Heroin--The Teen Addict Next Door

By Andrew Sullivan

Outside of Minneapolis, Minn., 21-year-old Ashley sits in the furnished basement of her high-end suburban home, a room that she calls her "dungeon."

"I'm literally just rotting," she said, "There's nothing I can think of that's good in my life right now."

Ashley lives the life of a full-time junkie, smoking as many as 100 hits ofheroin a day. Her life is consumed by the multiple trips she takes into the city every day to get her fix, and a desperate search for the more than $100 a day she needs to pay for her addiction.

"It's the first thing I think of when I wake up in the morning, its the last thing I think of when I go to bed," she said, "It's just what my life is revolved around."

Life wasn't always like this for Ashley. She was a good student in high school and college, and hoped to one day become a social worker.

"She's a beautiful girl and she just had so many dreams," her mother, Cheri, recalled. "And then it all just disappeared."

Heroin is a drug that has haunted our country for generations, but in recent years it has posed an increasing threat to American youth. Since 2007, the number of heroin users in the U.S. has nearly doubled, and half of all first-time users are younger than 26 years old, according to theSubstance Abuse and Mental Health Services Administration.
A Deadly Combination
By the time she realized the truth, Ashley was hooked. Over the next year, she dropped out of school and quit her part-time job as she sank deeper into addiction.
"He was addicted to this, and he wanted somebody else with him to share it," Ashley said.Ashley experimented with drugs during her freshman year of college, and she regrets that one day, she tried smoking hash with a friend. After a few weeks of using the drug, her friend came clean; the drug that they'd been smoking was actually heroin.

Low Price Attracts Youth

"Years ago, when you got a call about a heroin overdose, you'd expect that you were going to find a homeless person in an alley somewhere," said Lieutenant Bill Burke, a narcotics detective in Suffolk County, Long Island, N.Y. "Now we're seeing kids in the suburbs overdosing. First it was young people in their twenties, now there are teenagers."

The number of deaths caused by heroin overdose has shot up by at least 50 percent over the past decade, according to a review conducted by the Associated Press, and some areas have been hit harder than others.

"We've seen a doubling in the increase of opiate-related deaths in the last three or four years," said Steve Levy, County Executive in Suffolk, N.Y. "It's in a very pure form these days. It's not the heroin of the previous generation."

While the purity level of heroin has typically ranged from 5 to 20 percent, the purity of heroin produced in Mexico has started to hover around 40 percent, according to the DEA. This high potency level means that addicts are more often able to smoke or snort the drug, avoiding the needle that might scare away a first-time user.

Also attractive to first-time users is the drug's relatively low price. Often, young people will make the jump to heroin after first becoming addicted to prescription opiates, such as Oxycontin. These pills can be pricey -- as high as $50 for one dose -- and the relatively low price tag on heroin -- as little as $10 per dose -- can push young users to try the drug they never would have used otherwise.

"This is a spiral into the abyss for a lot of these young people, who one day very innocently start looking through mom and dad's cabinet and take an Oxycontin pill," said Levy. "It's bad news where it could end up.

In Minneapolis, where Ashley goes on her daily trips, the purity of heroin is the highest of any city in the U.S., and the average price of the drug is among the lowest, according to the DEA. For young users in the area, this is a deadly combination.

'Five Minutes of My Time for That Much Money'

Heroin is famous for its euphoric high, a feeling that lasts 15 seconds, but comes to consume the life of an addict.

"You're just floating on a cloud," said Dylan, a friend of Ashley who's also a heroin user. "There's no care in the world. It's like a rush, just a rush of numbness."

This feeling comes at a price. It's quickly followed by heroin withdrawal -- an intense sickness that Ashley described as "10 times worse than the flu." Ashley said she no longer enjoys the high, but needs to come up with more than $100 per day to "stay well" and avoid the drug's all-consuming withdrawal.

The fate of Ashley's friend illustrates the Catch-22 of being a parent to a heroin addict."Lately it's been about like four, five, but I've had days when I've gotten like fifteen guys in a day," the friend said. "I don't feel like there's any lower I could go right now -- besides death."
Because she charges as little as $20 for sex, she needs to sell herself to several men every day to keep herself from withdrawing.
"I had no other way," the friend said, "I figured, whatever, five minutes of my time for that much money, it's not that important anymore. I don't care that much."Coming up with this money is a full-time job, and can force users to sink to unimaginable depths in order to feed their addiction. Ashley's friend, a former straight-A student who asked that her name not be used, has had to resort to prostitution in order to "stay well."

