Shadi Fouad

Common or street names: Adam, Beans, Clarity, Disco Biscuit, E, Ecstasy, Eve, Go, Hug Drug, Lover’s Speed, Molly, Peace, STP, X, and XTC

MDMA (3-4 methylenedioxymethamphetamine) is a synthetic, psychoactive drug with a chemical structure similar to the stimulant methamphetamine and the hallucinogen mescaline. It commonly referred to as Ecstasy or Molly by users.

MDMA is an illegal drug that acts as both a stimulant and psychedelic, producing an energizing effect, as well as distortions in time and perception and enhanced enjoyment from tactile experiences. MDMA is a Schedule I substance under the Controlled Substances Act, which means that the DEA has determined that it has no medical benefit and a high potential for abuse.

MDMA was first synthesized by a German company in 1912, possibly to be used as an appetite suppressant. It has been available as a street drug since the 1980s, and use escalated in the 1990s among college students and young adults. Then, it was most often distributed at late-night parties called "raves", nightclubs, and rock concerts.

As the rave and club scene expanded to metropolitan and suburban areas across the country, MDMA use and distribution increased as well. MDMA is frequently used in combination with other drugs. Today, the drug is still used by a broader group of people who more commonly call it Ecstasy or Molly.

See also: Ecstasy

MDMA is most often available in tablet or capsule form and is usually ingested by mouth or crushed and snorted.

Ecstasy traffickers consistently use brand names, colors and logos as marketing tools and to distinguish their product from that of competitors. The logos may be produced to coincide with holidays or special events. Among the more popular logos are butterflies, lightning bolts, and four-leaf clovers.

It is also available as a powder and is sometimes snorted, taken as a liquid, and it is occasionally smoked but rarely injected. The drug’s effects generally last from 3 to 6 hours.

Users may take several tablets at once or in succession over a period of time. Abusers may also use in conjunction with other psychoactive drugs like LSD. As with many other "party drugs", ecstasy is rarely used alone and it is frequently combined with alcohol and marijuana.

MDMA stimulates the release of neurotransmitters, such as serotonin and norepinephrine, from brain neurons producing a high that lasts from 3 to 6 hours, but the length of a high is variable based on the user. The drug's rewarding effects vary with the individual taking it, the dose taken, purity of the MDMA, and the environment in which it is taken.

MDMA can produce stimulant effects such as an enhanced sense of pleasure and self-confidence and increased energy. Its psychedelic effects include feelings of peacefulness, acceptance, and empathy.

MDMA exerts its primary effects in the brain on neurons that use the chemicals serotonin, dopamine and norepinephrine to communicate with other neurons.

Serotonin is most likely responsible for the feelings of empathy, elevated mood, and emotional closeness experienced with this drug. Overall, these neurotransmitter systems play an important role in regulating:

Research in animals indicates that MDMA is neurotoxic and may affect the brain. Clinical studies suggest that MDMA may increase the risk of long-term or permanent problems with memory and learning.

Shorter-term health effects include:

Also, there is evidence that people who develop a rash that looks like acne after using this drug may be at risk of severe side effects, including liver damage, if they continue to use the drug.

Because use promotes trust, closeness, empathy, and enhances sexual desire, the risk of unsafe sexual practices may increase, resulting in HIV/AIDS, hepatitis, or other sexually transmitted diseases.

Damage to brain serotonin neurons can occur; serotonin is thought to play a role in regulating mood, memory, sleep, and appetite. Studies are conflicting on MDMA use and its affects on memory and cognition.

Research results are controversial on whether MDMA can be addictive. Some people do report signs and symptoms of addiction. Almost 60% of people who use Ecstasy report some withdrawal symptoms, including fatigue, loss of appetite, depressed feelings, and trouble concentrating.

Users may encounter problems similar to those experienced by amphetamine and cocaine users, including addiction. Research has shown that animals will self-administer MDMA, an indicator of a drug's abuse potential.

Some people who use MDMA do report symptoms of addiction, including continued use despite negative consequences, tolerance, withdrawal, and craving, according to the NIH.

After moderate use of the drug over one week, psychological and physical effects due to withdrawal may include:

MDMA-related fatalities at raves have been reported. The stimulant effects of the drug, which enable the user to dance for extended periods, combined with the hot, crowded conditions usually found at raves can lead to dehydration, hyperthermia (dangerous increase in body temperature), and heart or kidney failure.

