Mixing MDMA (Molly) and Alcohol: a Risky Move

Drinking alcohol with MDMA or molly is common. People think using both can make them feel good longer.

But the two can interact in dangerous ways in your body.

Read on to find out what happens when you mix alcohol and MDMA.

What is MDMA (molly)?

Methylenedioxymethamphetamine (MDMA) is also called molly or ecstasy. The drug is a stimulant with minor hallucinogenic effects.

Other drugs are often mixed in MDMA, but there’s no real way knowing what these drugs are. These designer substitutes can cause serious reactions in some people.

Molly is a powder sold mostly in capsule form. Ecstasy is sold as colorful tablets. Some other street names include:

  • beans
  • blue Superman
  • chocolate chips
  • clarity
  • happy pill
  • Scooby snacks
  • skittle
  • dancing shoes
  • vitamin E

Effects of MDMA

MDMA increases three important brain chemicals: dopamine, serotonin, and norepinephrine. This causes people to have feelings of euphoria and energy, along with other side effects.

MDMA starts to work in less than an hour. How long it lasts and reactions from the drug depend on whether other drugs are mixed in and what drugs if so, and whether you’re also drinking alcohol.

Taking MDMA with other substances can increase the risk of stimulant effects, like raised:

  • blood pressure
  • heart rate
  • body temperature

It can also cause dehydration. Alcohol makes this worse. We’ll discuss that in a bit.

Effects of alcohol

Alcohol has a depressant effect on the brain. This means it has some opposite effects from MDMA.

It dulls thinking and judgment.

However, alcohol in large amounts can also increase blood pressure and heart- related problems. This side effect worsens if you take MDMA.

What happens when you combine MDMA with alcohol?

People often use MDMA and alcohol together to extend the good feelings from MDMA.

The problem is the liver metabolizes both drugs. Too much alcohol can slow the removal of MDMA from the body, causing a buildup. This can lead to more serious side effects or stronger adverse reactions with MDMA.

Alcohol and MDMA together can increase the release of dopamine and serotonin in your brain. This can cause some people to take more MDMA and drink more alcohol to keep feeling the effects.

Both drugs affect thinking and awareness. Taken together, that means you’ll have problems with movement and coordination.

Doing things that are normally easy for you, like driving, can become difficult and unsafe. You may not be able to accurately judge distances, for example.

MDMA can also cause serotonin syndrome. Symptoms include:

  • confusion
  • muscle spasms
  • raised heart rate
  • high blood pressure

Alcohol increases this risk and can make serotonin syndrome more severe.

Increased harmful effects

Whether you experience severe side effects depends on:

  • any existing health conditions
  • whether you’ve taken other substances with MDMA and alcohol
  • amount of alcohol consumed

Binge drinking while taking MDMA can lead to:

  • increased blood pressure
  • increased heart rate
  • changes to heart rhythm
  • depression
  • confusion
  • anxiety
  • seizures
  • changes in mental status
  • hallucinations
  • risk of an overdose of MDMA and alcohol

Binge drinking is defined as consuming four to five drinks within 2 hours.

Increased risk of organ damage and sudden death

There are several ways MDMA and alcohol can cause problems in the body.

Both can cause toxicity to some of the same major organs. These include the heart and brain. Combining the two stacks the deck for serious adverse reactions and chances of organ damage, stroke, and sudden death.

Studies show drinking alcohol with MDMA increases stress to the heart and can lead to heart-related toxicity.

MDMA raises body temperature. This causes excess sweating, sometimes to dangerous levels. MDMA also shrinks blood vessels and raises blood pressure and heart rate.

Binge drinking also causes high blood pressure, irregular heart rhythm, and stroke.

Drinking alcohol with MDMA makes you dehydrated quicker, since alcohol is a diuretic. That means it makes you pee more often. Alcohol also slows MDMA removal from the body. This builds the risk of injury to the:

  • heart
  • liver
  • kidneys
  • brain
Risks during pregnancy

Both alcohol and MDMA use during pregnancy pose risks to mother and baby.

