Methylenedioxymethamphetamine (MDMA), also known as ecstasy or “molly,” is a synthetic drug derived from amphetamine.1 It produces effects such as feelings of mental stimulation, decreased anxiety, and enhanced sensory perception. However, as with any street drug, using MDMA also comes with notable risks.
Ecstasy became popular during the 1970s and 1980s when it became a mainstream street drug associated with music festivals, raves, concerts, and clubs. BZP (benzylpiperazine) is now also being used as a “legal form” of ecstasy.
In 1985, the Drug Enforcement Administration (DEA) placed MDMA on the list of Schedule I drugs, meaning that it isn’t used to treat any medical condition and it has a high potential for abuse.2
Also Known As: Other common names for MDMA include Adam, Beans, Clarity, E, Hug, Love drug, Molly, Roll, Scooby snacks, Snowball, X, or XTC.
Drug Class: Ecstasy acts as both a stimulant and a hallucinogen.
Common Side Effects: Some of the more common side effects of ecstasy include nausea, blurred vision, rapid breathing, increased heart rate, and involuntary teeth clenching.
How to Recognize Ecstasy
Ecstasy usually comes in a small, colored tablet that may have a brand logo or cartoon character stamped on it. It can also come in a capsule, liquid, or powder form. It usually has a bitter taste. MDMA pills frequently include other dangerous substances such as meth, cocaine, ketamine, or LSD.
What Does Ecstasy Do?
MDMA works by boosting the activity of three brain chemicals called neurotransmitters: dopamine, serotonin, and norepinephrine.3 These chemicals play a part in a variety of functions such as mood, energy level, appetite, trust, sexual activity, emotions, and sleep.
People who use ecstasy report feelings of euphoria, warmth, openness, and clarity as well as heightened sensations of touch, sound, and smell. Some people report feeling energetic and uninhibited.
The effects typically begin within 30 minutes of taking the drug and last for three to six hours
What the Experts Say
One five-year study published in the Journal of Psychopharmacology found that only 60% of the ecstasy tablets they tested contained any MDMA at all.4 Those that did contain the drug were frequently mixed with other substances, most often bath salts (aka “fake cocaine“).
In nearly a quarter of the samples tested, researchers were not even able to determine what substances the pills contained. The researchers suggested that offering on-site pill-testing stations at concerts and other social events where ecstasy is commonly consumed might reduce risks to users.
The fact that most ecstasy pills contain unknown substances is dangerous because people taking the drug don’t know for sure what they are ingesting or how their body will react. Another danger is that potential interactions can occur between the ingredients as well as any other substances people use with MDMA such as alcohol, medications, or other drugs.
The drug is often taken at social events such as raves and concerts due to its energizing effects. The problem is that it is impossible to know if these effects are due to the drug itself or the presence of other stimulants that ecstasy is often mixed with.
MDMA was originally developed in 1912 as a pharmaceutical compound to help synthesize medications to control bleeding.
During the 1960s and 1970s, for example, a small number of psychiatrists started giving MDMA to their patients as a way to facilitate psychotherapy. Despite the fact that MDMA was not approved by the Food and Drug Administration (FDA), these doctors believed that it lowered their patients’ inhibitions, causing them to talk more openly and honestly.
While MDMA is still on the list of Schedule I drugs, studies are being conducted to see if it’s effective in treating anxiety in people with a terminal illness, as well as those with post-traumatic stress disorder (PTSD).6
Common Side Effects
Ecstasy can produce the positive effects that people seek in as little as 15 minutes, but it can also cause a variety of negative effects.
- Mental stimulation
- An increased sense of well-being
- Emotional warmth
- Feeling less reserved
- Decreased anxiety
- Increased energy
- Enhanced sensory perception
- Chills or hot flashes
- Teeth clenching
- Muscle cramping or stiffness
- Loss of appetite
- Disorganized thinking
- Restless legs
Other Adverse Effects
MDMA isn’t a harmless drug—there are serious risks involved with taking it, including hyperthermia, cardiovascular effects, impaired mental capabilities, risky behavior, and overdose.
