Some ‘Molly’ might be more than the users bargain for

Molly has developed a reputation as an ubiquitous, often-abused and sometimes deadly staple of the modern electric dance music scene. But the most dangerous part of the drug, according to experts, might be that what the Molly concertgoers and music fans are popping isn’t really Molly.

That means many who think they’ve tried Molly probably haven’t. Instead, they’ve most likely ingested some form of the drug laced with a contaminant, such as heroin or an amphetamine. Molly, in its untainted state, is rare.

Although many individuals who use the drug might not know that they’re ingesting possibly adulterated Molly, the effects of the drug that users wish to experience have produced an explosion in its popularity. 

“I’ve had many [patients] tell me they can start on a Friday night at a party and use continuously Friday night into Saturday, until maybe the sun comes up on Sunday,” said Dr. Neil Capretto, medical director of Gateway Rehabilitation Center. The center is an organization dedicated to the prevention, treatment, education and research of substance abuse and alcoholism with several locations in southwestern Pennsylvania.

Capretto said that of the about 65 percent of individuals at the center who are under the age of 30, two-thirds admit to having tried Molly — that’s about 40 percent of all the individuals he sees. And although most of these individuals are in rehabilitation for other drugs and state that Molly isn’t their drug of choice, the common refrain is that Molly is readily available at raves, parties and electronic music concerts.

Molly and the body

Molly supposedly earns its name from the molecule of pure MDMA it’s said to contain. It’s supposed to be the clean-cut form of MDMA, meaning that it contains no contaminants — just 100 percent MDMA.

MDMA stands for 3,4-methylenedioxymethamphetamine and is considered to have empathogenic effects, such as increased empathy and prosocial feelings. 

MDMA has become somewhat synonymous with the vernacular. However, Ecstasy isn’t necessarily MDMA: It’s MDMA that is, more often than not, mixed with a contaminant. Ecstasy, since it isn’t pure MDMA, is easier for users to come across than actual Molly. 

Karl Williams, the Allegheny County medical examiner, said his lab in Pittsburgh’s Strip District processes all of the drugs seized by police in the county.

Williams said that a much larger amount of the area’s MDMA-based drugs have been some form of contaminated MDMA, which means they aren’t Molly.

However rare legitimately pure Molly is, it’s nevertheless in hot demand right now because of its effects.

It affects the brain’s neurons that use serotonin — which regulates mood, aggression, sexual activity, sleep and sensitivity to pain — to interact with other neurons. Molly binds to the serotonin transporters, generating excessive amounts of serotonin in the synaptic space in two ways. First, by binding to transporters, Molly prevents serotonin from being picked up and moved out of the synapse. Second, these transporters can continue to bring in more serotonin, activating a greater number of receptors. 

“If your body had 100 units of serotonin it was going to slowly release over the next month [and] you take some Molly, it releases 75 of them in the next [few] hours,” Capretto said. “That feels pretty good, but when you come down, you have to take more and more. You’re running this deficit of serotonin.”

Using and coming down from Molly has been described to the rehabilitation center director as “Ecstasy on a Friday and Saturday” and then “suicide on Tuesday.”

“That can be an addictive quality,” Capretto said. “That’s not a fun way to feel, so a quick way to get out of that is to do more Molly.”

Ronald Cowan, of Vanderbilt University’s Cowan Lab, said that continued use of Molly, Ecstasy or any other MDMA-based drug could have permanent, long-term effects on the brain’s ability to produce and regulate serotonin. Cowan’s lab, which has primarily studied Ecstasy for more than a decade, produced studies that found that prolonged abstinence from Ecstasy-like drugs — such as Molly — can allow certain parts of the brain to recover. Yet for those individuals who continue to use such drugs, permanent damage of the serotonin system, such as the transporters, can occur in the neocortex. 

Such studies indicate that certain parts of the brain that help transport serotonin can be permanently damaged. Cowan said that because of serotonin’s role in a wide range of psychological functions, such damage could have far-reaching consequences.

“Serotonin has a role in a vast range of things, such as sleep-wake cycle, mood, body-image perception, anxiety, depression, memory, sex drive and others,” Cowan said. “It has a really, really broad role in the brain, and if you lower the serotonin, you can affect all of those to some degree.”