MDMA can raise cortisol levels. This hormone may cause nervous system damage to the baby.

One study found prenatal exposure to MDMA causes children to have slower mental and motor skill development in the first 2 years of life. Other older studies have found prenatal exposure to MDMA led to heart and muscle-related problems in infants.

Long-term effects of MDMA and alcohol use aren’t yet known, but it’s safest to avoid any substance use during pregnancy.

Precautions for MDMA use with drinking alcohol

MDMA very often contains other substances, like designer cathinones, caffeine, or amphetamines. Because of this, it’s very difficult to predict the side effects of using both MDMA and alcohol.

Never drive if you’ve taken MDMA, alcohol, or both together. Your balance, coordination, and awareness will be impaired, making it harder to judge distance.

Call 911 if you notice any of the following signs or symptoms in you or someone else:

  • excessive sweating
  • cold or clammy skin
  • nausea or vomiting
  • fainting

MDMA is illegal

MDMA has been around for decades and is still popular today. It’s most commonly used by people ages 18 to 25.

This is is also a similar age group that binge-drinks (18 to 34 years old).

Although it may be popular, MDMA is illegal in the United States and is considered a Schedule I drug. That means there are significant federal penalties for selling, buying, or using MDMA.

Treatment for MDMA or alcohol overdose or addiction

The Food and Drug Administration (FDA) hasn’t approved any medications for the treatment of MDMA overdose or MDMA addiction.

Instead, supportive measures can treat immediate critical symptoms, including:

  • cooling the body to bring down temperature
  • rehydrating with fluids
  • taking medications to treat other symptoms, like high blood pressure, heart-related problems, seizures, or anxiety

The risk of alcohol poisoning increases with MDMA use, because people drink more to avoid MDMA withdrawal.

Some serious symptoms of alcohol overdose can include:

  • seizures
  • pale, bluish skin tone
  • unconsciousness
  • unresponsive
  • difficulty breathing

Call 911 if you suspect someone is overdosing on alcohol or MDMA.

There are three FDA-approved medications for alcohol use disorder. Talk to your doctor about whether any of these medications are right for you.

Where to get help for substance use disorder today

If you or someone you know has a substance use disorder, the following organizations can provide free, confidential help and treatment referral:

  • SAMHSA Treatment Provider Locator
  • Alcoholics Anonymous
  • Narcotics Anonymous
  • Support Group Project

If you or someone you know is in immediate crisis, call the National Suicide Prevention Lifeline at 800-273-TALK for help 24/7.

Outlook for people who use MDMA and alcohol together

Taking alcohol with MDMA increases the risk of serious reactions and overdose.

MDMA starts to have an effect within an hour and can last around 6 hours. Alcohol can slow the removal of MDMA from the body. Studies show using them together can cause liver and nervous system toxicity.

Heavy or regular use of both substances can cause liver, kidney, heart, and other organ damage. We still don’t know the long-term effects of MDMA use on the brain.

The liver breaks down alcohol into acetaldehyde (ACH). MDMA can cause a buildup of this enzyme in the blood. High levels of ACH increases the risk of cancer, liver damage, and other reactions.

You might also drink more if you’re taking MDMA. This puts you at risk for alcohol poisoning.

There are several types of treatment available to help with substance use disorder. Talk to a healthcare provider to find the best treatment for you.

The bottom line

Many people drink alcohol and take MDMA together, but it can be dangerous to do so.

Your liver and kidneys play an important role in removing MDMA and alcohol from your body.

When both drugs are taken together, the organs get stressed and must work harder. Both substances stay in your system longer. This can increase your chances of a bad reaction or overdose.

MDMA is also often laced with other powerful drugs. Mixing alcohol with these unknown drugs means you might have an unexpected reaction.

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