Ecstasy (MDMA) Use, Effects, and Treatment

Ecstasy, known chemically as MDMA (3,4-methylenedioxymethamphetamine), is a synthetic drug that has gained widespread popularity among adolescents, college students, and young adults, especially in social settings like parties and music festivals.

We offer resources for support and treatment options available for those affected by ecstasy misuse.

What Is Ecstasy?

Ecstasy, scientifically known as 3,4-methylenedioxymethamphetamine (MDMA), is a synthetic substance that has structural similarities to amphetamines and displays both stimulant and hallucinogenic effects. It primarily enhances mood and cognitive function, producing effects such as increased energy, emotional warmth, and enhanced sensory perception.

This substance is most commonly consumed in the form of colorful tablets or capsules, often imprinted with distinctive logos or designs. Some users may also choose to snort the crystalline powder derived from the drug or ingest it in liquid form. Regardless of the method of consumption, the experience can vary significantly based on dosage and individual physiology, resulting in a complex interplay of effects. This variation has led to both popularity and concern regarding its use in recreational settings.

What Are Different Names For Ecstasy?

In addition to ecstasy, other historically used street names for MDMA include:

• Molly.
• E.
• X.
• XTC.
• Adam.
• Disco Biscuit.
• Hug Drug.

While in the past ecstasy was associated primarily with the rave or club scene, the use of MDMA has become more widespread in recent years.3

Among teens surveyed in 2018, more than 4% of 12th graders in the U.S. reported using ecstasy at some point in their lives.

Even some very young teens are experimenting with the drug. More than 1.5% of 8th graders reported ever having used the drug.

Despite evidence to the contrary, the myth that ecstasy is a “safe” drug continues.

How Does Ectasy Impact the Brain?

Ecstasy increases the activity of three neurotransmitters: serotonin, dopamine, and norepinephrine.

• Increased dopamine activity is associated with a boost in energy and acts in the brain reward system to strongly reinforce certain behaviors.
• Norepinephrine speeds heart rate and increases blood pressure.
• Serotonin affects mood, sleep, appetite; a surge in serotonergic activity may underlie the boost in mood, empathy, and emotional closeness sometimes experienced by those using MDMA.

While serotonin is released in abundance during ecstasy use, after use the brain becomes temporarily depleted of this neurotransmitter. This relative dip in serotonin activity could contribute to the feelings of anxiety, fatigue, and depression often associated with an ecstasy comedown. Chronically decreased active serotonin levels may contribute to the following symptoms commonly seen in regular ecstasy users:

• Bouts of depression.
• Anxiety.
• Paranoia.
• Problems with attention and memory.
• Confusion.

How Does Ectasy Impact the Body?

Many of MDMA’s effects are dose-dependent, meaning the amount of MDMA taken can have a significant impact on how the drug affects the body.

Though substance purity and total dose vary wildly, previous estimates place most tablets between 50 mg and 150 mg; however, short of analyzing the contents in a lab, the dose contained in such an illicit product is anyone’s guess. 

An unexpectedly high dose can cause significant adverse effects. Adding to the danger, people using the drug often take a follow-up dose to prolong the comedown, further risking their health. 

Additionally, ecstasy tablets, especially those sold online on the “dark net,” are more potent than ever before. According to a European study, while tablets in the ’90s and early 2000s average about 50 mg  to 80 mg, the average dose of an ecstasy tablet on the current market is now 125 mg. Some “super pills” have been marketed, with doses ranging between 270 mg and 340 mg.

Side effects that may occur from MDMA use, which may be more intense and likely to occur with higher doses, include: 

• Mild depersonalization.
• Disorganized thoughts.
• Restlessness.
• Headache.
• Jaw clenching.
• Teeth grinding.
• Stiffness in muscles and joints.
• Nausea.
• Loss of appetite.
• High blood pressure.
• Chills.
• Sweating.
• High body temperature.
• Loss of consciousness.
• Seizures.

Is Ecstasy Misuse Life-Threatening?

Many people mistakenly perceive ecstasy as a harmless recreational drug or a non-addictive feel-good substance. However, there have been numerous reports of deaths related to MDMA use.

One significant danger for ecstasy users is hyponatremia, which is an abnormally low level of sodium in the blood. Users often dance for long periods in warm environments, like clubs or parties, leading to dehydration. To combat this, ecstasy users typically drink large amounts of water.

While multiple physiological factors may contribute to this issue, excessive water intake, combined with drug-induced changes in kidney function and water excretion, results in a dilution of sodium levels in the blood. In severe cases, this can cause water to shift from the blood into the cells, leading to brain swelling. This condition can result in altered mental status, seizures, coma, and even death.

