What is MDMA?

MDMA is a synthetic drug that acts as a stimulant and hallucinogen. It produces an energizing effect, distortions in time and perception, and enhanced enjoyment from sensory experiences. It has also been described as an entactogen—a drug that can increase self-awareness and empathy.

Ecstasy is often used to refer to MDMA in the tablet or capsule form, which is the most common way people take the drug. Researchers have determined that many ecstasy tablets contain not only MDMA at different concentrations, but also a number of other drugs or drug combinations that can be harmful. Adulterants found in ecstasy tablets purchased on the street have included methamphetamine, the anesthetic ketamine, caffeine, the diet drug ephedrine, the over-the-counter cough suppressant dextromethorphan, heroin, phencyclidine (PCP), and cocaine.

How is MDMA used?

MDMA is most often available in tablet or capsule form and is usually ingested by mouth or crushed and snorted.

Ecstasy traffickers consistently use brand names, colors and logos as marketing tools and to distinguish their product from that of competitors. The logos may be produced to coincide with holidays or special events. Among the more popular logos are butterflies, lightning bolts, and four-leaf clovers.

It is also available as a powder and is sometimes snorted, taken as a liquid, and it is occasionally smoked but rarely injected. The drug’s effects generally last from 3 to 6 hours.

Users may take several tablets at once or in succession over a period of time. Abusers may also use in conjunction with other psychoactive drugs like LSD. As with many other "party drugs", ecstasy is rarely used alone and it is frequently combined with alcohol and marijuana.

What are the effects of MDMA use?

MDMA stimulates the release of neurotransmitters, such as serotonin and norepinephrine, from brain neurons producing a high that lasts from 3 to 6 hours, but the length of a high is variable based on the user. The drug's rewarding effects vary with the individual taking it, the dose taken, purity of the MDMA, and the environment in which it is taken.

MDMA can produce stimulant effects such as an enhanced sense of pleasure and self-confidence and increased energy. Its psychedelic effects include feelings of peacefulness, acceptance, and empathy.

How does MDMA affect the brain?

MDMA exerts its primary effects in the brain on neurons that use the chemicals serotonin, dopamine and norepinephrine to communicate with other neurons.

Serotonin is most likely responsible for the feelings of empathy, elevated mood, and emotional closeness experienced with this drug. Overall, these neurotransmitter systems play an important role in regulating:

• mood
• energy/activity and the reward system
• appetite
• aggression
• sexual activity
• sleep
• sensitivity to pain
• heart rate, blood pressure

How dangerous is MDMA?

Shorter-term health effects include:

• nausea
• muscle cramping
• involuntary teeth clenching
• blurred vision
• chills
• sweating / hyperthermia

Also, there is evidence that people who develop a rash that looks like acne after using this drug may be at risk of severe side effects, including liver damage, if they continue to use the drug. 

Because use promotes trust, closeness, empathy, and enhances sexual desire, the risk of unsafe sexual practices may increase, resulting in HIV/AIDS, hepatitis, or other sexually transmitted diseases.

Damage to brain serotonin neurons can occur; serotonin is thought to play a role in regulating mood, memory, sleep, and appetite. Studies are conflicting on MDMA use and its affects on memory and cognition.

Can I get addicted to MDMA?

Research results are controversial on whether MDMA can be addictive. Some people do report signs and symptoms of addiction. Almost 60% of people who use Ecstasy report some withdrawal symptoms, including fatigue, loss of appetite, depressed feelings, and trouble concentrating.

Users may encounter problems similar to those experienced by amphetamine and cocaine users, including addiction. Research has shown that animals will self-administer MDMA, an indicator of a drug's abuse potential.

Some people who use MDMA do report symptoms of addiction, including continued use despite negative consequences, tolerance, withdrawal, and craving, according to the NIH.

After moderate use of the drug over one week, psychological and physical effects due to withdrawal may include:

• irritability
• depression
• confusion
• agression and impulsiveness
• muscle cramps
• problems with sleep
• anxiety
• memory deficits
• loss of attention
• nausea and decreased appetite
• loss of interest in sex