Stimulants Why is "Molly" and MDMA so toxic?

[GetMeOutOfThisCRAP]

I've actually never dabbled in Molly before or stronger forms of MDMA (not really educated on what Molly necessarily is other than "pure MDMA?"). It seems to be a typical West Coast drug.. or at least in some cities mostly a higher end designer drug or expensive club scene kind of substance. But the horror story posts on the MDMA recovery thread terrify the shit out of me. I've never seen folks struggle with such crippling long term depression/anxiety/other physical symptoms that seem to never fully alleviate themselves after years and years.

Why is Molly so detrimental to people's physical/mental health--even more than methamphetamine? I just don't see why it's so severely toxic in comparison to (generalized sorry) any other drug on the planet? I don't think I'll ever be trying it now. Or if so some day--just a one and done type of thing. If other stimulants can be highly abused and not even put a dent in someone's health compared to pure ecstacy, I don't see much incentive for that kind of high as it brings doom to all.

 

[G_Chem]

Don’t let those stories scare you, when used right this drug can bring about so much positivity in ones life. As someone that used to be a self described “expert” in the topic of LTC (started researching and helping others 2011 or so) I’ve come to conclude these are often individuals with pre-existing anxiety and the condition is at least majorly anxiety based.

Also the typical profile of someone with LTC (I originally termed it MDMA Induced DP/DR) is 18-22 with little to no history of prior drug use, often it happens on the first or first couple of uses, and much of the time includes a larger than average dose. I don’t think you fit

I was of the same mindset before o tried it, back then the “holes in the brain” myth run rampant. Very glad I went against that judgement.

-GC

 

[burn out]

It's just an unforgiving substance that massively throws your brain chemistry out of wack.

 

[AlphaMethylPhenyl]

I think it has to do with the destruction of serotonergic vesicles because of the acidity of dopamine

 

[jimdron]

I consumed weed, LSD, mushrooms, coke, MDMA - MDMA is by far the worst in terms of hangover. Depression is heavy and it (in my case, maybe, I fear) could transform into longer term depression. And when I am high on MDMA - I kind of feel it, the high is something that is so good, that should be costly when I am back in my usual semi-depressed anxious state. MDMA is for rare occasions, it is by far the most powerful drug I have taken.

 

[diaphon]

MDMA is not known to be more harmful than many other illegal drugs (see research from David Nutt's group at Imperial College London, which plots the major drugs of abuse on a two-axis grid with harms to self and harms to society as the dimensions). Nutt's work suggests that alcohol and tobacco have the most significant harms, followed closely by heroin. Cocaine is in the next tier down, and pretty much all other drugs of abuse are small potatoes in comparison to any of those.

MDMA is not associated with stroke or heart attacks, while cocaine and amphetamines certainly are. It's also not associated with cancers, which tobacco certainly is, or with the myriad health conditions linked to alcohol (liver disease, diabetes, obesity, cardiovascular disease, and dementia). In terms of mental health, depression associated with alcohol a far biggest risk than with any other drug I can think of.

Because it's difficult to do legal research on MDMA, it's long-term effects have primarily been studied in heavy polysubstance abusers. I don't think anyone can say with certainty what happens in typical MDMA users after moderate repeated consumption. Probably not loss of serotinergic neurons, though, since this has never been documented in human subjects (@G_Chem rightly points to the "holes in the brain" myth, a disingenous study done in mice where the researchers used doses 50-100x what a recreational user would take). In fact, MAPS specifically tested this serotinergic hypothesis as part of their clinical trial application to the FDA, and so far they have found no evidence for it.

The proposed mechanism is that MDMA causes the brain to release lots of serotonin and norepinephrine, and then prevents re-uptake of both. Some people argue that by disrupting the transport mechanisms, MDMA can cause non-specific reuptake into the neuron and somehow cause free radical production and cell death. I suppose that's theoretically possible. It hasn't been shown in humans.

Since this is a harm reduction website, let's focus on sensible harm-reduction. MDMA is a powerfully psychoactive drug that also strongly activates the sympathetic nervous system. The only way to obtain it is illegally, from questionable sources. No matter what this is a high risk situation. But on the spectrum of illegal recreational drug use, MDMA is relatively low risk.