"I've had a lot of friends say, 'Just kick her out.' Even the police have said that," said Ashley's mother, Cheri.

This can be an impossible decision to make, however, knowing how low a heroin addict will go to get a fix on the streets. Instead, Ashley's parents admit they give her cash and don't ask many questions. Ashley panhandles and steals extra money from her parents to make ends meet.

"It's a really sick feeling to know that's my parents' money," Ashley said, "It really sucks to know that that's how I repay them back."

'I Want to Get Sober'

Shortly after "20/20" met Ashley, she was offered an opportunity to attend the Young Adult Female Program, which is run by Caron Treatment Centersin Wernersville, Pa.

This is not an everyday opportunity. There are more than 23 million addicts in America that need treatment, but last year fewer than 1-in-10 were able to get help at a specialty substance abuse facility, according to the Substance Abuse and Mental Health Services Administration.

With this rare opportunity in place, Ashley is ready to take the plunge. "My mind is just like 'I want to get sober, I want to get sober,'" said Ashley, "I'm going to get sober."

With a relapse rate that several studies cite as higher than 80 percent, the odds are stacked against Ashley.

Relapse, Cory Monteith, and Understanding Addiction

The death of Cory Monteith reminds writer Tyler Gillespie that we all could do better when it comes to talking to each other about addiction.

When I first saw a Facebook post featuring Cory Monteith making an L-shape on his forehead in signature Glee promo fashion, I thought Fox canceled the show. But, as I scrolled through my feed and saw the same photo with “he was so young” written again and again, I realized Monteith had died. But then I thought, these statuses could have been about my own potential relapse.

At 26, I’m a recovering alcoholic, two years sober. Earlier this month, Monteith died at age 31 in his room at Fairmont Pacific Rim Hotel. Toxicology reports show the cause of death was mixed drug toxicity, involving heroin and alcohol. “He did it to himself,” a friend’s status read. “He snorted his life away.” This comment was a reminder on how people really feel about recovering addicts like me.

Months ago I read that Monteith struggled with substance abuse issues, and it immediately made me relate to him more. As Finn Hudson on Glee, he came off as whiny and pedestrian and too much like the boys in high school who made me feel lesser. Knowing Monteith had an addiction made him more real to me. That probably sounds cruel or evil, but knowing that a fresh-faced TV star shared similar struggles, gave me some type of comfort. It bonded us. If you’ve ever felt out of place somewhere, then you might know what I mean.

Like him, I abused alcohol in my teens. Like him at age 19 I went to rehab (mine an outpatient treatment, court-ordered because of a DUI). Like him, I got sober. Recovering — the “ing” means a constant and evolving state. Even if I’m not still using, it’s there. It’s a mental state. Like him, relapse is always a possibility.

People on my Twitter and Facebook feeds expressed confusion and shock over Montieth’s death. He wasn’t a hot mess in the media like Amy Winehouse, a celebrity whose addictions unfortunately made almost as many headlines as her immense talent. Monteith looked fine and healthy and normal. I never heard any stories about Monteith getting kicked out of clubs or driving around with liters of vodka in the passenger seat. His death made me think of addicts I know with spouses and kids and jobs as accountants. Everything in their life seemed controlled until one day they passed out in their front lawn during a child’s birthday party. Montieth seemed to keep it together, at least publicly. Before I quit drinking, I went through a period of “perceived stability” or more accurately called: secret binging. When it comes to addiction, someone doesn’t have to look out of control to actually be out of control.

A few days before Monteith’s death, a friend and I talked about her recent heroine relapse. As these things tend to go, a one-night indulgence turned into a three-week binge.

“Nothing scares me more than relapsing,” I told her. “It sneaks up on you.”

