Listening to the 18-minute musical monologue has been a Thanksgiving tradition among folk music fans for decades.
This summer at least four young people attending music events in New York, Boston and Seattle died, apparently after taking the party drug “molly.”
Molly, or MDMA, is the chemical in ecstasy, the 1990s club drug.
It’s very popular these days because it is perceived to be purer than ecstasy and it induces a feeling of euphoria and empathy towards others.
But because it’s often sold in powder form, it can be adulterated with other substances and many users aren’t aware of that.
Doctors who have studied molly say it speeds up metabolism and users who overdose at clubs and dance parties don’t feel it at all until it’s too late.
JEREMY HOBSON, HOST:
It's HERE AND NOW, and this next conversation might not be appropriate for younger listeners. It's about the party drug Molly and this summer, at least four college-age kids attending music events have died, apparently after taking the drug, which is also called MDMA. Performers like Miley Cyrus have, some would say, glamorized it.
(SOUNDBITE OF SONG, "WE CAN'T STOP")
MILEY CYRUS: (Singing) We like to party, dancing with Molly and doing whatever we want...
HOBSON: Well, one former user who did not want to be identified says Molly makes people feel euphoric, and it improves sex.
UNIDENTIFIED MAN: The first time I took it, it was crystal form. I ingested, and it was definitely a bonding experience. I took it with a partner. We were just like, really - like, out of this world.
HOBSON: Well, our next guest was stunned when her college-aged son called her two years ago, asking "What is this Molly drug? It's everywhere." And she had no idea. Well, now she does. Dr. Marla Kushner is an addiction specialist. She's medical director for the New Hope Recovery Center in Chicago, and she's with us now. Welcome.
MARLA KUSHNER: Thank you.
HOBSON: So let's talk first about these overdoses. When we say that people overdose on Molly, does that mean that they took too much of it, or that they had a bad pill or a bad experience with it?
KUSHNER: It's usually that they're taking a higher dose of it for their body type. And what happens when they take that drug, it can cause the body's internal regulation for body temperature to malfunction. So it can lead to liver damage and cardiovascular damage, and overdose.
HOBSON: And as somebody who focuses on people who use this drug, are you surprised that we've had so many incidents and deaths this summer?
KUSHNER: I'm saddened by it. I'm not surprised, though, that it's happening. It's become more common. It's actually increased - they're saying 123-fold in the past five years.
HOBSON: Wow, the use of it?
KUSHNER: The use of it.
HOBSON: And it's, we read, 15- to $50 a dose. What is a dose? Is it just a pill?
KUSHNER: Well, it's a powder form or a crystal form that sometimes can be packed into a capsule. The new way that we're hearing about is parachuting, where it's put into pieces of napkin and then swallowed that way. Or it can be snorted.
HOBSON: What is it about Molly that drives so many people to take it?
KUSHNER: The misconception that it's a pure drug and that, you know, ecstasy may be adulterated by other different types of drugs but that Molly has the image of being a pure form in its crystal or powder form, and that it may be safe. There's a misconception that it's widely used in psychiatric practices to help patients open up their minds.
HOBSON: You're saying that is not true.
KUSHNER: Well, there has - there is research going on about that, but it's not a widely used practice. And as of right now, it's considered a Schedule 1 drug, which means it is illegal to use and that there are no medical accepted uses for it, at this time.
HOBSON: Is the Molly that's out there right now actually pure, as they say, or is it being cut with other things?
KUSHNER: Well, again, you never know for sure what you're getting. You know, supposedly it is the pure form, and that's what's attractive about it. But again, you know, where are you getting it from? How do you actually know for sure what you are getting?
HOBSON: Well, let's talk about the consequences, and I want to first start with the short-term consequences. What happens to you when you have too much of it, or you have a bad strain of it?