EDIT: I do recognize the truth in @jimdron's story above, though. For people who are already struggling with depression, MDMA is probably a high-risk choice.

 

[jimdron]

MDMA is not known to be more harmful than many other illegal drugs (see research from David Nutt's group at Imperial College London, which plots the major drugs of abuse on a two-axis grid with harms to self and harms to society as the dimensions).

EDIT: I do recognize the truth in @jimdron's story above, though. For people who are already struggling with depression, MDMA is probably a high-risk choice.

Pure physical (chemical) harm is probably not what is most important for most users. Interplay of drug usage with psychological state, particularities of other circumstances is likely much more important. E.g. if one starts using MDMA each week or even more often, there is something is user's life that attracts user to such drastic measures. That aside, MDMA in my particular experience is the drug that kicks me the most. Roll is so pleasurable for so long.

 

[burn out]

MDMA is not known to be more harmful than many other illegal drugs (see research from David Nutt's group at Imperial College London, which plots the major drugs of abuse on a two-axis grid with harms to self and harms to society as the dimensions). Nutt's work suggests that alcohol and tobacco have the most significant harms, followed closely by heroin. Cocaine is in the next tier down, and pretty much all other drugs of abuse are small potatoes in comparison to any of those.

This is way too general to be relevant in a discussion like this and depends heavily on the criteria being used to assess harm, in which case here I am guessing they are using overall harm to society. Of course tobacco and alcohol are going to do more overall harm because the rate of usage is so much higher. But on an individual level, that does mean that smoking a cigarette is more dangerous than taking MDMA.

MDMA is not associated with stroke or heart attacks, while cocaine and amphetamines certainly are. It's also not associated with cancers, which tobacco certainly is, or with the myriad health conditions linked to alcohol (liver disease, diabetes, obesity, cardiovascular disease, and dementia). In terms of mental health, depression associated with alcohol a far biggest risk than with any other drug I can think of.

Again, that is because so much more alcohol is consumed than MDMA. If as many people took MDMA every weekend for years on end as people do with alcohol, there would be a lot more depression associated with MDMA. In fact, I would argue that aside from legality, one of the major reasons people don't take MDMA that often is because it is so toxic and draining and that is what the OP was asking about.

 

[diaphon]

This is way too general to be relevant in a discussion like this and depends heavily on the criteria being used to assess harm, in which case here I am guessing they are using overall harm to society. Of course tobacco and alcohol are going to do more overall harm because the rate of usage is so much higher. But on an individual level, that does mean that smoking a cigarette is more dangerous than taking MDMA.

I'm sorry that you think my post isn't relevant. Maybe if you read the paper I'm referring to you would understand the point a bit better. That research is highly influential, widely cited, and has been discussed on Bluelight in several threads.

The entire point is that there are two dimensions of harm - individual health and social harms. I mentioned that in my first post.

I think you've made the point yourself when you wrote that "aside from legality, one of the major reasons people don't take MDMA that often is because it is so toxic and draining and that is what the OP was asking about." The fact that consumption of MDMA is often self-limiting is one of the reasons it is less harmful and less addictive than alcohol and tobacco.

I do encourage you to read Prof. David Nutt's arguments about a new way of thinking about drug harms. All of your objections are thoroughly addressed in his work.

 

[burn out]

I am familiar with Dr. Nutt's work. My point was that the OP was asking what makes MDMA so toxic compared to other drugs, not whether or not it is more harmful in some overall sense.

 

[diaphon]

I am familiar with Dr. Nutt's work. My point was that the OP was asking what makes MDMA so toxic compared to other drugs, not whether or not it is more harmful in some overall sense.

The OP's post speaks for itself when he writes "Why is Molly so detrimental to people's physical/mental health--even more than methamphetamine? I just don't see why it's so severely toxic in comparison to (generalized sorry) any other drug on the planet?"

