Molly (MDMA) and Alcohol

The most recent data available shows that in 2022, 8 million Americans experienced both a drug use disorder and an alcohol use disorder at the same time.¹ While the misuse of  any kind of addictive substance alone can be dangerous, combining drugs with alcohol can produce serious health risks and potentially fatal outcomes.²

This article will discuss the specific risks associated with the co-use of MDMA and alcohol, offer more information on what MDMA is, and provide treatment-related information for those looking for professional care to put a stop to their substance use disorder.

What is Molly (MDMA)?

MDMA (3,4-methylenedioxymethamphetamine), is a synthetic drug that produces both stimulant and hallucinogenic effects.³ It was initially used in social settings, such as at raves or in nightclubs, but its use has since expanded to other more common settings, with males between the ages of 18-25 being the most frequent consumers.⁴

The pill form of MDMA is often referred to as ecstasy or Molly, while the term Molly is usually reserved to describe the pure, crystalline powder form of MDMA.³ This substance can be ingested orally, smoked, or snorted, but is rarely injected.⁵ Both pill and powder forms are often found to be contaminated with other substances, which can increase one’s risk of suffering serious health-related dangers.^3,5

When under the influence of Molly, a person can experience its psychostimulant effects, including feeling energized, losing grasp of time, having distorted perceptions, and experiencing increased pleasure from sensory encounters.³ MDMA can also produce an increase in one’s self-awareness and feelings of empathy.³ These effects generally develop approximately 45 minutes after consuming MDMA (in pill form) and peak about 15 to 20 minutes after they begin.² Effects usually fade during the 3 hours that follow.³

Mixing MDMA and Alcohol

The practice of using more than one substance simultaneously or within a short span of time is known as polysubstance use.² It is common for people to engage in polysubstance use, which for some may include mixing ecstasy with other substances, including alcohol.⁵  Combining drugs and alcohol generally isn’t safe, and can increase one’s risk of overdose and serious damage to the body.² 

Alcohol and Ecstasy Effects

Someone who misuses alcohol can develop a number of acute health effects that can impact their wellbeing. These effects can include:⁶

• Lowered inhibition.
• Relaxation or reduced tension.
• Slow reflexes and reaction time.
• Reduced coordination.
• Impaired judgment.
• Slurred speech.
• Sleepiness.

The misuse of ecstasy can also trigger the onset of several short-term effects, such as:⁷

• Lowered inhibition.
• Enhanced sensory perception.
• Increased heart rate and blood pressure.
• Muscle tension.
• Nausea.
• Faintness.
• Chills or sweats.
• Sharp rise in body temperature.

When mixing MDMA with alcohol and using them at the same time, the acute effects of each may be experienced, however alcohol can also increase the risk of developing hyperthermia and hyponatremia – rare but serious acute adverse effects of recreational MDMA use.⁸ 

• Hyperthermia. This condition, where body temperature rises, can quickly cause sodium imbalances and breakdown in the muscles, which can lead to kidney failure or swelling in the brain.⁹ If left untreated, these effects can have permanent consequences.⁹
• Hyponatremia. Consuming excessive amounts of liquids while under the influence of ecstasy and alcohol can cause a condition known as hyponatremia.⁹ As the body retains liquids, electrolytes can quickly become imbalanced and serious effects such as brain swelling can occur.⁹

MDMA-induced hyperthermia and hyponatremia generally occur in a setting of vigorous physical activity (such as dancing) while someone is under the influence of MDMA.⁸ Dancing in a hot environment like a nightclub while under the influence of MDMA can induce heavy sweating and dehydration. The increased dehydration and rising body temperature can result in hyperthermia.⁸

Increased dehydration can also result in a person increasing their fluid intake. Rapidly consuming excessive amounts of liquid, particularly in the setting of raised body temperature, can result in hyponatremia, where retaining the liquids causes electrolytes to become quickly imbalanced, resulting in serious effects such as brain swelling.⁹

The dehydration experienced as a result of MDMA use can be further exacerbated by increased sweating due to dilation of blood vessels and other effects of alcohol. When this occurs, using both alcohol and MDMA together raises the risk of experiencing these two rare but potentially deadly adverse effects of MDMA.⁸

Treatment for Polysubstance Addiction

Whether your polysubstance use includes MDMA and alcohol or not, it is important to know that effective treatment is available and recovery is possible.

The journey to recovery is different for every person, but some options for addiction treatment may include one or more of the following:

• Medical detox. This is the process of clearing the body of addictive substances while under medical supervision. Getting professional care can help a person get through detox by minimizing withdrawal symptoms with supportive or medical management, thus improving their chances for long-term recovery.¹⁰
•  Inpatient treatment. Inpatient treatment consists of 24/7 care in a hospital or residential setting. These programs provide high levels of structure that can helpful in establishing new, healthy life patterns and appropriate support for substance use disorders.¹¹
• Outpatient treatment. Outpatient treatment allows a person to continue living at home while still obtaining therapeutic care for their substance use disorder during the week.¹¹ Depending on their needs, patients may visit the facility one to several times per week for treatment. 
• Aftercare. These programs consist of any kind of ongoing involvement in recovery services after a more formal treatment program. They may be professional services such as a recovery coach or ongoing check-ins with a therapist, or community-run services such as mutual aid groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).¹¹

Finding Addiction Rehab for Co-Ocurring Substance Use Disorders

If you or someone you love is struggling with ecstasy, alcohol, or other substance use, help is available. There are online directory tools, such as the AAC directories tool, that can help with finding co-occurring substance use disorder treatment near you.

Figuring out how to pay for rehab can feel like another hurdle to overcome when considering treatment. But online tools can help you verify insurance, or you can call an admissions navigator who is available 24/7 to help with these and other questions. Reach out today, and begin your new life.