Repeated use within a short timeframe can be dangerous because the drug cannot be adequately removed from the body.

Other drugs chemically similar to Ecstasy, such as MDA (methylenedioxyamphetamine, the parent drug of Ecstasy) and PMA (paramethoxyamphetamine) have been associated with fatalities in the U.S. and Australia and are sometimes sold as Ecstasy. These drugs can be toxic to the brain or create additional health risks to the user.

Additionally, the illegal sale of Ecstasy or Molly makes it prone to being “cut” with other illicit and potentially toxic or deadly chemicals. Ecstasy or Molly may contain other substances in addition to MDMA, including:

While the combination of Ecstasy with one or more of these drugs may be inherently dangerous, users might also voluntarily combine them with substances, such as marijuana, alcohol, or opioids, putting themselves at further risk of physical harm, overdose, or death.

In addition, fentanyl has been increasingly found cut into other street drugs, often unknown by the user and leading to fatalities.

There are no specific treatments for MDMA addiction. Therapy is typically directed by a substance use clinic or health care provider and involve supportive care and behavioral and group therapy.

If you need help with a drug addiction concern, you can call the SAMHSA Treatment Locator at 1-800-662-HELP (1-800-662-4357), a confidential and anonymous source of information available 24 hours a day, 7 days a week.

The DEA considers MDMA an illegal schedule I drug with no recognized medical uses.

Researchers are looking at MDMA use as a possible treatment for:

Recently, the FDA designated MDMA-assisted psychotherapy for PTSD as a Breakthrough Therapy and ongoing MDMA studies can be found on clinicaltrials.gov.

Apple sells the world’s most popular smartwatch, but it’s not a standalone product. If you don’t have an iPhone, you might be wondering what you can do with an Apple Watch or if you can use one at all.

It’s not possible to set up an Apple Watch without using an iPhone. The Watch must be paired with an iPhone to link an Apple ID. You cannot use an iPad to complete this procedure; it must be an iPhone 6s or later running at least iOS 15.

You can’t use an Android device to set up an Apple Watch. The Watch is designed to be a companion device to an iPhone for much of its functionality. This is particularly true of the Wi-Fi model, though Apple also sells an Apple Watch with cellular connectivity that operates more like a standalone device.

Once you’ve set up your Apple Watch with cellular you can do many of the things you’d normally rely on an iPhone for, like receive text messages, take phone calls, and access functions that depend on the internet. Unfortunately, this isn’t advisable due to the power drain placed on your Watch when using cellular data.

You’re unlikely to receive all-day battery life if using your cellular Apple Watch away from your iPhone for prolonged periods. Wi-Fi models depend on your iPhone so you miss out on a lot of functionality when your paired iPhone is out of range. The exception here is when you’re in the presence of a Wi-Fi network that you’ve connected to before (when your iPhone was present).

Some functions don’t depend on an iPhone, particularly related to health and exercise. While wearing your Apple Watch, your steps, and active calories will be counted which means you can work on filling your Move, Exercise, and Stand rings with or without your iPhone.

Your Watch will continue to track and record your heartbeat, and you can take your heart rate with the Heart app or perform echocardiograms with the ECG app. You can use your Watch’s alarm and timer, or play music that has been stored on your Watch (with paired headphones). If you sleep in your Watch your wearable will continue to monitor sleep quality.

You can also pay for items with Apple Pay or use cards stored in your Apple Wallet that are already available on your Watch. Apps like Voice Memos, Photos, Calendar, and Noise will continue to work as expected.

If you have a cellular model then the potentially life-saving fall detection feature will work (assuming you have cellular reception and battery life), but Wi-Fi models won’t be able to contact emergency services without an iPhone nearby.

If you don’t own an iPhone, the Apple Watch probably isn’t for you. Even if you use another household member’s iPhone to set the device up, this still isn’t ideal since the Watch is designed to work with your own personal Apple ID and device. You’ll want to save your own health data to your own account, for example.

Instead, take a look at the alternative smartwatches available to you. If you have an Android device, other options will provide a better experience than a solitary Apple Watch.

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