Milder symptoms of hyponatremia may include:

• Headache.
• Confusion.
• Fatigue/lethargy.
• Muscle weakness.
• Muscle cramps.
• Nausea.
• Vomiting.

The dangers associated with altered fluid balance and hyponatremia include the risk of severe increases in body temperature, known as hyperthermia. Research in animals suggests that ecstasy (MDMA) may impair the body’s ability to regulate its temperature effectively.

MDMA use is often linked to prolonged physical activity in hot environments, such as crowded dance clubs, creating a perfect scenario for dangerously elevated body temperature.

If left untreated, hyperthermia can lead to a serious condition called rhabdomyolysis, in which muscle tissue breaks down and releases its protein contents into the bloodstream. Additionally, hyperthermia may worsen electrolyte imbalances and fluid shifts, potentially resulting in kidney failure or swelling of the brain.

Understanding Ecstasy, SSRIs, and Serotonin Syndrome

People who take selective serotonin reuptake inhibitors (SSRIs)—for example, Prozac—and use ecstasy, may be at increased risk of a serious condition called serotonin syndrome. Serotonin syndrome symptoms include:

• Agitation.
• Hallucinations.
• Coordination problems.
• Abnormal movements of the eyes.
• Nausea.
• Vomiting.
• Diarrhea.
• Rapid heart rate.
• Rapidly changing blood pressure.
• Fever.
• Excessive sweating.
• Shivering.
• Tremors.
• Coma.

When treated quickly, the prognosis is good. However, untreated serotonin syndrome may progress in severity and could potentially lead to marked agitation, hyperthermia, muscle breakdown, renal damage, and death.

Can MDMA Be Laced With Other Drugs?

Illicit samples of ecstasy commonly contain other adulterant drugs and may even be completely devoid of MDMA. Other drugs that have been found in products sold as MDMA include:

• Ephedrine.
• Dextromethorphan (DXM).
• Ketamine.
• Methamphetamine.
• MDA (methylenedioxyamphetamine).
• PMA (paramethoxyamphetamine).

The truth is that no one buying ecstasy will know with certainty what drug or drugs they are consuming, so anyone seeking the desirable effects of MDMA is truly putting their health—and sometimes their life—at risk.

What Are the Signs of Ecstasy Addiction?

A person using ecstasy may believe that their consumption will never lead to problems because they perceive the substance as safe when used in moderation.

While the typical patterns of ecstasy use can differ from those of more conventionally addictive substances like cocaine and heroin, there is evidence that suggests addiction-related issues can still arise with ecstasy use. These issues may include tolerance, withdrawal symptoms, and drug cravings.

There are warning signs to watch for in individuals who use ecstasy. These signs may indicate a shift from occasional recreational use to a more problematic and compulsive pattern of drug use.

Problematic ecstasy use may include some of the following signs or changes in behavior:

• Pulling away from friends, family, coworkers, and social functions to go and get high instead.
• Inability to cut down or stop despite attempts to do so.
• Persistent use or abuse of ecstasy when it is causing emotional, financial, legal, health-related, or other problems in life.
• Spending a lot of time and energy focused on buying and using the drug.
• Using more ecstasy than originally intended (e.g., taking multiple doses before night’s end to keep the high going).

Some individuals who use this drug may exhibit outward symptoms of psychiatric problems, such as paranoia and extreme anxiety that causes panic attacks.

Finding MDMA/Ecstasy Addiction Treatment

Professional treatment for an ecstasy or MDMA use disorder may take place in various settings. Treatment will consist of therapy and behavioral interventions, since there are no approved medications to treat MDMA addiction.

The appropriate setting and treatment plan should be determined by a person’s individual needs. Factors to consider are:

• The severity of the addiction.
• The presence of any co-occurring mental health conditions.
• Facility location and available programs.
• Financing options (and whether they accept insurance).

At inpatient addiction treatment facility near Dallas, we offer comprehensive rehab for ecstasy/MDMA addiction. Our levels of addiction treatment and services include:

• Medical detox.
• Inpatient or residential treatment.
• Partial hospitalization.
• Intensive outpatient.
• Standard outpatient.
• Sober living.

To learn more about our transformative programming, rehab facility amenities, and admissions process, call us at  today. Our staff is available 24/7 to answer your questions, review rehab payment options, and check to see if your health insurance covers rehab.

You can also find out whether we accept your health insurance plan and confirm your benefits by filling out this quick and secure online form.

Don’t let your addiction reach rock bottom.

If you or someone you love is struggling with substance abuse and unsure where to turn, we are ready to help you get the treatment you need.