For me, a healthy fear of relapse helps keep me sober. Most people don’t plan their relapse – it can happen on a random Tuesday night when you go to the corner store to get Sour Patch Kids and cigarettes and end up with a jug of wine. Addiction is a progressive disease, which means that it gets worse with time. A lot of non-addicts don’t want to talk about it that way, acknowledge it’s not as easy as “putting down the bottle.” We have to learn to deal with stuff like going to a dinner party and passing up the wine. We have to re-learn how to function in society. We have to re-program ourselves.

When a celebrity dies of an overdose, people usually lament the loss of talent, not the actual person. In Monteith’s case, people wonder how they’ll write Finn out of Glee. This is the truth for any addict — a young addict, especially, because we are known to be selfish and destructive. The stigma around addiction still moves the conversation toward “he did it to himself” like you can turn off addiction whenever you want. The danger in this type of thinking is that it stops dialogue surrounding healthy ways to deal with addiction. I understand the cynicism. We usually are toxic people when actively using, but the sentiment trivializes our struggle.

In March, Monteith voluntarily checked into rehab, a sign that he was struggling but still trying to work on his issues. His openness about addictions was commendable and brave. He starred on a wildly popular show about high school, he didn’t have to ever publicly address it. By doing so, he saved kids's lives because his honesty showed addiction can happen to anyone. He was working on it and he let other people know it’s OK to be working on it.

While I never met Cory Monteith, I’ve known plenty of people like him. He is in my friend who talks to me about her problems on a Friday night, he is your former roommate, and he is someone like me. We need to examine how we address addiction, and not just assign blame to the deceased. Not every addict relapses, but some people do. Some die from it, others don’t. For those who do die from it — celebrity or not — I hope we can move toward remembering what addicts did as people and not just as their disease.

Marijuana and Teens

Many teenagers experiment with marijuana. Friends, peer pressure, and portrayal of marijuana in the media often affect a teenager's decision to use. Parents can also play an important role in teaching their children about the risks of using drugs.

Buying and using marijuana is illegal. Still, teen marijuana use is at its highest in 30 years, and teens are now more likely to use marijuana than tobacco. In 2011, a national study showed that one in eight 8th graders, one in four 10th graders, and one in three 12th graders have used marijuana in the past year.

There are over 200 different street names for marijuana. Many of them are based on the type of drugs or tobacco that is mixed in with the marijuana, "brands" from various areas in the country or around the world, or specially bred strains. Some common names include blunt, bud, pot, spliff, and weed. "K2" and "spice" are examples of synthetic (man-made) marijuana-like drugs. There are also street names for smoking marijuana, including blazing, bonging, puffing, and toking.

Parents and Prevention
Talking with your child when they are in elementary or middle school in an honest and open way can prevent drug use in the future. The following are tips on for how to discuss marijuana with your child:

• Ask what he/she has heard about using marijuana. Listen carefully, pay attention, and do not interrupt. Avoid making negative or angry comments.
• Offer your child facts about the risks and consequences of smoking marijuana
• Ask your child to give examples of the effects of marijuana. This will help you make sure that your child understands what you talked about.
• If you choose to talk to your child about your own experiences with drugs, be honest about your reasons, be careful not to glamorize marijuana or other drugs, and discuss the negative things and dangers that resulted from you or your friends' drug use

Sometimes parents may suspect that their child is already using marijuana. The following are common signs of marijuana use:

• Dizziness
• Acting silly for no reason
• Being hungry and eating more than usual
• Red eyes or use of eye drops
• Increased irritability or grumpiness
• Reduced motivation and lack of interest in usual activities
• Trouble remembering things that just happened
• A smell on clothes, or the use of incense or other deodorizers
• Owning clothing, posters, or jewelry encouraging drug use
• Having pipes or rolling papers
• Stealing money or having money that cannot be accounted for

Many teenagers believe that marijuana is safer than alcohol or other drugs. When discussing marijuana with your child, it is helpful to know the myths and the facts. The following are some common myths about marijuana:

• "It is harmless and natural, it is only an herb, and it won't affect me long-term"
• "It is not addictive"
• "It doesn't hurt me as much as smoking tobacco"
• "It makes me feel calm"
• "It doesn't affect my thinking or my grades"
• "It's safe because it is used as medicine for cancer and other diseases"

Effects of Marijuana
Regular use of marijuana can lead to dependence, which causes users to have a very hard time stopping. When teens use marijuana regularly, they may crave marijuana and give up important activities to use marijuana. If they stop using, they may suffer from withdrawal symptoms which can include irritability, anxiety, and changes in mood, sleep, and appetite.

