Greatist’s #WTF is series looks at new trends in health and fitness to explain what the heck they are, why people care, and if they live up to the hype.

Hey, have you heard about Molly? We’re not talking about the girl next door — Molly is a nickname for a pure form of MDMA, a drug that’s currently the Queen Bee of the party scene (at least, according to Miley Cyrus). Read on to learn what it is, how it’s used, and why it’s so dang popular all of a sudden.

Photo: Elad R

What’s the Deal?

MDMA is an abbreviation of the drug’s chemical name, 3,4-methylenedioxy-N-methylamphetamine (try saying that five times fast). Molly (short for “molecular,” because MDMA is produced in a lab) is classified as an empathogenic drug, which means it affects the brain and spinal cord to produce specific emotional and physical side effects. Taking Molly, a.k.a. “rolling,” tends to make people feel upbeat, more connected to others physically and emotionally, energized, confident, relaxed, euphoric, and sensitive to touch and visual stimulation. Physically, people on Molly often experience dilated pupils, dry mouth, clenched jaws, tense muscles, and sweating. In high doses, Molly can cause unpleasant reactions such as panic attacks, hallucinations, or anxiety. The drug’s effects (both positive and negative) last between three and five hours.

Molly is frequently described as a purer or “safer” form of the popular club drug ecstasy (E), which is famous (or infamous) for being “cut” or mixed with other substances, from amphetamines to caffeine to LSDWhat’s in a label? Ecstasy sellers’ perceptions of pill brands. Duterte M, Jacinto C, Sales P, Murphy S. Institute for Scientific Analysis, San Francisco, CA, USA. Journal of Psychoactive Drugs. 2009 Mar;41(1):27-37.. But Molly, like any drug, is hardly pure as driven snow.

MDMA’s reputation as a safer drug option is problematic because, in reality, all illegal drugs are inherently unsafe due to lack of regulation. It’s nearly impossible to know exactly what’s in a pill, powder, capsule, or tablet (unless you walk around with a test kit in your pocket). Moreover, studies have shown that MDMA — when consumed in pure form and also when mixed with other drugs or chemicals — can potentially cause bleeding within the brain, persistent psychosis, immune system issues, and long-term brain damage3 cases of primary intracranial hemorrhage associated with “Molly”, a purified form of 3,4-methylenedioxymethamphetamine (MDMA). Kahn DE, Ferraro N, Benveniste RJ. University of Miami Miller School of Medicine, Department of Neurology, USA. Journal of the Neurological Sciences. 2012 Dec 15;323(1-2):257-60.Persistent psychosis after a single ingestion of “Ecstasy” (MDMA). Patel A, Moreland T, Hag F, Siddiqui F, Mikul M, Qadir H, Raza S. Department of Psychiatry, University of South Alabama, Mobile. The Primary Care Companion to CNS Disorders. 2011; 13(6).Methylenedioxymethamphetamine (MDMA, “Ecstasy”): a stressor on the immune system. Connor TJ. Department of Physiology, Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland. Immunology. 2004 Apr; 111(4):357-67.Does recreational ecstasy use cause long-term cognitive problems? Kelly PA. Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK. The Western Journal of Medicine. 2000 Aug; 173(2):129-30..

Why Do People Care?

Although Molly’s been making headlines lately (thanks in large part to mentions in pop music), 2013 is hardly the drug’s first time at the rodeo. German pharmaceutical company Merck first patented MDMA nearly a century ago, way back in 1914. The drug rose to popularity during the 1950s and ’60s, when psychiatrists experimented with using psychedelic drugs (including LSD and psilocybin, the active chemical found in magic mushrooms) to treat depression, alcoholism, and other mental health problems.

For the most part, this experimentation came to an end in 1970, when President Nixon signed the Controlled Substances Act to classify various drugs into categories based on potential for abuse and use as a medical treatment. In 1985, MDMA received its current classification as a Schedule 1 controlled substance, meaning that it has no recognized medical use, a high potential for abuse, and is illegal to make, sell, trade, or possess.