In the course of its studies, the Cowan Lab looked at college students who had reported moderate use of Ecstasy. The researchers found that MDMA increases the number of serotonin receptors, but has a harmful effect upon serotonin axons, the part of a neuron that carries information over long distances. 

Cowan said that his lab is very convinced that every time you take a hit of Ecstasy, you are losing part of your serotonin system.

Cowan also said he has seen little evidence to suggest that Molly is anything different from Ecstasy, so the effects of Molly on the brain are relatively similar to the effects of Ecstasy.

Molly and electronic music

The music scene most commonly associated with Molly is electronic dance music, or EDM. This association is compounded each time there is a Molly-induced death at an electronic music festival. The two deaths at the August Electric Zoo music festival in New York City were attributed to lethal overdoses of MDMA-related drugs. In 2010, after an attendee of Electric Daisy Carnival suffered from delusions after taking Ecstasy, she fell to her death from the 27th floor of her Las Vegas hotel.

This says nothing of the scores of concertgoers who are arrested for narcotics possession at concerts such as Ultra Music Festival, Bonnaroo and the aforementioned Electric Zoo and Electric Daisy Carnival.

According to Tucker Vento, a Pittsburgh DJ and producer, the recent rise in popularity of EDM has caused many more concertgoers to become interested in the drugs, which are typically available at shows and events. The music’s shift into the mainstream has opened up a previously small subculture to a slew of new fans who appropriate the culture in a way that sees the drugs as the more important aspect of the electronic music scene.

He said that while the drugs have always been around, it’s only recently that their use has become so prevalent. Now, they’re easier to obtain than ever.

“You might be out of luck in a small town, but find yourself at an electronic music festival, and it’s hard not to notice the people milling about the crowds asking if you want to meet their friend Molly,” he said in an email.

Vento said that Molly’s emergence as a vogue drug brings people to raves and electronic music concerts who otherwise wouldn’t have attended. This, mixed with EDM’s increased notoriety, has exposed many new young people to this drug.

Capretto says that Molly is in high demand right now not only because of its media attention, but also because buying it is easy. A capsule of Molly can go for as little as $20 to $30 at a show or nightclub, said Capretto.

Each capsule typically contains one hit. However, concertgoers are known to ingest multiple doses throughout the course of their “roll,” which is the colloquial name of the duration for which a user experiences the effects of the drug.

Now that these drugs are chic, as Vento described them, the previously contained culture of electronic music has found itself flooded with individuals who recklessly consume MDMA drugs, increasing the demand, market and number of people making and selling MDMA-related drugs and the clean-cut Molly. With the increase comes a subsequent increase of individuals creating laced MDMA-related drugs. 

Molly lookalikes

Capretto said Ritalin, heroin, Adderall and Sudafed are commonplace ingredients in Ecstasy and other MDMA-based drugs. Non-MDMA drugs are often mixed into the MDMA-related drugs concertgoers purchase. As a result, pure MDMA — actual Molly — is becoming harder to procure. 

Mike Manko, a spokesman for the Allegheny County district attorney’s office, said that while the rate of seizure with the use of Molly and other forms of MDMA has increased, it’s are nowhere near the rates of seizure associated with more dangerous drugs such as cocaine or heroine.

Manko made it a point to stress that just because the media is paying more attention to MDMA-related drugs does not mean that their use is only a recent occurrence, regardless of the hype surrounding recent related events.

Vento said that he thinks that this attention feeds into a cycle: More people want the drug when there’s more attention paid to it, which attracts more people to the manufacturing and selling of the drug. And, he said, “As with any high-demand product, you get knockoffs.”  

“So now you have a lot of people doing irresponsible things in even more irresponsible quantities, and you have drugs that are tainted with who-knows-what,” Vento said, adding that such a recipe could cause the death of concertgoers.

Cowan said that deaths from these sorts of drugs are very rare, as researchers believe that thousands of young people use them every weekend, and the amount of deaths isn’t proportional to the amount of suspected consumption. While people do occasionally die from MDMA-related drugs, Cowan said that it is usually because of contaminants, which are believed to have caused the Electric Zoo deaths last August.

Williams’ lab’s findings attest to how frequently Molly knockoffs are laced with a contaminant. Out of all the MDMA seizures his crime lab has seen, hardly any of them have produced pure, clean-cut MDMA, meaning that these drugs aren’t Molly: These seized drugs are part MDMA and part something else.

“We’re just plain not seeing pure MDMA,” Williams said.