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MDMA/Ecstasy Dangers of Use, Addictive Potential, and Treatment Options

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Ecstasy is an illicitly manufactured, synthetic drug used by many people for different reasons, such as to increase feelings of well-being or feel emotional closeness to others.1 Although ecstasy initially became popular for use at raves or parties, its use has become much more widespread among people in various other settings.1

Ecstasy use is associated with several adverse effects and potential health risks. Though the question of whether ecstasy is addictive or not has yet to be fully answered, ecstasy use can be quite problematic for some. Substance use disorders involving ecstasy use may benefit from professional treatment. A professional rehab facility can provide support and different therapies to help you, or a loved one, start the path to recovery.2

What Is Ecstasy/MDMA?

Ecstasy is the commonly used term for the synthetic drug 3,4-methylenedioxy-methamphetamine, or MDMA.2 It’s also known by various street names, such as molly, XTC, E, X, beans, and adams.3 Ecstasy is known as a club drug or party drug because it was originally used mainly at clubs, raves, and festivals, but it’s now taken in a variety of settings.3

People typically swallow ecstasy in capsule or tablet form, but some people use it as a liquid or snort ecstasy as a powder.2 Ecstasy tablets, and the purported “pure” powder referred to as molly, are often cut with other substances. These include MDA, methamphetamine, ketamine, caffeine, amphetamine, cathinones (bath salts), synthetic cannabinoids, and/or opioids, such as fentanyl.2,3

People are often unaware of these additives, which can result in additionally unpredictable and even more dangerous effects.2

What Does Ecstasy Do?

Ecstasy shares chemical structural and pharmacological similarities with both amphetamine stimulants and hallucinogens.1 Using ecstasy can result in different perceptual and mood-altering effects that are similar to those of other hallucinogenic and stimulant drugs, such as:2

  • Increased energy.
  • Feelings of pleasure.
  • Emotional warmth.
  • Distortions in time or perception.

Ecstasy’s effects and the associated high are largely due to its impact on different chemical messengers, or neurotransmitters, in the brain, namely serotonin, dopamine, and norepinephrine.1 As with amphetamines, ecstasy increases the release and/or prevents the reuptake of these chemicals, which artificially boosts levels of active neurotransmitters in your brain.1

Increased serotonin may result in the elevated mood, increased trust, empathy, and sexual arousal associated with ecstasy. Increased norepinephrine affects heart rate and blood pressure, which can make ecstasy use especially dangerous for people with cardiovascular issues.2 The ecstasy-related surge in dopamine is thought to underlie the increased energy and activation of the reward system, which may reinforce drug-taking behaviors.

While it influences all 3 of these types of brain signaling, ecstasy specifically amplifies serotonin and norepinephrine activity, more than it does that of dopamine.1

Is MDMA Addictive?

MDMA is categorized as a Schedule I drug under the Controlled Substances Act, which means that it has no accepted medical use in the U.S., and it has a high potential for misuse.3 Research is not yet conclusive as to whether ecstasy is addictive, and there hasn’t been a substantial amount of research conducted on its addictive potential in humans, but ecstasy is known to act on the same brain areas as other addictive drugs.1

Some people have reported certain signs of addiction with drugs like ecstasy, including continued ecstasy use despite the negative mental and physical health consequences, cravings, tolerance (needing more to achieve prior effects), and withdrawal symptoms when they stop using the drug.1,2

Continued use of ecstasy can no doubt become significantly problematic for some people, and signs such as these, if present, may meet the diagnostic criteria for what’s known as a substance use disorder (SUD). Compulsive or otherwise problematic ecstasy use may be officially diagnosed by professionals as what’s known broadly as a hallucinogen use disorder or, more specifically, an MDMA use disorder.1,4

Teens and young adults may be more likely to use and misuse ecstasy.3 According to the National Institute on Drug Abuse, males aged 18–25 make up the largest population of ecstasy users, and most people start using it at around age 21.1 As mentioned earlier, ecstasy has historically been used more often at parties, raves, and nightclubs, but its use has spread to a wide range of additional settings, including college campuses.1,3

MDMA abuse often involves a practice called “stacking,” which means taking 2 or more tablets at once, or “piggy-backing,” which means taking several tablets over a short period of time.3 Additionally, using ecstasy and LSD together, known as “candy-flipping,” has become an increasingly common practice among younger adults.3

According to the 2021 National Survey on Drug Use and Health, nearly 2.2 million people aged 12 and older had used ecstasy in the past year.5

Ecstasy Side Effects and Signs of Ecstasy Use

Using ecstasy can have a range of effects, some of which can be viewed as pleasant, while others can be unpleasant, uncomfortable, or severe.