Ecstasy (MDMA often mixed with other drugs) became extremely popular as a club or rave drug in the 1990s, particularly among teens. Although E is still widespread in the rave scene, it’s much less popular than it was back in the era of Nirvana and flannel shirts. E gradually developed a reputation for being dangerous — in 2001, the drug caused 76 reported deaths, most of them due to overheating (after dancing for hours in a hot room), combining the drug with alcohol, or an interaction between MDMA and other substances in an E tablet.

That last cause is important, and it helps explain why Molly has become so popular. Molly is a supposedly clean, pure form of MDMA, without the amphetamines or other “dangerous” chemicals that caused so many Ecstasy scares in the late ‘90s and early 2000s. Perhaps because it’s perceived as a safe, fun drug, Molly’s been turning up left and right in pop culture. Last March at Ultra (a three-day electronic music festival in Miami), Madonna got into hot water for asking concertgoers if they’d “seen Molly.” Miley Cyrus’s summer hit “We Can’t Stop” features lyrics that state: “We like to party / Dancing with Molly / Doing whatever we want”. Both musicians begged ignorance ­— Madonna claimed to be referencing a DJ friend’s song called “Have You Seen Molly” and Cyrus initially explained that the lyric was actually Miley, not Molly. Recently, though, Cyrus changed her (more PR-friendly) tune and clarified that the song does, in fact, reference the drug and not her name.

The Verdict

While some pop culture critics believe the brazen mentions of Molly in Top 40’s music suggest that the drug’s going out of style like acid-wash jeans, others are wary. Molly (with costs up to $50 per dose) is becoming more mainstream and widely used than other illegal drugs. That’s perhaps because it’s considered generally benevolent — it’s non-addictive, almost always generates a “happy” trip (unlike LSD, for example, which can produce “bad trips”), and helps concertgoers and dancers feel more connected to the music and to each other.

It’s easy to pigeonhole all drugs, especially those that appeal to young teens, as inherently bad and dangerous. But it’s hard to classify Molly as either “fun” or “evil,” because it has plenty of uses beyond helping millennials cut loose at parties and raves.

For example, scientists and psychologists are currently experimenting with Molly as a treatment for patients with Post Traumatic Stress Disorder (PTSD)The safety and efficacy of { /-} 3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study. Mithoefer MC, Wagner MT, Mithoefer AT, Jerome L, Doblin R. The Journal of Psychopharmacology. 2011 Apr;25(4):439-52.. The treatment is pretty far from “dancing with Molly” — in every clinical trial, the participants received a low dose of MDMA once a week and participated in regular talk-based therapy sessionsA randomized, controlled pilot study of MDMA (±3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD). Oehen P, Traber R, Widmer V, Schnyder U. The Journal of Psychopharmacology. 2013 Jan; 27(1):40-52.MDMA-assisted psychology using low doses in a small sample of women with chronic posttraumatic stress disorder. Bouso JC, Doblin R, Farré M, Alcázar MA, Gómez-Jarabo G. Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain. Journal of Psychoactive Drugs. 2008 Sep;40(3):225-36.. Researchers are also currently working on a clinical trial testing whether MDMA can meet the specific emotional needs of Army veterans and firefighters with PTSD.

The results so far are pretty encouraging. A recent follow-up study tracked down PTSD patients who participated in earlier MDMA clinical trials — and of the original 19 participants, only two experienced relapses of their symptomsDurability of improvement in post-traumatic stress disorder symptoms and absence of harmful effects or drug dependency after 3,4-methylenedioxymethamphetamine-assisted psychotherapy: a prospective long-term follow-up study. Mithoefer MC, Wagner MT, Mithoefer AT, Jerome L, Martin SF, Yazar-Klosinski B, Michel Y, Brewerton TD, Doblin R. The Journal of Psychopharmacology. 2013 Jan; 27(1):28-39..

In spite of these trials, MDMA is still classified as a Schedule 1 drug, meaning it doesn’t have any recognized medical use and carries a high risk of abuse. It seems Molly faces the same challenges as other drugs, such as marijuana, which have legitimate medical uses but are also used recreationally. In the future, the DEA will need to find a balance between recognizing Molly’s power as a therapeutic drug and protecting young people from using drugs dangerously.

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