MDMA, or Molly, is a synthetic stimulant with psychedelic effects. It can produce feelings of energy, distortions in time and perception, heightened sensory stimulation, empathy toward others, increased sexual drive, and a sense of wholehearted happiness.1, 2 Pure MDMA may be found as a pale crystalline powder form, though pressed pills are also used. Ecstasy is the term (or the “brand” for an illicit product, essentially) commonly used to designate a pill form of MDMA, which often contain other substances like methamphetamine, ketamine, cocaine, or caffeine—substances which can further lead to unpredictable effects and consequences.1
MDMA/ecstasy is a common club and party drug due to its euphoric and energizing effects. The effects of ecstasy begin approximately 30 to 45 minutes after you take the pill and can last as long as six hours, depending on the concentration and purity of the drug.1 The immediate effects of MDMA vary from person to person, especially if it is combined with other substances, as it often is with ecstasy pills.
MDMA creates its effects primarily by altering the activity of three central chemicals in the brain:2
- Serotonin, which is related to mood, sleep, appetite, and sexual arousal.
- Dopamine, which affects energy and activity levels, as well as euphoric feelings.
- Norepinephrine, which increases a person’s heart rate and blood pressure.
While once considered a relatively benign drug, a number of incidents involving MDMA use have demonstrated some serious risks involved with abuse of the drug: MDMA/ecstasy was involved in 22,498 emergency department visits in 2011.3
Despite the undeniable medical risks, rates of MDMA use remained stable from 2002 to 2014, with 609,000 people reporting past-month use in 2014.4 Clearly, while MDMA use may seem like a simple way to have a good time, the potential consequences can be disastrous.
Short-Term Side Effects of MDMA/Ecstasy
The pleasurable effects of MDMA go hand-in-hand with the potentially risky side effects, and not everyone who tries ecstasy will have a good experience. Aside from the desired euphoric high, those who abuse ecstasy and MDMA may experience a number of undesirable health effects.
Some users may find themselves suffering from:5
- Muscle cramps.
- Blurred vision.
- Excessive sweating.
- High body temperature.
One of the most dangerous effects of an MDMA high is the drastic increase in body temperature, also known as hyperthermia, which can ultimately lead to liver, kidney, and cardiovascular failure—and in some instances, death.1
The days following MDMA use can be difficult for some users. Nearly 80% of users experience exhaustion and depression in the days following use, likely due to serotonergic depletion.6 These short-term effects can be uncomfortable, but the long-term risks are where MDMA’s danger truly lies.
What are the Long-Term Side Effects?
When used long-term, MDMA can have severely detrimental effects on the user. One of the biggest concerns is neuronal damage. Very high single doses and successive moderate doses have demonstrated damaging effects on serotonergic neurons in higher brain regions like the neocortex of animals like rats and primates.6
Neuronal changes due to long-term MDMA abuse might help to explain a number of the associated unpleasant side effects, including:2, 6
- Sleep problems.
- Decreased appetite.
- Lower sexual drive.
In addition, some studies have found cognitive performance deficits in long-term, heavy users.6
There is some question as to whether the cognitive impairments are due to MDMA use alone or to heavy drug use in general, since many MDMA users also engage in other substance use.6 There is evidence that the persistent cognitive impairments seen in moderate MDMA users are no more severe than those seen in heavy drug users in general, but that poly-drug use in conjunction with MDMA might increase these risks.7
Increased Risk of Overdose
If you begin using MDMA on a regular basis, you may find that you need more and more of the drug to produce the same effects that it once did, a development otherwise known as tolerance. This can cause you to take the drug in larger amounts, which puts you at greater risk for an MDMA overdose.
Warning signs of an MDMA overdose include:1, 8
- Hyperthermia (overheating).
- High blood pressure.
- Panic attacks.
- Loss of consciousness.
Another potentially lethal medical crisis that can arise with heavy MDMA use is called serotonin syndrome, wherein the brain is flooded with dangerous amounts of serotonin.
Symptoms of serotonin syndrome include:5
- Rapid heartbeat.
- High blood pressure.
- High body temperature.
- Flushed appearance to skin.
- Loss of coordination.
- Hyperactive reflexes.
If you suspect that you or someone you know is suffering from MDMA overdose, you should call 911 immediately. In many cases, those who experience an overdose also struggle with underlying substance abuse issues and may benefit from the help of an ecstasy and MDMA addiction treatment.
Once you make a commitment to stop abusing ecstasy and MDMA, you should begin looking for an effective drug treatment program. The key to success is finding one that works for you.
When drug use abruptly stops, you might experience some form of withdrawal. At the outset of many treatment programs, you will go through a period of supervised drug detox to help you through this potentially rough experience of withdrawal symptoms. The intensity of any detox will vary from person to person and will be influenced by factors, such as how long they took the drug and if there are any other addictions involved.
Withdrawal symptoms from MDMA include, but are not limited to:2
- Severe depression.
- Difficulty concentrating.
- Loss of appetite.
- Extreme fatigue.
There are many different types of ecstasy and MDMA addiction treatment programs available to suit each individual. One of the most effective methods includes inpatient treatment programs. Inpatient treatment temporarily removes you from your old way of life and places you into a supervised treatment facility. It also helps to eliminate some of the stresses you might encounter attempting to quit on your own by removing you from temptation and minimizing relapse risks while you undergo ecstasy and MDMA detox. Inpatient treatment often includes medical monitoring and access to medical services to ensure your safety throughout the detox duration.
Another option for recovering MDMA users is outpatient treatment. Though you’ll go through a similar period of detox and receive similar treatment interventions to someone enrolled in an inpatient program, you are allowed to live and work at home throughout the program, rather than in a medically supervised treatment facility. This may be an effective treatment option for someone with a strong, supportive network of family and friends, and for those who suffering from less severe addictions. Outpatient programs might not be the best fit for someone who suffers from multiple addictions.
If you or someone you love has questions concerning ecstasy and MDMA addiction treatment, call a treatment support representative at to find help. Calls are always confidential, private, and secure.
- Drug Enforcement Administration. (n.d.) Drug Fact Sheet: Ecstasy or MDMA.
- National Institute on Drug Abuse. (2016). DrugFacts: MDMA (Ecstasy/Molly).
- Substance Abuse and Mental Health Services Administration. (2013). Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits.
- Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health.
- U.S. National Library of Medicine. (2014). Serotonin Syndrome.
- Parrott, A. C. (2001). Human psychopharmacology of Ecstasy (MDMA): a review of 15 years of empirical research. Human Psychopharmacology: Clinical and Experimental, 16. 557-577.
- Hanson, K. L. & Luciana, M. (2010). Neurocognitive impairments in MDMA and other drug users: MDMA alone may not be a cognitive risk factor. Journal of Clinical and Experimental Neuropsychology, 32(4). 337-349.
- National Institute on Drug Abuse. (2006). MDMA (Ecstasy) Abuse.