People may experience symptoms of the ecstasy high that are perceived as desirable, such as increased energy, feelings of pleasure, emotional warmth, distortions in time or perception, and an increased desire to talk about emotional events and experiences.1,2

These and other symptoms of ecstasy use usually begin around 30–45 minutes after it’s been taken orally, with effects peaking 15–30 minutes after onset and typically lasting 4–6 hours. However, effects can vary and can also last longer in some cases and differ depending on the individual.1,3

In addition to the perceived positive effects, ecstasy can have a wide range of adverse health effects, including:

  • Headache.1
  • Blurred vision.2
  • Perceptual changes, such as problems driving a car, which could lead to accidents.1
  • Illogical thoughts.1
  • Nausea.2
  • Appetite loss.1
  • Involuntary teeth clenching.2
  • Muscle cramping.2
  • Chills.2
  • Sweating.2
  • Restless legs.1

People often take multiple doses of ecstasy once the initial high fades, which can increase the likelihood of experiencing certain undesirable side effects. Some people may experience certain side effects days after use.1

The nature and severity of adverse ecstasy effects can also vary depending on whether you (knowingly or unknowingly) ingested contaminants or any other additional substances.1

Over the course of the week following moderate ecstasy use, people may also experience additional adverse effects, some of which can also vary depending on other substances used. These include:2

  • Anxiety.
  • Depression.
  • Irritability.
  • Impulsiveness.
  • Aggression.
  • Sleep problems.
  • Memory and attention problems.
  • Decreased appetite.
  • Lack of interest in and pleasure from sex.

Dangers of Ecstasy Misuse

Ecstasy addiction and misuse can present a range of dangers. One of the uncomfortable effects of ecstasy use can be withdrawal, which refers to the symptoms that can occur when someone stops or cuts down their ecstasy use.2 Some reports show that people who use ecstasy develop withdrawal symptoms, such as:2

  • Depression.
  • Fatigue.
  • Loss of appetite.
  • Trouble concentrating.

Another potential danger associated with molly use is polysubstance use.2 Polysubstance use means using two or more substances at the same time or within a short time of each other, and is something that can happen either inadvertently (such as when other drugs are used to adulterate or entirely replace what a person thinks is ecstasy) or when ecstasy is intentionally consumed with other substances.2,6 Ecstasy use frequently occurs in combination with cocaine, alcohol, and marijuana use, which can present a range of dangers.1,6

Using cocaine or other stimulants with ecstasy can increase your risk of brain injury, liver damage, heart attack, stroke, seizures, and other forms of overdose toxicity.6 Mixing ecstasy with alcohol or marijuana can also increase a person’s risk of experiencing adverse health effects.1,9

The dangers of ecstasy misuse and addiction can also include more severe health effects than those listed above. Some of these can be long-term effects of MDMA use, while others can occur days or weeks after last use.1 They may include:1

  • Panic attacks.
  • Hyperthermia, or dangerously elevated body temperature.
  • Dehydration.
  • Rhabdomyolysis (muscle tissue breakdown) and kidney injury.
  • Electrolyte disturbances and brain swelling.
  • Irregular heartbeat (arrhythmia) and other cardiovascular issues.
  • Harm to the fetus if used during pregnancy.
  • Ecstasy overdose, which can be fatal in rare cases.

People can also suffer from the secondary effects associated with ecstasy addiction and frequent use, such as legal, financial, relationship, work, and family problems.7

Getting Help for Ecstasy Abuse or Addiction

If you’re struggling with ecstasy addiction or you’re wondering how to help someone with ecstasy addiction, you should know that ecstasy addiction treatment is available to help people start the journey to recovery.

MDMA Addiction Treatment Types

Treatment may take place in different settings depending on a person’s specific needs. Rehab may start with detox to support the individual during withdrawal, followed by an inpatient or outpatient drug recovery program.7,8

It’s important to note that no medications have been approved to specifically manage ecstasy withdrawal or addiction. Treatment often focuses on behavioral therapies, such as cognitive behavioral therapy (CBT), which helps people develop healthier, more positive thoughts and behaviors and improve their stress management skills.1

People with SUDs sometimes have co-occurring mental health conditions, such as depression and anxiety.9 As SUDs and mental health conditions can worsen the outcome of one another, a dual diagnosis program that addresses both conditions can help people recover from both disorders.9

Find Ecstasy Addiction Treatment Centers

Although ecstasy misuse can negatively impact your life, there’s always hope, regardless of how things might seem right now. Rehab and treatment can help you take back control of your life, recover from ecstasy addiction, and resume a healthier and more productive existence.10

American Addiction Centers (AAC) is a leading treatment provider and has trusted rehab programs across the country. If you’d like to learn more about treatment and rehab, please call our free, confidential helpline at to discuss your options. You can also find rehabs near you using the drugabuse.com directory and/or instantly verify your health insurance coverage.

MDMA Addiction Treatment Levels of Care

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Senior Medical Editor
Dr. Thomas received his medical degree from the University of California, San Diego School of Medicine. During his medical studies, Dr. Thomas saw firsthand the multitude of lives impacted by struggles with substance abuse and addiction, motivating him to seek a clinical psychiatry preceptorship at the San Diego VA Hospital’s Inpatient Alcohol and Drug Treatment Program. In his post-graduate clinical work, Dr. Thomas later applied the tenets he learned to help guide his therapeutic approach with many patients in need of substance treatment. In his current capacity as Senior Medical Editor for American Addiction Centers, Dr. Thomas, works to provide accurate, authoritative information to those seeking help for substance abuse and behavioral health issues.
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