Table of Contents
Ecstasy/MDMA Addiction, Abuse, and Symptoms


The Basics

MDMA causes increases in mood, energy, and pleasure and can distort someone’s sense of time and place. Because of these effects, the drug is primarily abused by people looking to feel good or have a good time, often in a party scene. The effects of MDMA are both psychedelic and stimulating in nature, and many people experience a reduction of inhibitions when they’re on the drug.

Ecstasy is a tablet form of MDMA. However, the tablets don’t always contain pure MDMA. Ecstasy tablets have been shown to have other drugs included, such as cocaine, ephedrine, meth, caffeine, and over-the-counter cough medicine. The unknown formulation that can be present in ecstasy can make taking these pills extra risky and dangerous, especially when someone has also been drinking.

One of the immediate dangers of ecstasy abuse is toxicity, which occurs when someone has overdosed. This can lead to hallucinations or emergency physical problems related to the heart, neurological system, or cerebrovascular system. Potential long-term effects of MDMA abuse can include depression, problems with memory or concentration, heart disease, aggression, and anxiety.

Primary Ecstasy Dangers

  • Addictiveness. A comprehensive study conducted by Nutt et. al. in 2007 looked at the addictive and harmful natures of various types of drugs. During that study, the researchers had independent experts rate various drugs and calculated the average ratings each substance received for various factors. Ecstasy scored an average rating of 1.13 out of 3.0 for dependence, which is on the lower side of the list of drugs considered in the study. Only solvents, alkyl nitrates, and khat scored lower.
  • Risk of overdose. According to the Centers for Disease Control and Prevention, overdoses related to psychostimulant drugs is on the rise. In 2017, more than 10,000 people in the U.S. died from overdoses, reflecting a concerning 37% increase when compared to just the year before. West Virginia and Alaska had the highest overdose rates among the 50 states, although the Midwest region saw the highest increase year over year.
  • Unintended side effects. Some common side effects of MDMA include dehydration, disorganized thoughts, sweating, headache, panic attacks, restless legs, and lack of appetite. More serious side effects can include brain swelling, hyperthermia, and kidney failure.
  • Legal Risks. Ecstasy is a Schedule I drug. Trafficking can result in up to 20 years in prison and up to $1 million in fines for a first offense. Even just possession of a controlled substance carries stiff legal penalties, though they vary by state.

Ecstasy Background Information

Derived From A synthetic substance created in clandestine labs
Ways Used Swallowing via tablets, sometimes smoked or snorted in a crushed form, rarely injected
Scientific Name MDMA, methylenedioxy-methylamphetamine
Slang/Street Names for Ecstasy Molly, X, XTC, beans, clarity, hug drug, disco biscuit, eve, go, lover’s speed, peace
How Long in Bodily System Half-life: 7 hours

MDMA is metabolized by the liver into a secondary substance, which has a longer half-life. It can take up to four days for this secondary substance to leave the body.

Punitive Legal Measures: Using/Possession First-time offenders can face up to a year in prison. Some state laws may come into play to determine the exact length of sentencing and any associated fines.
Punitive Legal Measures: Selling/Distributing First-time offenders selling or distributing MDMA can face up to 20 years in prison and up to $1 million in fines.
DEA Drug Rating Schedule I

Signs of Ecstasy Abuse

Behavioral Symptoms of Ecstasy Usage and Abuse

How ecstasy affects the brain

Ecstasy and other versions of MDMA have an impact on three specific chemicals in the brain. This impact is what causes the high associated with the drug.

  • Serotonin is the chemical that helps to impact how you feel emotionally; it also helps regulate functions such as sleep, hunger, and sexual arousal.
  • Norepinephrine can increase your blood pressure and heart rate when increased levels of it occur in your body.
  • Dopamine is normally how your body rewards itself for good behaviors; it’s a pleasure hormone that helps you feel energized and happy.

Ecstasy causes unnaturally high releases of all three of these chemicals, so you feel increased pleasure, energy, and happiness without the natural triggers to which your body normally responds. Additionally, if those triggers are present, then you may experience a greater-than-normal reaction to them. While that sounds nice, it does have an unnatural impact on your brain and body.

Behavioral signs of Ecstasy usage and abuse

Individuals currently abusing ecstasy may demonstrate heightened perceptions and increased feelings of a positive nature, especially in response to sensations. They might have an unnaturally long level of energy, still going strong after everyone else has grown physically and mentally tired of the activity at hand. Because of the increase in sensory response, individuals on MDMA may seek out activities that increase sensations, including physical touch and intimacy.

Behavioral signs of regular ecstasy abuse can include staying up for days at a time, becoming paranoid or impulsive, and problems with cognitive function, including memory or focus. Some people may start to clench their teeth regularly or display other tension around the mouth.

Physical Symptoms of Ecstasy Abuse

How Ecstasy affects the body

MDMA’s effect on the “pleasure” chemicals of the brain reaches throughout the entire body. The drug can make you feel warm, both physically and emotionally. Since it ramps up norepinephrine, it can lead to increases in blood pressure and heart rate. The results can range from mild, such as physical flushing, to extreme and severe, such as cardiac arrest.

Ecstasy often causes someone to feel so much extra energy that they’re abnormally active for longer periods of time — whether or not their body is in the right shape to sustain that type of activity without health concerns. That can drive up body temperature, especially since MDMA itself interferes with your body’s ability to naturally regulate temperature.