Marijuana can also cause serious problems with learning, feelings, and health. Tetrahydrocannabinol (THC) is the active ingredient in marijuana. THC affects the brain's control of emotions, thinking, and coordination.

Use of marijuana can lead to:

• School difficulties
• Problems with memory and concentration
• Increased aggression
• Car accidents
• Use of other drugs or alcohol
• Risky sexual behaviors
• Increased risk of suicide
• Increased risk of psychosis

Long-term use of marijuana can lead to:

• The same breathing problems as smoking cigarettes (coughing, wheezing, trouble with physical activity, and lung cancer)
• Decreased motivation or interest
• Lower intelligence
• Mental health problems, such as depression, anxiety, anger, moodiness, and psychosis
• Decreased or lack of response to mental health medication
• Increased risk of side effects from mental health medication

Medical Marijuana
Currently, only man-made forms of THC are approved by the Food and Drug Administration (FDA) for a very small number of specific medical uses. There are no FDA-approved medical reasons for children or teenagers to use marijuana or THC in any form.

"Medical marijuana" is not checked for ingredients, strength, or safety. There is no evidence that medical marijuana is any safer than other marijuana.

The use of marijuana is illegal in the United States and prohibited by Federal law. However, medical marijuana laws are different from state to state. Several states allow the use of medical marijuana for adults. Almost all of these states still say that it is a crime for minors to sell, have, or use marijuana.

Conclusion
Marijuana use in teens can lead to long-term problems. Teens rarely think they will end up with problems related to marijuana use, so it is important to begin discussing the risks with your child early and continue this discussion over time. Talking openly with your child will help with prevention. If your child is already using, open communication will help you know more about his or her use. If you have concerns about your child's drug use, talk with your child's pediatrician or a qualified mental health professional.

Hand sanitizer: The new vodka for teens?

There's a new trend among teens looking for a buzz, doctors say, and it surrounds an unlikely household item designed to keep us germ-free: ethanol-based hand sanitizer.

Teenagers are using it this stuff to get high, according to health officials. Poison control centers nationwide say reports are on the rise.

The big issue here is the alcohol content, says Dr. Robert J. Geller, a medical toxicologist and Emory University pediatrician.

He says these sanitizers "are actually products that are 60% ethanol which means they are 120 proof," and "if you drink 2 ounces of it, it's like drinking 3 ounces of 80-proof tequila."

In California, where word of the trend first surfaced, there have been reports of 60 teenagers exposed since 2010, says Dr. Cyrus Rangan, toxicologist and assistant medical director of California Poison Control.

In recent months L.A. County doctors noticed an increase in cases, so last week they asked the California Poison Control Center to run numbers to see if data matched their instincts.

But nationwide statistics haven't been compiled, so CNN asked the  American Association of Poison Control Centers check their database.

Turns out the number of cases around the country are going up too.

Last year there were 622 calls involving cases where teenagers reported exposure to ethanol-based hand sanitizer, according to the AAPCC.  So far this year, they've already received 203 calls.

The specifics of each case aren't known, but overall, "77% of teen exposures to hand sanitizers were oral; the rest were mainly the eye and skin," says Loreeta Canton, spokeswoman for the AAPCC.

None of the reports involving hand sanitizers resulted in the deaths of young people, although one 2011 report involved a teen "with major effects that were life-threatening," according to the AAPCC.

Also in 2011, there were 14 teens with "moderate effects"requiring treatment that were not life-threatening and 122 cases of teens with "minor symptoms" that were "minimally bothersome and generally resolved rapidly," the AAPCC says.

So far this year, poison centers have received hand sanitizer reports of one incident that was "life threatening or resulted in disability or disfigurement," one incident that "required treatment, but was not life threatening" and 48 which were "minimally bothersome and were resolved rapidly."

For teens there can be serious consequences, says Geller, from sedation, to vomiting, to slowed breathing, "it really depends on how much they take and how often they are doing this."

