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Health & Wellness

The Trouble with Molly

Drug was used in spate of overdoses, fatalities

A series of recent overdoses—three of them fatal—attributed to the club drug MDMA, known as molly, has raised new concerns about its potentially lethal consequences.

Late last month, three people at the House of Blues in Kenmore Square overdosed on the drug, a purportedly pure powdered form of 3, 4-methylenedioxy-N-methylamphetamine, the active ingredient in ecstasy. One of the three, a 19-year-old student from Derry, N.H., died. Over Labor Day weekend, there were two more molly-related deaths, at a music festival in New York City, and three overdoses at a Bank of America Pavilion concert here in Boston.

Use of the drug appears to be on the rise. Government data show that the number of emergency room visits by people who had taken molly increased 123 percent from 2005 to 2009, the most recent year for which statistics are available. And the drug has become a popular topic among musicians, with artists Kanye West, Rick Ross, and Miley Cyrus referring to it in their songs.

The drug—popular because it creates feelings of euphoria and increased energy—is easy to get and relatively inexpensive, selling for $20 to $50 a dose. But the recent surge in deadly overdoses has law enforcement officials concerned that a bad batch of the drug is available in the Northeast.

Makers and sellers of the drug often cut it with dangerous substances such as amphetamines, cocaine, caffeine, and PCP. Anthony Pettigrew, a spokesman for the New England division of the Drug Enforcement Agency, recently told the Boston Herald that “there’s no good batch of molly, MDMA,or Ecstasy….you have no idea what’s in this stuff. Dealers want to make more money, so they’ll mix and adulterate the stuff with meth and any number of other drugs.”

The recent spate of overdoses has prompted the Boston University Police Department to post a fact sheet about molly and ecstasy to its website and Twitter account. Citing information compiled by the National Institute on Drug Abuse and NIDA for Teens, the fact sheet warns that the drug can cause anxiety and agitation as well as depression. Users are vulnerable to dehydration, particularly if they’re in a space where temperatures are high. Molly can also interfere with the body’s ability to regulate temperature, leaving those taking it at risk of developing hypothermia.

BU Today spoke about molly with David Farb, a School of Medicine professor and chair of the pharmacology and experimental therapeutics department.

Boston University BU, drug use safety, molly extasy MDMA risks, expert David Farb School of Medicine professor and chair of the pharmacology and experimental therapeutics department

David Farb, a School of Medicine professor, says that the recent overdoses and deaths associated with the drug molly “suggests that there is something bad about the batch that’s going around.” Photo by Kalman Zabarsky

BU Today: What exactly is molly?

Farb: Molly is just a new name for MDMA, but there are some designer drugs and additives that may be part of the substance.

How does the drug work in the brain?

It increases serotonin and dopamine levels in the limbic system.

Is there a way to quantify how dangerous the drug is?

One would have to define “dangerous,” but the cluster of recent cases of overdoses and deaths suggests that there is something bad about the batch that’s going around. It could, of course, be mixed with something that increases risk (MDMA plus methamphetamine would be a bad combination). Or maybe the MDMA dose is just unusually high.

Is the fact that molly is often cut with other substances—e.g., crystal meth or cocaine—one of the reasons it can be deadly?

Yes. If MDMA is combined with other drugs in the formulation known as molly, rather than pure MDMA, it can have more adverse side effects.

How addictive is it?

The addictive potential hasn’t been demonstrated.

You’ve said that any use of this drug constitutes drug abuse. Can you explain that?

The use of a drug for purposes other than therapeutics is ill-advised, and in particular, using a drug for the purpose of inducing an altered state of consciousness without being under the care and advice of a physician, i.e., obtaining the drug illegally, is abuse of the drug.

What symptoms would indicate someone is in danger of overdosing?

Severe adverse reactions to MDMA are generally attributed to hyperthermia. Dehydration and physical exertion—for example, dancing—in an overheated environment and/or exposure to diuretics (alcohol and caffeine) can exacerbate it. Serotonin syndrome (which includes hyperthermia among its symptoms) is a known, if uncommon, idiosyncratic effect of drugs that increase serotonin.

16 Comments
john o'rourke, editor, bu today
John O’Rourke

John O’Rourke can be reached at orourkej@bu.edu.

16 Comments on The Trouble with Molly

  • R. Andre Chapman, MCJ on 09.11.2013 at 8:41 am

    Thank you for this article, very knowledgeable and poignant. Great also to use the great resource we have here at BU, Dr. Farb.

  • Joe on 09.11.2013 at 8:55 am

    Rarely do you hear a cop all but admit that drug prohibition, and hence the inability to validate its contents, is the main cause of that drug’s related ailments.

    Also, to the author, its hard to really weigh the danger of MDMA without some context. In the same time frame, how many reported alcohol overdoses were there?

