The Effects of Ecstasy Use
Overview of Ecstasy
Ecstasy is the more common street name for 3,4-methylenedioxymethamphetamine—a highly addictive, illicit drug also known as MDMA, or "Molly." This drug shares chemical structural similarities with both amphetamine and certain hallucinogens and elicits both stimulant and sensory altering effects.1
MDMA is known by many names, including:1,2
- Lover’s Speed.
The drug was developed by a German pharmaceutical company, Merck KGaA, in 1912.3 By the 1980s, ecstasy became a popular drug in party culture thanks, in part, to a man named Alexander Shulgin—a psychopharmacologist from Harvard who began experimenting with the drug in his backyard. Soon, the drug went mainstream and began showing up at electronic music festivals, raves, and clubs.4 In 2016, 1.4 million people aged 12 or older were current users of hallucinogens (note: MDMA is categorized as a hallucinogen in this survey).5
Ecstasy came under scrutiny in 1985 when the U.S. Drug Enforcement Administration (DEA) placed an emergency ban on the substance. It was placed on the list of Schedule I drugs, meaning that it has a high potential for abuse and no accepted medical uses.2
The drug is often encountered as a colorful tablet imprinted with a logo. It may also be found in capsule, powder, or liquid form.2
Learn more about MDMA in our article, Ecstasy History and Statistics.
The Dangers of "Molly"
The following video from UMass Medical school describes why Molly isn't the safe alternative to some other drugs that some believe it to be.
Credit: UMass Medical School
Short Term Effects
Shortly after taking MDMA, the user may experience a range of effects due to the combination of stimulant and hallucinogenic properties. The acute effects of ecstasy can last anywhere from 3 to 8 hours. Potential effects include:7
- Heightened emotions.
- Heightened sense of mental clarity.
- Decreased appetite and thirst.
MDMA can be dangerous in the short term and may cause:2
- Raised blood pressure.
- Elevated anxiety.
- Blurred vision.
- Involuntary clenching of the teeth.
- Muscle tension.
Other unexpected effects may occur if the ecstasy pills are adulterated with other substances like methamphetamine, caffeine, or ketamine. MDMA users are often unaware that the product sold on the street frequently contains other substances that could be extremely dangerous when mixed with MDMA. Molly commonly contains additives such as cough medicine, bath salts, cocaine, caffeine, ephedrine, selegiline, and ketamine.2,8 In fact, at times, people will intend to buy ecstasy, but the purchased pills contain none of the substance at all.8 Effects will vary wildly from one instance of drug use to another. And mixing unknown additives with other drugs like alcohol or marijuana can significantly increase your risk of adverse side effects.8
MDMA’s intoxicating effects can last up to 8 hours. It’s common for people to take another dose when the effects of the first begin to fade. For up to a week after using the drug, a person may experience any of the following side effects:8
- Sleep problems.
- Memory problems.
- Suppressed appetite.
- Lack of interest in sex or an inability to derive pleasure from it.
- Impulsive behavior.
While rare, ecstasy overdose may cause death from hyperthermia or heart, liver, or kidney failure.8 Because it masks the need for food, water, and rest while increasing temperature and level of physical activity, this substance has also been linked to severe dehydration. Because users may drink a lot of water to counteract the dehydration, they may develop a serious electrolyte imbalance or brain swelling due to water retention.8
Because it enhances the release and activity of serotonin from certain neurons, MDMA is believed to deplete levels of serotonin throughout the brain. Because it plays an important role in pain, mood, sexual desire, and sleep, impaired serotonin neurotransmission can impart severe psychological after-effects and cognitive impairments for long periods even after use has ended.2 Without proper functioning of the neurotransmitters, conditions such as depression, anxiety, and insomnia are more likely to occur and may persist for long periods.2
People who regularly use MDMA may suffer from enduring effects. Research shows that prolonged MDMA use can also lead to:2,7
- Impaired ability to pay attention.
- Increased impulsiveness.
- Memory loss.
- Lowered interest in sex.
