Some call it Ecstasy. Others call it Molly, X, or rolls. Regardless of its street name, MDMA has been a popular drug of abuse for the past 4 to 5 decades.

A German chemist first synthesized the drug in the early part of the 20th century. But it had limited potential as a pharmaceutical agent. Years later, in the 1970s, interest in the compound was somewhat revived after a few vocal members of scientific and treatment communities began to advocate for its use in psychotherapy.

Eventually, it became a street drug that was popular in the club scene in the 80s and 90s. Today, a few studies have investigated whether MDMA can help treat conditions such as PTSD, depression, and anxiety.

What Is MDMA?

MDMA, or 3,4-methylenedioxymethamphetamine, is a psychoactive stimulant that increases the release of 2 key neurotransmitters within the brain—dopamine and serotonin. Street names for MDMA include Ecstasy, X, Molly, E, beans, love drug, and rolls.¹

Common MDMA effects include:¹

Euphoria.
Increased empathy.
Energy.
Sexual desire.
Relaxation.
Enhanced perception.

However, MDMA can also have potentially uncomfortable effects like:¹

Nausea.
Chills.
Sweating.
Rapid heart rate.
Increased body temperature.
Jaw clenching.
Dry mouth.

Since the drug artificially spurs the release of serotonin, when it wears off, the user is left with a relative depletion of serotonin in the brain, which may be associated with temporary depression and irritability. The long-term effects of MDMA are not well known.²

People most commonly take MDMA in pill or tablet form. The tablets are rarely pure and are often cut with other drugs such as cocaine, methamphetamine, caffeine, and synthetic cathinones.^{1, 2}

Discovery of MDMA

Anton Kollisch, an employee at the German pharmaceutical company Merck, first synthesized methylenedioxymethamphetamine in 1912. He was trying to develop a vasoconstrictor to stop bleeding and accidentally discovered MDMA instead, which was then referred to as methylsafrylamine.³

In 1914, the company patented it for potential pharmaceutical use, but it was never taken further since no legitimate medical use was identified at the time.³

MK Ultra Experiments

In the 1950s, the U.S. government began studying MDMA as part of the MK Ultra program, which involved the examination of psychological compounds such as MDMA and mescaline for use in psychological warfare. The U.S. Army also conducted the first toxicology experiment on MDMA during this time at the University of Michigan. However, none of these experiments moved past animal test subjects, and they have since been declassified.⁴

Rediscovery of MDMA

American chemist Alexander Shulgin was the first to document studies on MDMA’s psychoactive properties. He conducted one study alongside Dr. David Nichols on the effects of MDMA, with the results published in The Pharmacology of Hallucinogens in 1978. Shulgin felt the drug could be valuable in therapy and shared it with his psychotherapist friend, Leo Zeff, in 1977. Zeff was impressed with his experience and introduced it to other therapists, who in turn spread it further. At Zeff’s memorial service, it was said that he had introduced MDMA to at least 4,000 other therapists.^{4, 5}

Use in Psychotherapy

Shulgin and Zeff’s enthusiastic endorsement of MDMA as a therapeutic tool inspired more widespread use of the drug in psychotherapy beginning in the 1970s.³ By the 1980s, more than 1,000 therapists were using the drug as a therapeutic aid. An estimated 500,000 doses were given from the time it was “rediscovered” until its use was made illegal.⁶

Therapists fought against MDMA’s restriction because they valued it as a therapeutic tool and did not want it to see the same fate as LSD, which the federal government banned in 1967. They attempted to control the spread of information on the drug, hoping they could get enough informal research completed before it became public. They were successful at keeping the drug on a low profile from 1977 to 1984, but it eventually became a popular drug of abuse and the U.S. government took notice, with the Food and Drug Administration (FDA) making it a Schedule I substance.³

The 1980s and DEA Scheduling

Increased usage of MDMA during the 1980s caught the eye of the Drug Enforcement Agency (DEA), which published a notice in 1984 that it intended to declare MDMA a Schedule I drug.³ As a result, a group of psychotherapists, physicians, lawyers, and researchers requested a hearing to determine whether or not it should be scheduled. The initial hearing was held on February 1, 1985, and it was determined that 3 more hearings would take place before a determination was made.⁷