The point of Nutt's research is that MDMA is not more detrimental to people's physical and mental health than drugs like alcohol or tobacco. He's talking about toxicity in the specific physical sense of disease burden due to drug use on one dimension, and specific harms to society on the other dimension.

Is that still too general for you? The LD50 of MDMA about 10x the normal recreational dose. The LD50 of alcohol ranges from 7-14x the normal recreational dose. I wouldn't say that is a severe difference in toxicity, defined in the pharmacological sense of that word.

The OP is worried about taking MDMA because of its toxicity and that is a reasonable concern for any drug, and an especially reasonable concern for an illegal drug of unknown provenance. But it's simply not true that MDMA is more toxic than other drugs. I realize you've dug yourself a hole by criticizing my post as "too general to be relevant," but I'm happy to stand behind it. MDMA is simply not more toxic than other drugs.

 

[burn out]

So while I understand you may take issue with that particular statement the OP made, I think it is perfectly valid to ask why MDMA tends to be so much harder on people compared to other drugs, at least when used with similar frequency. For example, you just don't see stories all over forums like bluelight where people are saying "I had a few beers four months ago and now my mind is all screwed up" or "I smoked too many cigarettes 7 months ago and I'm stuck in long term come down ever since". Even with meth, most of the time the people with long term issues from meth use did quite a lot of meth. However, what you do see with MDMA is this phenomenon of stories of people who took what would be a relatively small amount compared to other drugs and are reporting long term issues from it.

 

[diaphon]

So while I understand you may take issue with that particular statement the OP made, I think it is perfectly valid to ask why MDMA tends to be so much harder on people compared to other drugs, at least when used with similar frequency. For example, you just don't see stories all over forums like bluelight where people are saying "I had a few beers four months ago and now my mind is all screwed up" or "I smoked too many cigarettes 7 months ago and I'm stuck in long term come down ever since". Even with meth, most of the time the people with long term issues from meth use did quite a lot of meth. However, what you do see with MDMA is this phenomenon of stories of people who took what would be a relatively small amount compared to other drugs and are reporting long term issues from it.

There I absolutely agree with you, the reports on Bluelight in that big long terms harms thread are worrying. I do understand why the OP has concerns. The scientific literature doesn't reflect what we're seeing from those first hand reports, and I'm not sure what to make of that difference. I guess on a personal level I'm trying to be cautious and reasonable and open to having my mind changed.

 

[MsDiz]

There I absolutely agree with you, the reports on Bluelight in that big long terms harms thread are worrying. I do understand why the OP has concerns. The scientific literature doesn't reflect what we're seeing from those first hand reports, and I'm not sure what to make of that difference. I guess on a personal level I'm trying to be cautious and reasonable and open to having my mind changed.

It’s worth spending time and reading those threads. Your mind may well have to open...

 

[GetMeOutOfThisCRAP]

I'm sorry I was rather busy lately.

I feel like my post was a bit vague, but regardless I felt like many of the arguments had valid perspectives anyway. I was focusing on the mental component of the drug as opposed to the physical harm (few care about stimulant's physically harmful effects let's be honest ). The severe and long-lasting depression/anxiety/complete inability to focus seem incredibly daunting.

I've never seen users be plagued (complaining isn't a justified word) about the long-lasting and in some cases seemingly permanent negative side effects of MDMA like I have with any other substance discussed on BL. These users are suffering... Of course any substance has some form of suffering and that's the toll we mostly expect as addicts. However, I'm wondering why the mental component seems to be so hellish with MDMA abuse. Many meth users state that the time period for mental recovery seems to be a couple of months to a year. Still, some report some permanent negative effects--yet I've never seen a methamphetamine addict personally write such pain into words over their use and even over the years. Meth seems to be the regarded "strongest" stimulant (just threw that in for a direct comparison from one stimulant to the next).

However, I did not consider alcohol poly-substance abuse into the equation so thanks! I am an adderall pot-goblin and actually do not feel a single side effect of my use and or abuse. Ecstacy though? I feel something negative from the times I've done that. Never had the "pure ecstacy" AKA MDMA. I'm a bit scared.

