The Most Recent Episode of Molly Use: Implications for Prevention Among College Students

Molly is a form of MDMA (3,4-methylenedioxymethamphetamine) argued to be “purer” and less harmful than other forms of MDMA, such as ecstasy. However, previous research has suggested that Molly use is associated with adverse health problems (e.g., organ failure, death) and is uniquely related to greater substance-related harms (e.g., blacking out, withdrawal problems). Given the growing popularity of Molly use and its associated harms, studies aimed at understanding proximal factors surrounding Molly use are warranted and may benefit prevention efforts. Consequently, the present study sought to address gaps in our knowledge about Molly use by determining specific event-level characteristics (e.g., contextual factors, risk behaviors) during the most recent episode of use. Participants (N = 151; 66.7% female) were college drinkers aged 18 to 25 years who endorsed lifetime Molly use. Participants completed an online survey including measures on their typical Molly use and related to the pattern of use (i.e., number of hits, duration, and amount spent), context (i.e., how many people and whom they were with, locations) and risk behaviors (i.e., sexual behaviors, other drug use) during their most recent use episode. All analyses were examined by gender. Findings revealed that for use patterns, between one and two hits were typically reported, and about half of participants did not pay for Molly. The most recent episode typically occurred between 8:00 PM and 10:00 PM. Most participants indicated that they were with friends while using and used Molly in one location, which was typically while at a party. Regarding risk behaviors, over half of our sample reported engaging in at least one sexual behavior, including about 25% engaging in vaginal sex. Molly was commonly used (about 75%) in combination with other substances. No gender differences were observed among these relationships. To our knowledge, this is the first study to examine contextual factors surrounding Molly use. Our findings highlighted the relevance of social context on Molly use. Given that sexual activity and polysubstance use were common in combination with Molly use, prevention efforts may want to educate individuals on these potential co-occurring risky behaviors. Overall, findings from the present study provide preliminary knowledge to guide future research and inform prevention efforts to address substance use in college students.