- Aggressive behavior.
Is Ecstasy Addictive?
Although some report becoming addicted to MDMA, research evidence and clinician viewpoints on whether MDMA is addictive vary. Some studies show that rats will continue administering MDMA in a similar way to the way they self-administer cocaine, although to a lesser degree.8
MDMA use may also lead to tolerance and physical dependence, common markers of addiction.
Someone with a growing tolerance to MDMA will need more and more to achieve the same level of effects. For example, a new user of ecstasy may take a single tablet, a semi-regular user may take several tablets, and a chronic user may take up to 25 tablets in a single session. Binge use or intense self-administration is sometimes referred to as “stacking” (taking many tablets at once) or “boosting” (taking dose after dose). Tolerance and binges are linked to higher rates of drug-related problems.9
Chronic ecstasy use may also result in a physical dependence. Someone dependent on ecstasy could experience an uncomfortable withdrawal syndrome when not on the drug. Some MDMA users report withdrawal symptoms such as:2
- Loss of appetite.
- Problems concentrating.
Repeated MDMA use may lead to compulsive using behaviors. Work, school, commitments, and relationships can easily become subordinate to the drug. Such a shift in priorities can mark the beginning of addiction, or a substance use disorder. People addicted to MDMA will be more likely to engage in dangerous, risky, or illegal activity to get more in spite of the possible repercussions.10
Ending a period of ecstasy use—one that has occurred at high levels, or for an extended period of time—is a difficult process and one that can benefit immensely from professional treatment. Given that some MDMA users may essentially be self-medicating for stressful life events, professional substance abuse treatment approaches that integrate especial attention to mental health issues can help individuals address emotional traumas and conflicts that fuel their MDMA abuse.11
There are no medications specifically approved for the treatment of MDMA addiction, so the crux of treatment will be therapy, in which the individual will work to understand the nature of their addiction and their triggers.8 The most effective treatments for people struggling with an MDMA use disorder are cognitive behavioral interventions. These types of therapies are designed to help a person become more mindful about their thoughts, behaviors, and expectations.
Using cognitive behavioral therapy will help a person learn coping skills so they don't turn to MDMA for relief from their stressors. People who are recovering from an MDMA use disorder may also find an enormous amount of hope and relief through attending recovery support groups. Becoming part of a weekly group is a great and cost-effective way to support long-term recovery.12
When you are ready to find a treatment program, you can search online. Before calling, it may help to create a list of questions to ask. It’s always a good idea to be as prepared as possible before you choose a rehab. If you have questions about insurance, payment plans, types of therapy used, or average length of stay, make sure to discuss these with any potential programs. If you do have insurance, have your card and ID number handy. You can call the number on the back of the card to see what your insurance plan covers.
- National Institute on Drug Abuse. (n.d.). Methylenedioxy- methamphetamine (MDMA).
- National Institute on Drug Abuse. (2018). Commonly Abused Drugs.
- Passie, T., & Benzenhöfer, U. (2016). The history of MDMA as an underground drug in the United States, 1960–1979. Journal of psychoactive drugs, 48(2), 67-75.
- The Atlantic. (2013). Electronic Dance Music’s Love Affair With Ecstasy: A History.
- Substance Abuse and Mental Health Services Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health.
- National Institute on Drug Abuse. (2017.). What is the history of MDMA?
- Scientific American. (n.d.). What are the effects of the drug Ecstasy?
- National Institute on Drug Abuse. (2018). MDMA (Ecstasy/Molly).
- Parrott, A. C. (2005). Chronic tolerance to recreational MDMA (3, 4-methylenedioxymethamphetamine) or Ecstasy. Journal of Psychopharmacology, 19(1), 71-83.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Moonzwe, L. S., Schensul, J. J., & Kostick, K. M. (2011). The Role of MDMA (Ecstasy) in Coping with Negative Life Situations Among Urban Young Adults. Journal of Psychoactive Drugs, 43(3), 199–210.
- National Institute on Drug Abuse. (2017). How are MDMA use disorders treated?