Dr. Jennifer Shu, a CNN consultant and Atlanta pediatrician, says this is not a new concept for teens, it's just a new product for them to try. She says, "when used the wrong way, a lot of these things can have unintended consequences."

Ethanol can interfere with normal body functioning and side effects can range from sedation,  loss of coordination, and reaction timing, warns Dr.Carl Baum, a pediatric emergency physician and a medical toxicologist. "Too much ethanol can lead someone to have dangerous drops in blood sugar," just like drinking too much alcohol.

Teens are being exposed through friends and finding recipes online to help make it more palatable, Rangan says. Some teens even add ingredients to separate the alcohol from the rest of the gel while some dilute it down.

Drinking hand sanitizer poses the same risks as drinking alcohol for kids, says Rangan. "Regard it like you would regard any kind of medication in your house and monitor the amount in your house." He suggests parents use foam sanitizers which might be a little less appealing for a teenager to use in a recreational way.

"I think it's just because of the easy accessibility," he says,  "teens who are showing behaviors of intentionally taking hand sanitizer in an effort to get the alcohol high need to be evaluated for why are they doing that, and is this a symptom of a larger problem of substance abuse."

For more information on alcohol abuse and kids visit Elizabeth Cohen's"Empowered Patient" at CNN.com.

Teens and Drugs: Facts Parents Need to Know

Teen drug abuse facts

• There are many stages of drug abuse, ultimately leading to difficulty in managing one's life as a result of using drugs.
• Individuals who begin using drugs as juveniles are at greater risk of becoming addicted compared to those who begin drug use as an adult due to the immaturity of the teenage brain, particularly of that part of the brain that controls impulses.
• The symptoms of drug abuse include tolerance to a substance, withdrawal episodes, using more drugs for longer periods of time, and problems managing life issues due to the use of a drug.
• Substance abuse is caused by a number of individual, family, genetic, and social factors rather than by any one cause.
• Although a number of genes play a role in the development of substance abuse, this is a disease in which other factors more strongly influence its occurrence.
• Substance-abuse treatment is usually treated based on the stage of the addiction, ranging from management of risk factors and education to intensive residential treatment followed by long-term outpatient care and support.

• What drugs are abused by teenagers?

  Virtually every drug that is abused by adults is also abused by adolescents. In addition to alcohol, common categories of drugs of abuse include the following:

  • Tobacco products (for example, cigarettes, cigars, chewing tobacco)
  • Cannabinoids (for example, marijuana, hashish), sometimes called "pot, weed, Mary Jane, or herb" and is smoked in a "joint," "blunt," "bong," "backwood," or pipe
  • Cold medications (for example, chlorpheniramine and pseudoephedrine [Sudafed], diphenhydramine [Benadryl]
  • Inhalants (for example, gasoline, ammonia), the use of which is often referred to as "huffing"
  • Depressants (for example, barbiturates, benzodiazepines), sometimes called "reds, yellows, yellow jackets, downers or roofies"
  • Stimulants (for example, amphetamines, cocaine, methamphetamine), sometimes called "bennies, black beauties, speed, uppers, blow, crack, rock, toot, crank, crystal, or skippy"
  • Narcotics (for example, morphine, heroin, codeine, oxycodone[Oxycontin], hydrocodone/acetaminophen [Vicodin], sometimes called cody, schoolboy, dope, Tango and Cash, or monkey"
  • Hallucinogens (for example LSD, "mushrooms"), sometimes called "acid, yellow sunshines, buttons, or shrooms"
  • Dissociative anesthetics (for example, phencyclidine/PCP, ketamine), sometimes called "lovely, boat, Love Boat, angel dust, K, vitamin K, or cat" and whose use is often referred to as "getting wet"
  • Club drugs (for example, Ecstasy), sometimes called "X"
  • Others (for example, anabolic steroids), sometimes called "juice or roids"

  • What are some adolescent drug use statistics?

