How to Use MDMA (Molly)

MDMA is a truly remarkable medicine for working with difficult emotional experiences. The clinical results have far exceeded other interventions for a range of uses (see the research section at the bottom of this page).

MDMA is a synthetic psychedelic, first developed by the pharmaceutical company Merck in 1912. It has been widely studied since then, particularly for psychotherapeutic uses. With the rate of academic research growing rapidly, it is likely that MDMA will become FDA approved for therapeutic use within the next few years, and MAPS.org is focused on moving it through the approval process. MDMA is being widely tested for post-traumatic stress, with results that surpass any other existing treatment method.

MDMA is a particularly appealing psychedelic for therapists and researchers because the subjective mental experience feels fairly stable, while creating a dramatic increase in emotional openness and a reduction in fear and anxiety.

Before you begin, be sure to read our safety section and see the special safety considerations for MDMA at the bottom of this page.

Dosage

Because MDMA has anti-anxiety and anti-fear effects, it is generally considered safe to use a full dose your first time and each time you use MDMA (generally 75mg - 125mg depending on the individual). It is important to measure the dose carefully. Milligram-precision scales cost about 20 dollars (here’s an Amazon search for ‘milligram scale’).

Some therapy protocols add a ‘booster dose’ of about 60mg of MDMA 2-3 hours after the first dose to extend the period of therapeutic effects and provide more time for deep exploration.

Step by Step

MDMA will typically be in the form of a powder, pill, or crystal. Again, be sure that you are receiving pure MDMA, not mixed with other drugs or stimulants like caffeine. 'Molly' is another term for pure MDMA, distinguished from 'Ecstasy' which often contains MDMA but is not pure MDMA. If the MDMA is in pill form, you’ll have to be confident of the reported dosage, as fillers are added to create a pill and weighing the pill will not indicate the MDMA content. As always, do not take any MDMA if you are unsure of quantity or purity.

  • STEP ONE
    Be sure that you have set aside enough time in a comfortable setting. You will need about 3-4 hours for a typical dose without a booster. Make sure you won’t feel rushed or intruded upon, so that you can focus on the experience and get the most benefit.
  • TWO
    Make sure you have your dose measured and ready. Start with 90mg if you aren’t sure what level is best for you. Some individuals may go as high as 130mg, but it’s fine to start on the lower side for your first experience.
  • THREE
    Swallow the pill, powder, or measured crystals. With powder or crystals, you can simply drop it into a small amount of water and drink it down (if any sticks to the cup, add more water and get the rest). You can also empty out a vitamin capsule and put the powder inside or put it on a tiny piece of tissue paper, fold it up, and swallow it like a pill. Whatever seems easiest for you is fine.
  • FOUR
    Once you take the MDMA, you will have about 30-60 minutes before the effects begin. This is another chance to make sure you get setup with anything you will want to have handy. Lots of folks like to write during the experience, about their ideas and feelings, so you may want to have paper or a computer handy. If you are interested in addressing particular emotional or psychological challenges in your life, you may want to make a list of issues that you want to think about during the experience.
  • FIVE
    As the MDMA begins to kick in, you will start to feel a sense of peacefulness and openness. However, it’s a very subtle feeling, so depending on your mood, you may not notice at first. Some people have physical feelings that accompany the mental effects, usually a sense of warmth and a desire to snuggle up in soft clothes or blankets. Drink water! MDMA can sometimes make people warmer than they realize. You may also notice a change in your perception of lights, slight visual halos or glows. You may also feel an urge to clench your jaw (some people say that taking a calcium-magnesium supplement ahead of time reduces this urge). Everyone’s experience varies slightly.
  • SIX
    Once the MDMA is in effect, you’ll notice that your thoughts and emotions feel different. You’ll experience a significant decrease in anxiety and fear and an openness to ideas and emotions that you may have avoided in the past. You’ll feel deep love and empathy for those around you. And you’ll find that you can get pulled very deeply into a particular thought or idea, enveloped in it. The power of MDMA appears to come from this process-- people are able to experience feelings and ideas that they previously had emotional challenges with. By facing those feelings without the fear and anxiety that you have experienced in the past, your mind is able to understand and re-store those memories without the painful emotional reactions. This is what makes MDMA so effective for the treatment of PTSD, even in just one or two sessions.
  • SEVEN
    As you experience this process, try to stay as open to your feelings and ideas as you can. If you have been depressed or stressed or anxious, you’ll find that you can still feel those feelings intensely and they can be very immersive. However you’ll also notice that there’s a certain softness present in even the most difficult feelings-- you may still feel troubled by a problem in your life, but you’ll also be able to look at the issue with more openness and the fear that you associate with that problem will be much reduced. The more you can stay open to even the most challenging feelings, the more meaningful and effective the experience will be.
  • EIGHT
    If you are taking MDMA with another individual, think about the same things. You may be trying to work through problems together or heal old wounds. Try to stay open to even the most difficult parts of your relationship, and you’ll find that MDMA makes that much easier and emotionally safe. In particular, MDMA can give you a safe opportunity to express your own fears and anxieties and doubts, emotions that you may be keeping bottled up at other times. Even when just one person has taken MDMA, the dramatic openness that it creates becomes apparent to the other person and they are able to be deeper and more open themselves. If you are thinking about your issues with another person, but they are not present, consider writing them a letter expressing yourself.
  • NINE
    Don’t forget to just relax into the experience. Even if you are using MDMA to solve specific psychological, emotional, or relationship challenges, it’s worth taking a few minutes just to relax and be present with the experience without any particular goals. Not only does it give you relief and relaxation, but you may find that important realizations arise about issues that you weren’t even expecting to think about.
  • TEN
    If you want to prolong the peak of the experience -- you can take a booster dose of about 60mg (or half the original dose) two hours after you first take the initial dose. This will add another 1.5-2 hours to the experience and will give you more time to work.
  • ELEVEN
    As the effects of MDMA start to fade, you will likely still feel much of the same openness and relief from fear and anxiety. Gradually, you will start to feel back to your normal self, and this can lead to a bit of disappointment as old mental habits start to pop up. Getting to such a free space and then coming back to yourself can leave you longing to always be so free. But as you think about your experience and the ideas and feelings you had, you’ll realize that so much of that freedom and openness is still with you. Take some time to think about what’s happened and to remind yourself to bring some of that openness into your day to day life.