 

[burn out]

There I absolutely agree with you, the reports on Bluelight in that big long terms harms thread are worrying. I do understand why the OP has concerns. The scientific literature doesn't reflect what we're seeing from those first hand reports, and I'm not sure what to make of that difference. I guess on a personal level I'm trying to be cautious and reasonable and open to having my mind changed.

Yes, in my experience there is sometimes a disconnect between the scientific literature and what actual users of the drug are reporting in the real world. Benzodiazepines are a classic example of this. As you may be aware, benzos are capable of causing a protracted withdrawal syndrome which lasts for years and can be seriously disabling and extremely painful. You will find tons user reports of this online not only on bluelight, but also on entire forums dedicated to withdrawing from benzos and the internet benzo community is far more knowledgeable about this condition than the vast majority of doctors and scientists.

There are likely multiple reasons for this, such as not enough long term studies, poor study design, disbelief among the researchers that a withdrawal syndrome could go on so long and subsequent lack of research interest and suppression of information by the pharmaceutical companies (probably not the case with MDMA). I am not familiar enough the literature on MDMA to speculate further but I will say that when I want to learn about a substance, I give at least equal weight (if not more weight) to user reports as to the scientific literature.

Of course the trouble with user reports is that it's very difficult to determine the percentage of users experiencing the effects being discussed, due to selection bias. Obviously people who suffered major problems from using MDMA are going to be more likely to come on Bluelight and make a post about it than people who only had good experiences and never had a long lasting come down.

 

[jimdron]

Yes, in my experience there is sometimes a disconnect between the scientific literature and what actual users of the drug are reporting in the real world.

That is my perception (not much experience so far) of MDMA. I thought of it as rather safe (judging mainly form medical reports) but I am changing my opinion into that MDMA is too volatile if used often (say, once a week or more often). Or maybe more precisely - it is at least as harmful as say coke. Maybe even more harmful considering it's longer duration and more intense effect.

MDMA's effect is "nice", "soulful", but my intuition (took MDMA 3 times in my life) is that to use take MDMA once a week or more often is crazy. It is intense, one would not have much energy for anything else besides MDMA on such a schedule.

 

[tweakerguy]

That is my perception (not much experience so far) of MDMA. I thought of it as rather safe (judging mainly form medical reports) but I am changing my opinion into that MDMA is too volatile if used often (say, once a week or more often). Or maybe more precisely - it is at least as harmful as say coke. Maybe even more harmful considering it's longer duration and more intense effect.

MDMA's effect is "nice", "soulful", but my intuition (took MDMA 3 times in my life) is that to use take MDMA once a week or more often is crazy. It is intense, one would not have much energy for anything else besides MDMA on such a schedule.

Yes MDMA, or MDA (no methamphetamine molecule) is best saved strictly for "special occasions", much like you would LSD or mescaline. The diminishing returns come fast. Serotonin is nothing you wanna mess with on top of that, however.

Ecstacy is classified as a psychedelic stimulant, so that should tell you something.

 

[Zephyn]

I think a lot of the toxicity comes from redosing. IIRC, and without reverifying, after the first dose depletes your serotonin, the second pulls dopamine into the cleft misshaping it

 

[burn out]

That is my perception (not much experience so far) of MDMA. I thought of it as rather safe (judging mainly form medical reports) but I am changing my opinion into that MDMA is too volatile if used often (say, once a week or more often). Or maybe more precisely - it is at least as harmful as say coke. Maybe even more harmful considering it's longer duration and more intense effect.

MDMA's effect is "nice", "soulful", but my intuition (took MDMA 3 times in my life) is that to use take MDMA once a week or more often is crazy. It is intense, one would not have much energy for anything else besides MDMA on such a schedule.

Well it's way more harmful than cocaine on a per use bases, but due in part to this fact you're much more likely to use cocaine habitually. I did tons of cocaine and don't really feel any long terms from it, weed and psychedelics have had way more negative effects on me than cocaine. If I had done anywhere near that amount of MDMA, I am sure the side effects would have been devastating.

Of course cocaine does come with a greater risk of stroke or heart attack than MDMA,although sudden deaths have been associated with MDMA as well.