Addiction Drug Use Ecstasy/MDMA What to Know About Ecstasy Use By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on June 24, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Diverse Images / Getting Images Table of Contents View All Table of Contents What Does Ecstasy Do? Common Side Effects Signs of Use Myths & Common Questions Addiction & Withdrawal How to Get Help Methylenedioxymethamphetamine (MDMA), also known as ecstasy or "molly," is a synthetic drug derived from amphetamine. 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 has a high potential for abuse. 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. 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. The Effects of MDMA on the Brain 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. 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 people who use MDMA. 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 bodies 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. Off-Label Uses 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. Although 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). 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. Positive Effects Mental stimulation An increased sense of well-being Emotional warmth Empathy Feeling less reserved Decreased anxiety Increased energy Enhanced sensory perception Negative Effects Nausea Chills or hot flashes Sweating Teeth clenching Muscle cramping or stiffness Loss of appetite Disorganized thinking Dehydration Restless legs Agitation 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. Hyperthermia MDMA is often used during high-energy activities, 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. 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. Cardiovascular Effects 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. This underscores how dangerous it is to engage in activities like driving while you're under the influence of MDMA. Risky Behavior 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 habitsChills or sweatsConfusionDilated pupilsHigh and long-lasting energy levelsHigh levels of euphoriaMood changesMuscle tensingSensitive emotionsTeeth clenchingThe 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 Seizures You should contact emergency services immediately if you suspect someone has overdosed or is having a negative reaction to ecstasy. Common Questions While some consider ecstasy a safe "party" drug, it can lead to a variety of short- and long-term effects. Mood issues such as anxiety, restlessness, irritability, and sadness can last up to a week after using MDMA. People also sometimes have memory and concentration problems and experience a lack of pleasure from sex. Similarly, impulsive behavior, aggression, sleep issues, loss of appetite, and heart disease have been observed in people who regularly use MDMA. 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. Facts About Ecstasy (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 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 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. When Does Drug Use Become Dependence How Long Does Ecstasy Stay in Your System? How long ecstasy lasts and stays in your system depends on several 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. How Long MDMA Stays in Your System Addiction The National Institute on Drug Abuse (NIDA) reports that there has not been conclusive research indicating whether or not MDMA is addictive. 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. Withdrawal When you use MDMA, your brain releases a flood of neurotransmitters that bring on the uplifting effects of the drug. 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: AnxietyConfusionDifficulty concentratingDepressionFatigueInsomniaPoor 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. Cognitive-behavior therapy, individual counseling, and support groups are approaches that might be utilized in either outpatient or residential settings. 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Dunlap LE, Andrews AM, Olson DE. Dark classics in chemical neuroscience: 3,4-Methylenedioxymethamphetamine. ACS Chem Neurosci. 2018;9(10):2408-2427. doi:10.1021/acschemneuro.8b00155 Meyer JS. 3,4-methylenedioxymethamphetamine (MDMA): Current perspectives. Subst Abuse Rehabil. 2013;4:83-99. doi:10.2147/SAR.S37258 Mustafa NS, Bakar NHA, Mohamad N, et al. MDMA and the brain: A short review on the role of neurotransmitters in neurotoxicity. Basic Clin Neurosci. 2020;11(4):381-388. doi:10.32598/bcn.9.10.485 Saleemi S, Pennybaker SJ, Wooldridge M, Johnson MW. Who is “Molly”? MDMA adulterants by product name and the impact of harm-reduction services at raves. J Psychopharmacol. 2017;31(8):1056-1060. doi:10.1177/0269881117715596 Althobaiti YS, Sari Y. Alcohol interactions with psychostimulants: An overview of animal and human studies. J Addict Res Ther. 2016;7(3). doi:10.4172/2155-6105.1000281 Byock I. Taking psychedelics seriously. J Palliat Med. 2018;21(4):417-421. doi:10.1089/jpm.2017.0684 Parrott AC. MDMA and temperature: A review of the thermal effects of “Ecstasy” in humans. Drug Alcohol Depend. 2012;121(1-2):1-9. doi:10.1016/j.drugalcdep.2011.08.012 Asser A, Taba P. Psychostimulants and movement disorders. Front Neurol. 2015;6:75. doi:10.3389/fneur.2015.00075 National Institute on Drug Abuse. MDMA (Ecstasy) abuse research report. McHugh RK, Hearon BA, Otto MW. Cognitive behavioral therapy for substance use disorders. Psychiatr Clin North Am. 2010;33(3):511-525. doi:10.1016/j.psc.2010.04.012 Additional Reading National Institute on Drug Abuse. MDMA (Ecstasy/Molly) DrugFacts. By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.