    • Greg on 09.11.2013 at 10:18 am

      I agree with the concern of context, but comparing numbers of MDMA overdose to alcohol would be a false comparison. The dangers of any substance should we weighed in proportionality, not raw numbers. Far more people consume alcohol than MDMA. If a comparison is needed, it should be what percent of users of MDMA overdose as opposed to the percent of alcohol consumers who overdose. Given that there’s no knowledge of how many people consume either substance, this type of comparison is likely impossible to project for academic purposes.

  • Anon on 09.11.2013 at 10:55 am

    Fun fact, people abuse alcohol more than they abuse molly, if you’re smart and know what you’re doing, alcohol is worse for the body.

    • anon on 09.11.2013 at 7:17 pm

      I fully agree with this statement. There are ways to use drugs responsibly, outside of the care and advice of a physician. Achieving altered states of consciousness may be beneficial to the user, whether to have fun or explore whichever, whatever within his/herself.
      And blacking out on alcohol has been rated by several research studies to be much much worse for you than using MDMA and staying hydrated.
      I believe the source of the problem is the ‘bad batch’ theory- where ‘molly’ has been tested recently to contain much more than MDMA and kids don’t know what theyre getting.
      In addition, people don’t use drugs responsibly, are inexperienced with drugs, and listen to their friends and rand-os at EDM shows. Molly is becoming a gateway hard-drug and that’s dangerous because new users don’t understand dosages, the proper contexts to buy and use, or how to take care of themselves while using such drugs

  • Random on 09.11.2013 at 11:08 am

    People generally don’t overdose on MDMA itself. The LD50 for the drug is pretty high (the average person probably wouldn’t be willing to even spend the money it would cost to overdose since it would be several hundred dollars for one time). That being said, people generally overdose on what MDMA is cut with, test your drugs if you plan to use them. Saying “don’t do drugs, they’re bad, mkay” isn’t doing any favors because people will always do drugs. Also don’t buy your drugs off the nice man at the concert, they’re more than likely cut pretty bad.

  • Anne Walton on 09.11.2013 at 11:53 am

    I suspect more people have died from heroin overdoses than will ever die from “molly. Heroin is cheap, readily available, and deadly. Wish there was more public education on its use. Perhaps it’s because heroin is considered to be a “street drug” and molly a club drug. Heroin deaths occur out of the public’s eye. Out of sight, out of mind as the saying goes.

  • Anon on 09.11.2013 at 7:26 pm

    Greg, the proportion of people who visit the ER from alcohol is definitely higher than from E. Just don’t be stupid with any drug (alcohol included): stay hydrated, take breaks to cool off, and don’t take more than you can handle – know your limits.

  • nathan on 09.12.2013 at 2:50 pm

    MDMA as a substance is a safer drug than most prescriptions.
    MDMA as a street drug suffers from the dangers imposed by drug dealers and their reactions to drug prohibition laws. E has killed a few people due to dehydration. The DEA has killed more people by enforcing the laws and driving the distribution network into the hands of criminals.
    - – -
    Drug policy is not simple. Simple solutions like prohibition and ‘just say no’ don’t work. Drug use in consultation with your doctor(s), as is now possible for marijuana, is much more sane than the laws of the USA for most of our lives.
    - – -
    It is very encouraging to hear a DEA agent blame the deaths on adulterated drugs rather than the actual chemicals. Many folks in the DEA have to be getting sick of spending resources on mildly dangerous drugs when they could be focusing on seriously dangerous drugs like meth.

  • Suprised on 09.13.2013 at 6:40 am

    I’m pretty suprised at how many of you endorse molly use. Likely none of you are experts but some still claim to know how to use the drug resposibly. How can you so eagerly defend its legalization? The drug, cut or not, is addictive and dangerous. Dehydration and depression are well known dangerous after-effects yet for the simple euphoria you get you might have all party goers use it.

    • Alexis on 09.14.2013 at 12:01 pm

      “The addictive potential hasn’t been demonstrated.”

    • Overlord of the Underclassmen on 09.15.2013 at 3:41 pm

      I completely agree with this view…I think people are defending it to somehow make their use of the drug excusable…

      It’ll be a dark day when it is widely acceptable to rely on chemicals to “have fun”.

    • Anon on 09.24.2013 at 11:24 pm

      The drug is not physically addicting, mental addiction is just lack of self control or care among other things. When spread out over a long enough period of time the drug has been show to be virtually harmless to the body.

  • Anonymous on 09.16.2013 at 5:13 pm

    Toxicology results have been released and the recent deaths were actually not caused by molly. The overdoses were attributed from methylone, which is also commonly known as bath salts. With everything that has happened, there’s definitely a lot of methylone circulating around the east coast that is being sold as molly.

    http://www.edmtunes.com/2013/09/recent-deaths-new-york-festivals-attributed-methylone/

  • Derp on 10.23.2013 at 4:23 am

    MDMA mixed is call extacy. MDMA alone is molly.

    Just saying..

    • Anon on 10.29.2013 at 2:40 pm

      Molly was originally the street name for MDMA but at this point molly means anything that looks remotely like MDMA that people are dumb enough to buy before testing.

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