    • In the U.S., about 3,000 teens smoke their first tobacco cigarette each day. About one-third of those adolescents become daily smokers. However, teen tobacco use generally continues has been declining since 2002.
    • Facts regarding underage drinking in the United States indicate that in 2008, 16% of eighth graders and 29% of 10th graders engaged in that behavior.
    • In 2008, the percentage of 12th-grade adolescents who have used any illicit drug except marijuana in the past month was about 25%, a decrease since 1997, when it was 30%.
    • As of 2010, about 30% of 10th-graders used marijuana in the past year. More than two-thirds of 10th graders said they could easily gain access to that drug.
    • In 2010, almost 3% of 12th graders had used cocaine in the past year, 8% had used the opiate Vicodin, 5% had used inhalants, nearly 5% had used "Ecstasy," and about 1.5% had used anabolic steroids.

    What are the dangerous effects of drug use in teens?

    Here are just a few of the many dangerous effects of drug use in adolescents:
    • Drugs of any kind decreases teens' ability to pay attention.
    • The younger a person is when they begin using drugs the more likely they are to develop a substance-abuse problem and the more likely they are to relapse into drug abuse when trying to quit.
    • Juveniles who use drugs are more likely to have unprotected sex, sex with a stranger, as well as to engage in sexual activity at all. This, in turn, puts them at risk for pregnancy, rape commission or victimization, and for sexually transmitted diseases.
    • Substance use can cause or mask other emotional problems, likeanxiety, depression, mood swings, or hallucinations (for example, hearing or seeing things). Either of those illnesses can result in death by suicide or homicide.
    • Anabolic steroids have been associated with impotence in boys and men, clitoral enlargement in girls and women, as well as baldness, stunted growth, heart attacks, strokes, liver disease, cancer, acne and infections, including HIV/AIDS in both sexes.
    • Depending on how the body takes in and processes each kind of drug, substances of abuse can affect virtually every one of the body's systems. Examples of this include permanent brain damage associated with inhalants, heart attack or stroke from stimulants, halted breathing from sedatives. Any of these problems can result in death.

Amphetamines--What Parents Need to Know

What It Is:	Amphetamines are very addictive stimulants that accelerate functions in the brain and body. They come in pills or tablets. Prescription diet pills also fall into this category of drugs.
Sometimes Called:	speed, uppers, dexies, bennies
How It's Used:	Amphetamines are swallowed, inhaled, snorted, or injected.
What It Does:	No matter how a person takes amphetamines, these drugs hit with a fast high, making the user feel powerful, alert, and energized. These "uppers" pump up heart rate, breathing, and blood pressure, and can also cause sweating, shaking, headaches, sleeplessness, and blurred vision. Prolonged use may cause hallucinations and intense paranoia. Users who stop taking amphetamines experience withdrawal symptoms, such as aggression, anxiety, and strong cravings for the drugs.

Reviewed by: Yamini Durani, MD

What Parents Need to Know About Molly

 "Have you heard of molly?" the girl next to me asked. She was swaying from side to side, bobbing her head to the bass vibrating throughout the sold-out venue.

The room around us was buzzing with anticipation. Music was blasting. People were dancing and laughing and taking pictures. There was less than an hour until showtime, and I was about to see one of my favorite artists, so I was feeling pretty good. The girl next to me, Jessica, was obviously feeling better.

I turned to my fellow concertgoers, watching as they met Jessica's eyes, nodding their heads knowingly. Of course they had heard of molly.

Turns out, molly is a pretty popular lady these days.

According to the Drug Enforcement Administration, molly is the powder or crystal form of MDMA -- or 3, 4-Methylenedioxymethamphetamine, a chemical drug most commonly known for its use in the pressed pill Ecstasy.

Unlike Ecstasy, which has a reputation for being laced with everything from caffeine to methamphetamine, molly -- a name shortened from "molecule" -- is thought of as "pure" MDMA.

The DEA labels it a Schedule 1 controlled substance, considered to have a high potential for abuse and no accepted use in medical treatment, which means it's illegal.

This year, molly was abundant at music festivals -- if you knew where to look. At Miami's Ultra Music Festival, fliers littered the landscape mentioning her name like missing child posters: "Have you seen molly?" And when Madonna took to the stage to introduce an artist, the pop star asked the audience: "How many people in this crowd have seen molly?" A slew of cheers answered, though Madonna later said she'd been referring to a song, not to an illegal drug.

Hip-hop artists claim they know her -- she's casually mentioned by 2 Chainz in the Nicki Minaj track "Beez In the Trap," by Childish Gambino in his song "Unnecessary," by Kanye West in "Mercy," by Danny Brown in "Die Like a Rockstar."

