Ecstasy is becoming increasingly popular among young adults, but not without consequences: The substance has been shown to raise brain and body temperature, and can lead to death in hot environments like nightclubs, where the drug is often taken. Now, researchers warn, a supposedly more pure form of the drug may often be contaminated with potentially lethal substances, according to a new study.

“Ecstasy wasn’t always such a dangerous drug,” said Joseph J. Palamar, an assistant professor of Population Health at NYU Langone Medical Center (NYULMC), and lead author of the study, in a press release. Ecstasy is often differentiated from MDMA or “molly,” its supposedly pure form, but Palamar says taking MDMA over Ecstasy never ensures purity. "Users need to be aware that what they are taking may not be MDMA,” he said. MDMA is often contaminated with novel psychoactive substances, which are unregulated drugs that mimic the effects of illegal drugs. These substances are varied, but usually include synthetic cathinones, more commonly known as "bath salts."

"Given the sharp rise in poisonings and recent deaths at dance festivals related to ecstasy use, research was needed to examine whether nightclub/festival attendees who use Ecstasy or Molly have been unintentionally or unknowingly using bath salts," Palamar said. "Little is known about these new drugs and some may be more dangerous than MDMA."

To assess the purity of MDMA, Palamar and his team conducted a study that surveyed young adults outside of nightclubs and dance festivals about their use of MDMA and bath salts, and collected hair samples from 48 participants who reported ecstasy use.

"A lot of people laughed when they gave us their hair, saying things like ‘I don't use bath salts; I'm not a zombie who eats people's faces!’ Yet our findings suggest many of these people have been using bath salts without realizing it."

The researchers found that only half of the collected hair samples tested positive for MDMA, while another half tested positive for bath salts and other novel psychoactive substances. The most commonly detected bath salts were butylone and methylone, which the paper cites as common adulterants in ecstasy. One sample even tested positive for alpha-PVP, a strong stimulant otherwise known as “Flakka.”

"As Molly is becoming a much riskier substance, I really hope that those who decide to use educate themselves about what they're doing,” Palamar said. “While it is safest to avoid use, test kits are available online for those who decide to use, and want to ensure that they're taking real MDMA and not a new synthetic stimulant such as Flakka."

Source: Palamar J, Salomone A, Vincenti M, Cleland CM. Detection of “bath salts” and other novel psychoactive substances in hair samples of ecstasy/MDMA/”Molly” users. Drug and Alcohol Dependence. 2016.