NPN Workshop Overview and Implications for Prevention Heather Martinsen, MSW Prince William County Community Services

What You Should Know About MDMA (Ecstasy/Molly): Implications for Prevention This workshop was presented by Khary Rigg, PH.D, Assistant Professor, University of South Florida Department of Mental Health Law & Policy I chose to attend this workshop because I have not heard much about this drug recently and wanted to learn about new trends and frequency of use. There was an emphasis on marijuana and opioids throughout the conference, I thought it was important not to overlook the other drugs used by young people.

Workshop Description MDMA (ecstasy/molly) has become the drug of choice for many young adults across the United States. This presentation will begin with a brief history of MDMA, a discussion of how and why it’s used recreationally, and an outline of MDMA’s evolution from ecstasy to molly. In addition, the presenter will attempt to clarify some popular myths about MDMA and conclude with information on what is being done to reduce the use of MDMA and the harm it causes to users. -From NPN Workshop Description

MDMA & Ecstasy/Molly “Molly” is most often the pure form of MDMA. Molly comes from “molecular” Ecstasy is a pill which can be swallowed of dissolved in the mouth. Molly can be a pill, powder or crystal which can be swallowed or snorted and marketed as a purer form of MDMA.

Why is MDMA Popular? Reputation for being euphoric Affordable and linked to social activities Ecstasy is $10-$15 a pill. Molly is $20-35 depending on reputation and purity. Use is connected with raves, dance parties, and group activities. Low number of observable side effects Logos and branding are a good marketing tool

Use of MDMA is not as widespread in general population. However, 7% report lifetime use Urged us to remember that this is still 23 million people who have used MDMA Dr. Rigg shared that he has seen an increase in use in Black Males in South Florida. He is continuing with research into the usage in this population and looking at trends nationally. MDMA seems to be referenced more in rap music which may be changing the population who uses.

Paraphernalia Paraphernalia is not illegal After someone ingests/snorts/injects the substance what is left in their possession is most likely not illegal. Users may have: Menthol products-increases physical sensations Lollipops and pacifiers-decreases risk of grinding teeth Glowsticks- increases visual trails and stimulation Lotions and Oils- increases physical sensations and linked to massages, sexual activity

Risks & Side Effects MDMA is probably the most contaminated drug in our communities. Users have no idea what adulterants are in their product. The impurity of molly and ecstasy varies. Ecstasy or Molly may also contain: Psychoactive substances designed to mimic the effects of MDMA such as MDA or bath salts Stimulants like amphetamines, cocaine, or meth More rarely can include ketamine, or DXM (found in OTC cough medicines)

Risks & Side Effects One hit/dose of MDMA increases body temp by one degree and impacts the body’s ability to regulate temperature. Short-term effects: nausea, sweating, euphoric feelings, heightened senses, rise in body temperature, possibility of seizures. Long-term effects: Depression, cognitive impairment, memory loss, decreased ability to make dopamine MDMA “related-death” more appropriate than and MDMA “overdose”

There are two other drugs that are often used with MDMA Alcohol: Combination can increase the risk of dehydration and overdoses Cocaine: Often used to soften the crash as MDMA losing effectiveness. Both substances are stimulants.

Implications for Prevention Should avoid fear-based messaging and focus on educating on side effects Many PSAs are alarming, yet ineffective The MDMA community use message boards to find the drug and share information about the impurities and side effects of certain pills in specific geographic areas. They are in a sense looking out for their own people. While we may think the 7% lifetime use rate is low, it is still impacting 23 million people in the US.

Implications for Prevention We should think about connecting with communities of users to provide education and engage in harm reduction methods. Message boards and MDMA users are promoting the use of testing kits to check for more harmful adulterants and MDMA levels in pills. Testing sites show the pills, geographic areas and levels of MDMA and adulterants for other users Some websites to look at are: Dancesafe.org https://erowid.org http://www.ecstasydata.org/