Afterwards

Once the MDMA has worn off, be sure that you drink lots of water and get a long peaceful sleep at night. MDMA can be mentally tiring and you need to rejuvenate.

Most people find that they have an afterglow from their MDMA experience that can last days or weeks, improving their mood and outlook and keeping them very open to others.

On the other hand, some people feel mentally drained by MDMA and have a foggy headed feeling for a day or two afterwards. Others will feel emotionally drained, and have a depressed mood for up to a week after the experience. Sometimes, these feelings begin two days after the experience, but not the day after. To combat this, some people who feel sensitive to that after-effect will take 5-HTP or L-Tryptophan (both are common supplements available from any source) for a few days after MDMA in an attempt to restore their serotonin levels. People who do feel drained after an MDMA session generally report that precise the MDMA dose can affect how they feel afterwards. Too much may leave them more drained than necessary. This is another reason to start with a modest, precisely measured dose to begin.

Nearly everyone, no matter how they feel the following week, finds that the thoughts, feelings, and emotional release that they experience on MDMA persists afterwards. In particular, any realizations that they had during the experiences tend to prove real and lasting.

Most remarkably, painful emotional associations with life experiences -- traumas, breakups, divorces, etc -- are dramatically reduced if that issue has been explored during the experience. You will find that when you think about that same painful experience after exploring it on MDMA, you will not have the same flood of emotional pain and tension that you would have had beforehand. The memory will be intact but the emotional strings will be looser.

Even for extreme emotional trauma, this holds true. In a recent research study for patients with PTSD, 83% of patients experienced reduced symptoms after just 3 MDMA sessions combined with therapy, vs. only 25% of patients who had therapy alone. Quite simple, MDMA is the most effective treatment for PTSD ever developed. Compare this level of success to traditional anti-depressants which have strong side effects and are dosed every day for years at a time (for a total of hundreds or thousands of doses) and which have very low rates of effectiveness, often just slightly above placebo.

Special Safety Considerations

In addition to our standard safety suggestions, there are three particularly important precautions for MDMA use:

  1. Be sure to use pure MDMA (also known as ‘Molly’). Because MDMA is usually one of the ingredients in the party drug ‘Ecstasy’, people often confuse the two. Ecstasy will typically include amphetamine, caffeine, and other substances that can interfere with a therapeutic goal. Often, even pills and powders sold as 'Molly' contain other ingredients. Be careful and trust your source.
  2. MDMA can lead to a ‘hangover’ effect for some people in the days after treatment. This can include depressed mood and fatigue. Because MDMA works on the body’s serotonin system, some scientists believe the hangover is caused by a temporary depletion of seratonin. Studies have not yet shown any long-term negative effects from MDMA use.
  3. Do not use MDMA is you are currently taking psychoactive pharmaceuticals, such as anti-depressents, anti-anxiety drugs, etc. In particular, SSRIs are thought to create a risk of ‘seratonin syndrome’ when taken in conjunction with MDMA. Always research any supplements or other medicines that you may be taking to avoid interactions.

Video: MDMA Therapy

MDMA Articles and Research

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