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Updated June 27, 2024
The drug Xanax is a depressant, and Molly is a psychoactive stimulant, so the two can seem like an odd pair. Those who use Xanax and Molly in combination have their reasons, however. They are part of a growing trend of “polydrug use,” which experts have called a serious public health threat. Polydrug use, often entailing both illicit and prescription drugs, is the taking of more than one drug or different types of drugs at the same time or after one another.
Taking multiple drugs in combination with each other, such as Xanax and Molly, raises the risks of overdose and other serious side effects. We’ll explore these dangers of Xanax and Molly below, including potential interactions, the mental health impact, and other important information that the public needs to know.
Understanding Xanax
What Is Xanax?
Xanax (alprazolam) is a benzodiazepine medication and is used to treat anxiety. The drug calms down the central nervous system (CNS), by rapidly crossing the blood-brain barrier to create sedation and pleasant sensations of drowsiness.
Mechanism of Action
Xanax binds to GABA receptors in the brain and central nervous system. This in turn increases levels of the neurotransmitter GABA (“gamma-aminobutyric acid”). GABA is what produces sensations of calm and relaxation.
Common Medical Uses
Xanax is commonly prescribed for anxiety, insomnia, and panic disorders. It is meant for short-term use only (less than 40 days, in most cases), because users build tolerance to the drug quickly. When doctors begin weaning patients off Xanax, they gradually reduce dosage over time to prevent rebound or withdrawal symptoms.
Risks Associated with Xanax Use Alone
The main risks associated with Xanax are dependency and addiction, on account of the drug’s fast-acting nature. Because its sedative effects set in quickly and wear off within a few hours, some people may take another dose before they are supposed to. With a pattern of Xanax misuse, tolerance can build up quickly, until an individual requires larger and larger doses to achieve the same level of anxiety relief.
Withdrawal from Xanax can be very dangerous, especially when a person with a Xanax addiction decides to stop cold turkey. They could be at risk of seizures, psychosis, and/or hallucinations.
Other withdrawal symptoms might be:
- Flu-like congestion/nausea/joint aches
- Headaches
- Insomnia
- Irritability/moodiness
- Depression
- Memory and concentration problems
Understanding Molly (MDMA)
What Is Molly (MDMA)?
Ecstasy contains a stimulant chemical called 3,4-methylenedioxy-N-methylamphetamine, or MDMA. Molly is the crystallized form of MDMA. Users think it is safer to take Molly than Ecstasy because Molly is thought to be purer than Ecstasy. Produced in makeshift street labs, Ecstasy often contains fillers or impurities like caffeine, meth, or low-grade cocaine.
Effects on the Brain and Body
Since Molly is a powder, the most common way it is ingested is in capsule form. Alternately, Ecstasy comes in aspirin-like tablets. Side effects of Molly and Ecstasy are similar since they essentially come from the same chemical MDMA. Within one to two hours after taking Molly, users start experiencing the following:
- Euphoria
- Talkativeness/extroversion/lack of impulse control
- Jaw clenching/teeth grinding
- Dilated pupils
- Sweating/increased body temperature
- Rapid heart and breathing rates
- Nausea
- Dizziness
- Dry mouth
- Visual and auditory distortions
Context of Recreational Use
The U.S. Drug Enforcement Agency lists Molly as a Schedule I-controlled substance due to its high potential for abuse.
Most people take Molly before attending a large party or “rave.” These parties last for days and involve hundreds of people coming and going 24/7. Rave attendees high on Molly may have unprotected sex with multiple sexual partners, because of the sexually arousing effects of the drug. Molly users are thus at higher risk of contracting sexually transmitted diseases, hepatitis, or HIV/AIDS.
Short-Term and Long-Term Risks of Molly Use
In addition to its psychedelic properties, Molly has some of the same effects as stimulants like methamphetamines. Short-term use can cause irregular heartbeat and worse, heart damage; and one week after use—depression, anxiety, irritability, aggression, and memory and attention problems.
Long-term Molly use can cause sometimes permanent damage to parts of the brain. The drug impacts multiple neurotransmitters and systems in the brain that govern mood, pleasure, and emotions, including the serotonergic, dopaminergic, and GABAergic systems. Chronic use has occasionally caused psychosis. By raising body temperature, Molly use can lead to kidney and cardiovascular failure, stroke, or seizure.
