MDMA is quickly becoming one of North America’s favorite drugs. According to a report by the United Nations, although MDMA use had previously been declining, as of 2010, it has seen a steady increase worldwide.

This resurgence is particularly high among young people. For example, in the United States, 2.5 of the 2.6 million MDMA users were of ages 14 to 34.

As the 2014 Global Drug Survey noted, MDMA has been voted the best value drug in the world, so it’s no wonder why it's so popular.

It’s also generally believed that Molly is a purer, and therefore safer, form of MDMA, which may contribute to the comeback the drug has experienced among our generation.

This consensus, however, is incorrect. MDMA is a substance contracted from 3,4-methylenedioxy-methamphetamine. “Molly” generally refers to the powder or crystal form of MDMA, whereas the term “Ecstasy” often refers to the pill or tablet. However, all these forms of MDMA share the same chemical properties, effects and risks.

In addition to being a popular drug of choice, users often describe MDMA as providing them with feelings of endless energy, euphoria and intimacy. The drug enhances physical sensations, increases awareness and helps some to enter a state of entactogenesis, where individuals feel positive about themselves and the world around them.

These feelings of love, happiness and social openness generally occur 30 to 45 minutes after ingesting, peak in 75 to 120 minutes and last for a period of approximately three to six hours.

In comparison to other drugs or alcohol, the effects of MDMA occur without causing the individual to lose too much physical and mental control.

Interestingly, aside from the positive feelings the drug elicits, many health researchers are finding new and promising uses for the drug, including assisted therapy for the treatment of social anxiety in autistic adults, and therapy for individuals with post-traumatic stress disorder.

If this drug has the power to make individuals feel so wonderful, has potential medicinal uses and is voted the best value drug in the world, what more is there to say about it, other than let’s all go get high?

Well, there are some health and safety concerns to consider.

Between 2005 to 2011, emergency room visits related to MDMA increased 128 percent among people younger than 21. There are also numerous reports in the media about MDMA-related fatalities caused by hyperthermia, hyponatremia and heart failure.

Critics argue the number of incidents and fatalities are quite low compared to other drugs, and the fault of these incidences lies in users who are simply not using the drug responsibly.

But who’s at fault if MDMA is not being used responsibly?

Even if MDMA was deemed safe, since it’s an uncontrolled substance, there are no tools in place to ensure its responsible use.

In other words, many over the counter drugs are “safe,” but this classification is strictly dependent on understanding the dose of the drug, the medical history of the person consuming the substance and other medications the individual may be taking.

Take Tylenol, for example. One 200 mg tablet of Tylenol may be safe for most, but a bottle of Tylenol at once can be fatal. A person who overdoses from Tylenol at least had the information readily available about what constituted safe use, and he was aware of the quantity and quality of the substance he was consuming.

A person brought the emergency room after consuming MDMA is not afforded these same luxuries.

Other than buying a marquis kit to determine the purity of the drug, individuals are left consuming MDMA blindly, not knowing if it has been cut with other drugs or chemicals, or if the amount they are taking is too much.

Information about proper dosage is also largely unavailable, although many agree that doses of MDMA should not exceed 125 mg for a 155-pound person on one occasion, and individuals should wait a few weeks before using MDMA again in order to allow the brain to replenish its serotonin levels, and to avoid the risks of neurotoxicity.

And then there’s the larger issue of how these chemicals affect the brain and nervous system over the short- and long-term.

MDMA is a stimulant, and it works by increasing the activity of the brains transmitters dopamine, norepinephrine and serotonin. The increase in serotonin also releases the hormones oxytocin and vasopressin. This contributes to the feelings of euphoria users describe.

But the brain must rebalance itself from the unexpected increase in these chemicals, and this requires a period of recovery.

This often has an adverse effect on the user, which may vary in degree and last anywhere from a few days to a few weeks. This comedown period can be of concern for individuals who already have issues with anxiety or depression, as this may amplify these negative feelings.

The effects of long-term use of MDMA and its ability to cause brain damage remains under debate in the scientific community. However, it’s accepted that MDMA is a neurotoxin and, therefore, has the ability to cause damage on the nervous tissue in the body. The effects of this neurotoxicity depend on the severity and degree of exposure to the neurotoxin.

MDMA is a dangerous gamble for users because they don’t have access to information on the dose or strength of the chemical(s) they are purchasing. They are often using too much MDMA over too frequent periods, and they are largely unaware of the short- and long-term effects.

Preaching abstinence and recommending young adults avoid MDMA is not an effective deterrent when its popularity continues to grow. It remains readily available to interested people, despite its illegal status in most countries.

Ultimately, there needs to be a better system in place to monitor and advise on its use.

Without which, as the demand for MDMA continues to rise, so too will its presence in the emergency room.