of connection with everyone else
- Waves of highs (that are at times almost too high)
- Loss of fears and anxieties
- A blissful relaxation, a feeling of utter peace and tranquility
- Empathy and compassion
- Utter trust in everyone (and animals too)
- A sense of complete wellbeing
MDMA can also cause:
- Blurred vision
- Muscle tension
- Extreme sweating
- Hallucinations and changes in perception
- Rapid heart rate
- Extremely dry mouth
- A loss of control of movements
- Involuntary grinding of the teeth that causes obvious jaw movements
New research into MDMA for therapy
SSRIs (selective serotonin reuptake inhibitors) are the main class of drugs used to treat depression and anxiety. These increase serotonin levels in the brain. So it is no wonder that therapists and researchers made the connection between this and MDMA.
In 2017 the US Food and Drug Administration (FDA) approved limited research on MDMA-assisted psychotherapy. So far, MDMA has been researched for its effectiveness in treating people with PTSD, alcohol addiction, anxiety, and depression.
MDMA therapy will generally mean the client taking a measured dose of MDMA in a therapy room. A team of at least two therapists will guide the patient at all times through their MDMA experience, which will usually take all day. Afterward, follow-up talk therapy, without the drug, will help the client process feelings that came up while on MDMA as well as the whole experience.
In a therapy setting, it has been realized that MDMA can help strengthen the therapist and client relationship. This could especially be valuable for people diagnosed with PTSD (post-traumatic stress disorder), such as some war veterans and those who have suffered sexual abuse.
These people often find it understandably extremely difficult or even impossible to talk in any way about what has happened. But MDMA can let them open up, which is important to make progress in their therapy.
In May 2021 findings of a new study with PTSD patients were published in the monthly peer-reviewed medical journal Nature Medicine. Researchers from the California-based Multidisciplinary Association for Psychedelic Studies (MAPS) that funded the study hope their findings will lead to MDMA gaining approval for therapeutic use in the next couple of years.
Their study involved 91 PTSD sufferers based in 15 different sites in America, Canada, and Israel who received either MDMA or a placebo. Participants included military veterans, first responders, and sexual assault victims.
Results were astounding, revealing that 67 percent of PTSD sufferers who had MDMA alongside an intensive course of psychotherapy no longer had the symptoms that had given them the PTSD diagnosis in the first place. Overall, 88 percent of those who received MDMA experienced a “clinically significant improvement” in their PTSD symptoms.
“PTSD is a difficult nut to crack,” said neuroscientist Jennifer Mitchell from the University of California in San Francisco, the lead author of the study. “One main reason is that traumas become stuck. But with MDMA, things that had really crystallized become more flexible, and this gives you the chance to shake the tree and let all the nuts fall out.
“If the therapy works at all 15 study sites, in all 15 populations with all 15 therapist teams, then chances are you’re onto something: that it’s not the water in Vancouver or the weather in Israel or some specific therapist in San Francisco. The chances are that it’s something to do with the MDMA itself.”
Then, some more research published this year in The Journal of Psychopharmacology, a peer-reviewed scientific journal, has concluded that MDMA can help people with depression. This report stated: “Depression is a major mental health issue worldwide, with high rates of chronicity and non-recovery associated with the condition. Existing treatments such as antidepressant medication and psychological treatments have modest effectiveness, suggesting the need for alternative interventions.”
It concluded that the results they found suggest that MDMA use is associated with a lower risk of depression. It added that further studies were needed.
A previous study in 2012 that was published in the Science Direct journal looked at the effects of MDMA in 40 people with or without a tendency to suffer from depression.
Half of the people were put in the MDMA group and the remaining 20 were in the control group.
The study concluded: “Subjects predisposed to depression had higher emotional distress when drug-free. Ecstasy ingestion decreased depressive symptoms in users predisposed to depression.”
For some years now, MDMA has shown positive results in couples counseling. Last month The New York Times’ Christina Caron wrote an article headlined Can MDMA Save a Marriage? She wrote: “Before MDMA was banned in the United States in 1985, psychiatrist George Greer conducted more than 100 therapeutic sessions of MDMA with 80 people and was the author of an informal observational study in which 29 of them participated.
“The participants did not volunteer with the intention of healing a relationship, Greer said, but, curiously, all subjects, except one, reported that communication had improved in their relationships after the MDMA session, either with their partner or with another person in their life.”
Research is ongoing into MDMA use in couples counseling, with a Canadian clinical psychologist presently seeking approval for a clinical trial with up to 60 couples. MDMA has also proved useful for anxiety sufferers.
In a compelling 2019 article from The Washington Post, Sarah Hogate Bacon, a lifelong athlete with a disease that was destroying her lungs, wrote about how she turned to MDMA to see if it could help with her anxiety. She wrote of her MDMA experience: “My breath felt fuller than any time I could remember since my diagnosis five years earlier with lymphangioleiomyomatosis, or LAM. It felt like oxygen was filling every cubic millimeter of my damaged lungs, turning them from antagonists to a supportive life force. And at that moment, the existential fear that always seemed to dog me dissipated.
“I talked about death as nothingness, which the guide helped reframe as a total lack of awareness and therefore absolute peace – a simple psychic shift, but it felt revelatory.
“My takeaways from the MDMA-guided therapy were significant: I was no longer crippled by anxiety about the progression of my disease, or by the fear of potential treatment outcomes.”
MDMA is still in its early stages of being researched for therapy use. But certainly, the findings so far indicate it could be an extremely useful therapeutic tool for some people.