Polydrug Use: Xanax and Molly
Definition and Prevalence of Polydrug Use
Those who engage in polydrug use, or the mixing of drugs, do so for various reasons, such as to enhance the desired effects or decrease the negative effects of a drug.
Polydrug use is prevalent, especially among those who use illicit substances. For example, a 2022 study in the journal Drug and Alcohol Dependence found that 37 percent of people who misused opioids also misused alcohol; another 15 percent of people who misused opioids misused alcohol, marijuana, and “other” substances.
Why People Combine Xanax and Molly
Long-term users of Molly take Xanax to help them manage the panic attacks, insomnia, depression, and paranoia they experience after coming down from a Molly high.
Impairment of memory, focus and motivation contribute to the overwhelming anxiety and despondency users feel after weekend-binging on Molly. Regular users of Molly refer to this severely depressed period as “Suicide Tuesday.” For relief from the distress, they may turn to Xanax.
Misconceptions and Perceived Benefits
Those who combine Xanax and Molly may have some misconceptions about the perceived benefits of Xanax—namely, that you can briefly take it to get through “Suicide Tuesday” without any negative health risks or effects. The problem with relying on Xanax is that it is one of the most addictive medications available with a doctor’s prescription. Second, it can be dangerous to buy Xanax from online “pharmacies” operating outside the U.S. Black market Xanax may contain harmful ingredients that are not regulated by the U.S. FDA.
Long-term Molly users who have relied on Xanax to help them deal with “Suicide Tuesday” can suffer worsening withdrawal symptoms if they suddenly stop taking Xanax. Suicidal ideation, attempted suicide, and overdose are the ultimate dangers of combining Xanax and Molly.
Pharmacological Interactions
How Xanax and Molly Interact in the Body
Xanax relaxes the central nervous system while Molly stimulates it. It might seem that the two drugs are just cancelling each other out, but exactly how these drugs interact at the molecular level is a complex question. For example, Xanax increases GABA, while Molly acts on multiple regions of the brain, including the GABAergic system.
Enhanced Effects: Sedation, Euphoria
Because Xanax and Molly have opposite effects, users of both typically do not take the two drugs at the same time. The main consensus on the internet among users is to take Molly on its own for the most euphoric high—then save the Xanax for later, after Molly is out of the system.
Potential Dangers of Combined Use on CNS
Molly is an “upper” that overstimulates the central nervous system. Xanax is a “downer,” slowing down the CNS. One danger of taking these drugs together is that they can disrupt the CNS’ innate capacity to self-regulate. A person may go into fight or flight mode or paralysis. They may experience high blood pressure or an irregular heartbeat. Combined use of these drugs only increases the prospect of complications.
Health Risks and Dangers
The long-term effects of combining Molly and Xanax can be devastating and, in some cases, permanent:
- Damage to areas of the brain involving memory, emotion, and learning
- Chronic depression and anxiety
- Heart and/or kidney failure as both drugs deteriorate blood vessels and nerve branches
- Irreversible psychosis (like alcohol-induced psychosis)
Overdose Potential and Case Studies
Taking too much Xanax can lead to an overdose, and the risks of overdose are higher with polydrug use. Most fatal overdoses are accidental and tend to occur when Xanax is taken with opiates and/or alcohol.
It is also possible to overdose on Molly. High doses of the drug can cause “hyperthermia” (a sharp increase in body temperature), which in turn can lead to organ failure (liver, kidney, or heart), swelling of the brain, and death. Molly-related fatalities tend to occur in conjunction with rave events and the night club scene. People have also survived intentional overdoses, although anecdotally.
Mental Health Implications
Impact on Mental Health Disorders
Xanax is a legitimate doctor-prescribed medication for panic disorder and other anxiety symptoms. However, if someone with a panic disorder also uses Molly, they can exacerbate their condition and make their symptoms worse. Just one pharmacologic dose of Molly is enough to trigger a panic disorder in a healthy person, according to research.
Increased Risk of Depression and Anxiety
Other studies have linked Molly to the onset of anxiety, depression, and insomnia, among still other mental health issues.