It seems the drug is on the minds of many. But questions about who -- or what -- molly really is remain.

Contradictions about makeup

An experience with molly starts with a bitter taste, users say, which is soon forgotten as the high kicks in.

"It felt like everything was amplified. It felt euphoric -- almost like a crazy adrenaline rush for a long time," said Evan, a young professional working in Michigan.

"You feel a lot more loose and comfortable in your environment," said recent Georgia high school graduate Jessica, who'd never used molly until the concert in July -- a friend's recommendation convinced her to give molly a try.

And then, usually after a few hours -- depending on the dose that is taken -- of dancing and moving and talking, the trip comes to an end.

"(After it was over), it wasn't like a depression, but it was like, 'Aw man, I wish I felt that way again,' " Jessica said.

MDMA acts as a stimulant and a psychedelic, according to the DEA. After being inhaled, eaten or parachuted -- folded into a tissue and swallowed -- molly ushers in euphoria. It floods users' brains with neurotransmitters serotonin, norepinephrine and dopamine, making them feel elated, empathic and full of energy.

MDMA first found popularity in the form of Ecstasy as the drug of choice among ravers at underground nightclubs in the early 1990s. But when questions arose over the purity of Ecstasy --- the drug was often mixed with other ingredients ---- people turned their attention to a purer form, said Nathan Messer, board president of the nonprofit organization DanceSafe, which promotes health and safety within the nightclub community.

"You knew you were getting the real thing and nothing but the real thing," he said. "Because people knew that (molly) was trustworthy, it became the go-to thing."

You knew you were getting the real thing and nothing but the real thing. ... (Molly) became the go-to thing.DanceSafe's Nathan Messer

Molly is a street name that has been in use for about a decade, Messer said. Although it originally referred simply to MDMA, the title "molly" is now given to a variety of legal substances with similar chemical structures.

Its exact makeup has been confused and contradicted among both users and experts. The DEA has labeled molly as MDMA, but Carl Hart, a Columbia University associate professor of psychology, said many researchers consider molly to be the chemical 6-APB, or Benzo Fury.

Messer said MDPV, methylone, mephedrone and butylone -- different substances or drugs -- are often sold as molly, while users such as Evan have heard countless rumors of molly's makeup, including that it's created from fertilizer.

Number of users unclear

Molly users tend be young, ages 16 to 24, said Pax Prentiss, co-founder and CEO of Southern California's Passages rehabilitation centers.

Exact numbers detailing molly's use are unclear -- studies conducted by U.S. health organizations such as the Substance Abuse and Mental Health Services Administration usually only quantify use of MDMA or Ecstasy, not molly specifically. But molly appears to be gaining popularity.

As the owner of a film company that shoots music videos and festivals, Evan often sees molly in use at shows.

And even for someone who doesn't consider himself to be an avid drug user, he said he found it easy to get his hands on some molly.

"All I had to do was text a friend," Evan said.

Because MDMA has long been associated with raves, the mainstream popularity of electronic dance music also contributed to molly's rising reputation, DanceSafe's Messer said.

In 2011, about 25 kilograms of molly worth at least $525,000 were recovered after a DEA investigation of a large-scale drug trafficking operation based in Syracuse, New York, a college town. The bust led to charges against 20 people.

Penn State University Police Chief Tyrone Parham said he and his officers first heard anecdotes about molly in 2011.

Parham said it's hard to get a real idea of how many students have used molly. Officers can catch users of marijuana -- the most common drug on Penn State's campus, according to Parham -- in the act because of the drug's conspicuous odor. But it's difficult to know if a student has misused molly because officers are often called after the drug has already been ingested -- if they are even called at all.

"I think it's one of those things, not just here but across the country, (that's hard) to get an understanding of how prevalent it is," he said.

A name with innocent appeal

Some consider the name picked for this white powder a clever marketing strategy: "Molly" carries both the innocent appeal of the girl next door and the implication that the drug is always pure MDMA. But because the chemical makeup of molly is often altered, taking the drug is dangerous, DEA spokesman Rusty Payne said.