MDMA is often used during high-energy activity, such as dancing at clubs or music festivals. However, it limits your body’s ability to regulate your temperature, so when you engage in vigorous activity for long periods of time, you’re at a higher risk of developing hyperthermia, a condition in which your body temperature becomes too high.7
Thankfully, hyperthermia is rare, but it needs to be treated immediately because it can quickly lead to muscle breakdown, which can then result in kidney failure and heart disturbances.
If you use it regularly, taking MDMA can cause your heart to stop working efficiently, an especially dangerous effect if you’re also engaging in strenuous activity.
Impaired Mental Ability
In the hours after you’ve taken ecstasy, there are significant impairments in your mental abilities such as processing information, memory, concentration, and your capacity to judge motion.2 This underscores how dangerous it is to engage in activities like driving while you’re under the influence of MDMA.
Because MDMA lessens your inhibitions and causes feelings of trust and emotional warmth, you’re more likely to engage in unsafe sexual activities that may result in getting (or giving) a sexually transmitted infection (STI) like hepatitis or HIV.
Your risk of engaging in unsafe drug use, such as injecting yourself with a dirty needle, is also higher.
Signs of Use
Some of the common signs that someone might be using ecstasy include:
- Changes in sleep habits
- Chills or sweats
- Dilated pupils
- High and long-lasting energy levels
- High levels of euphoria
- Mood changes
- Muscle tensing
- Sensitive emotions
- Teeth clenching
- The presence of drug paraphernalia (e.g., pills, tablets, powders)
Ecstasy use can also lead to an accidental overdose. Using other drugs or alcohol with MDMA increases this risk.
Overdose Signs to Watch For
- Feeling faint
- High blood pressure
- Loss of consciousness
- Panic attacks
You should contact emergency services immediately if you suspect someone has overdosed or is having a negative reaction to ecstasy.
Myths & Common Questions
One common ecstasy myth is that it is a safe “party” drug with few long-term effects. However, many people still feel anxious, restless, irritable, and sad up to a week after using MDMA.
People also sometimes have memory and concentration problems and experience lack of pleasure from sex. Similarly, increased anxiety, impulsive behavior, aggression, sleep issues, loss of appetite, and heart disease have been observed in regular MDMA users.8
It’s not clear if all of these effects are strictly from MDMA use. Some of them may be related to other drugs that people often use along with MDMA. These effects may also be attributed to the other (often unknown) ingredients found in MDMA.
Tolerance, Dependence, and Withdrawal
Some research, as well as anecdotal reports, suggest that people develop a tolerance to ecstasy after repeated use. When tolerance occurs, people must increase the amount of the substance they take in order to feel the same effects that they initially experienced.
Research also suggests that ecstasy has some dependence potential. Dependence means that people have to keep taking the drug in order to avoid experiencing the negative effects of withdrawal. In the case of ecstasy, the risks of physical dependence seem to be less likely than those of psychological dependence.
How Long Does Ecstasy Stay in Your System?
How long ecstasy lasts and stays in your system depends on a number of factors including metabolism, body mass, hydration levels, and food intake. The effects of the drug usually start within 30 minutes of consumption and the “high” lasts from three to six hours.
MDMA is usually detectable by urine drug tests for one to four days after taking the drug. The detection window can also be influenced by how much of the drug was taken.
The National Institute on Drug Abuse (NIDA) reports that there has not been conclusive research indicating whether or not MDMA is addictive.9 Ecstasy impacts many of the same neurotransmitter sites that are targeted by other addictive substances.
Animal studies have found that animals will self-administer the drug. But the research suggests that this effect is less pronounced than it is with other addictive drugs such as cocaine.
When you use MDMA, your brain releases a flood of neurotransmitters that bring on the uplifting effects of the drug.2 Afterward, you may find it difficult to achieve the same levels of happiness because your brain has depleted these neurotransmitters. This can lead to withdrawal symptoms like:
- Difficulty concentrating
- Poor memory
These symptoms of withdrawal can sometimes cause people to continue using in order to avoid feeling these unpleasant effects.
How to Get Help
If you feel that you have a problem with ecstasy use, it’s crucial that you get treatment. This will help you learn how to stop using MDMA, avoid substituting it with other drugs, and improve your mental health.
If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
Treatment options usually focus on behavioral therapies that help people change the underlying thought patterns that contribute to substance use.10 Cognitive-behavior therapy, individual counseling, and support groups are approaches that might be utilized in either outpatient or residential settings.