The drug Molly may have a cute name, but this stimulant can have very dangerous effects. This variant of 3,4-methylenedioxy-methamphetamine (MDMA) is related to ecstasy and typically taken as a pill, powder, or mixed with liquid (including alcohol) at clubs, raves, or large dance parties. The nickname stems from the word molecule, referring to the string of chemicals in MDMA.

Molly was, in the early 2000s, believed to be purer, and therefore safer, than ecstasy, which had been laced with all kinds of adulterants for years. However, just like ecstasy, Molly can come laced with unknown adulterants, some of which increase the risk associated with taking Molly.

Even if Molly is pure, however, it can still cause serious side effects, whether from one use or long-term abuse.

Brain Changes from Molly

 

Most of Molly’s effects come from dramatic changes to brain chemistry, affecting three neurotransmitters associated with mood: serotonin, dopamine, and norepinephrine. Molly mainly affects the release and reabsorption of serotonin, which regulates not just mood, but sexual behavior, aggression, pain sensitivity, and sleep.

Molly is primarily ingested orally, and it takes about 15 minutes to begin to affect the body and brain. When a person is high on Molly, they will feel more energized, appearing hyper or very alert. For some, Molly has mild psychoactive effects, changing how they perceive time. For others, changes in dopamine and serotonin lead to increased pleasure from physical touch. With a release of serotonin, other chemicals in the brain are triggered, including vasopressin and oxytocin, which are associated with love, trust, and sexual desire. Most people who take Molly report experiencing a heightened sense of empathy and feeling close to those around them.

These sensations typically lasts 3-6 hours; as the molecule is processed out of the body, the comedown begins. For some people, the comedown sensations from a loss of dopamine and serotonin can be so negative that they will take more Molly to overcome depression or physical discomfort. This can be dangerous.

Molly Also Causes Physical Changes

 

While a person is high on Molly, their body experiences consequences from the drug. These include:

  • Blurry vision
  • Muscle tension
  • Jaw clenching
  • Damage to teeth from grinding or clenching
  • Nausea
  • Stomach cramps
  • Increase in body temperature, even to dangerous levels, especially when physical activity like dancing is involved
  • Increase in blood pressure to potentially dangerous levels, which could cause cardiovascular damage, liver damage, and kidney damage
  • Rapid pulse and breathing
  • Chills or sweating despite elevated body temperature
  • Dehydration, especially when mixed with alcohol
  • Heat stroke

The Molly Comedown

 

A comedown from an intense drug like Molly is the equivalent of a hangover from alcohol. However, the changes in brain chemistry from Molly can be extensive enough that psychological effects may last for a week. The comedown from Molly is sometimes referred to as “aftereffects” because these changes in the serotonin synapses persist for several days. This is an unusual feature of this drug, and it increases the risk of long-term abuse.

Comedown effects from Molly include:

  • Impulsivity
  • Sadness
  • Depression (the most commonly reported symptom)
  • Restlessness, irritability, and anxiety
  • Thirst (another common symptom, although it is more easily alleviated)
  • Aggression
  • Loss of appetite
  • Insomnia or other sleep disturbances
  • Reduced interest or pleasure from sex
  • Reduced mental or cognitive ability, including poor memory or problem-solving

For some people, a small, recreational dose of Molly and the comedown afterward are manageable with basic self-care. However, for too many people, the comedown from Molly is disruptive and uncomfortable, which could lead to taking more of the drug just to feel normal. This can cycle into addiction.

Long-Term Damage

 

People who chronically abuse Molly will suffer serious health consequences. Because Molly primarily affects serotonin production, many of these consequences are structural changes in the brain. These changes present as:

  • Chronic depression
  • Confusion
  • Cravings for the drug
  • Severe anxiety
  • Paranoia
  • Chronic sleep problems
  • Depletion of serotonin or loss of neurons
  • Memory problems

 


 

Substantial amounts of MDMA or Molly can lead to chronic health problems too. Damage to major organ systems not only occurs from elevated temperature and rapid heartbeat but also the presence of large amounts of the drug itself.

Physical damage can include:

  • Liver damage
  • Kidney damage
  • Seizures
  • Hypertension
  • Arrhythmias
  • Molly and Neurotoxicity

     

    Any substance abuse can affect serotonin levels, but Molly is unique in the rapid changes to serotonin production it causes, leading to long-lasting comedown symptoms. When the brain does not produce serotonin on its own, the presence of serotonin metabolites goes down; this leads to degradation of serotonin transporters, then the terminals.

    Molly dramatically changes how serotonin is processed in the brain, which can destroy this important system. This is referred to as “MDMA toxicity.” Animal studies have shown that large doses of MDMA kills serotonin axons, which are responsible for releasing and processing serotonin in the brain. This exposure can cause damage lasting as long as seven years in primates.

    Overdose from Molly

     

    As noted by the website DanceSafe.org, an “overdose” on Molly, ecstasy, or MDMA may be a misnomer. The implication of the word suggests that it is possible to take a safe amount of the drug; however, even a “normal” dose of Molly could be too much, leading to heat stroke, dangerous dehydration, and heart damage, among other acute health conditions.

    The main cause of death from Molly is heat stroke. MDMA-based drugs have been known to elevate body temperature up to 108 degrees Fahrenheit. For adults, a body temperature around 100 degrees Fahrenheit is considered a fever while 103 is a high-grade fever; hyperpyrexia, or dangerously high fever, begins at 106 degrees. If Molly elevates the core body temperature to a high-grade fever, this can lead to internal damage. Hyperpyrexia can quickly cause damage to organs, especially the liver and kidneys; this causes death.

    Hyponatremia, or water retention, is a common but counterintuitive danger from Molly. While the drug can cause dehydration – also a dangerous side effect – water retention can lead to low sodium in the body, which can cause seizures and coma.

    Molly may be a popular club drug, but the side effects are all risky. Taking the drug once could lead to death; if a person abuses Molly consistently, they could suffer changes in their brain causing chronic depression and other mental problems. There is no safe way to take Molly, but for people who struggle with addiction to the substance, a rehabilitation program can help them to stop using the drug altogether.