KUSHNER: Well, the initial effects are stimulant-type of effects, and it can last for about three to six hours. And even after those three to six hours, some of those effects can last for up to about a week. And you talk to patients who are using some of these, and they'll tell you that even, you know, a week after they've used the drug that they're still experiencing some of these effects.
So that's why a lot of people like to use it. It's a stimulant. It makes you feel like everybody's your friend at a party. You're outgoing. You know, you're going to these concerts, and everything is great when you're on this drug. But what can happen if you take too much of it, or if you mix it with other substances - like alcohol, marijuana, other types of drugs out there - it can cause problems with your body's regulatory system.
And you can have a false sense of not being hungry, not being thirsty. People that are using Molly will get dehydrated from being at an outdoor venue, where it's overcrowded and it's hot; and that's when the autoregulation of the body can go into overdrive.
HOBSON: And the word that gets thrown around is hyperthermia, the opposite there for hypothermia. When you get too hot, your body overheats. And it can cause kidney and liver failure.
KUSHNER: Absolutely- and also heart attacks. It can cause, you know, cardiovascular failure as well.
HOBSON: What about the depression that people report feeling afterwards? Is that dangerous levels of depression?
KUSHNER: Those can be dangerous as well, and those are some of the effects that can happen after the use. So after - after the concert, after they go home; for the next week after, if you look at some of the information that's online, of people sharing their experiences with Molly. They'll even tell you, you shouldn't be doing this every day - you know, I only do it every - a couple times a month because of the effects and how long they last. So it's really interesting, even with people that are using Molly, that they're cautious about it.
HOBSON: Is it addictive?
KUSHNER: You know, there's research out there that it goes both ways, as far as whether or not it's addictive. And for something to be addictive, it's continuing to use it despite harmful consequences, whether they're physical consequences or psychological consequences. And is there a tolerance to it? So do they need to continue to use more of it each time that they use? And could there possibly be a withdrawal when they stop using?
So some of the research is showing that there is. I think it may be on an individual basis. You also need to look at family history, genetic predisposition for addictive diseases, and I think that can make a difference in certain people.
HOBSON: And of course, as we said, you learned about this and started looking into it when your son started college and said Molly is everywhere. You say he has not used it. But has he reported that things have gotten worse or better, to you, on his campus?
KUSHNER: You know, he's just said that it's there, and wanted to know what it was and what was about it. I was actually putting together a lecture on what adolescent young adults were using and what the new drugs of use were, and he happened to call me and ask me, you know, had I heard of this and what is it. And I thought, oh my goodness, I'm an addiction medicine specialist, and I wasn't aware of this - and began doing more and more research, and saw how common it is on college campuses. I joke that my first response was: I don't what it is, but don't do it.
HOBSON: When patients come in to you and they are using it, what do you tell them?
KUSHNER: I give them facts. I give them information. I let them know what the consequences could be physically and emotionally for them, when they're using. I don't hold judgment on patients who, you know, have the disease of addiction or experimenting, but I'm there to provide them the medical knowledge and to be able to help them in their decision-making.
HOBSON: And are they typically young, college age?
HOBSON: Wow. But they have decided on their own to come and seek treatment?
HOBSON: We heard, in the introduction to this, the song "We Can't Stop," by Miley Cyrus, where she says dancing with Molly. Are you concerned that this is becoming too widely accepted in popular culture like that?
KUSHNER: I am. I'm concerned that there's a misconception that it's safe, and that there won't be consequences from using it.
HOBSON: Dr. Marla Kushner is medical director of New Hope Recovery Center in Chicago. Dr. Kushner, thank you so much for coming in.
KUSHNER: Thank you for having me.
(SOUNDBITE OF MUSIC)
HOBSON: And we'd love to hear your thoughts on Molly. Are you concerned about its use? Hereandnow.org is the place to tell us. News is next. Transcript provided by NPR, Copyright NPR.
Experts share a range of perspectives on how to combat the Islamic State militant group, and the role the U.S. should play.