Since Xanax is a depressant, taking it to get through the rebound feelings of depression after Molly use can intensify those same symptoms of depression. Meanwhile, anxiety can increase upon cessation of Xanax use, as part of the withdrawal process.
Potential for Addiction and Dependence
MDMA and benzodiazepines affect the brain in similar ways. For example, both drugs increase levels of dopamine and serotonin by inactivating receptors for these neurotransmitters. The two substances also cause dopamine to flood specific structures in the brain’s meso-corticolimbic dopamine system. This area is thought to play a primary role in the development of addiction and the compulsive behaviors that accompany addiction.
While research indicates Xanax is an addictive substance, clinical results regarding the addictiveness of MDMA are not as conclusive. In animal studies involving MDMA, however, mice will self-administer MDMA after being given the drug for a few days. This leads addiction scientists to agree that MDMA, Molly, and Ecstasy do have the potential to cause addiction.
Dangers of Abusing Xanax and Molly
It can also be easier to overdose on Xanax following a Molly-binging episode. Since the effects of Xanax do not last more than a few hours, a Molly user will likely need more than just one pill to cope with the unpleasant side effects of coming off a Molly high. But when you are under the influence of Xanax, you can lose track of time and forget just how many Xanax you’ve taken. Most Xanax overdoses are due to people taking too much Xanax in a short period because they can’t remember when they took the last dose.
Legal and Social Consequences
Legal Implications of Using Xanax and Molly Together
Because Molly is in the same Schedule I category as other illegal drugs, such as heroin and LSD, being found in possession of Molly can result in jail or prison time, fines, and court-ordered drug rehab.
Xanax is also a controlled substance. If someone purchases or obtains it illegally (without a doctor’s prescription) and is found in possession of it, they could also be fined substantially and face prison time. (The amount of the fine will depend on where you reside and how much Xanax you have in your possession.)
Social Stigma and Community Impact
To what extent the social stigma of substance abuse and addiction is a barrier to recovery from Molly and Xanax is hard to say. Since Molly use is heavily associated with the dance club scene, it may not be as stigmatized as other forms of drug use. Users often report they take the drug to achieve a deeper sense of connection, sexual or spiritual, with those around them.
Molly’s impact may be more felt among certain communities, such as young adults, who are more likely to frequent dance clubs. Studies have also found that use of Molly is more prevalent among gay and bisexual men and women, who use the drug while clubbing to increase sexual arousal.
Public Health Perspective and Interventions
Molly is often misperceived as safer than other illicit drugs, on account of its so-called purity. The reality is that Molly is not guaranteed to be any purer than other drugs, because dealers cut it with other questionable substances.
Public awareness may be limited regarding the dangers of Molly. More people need to know that the drug has led to serious complications, sometimes death, and has sent many people to the ER. Similarly, when more members of the public know that Xanax has been implicated in countless overdoses, they can make safer decisions for themselves and their loved ones.
Harm Reduction Strategies
Education and Awareness Initiatives
Harm reduction strategies focus on educating users about overdose, with information about the signs of overdose and what to do if you overdose. Sometimes a university may post fact sheets about Molly on their website to caution young adult users about drug interactions and potential negative side effects.
Safe Use Guidelines for Xanax and Molly
Harm reduction often entails “safe” use guidelines for Xanax and Molly. The goal is really to help users engage in safer use of the drug, by informing them about what to know before, during, and after use of the drug.
Resources for Support and Treatment
Dual addictions almost always require professional treatment. That should include a medically supervised detoxification with round-the-clock monitoring by doctors and psychiatrists, because withdrawal symptoms may be severe enough to impact the heart, respiratory, and/or nervous system. Doctor-prescribed medications are also available in a professional detox. These can help reduce uncomfortable symptoms like anxiety and insomnia. Another key element of professional treatment is counseling and therapy to resolve the stressors, mental health issues, and other root causes of a substance use disorder.
Like other forms of polydrug use, combining Molly and Xanax is more dangerous than taking one of these drugs on its own. The potential for drug interactions and more intense side effects means there is a higher risk of health dangers, including overdose.
If you or someone you love is combining Molly and Xanax, our counselors are here to help. With treatment, many people have found a way out from polydrug use and gone on to live healthier, happier lives. Contact FHE Health today for more information.