In March 1985, 35 participants attended a conference at the Esalen Institute to discuss MDMA research.⁷ The researchers found that MDMA helped individuals in therapy better express their feelings, retrieve lost traumatic memories, and relieve emotional symptoms caused by those memories. Those at the conference favored making MDMA a Schedule III drug, as research showed it had therapeutic potential and moderate to low abuse potential. They also pointed out that no MDMA-related deaths had been reported since the beginning of its use in the 1970s.⁷

Despite the efforts of the psychological community, the DEA saw MDMA abuse as a nationwide problem and announced an emergency ban on May 31, 1985.³ It classified it as a Schedule I drug and claimed it had no known medical value.^{3, 7} It has been a Schedule I drug since that time, other than during a short period between 1987 and 1988.³

The 1990s and the Rave Scene

In spite of its Schedule I classification, MDMA continued to grow in popularity. Ecstasy tablets were a drug of choice at raves—late-night parties with loud electronic music and pulsating lights. Ecstasy became known as a “club drug,” with people taking it to stay up late, dance all night, and feel connected to others. MDMA was also popular on American and European college campuses.^{1, 2, 3}

The first FDA-approved clinical trial of MDMA also took place in the 1990s. It looked at whether MDMA could be used as an adjunct to psychotherapy and to help ease pain in terminally ill patients. Unfortunately, the results of this study were never published, though the study did pave the way for further research.³

MDMA Use Today

MDMA remains popular at raves, house parties, music festivals, and college dorms. According to the 2020 National Survey of Drug Use and Health, 2.6% of people aged 12 or older (or 7.1 million people) said they used hallucinogens like MDMA in the previous year.⁸

Emergency room visits have also increased dramatically since the drug was banned. In 2011 alone, there were more than 10,000 Ecstasy-related emergency room visits in patients under the age of 21.⁹

Some Ecstasy-related deaths have also been reported, usually as a result of heatstroke in association with increased physical exertion (e.g., dancing) and dehydration.² While rare, there is a potential for people with genetically determined difficulties in metabolizing the drug to overdose from a single use.¹

Many people who use MDMA illicitly see its effects as positive and potentially transformative. However, it can be potentially dangerous. People report taking the drug for the following reasons:^{1, 3, 4}

The desire for an altered state of consciousness.
Increased sociability
Feeling more connected to nature.
A changed outlook on life.
Increased enjoyment of music and dancing.
Improved psychological functioning.
Enhanced sexual desire and experiences.
Improved relationships.

However, people who use MDMA report problems related to the drug’s use, including:^{1, 3,}⁴

Difficulty sleeping.
Mood fluctuations.
Increased depression or anxiety.
Poor concentration or memory.
Irritability.
Weight loss.
Tremors.

Current Research About MDMA

Studies using low doses of MDMA to treat chronic, treatment-resistant PTSD have shown significant results. Patients given MDMA showed a 49.9-point average reduction in scores on the Clinically Administered PTSD Scale compared to only a 12.8-point average reduction for the placebo group.⁴ Long-term follow-up studies have also shown strong evidence of persistent recovery, with no major adverse effects reported.⁴

Clinical studies are ongoing for terminally ill patients, PTSD, substance misuse, depression, and anxiety in people diagnosed with autism. While research is ongoing about MDMA’s therapeutic benefits, it may have the potential to worsen some psychiatric illnesses. Despite more than 3 decades of research, uncertainties surround MDMA and its benefits in psychotherapy, the effects of long-term use, and the risk for addiction and dependence.^{2, 3, 4}

If you or someone you love is struggling with MDMA use, getting help may be an important step toward living a healthier life. While there is no medication approved for MDMA addiction treatment, behavioral therapy may be beneficial in helping a person remain abstinent and stop MDMA use.¹⁰ To learn more about drug and alcohol addiction treatment, contact American Addiction Centers and their caring team of admissions navigators at .

The History of MDMA (Ecstasy)