"(Suppliers) are making it look like something that is safe and easy to take, but in many cases, you're playing Russian roulette," Payne said.

"(Suppliers) are making it look like something that is safe and easy to take, but in many cases, you're playing Russian roulette.DEA spokesman Rusty Payne

And although MDMA tastes, smells and affects you differently than other drugs would, without having experience with each molly variation, there's no easy way to tell if the substance you take is pure, Messer said. But even as its pure form molly, MDMA can be dangerous.

The DEA sees MDMA supplied from Asia, Canada, even the Netherlands.

"You have no idea the lab environment these chemicals or substances were produced in," Payne said. "If they knew where things were produced, they might think twice."

Risky business

Some drug users have said they prefer molly over other illicit drugs because of the limited negative side effects they've experienced.

"Honestly, if I were to pick a drug out of anything else to do, I would pick molly," Evan said. "Molly has a lot to do with loud music and seeing lights -- getting excited about seeing something that's already cool and making it cooler."

There are no withdrawal symptoms associated with MDMA, and because prolonged use eventually begins to diminish users' highs, the risk of physical addiction is low, said Prentiss, the Passages rehab CEO. MDMA addictions make up less than 5% of the company's clientele, he said.

And hospital visits spurred by MDMA use appear to be few and far between. Less than 4% of emergency room visits in 2009 were because of MDMA, according to the Drug Abuse Warning Network, which is part of the Substance Abuse and Mental Health Services Administration.

In fact, with its mood-enhancing properties, MDMA is even being studied as a possible treatment for post-traumatic stress disorder.

But the Drug Abuse Warning Network's study also found that from 2004 to 2009, there was a 123% increase in the number of emergency room visits involving MDMA taken alone or in combination with pharmaceuticals, alcohol or both.

Theodore Bania, a medical toxicologist and emergency medicine physician at St. Luke's-Roosevelt Hospital in New York, said although many of the people who take molly don't end up in the emergency room, some users experience side effects that land them in the hospital.

MDMA, even in its pure form, can produce elevated heart rates and distortion of thought processes, causing users not to realize their rising body temperature or fading stamina as they continue to party. Combining MDMA with alcohol or other drugs can also be the cause of its more serious side effects.

Bania frequently sees patients who have complications from MDMA, ranging from dehydration and exhaustion to more severe side effects such as hyperthermia, seizures, electrolyte abnormalities, cardiac episodes and comas.

MDMA also depletes the body of some of its neurotransmitters, which can lead to a decreased mood about a day or two after using the drug. Prentiss said he has even seen the drug lead to long-term depression.

Users who haven't had exposure to molly's serious negative side effects sometimes think of it as a "safer" drug. But Hart, the Columbia associate professor, said claims that any drug is safe are ridiculous.

"A lot has to do with the doses people take," Hart said. "As you increase the dose over an extended period of time, you can expect to see some negative effects. That's a general rule the public really needs to understand."

Hart said he believes accurate education, not law enforcement, is key to minimizing the risks of illicit drugs such as molly. Because so many young people have already tried molly, he said experts need to make sure they are being realistic about the dangers of its use.

"What we've done and what we consistently do is we include people that exaggerate the harms," Hart said. "Kids are not listening because they've already had the experience. ... They (think they) should reject everything we're saying because we're not being accurate, and they know it."

'A softening against drugs'

Molly's rise in popularity can, in part, be attributed to the current culture, said Tammy Anderson, a professor of sociology at the University of Delaware who has studied the use of drugs, including MDMA, in nightclubs. "We're at a place here historically that people don't think marijuana is a drug anymore."

Although marijuana, like molly, remains on the DEA's list of Schedule 1 controlled substances, it's a drug that many citizens think of not only as minor but as one that should be legal. And 17 states have legalized it for medical use.

There is now greater permissiveness and lax attitudes toward drugs such as marijuana, so people move on to other substances, such as molly, and give themselves permission to use them, Anderson said.

"We are moving into a post-war on drugs era. We're seeing a softening of drug laws and a softening against drugs, especially among young people."

For now, the DEA is more focused on fighting the abuse of prescription medications such as Oxycontin and Valium. But as admirers plaster posters at concerts asking, "Have you seen molly?" officials can only hope she stays missing.