While ecstasy tends to increase your perception of sensations, it doesn’t actually heighten your overall awareness and ability to respond. In fact, in the hours after taking the drug, these functions in your body can actually suffer, and you may not be able to perceive and respond to motion as well as you normally are. This can make operating machinery, such as driving a car, very dangerous and even add risk to everyday physical activity, such as walking or running.

Early physical effects of ecstasy

The effect of ecstasy may begin around 45 minutes after taking the drug. Typically the first physical effects are a feeling of warmth, well-being, and sensory perception. Potential adverse health effects may be seen as early as the first hour of taking ecstasy, depending on how big the dose is, your own health and unique personal factors, and what else might be included in the drug you take.

This table illustrates the possible short-term physical effects associated with ecstasy.
Short-term Physical Symptoms
Initial (direct effects of drug, 30 – 60 min.) Emotional warmth
Enhanced sensory perception
Feelings of happiness
Jaw clenching
Lingering (within an hour of taking the drug) Increased blood pressure
Panic attack
Elevated body temperatureHot flashes and sweating or chills
Post-Use (several hours to days after use) Dehydration
Electrolyte imbalance
Loss of consciousness
Inability to properly perceive motion
Sleep disturbances
Difficulty concentratingBrain swelling

Severe and long-term physical effects of ecstasy

Long-term or heavy use of MDMA, including ecstasy, can lead to severe physical consequences. In fact, even occasional recreational use of ecstasy can have far-reaching implications for your brain and body.

One concern when using ecstasy is the impact from “stacking.” Your body metabolizes ecstasy in a certain way that creates secondary chemicals, and those chemicals then remain in your body for some time. Simultaneously, the changes that occurred to your serotonin levels aren’t corrected right away. Both of these factors mean that if you use ecstasy within a few days of the last time you used it, the impact to your body can be compounded by a stacking effect — that doesn’t mean you get a better high, but it does mean you put yourself at greater risk of long-term complications.

Some of those physical effects can include damage to your heart or an irregular heartbeat, depression and anxiety, problems with memory and cognition, inability to sleep well, changes in your appetite, and kidney problems.

This table illustrates the possible long-term physical effects associated with ecstasy
Long-term Physical Symptoms
Casual Lack of appetite
Sleep disturbances
Difficulty concentrating
Chronic (Including all of the above effects for casual use) Arrhythmia
Impaired cognitive function
Heart disease
Kidney failure
Withdrawal Cravings
Loss of appetite
Mental confusion

Further Resources

Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on both the symptoms and treatment of prescription stimulant addiction.

Ecstasy Usage

MDMA used more often in wealthier nations

According to data from the United Nations Office on Drugs and Crime, ecstasy is most prevalent in nations in Europe and in Australia. UNODC maps indicate that nations with the highest prevalence of ecstasy use include the Netherlands, Ireland, Australia, and New Zealand. Typically, MDMA use tends to be higher in westernized or wealthier nations, as the drug tends to align with leisure and party scenes.

UNODC estimates that between 8.4 million and 40.3 million people across the globe have abused ecstasy. That’s between 0.41% and 0.78% of the global population, although, obviously, rates of ecstasy use are higher in some areas.

Ecstasy Use Throughout the World
Highest Second Third
Regions with the Highest Number of Prescription Stimulant Users Europe Australia and New Zealand North America
Countries with the Highest Prevalence of Ecstasy Drug Use Netherlands (3.8%) New Zealand (2.4%) Australia (2.2%)

Ecstasy Usage Demographics in the U.S.

Adolescent ecstasy use has decreased but still exists

According to the National Institute on Drug Abuse for Teens, teen use of ecstasy has decreased since 2014. However, it’s still a drug of choice for older adolescents who want to use an illicit drug socially or at parties. In part, this may be because adolescents perceive ecstasy as a “low-harm” drug, as it’s less addictive than substances such as opioids or cocaine.

The NIMH notes that the most likely demographic to use MDMA is males who are age 18 to 25. In fact, use typically begins after the age of 21 as individuals are old enough to enter college-age drinking and party scenes where ecstasy is more likely to be available.

MDMA Use Among High Schoolers
Past Year (2018) Lifetime
8th grade (14-15 yo) 1.1% 1.6%
10th grade (15-16 yo) 1.4% 2.4%
12th grade (17-18 yo) 2.2% 4.1%

How to Find Help

Because of its relationship with pleasure and partying, ecstasy often has a less-than-serious reputation, especially among younger people. However, MDMA is a Schedule I drug with harsh legal consequences for anyone caught in possession of or selling the drug. It can also have life-threatening effects, particularly when someone stacks use. Long-term use of ecstasy can result in issues including renal failure, hyperthermia, and heart attack.

While ecstasy isn’t as addictive as some other drugs, it is possible for individuals become dependent both physically and psychologically on MDMA, depending on their unique circumstances. According to Jeremy Barnett, Credentialed Alcoholism and Substance Abuse Counselor, “While research is unclear on the potential for dependency to MDMA, the challenge in treatment is often sociocultural, more so than physiological or psychological. Those at risk for MDMA abuse are often in social environments where MDMA is readily accessible, such as nightclubs and large parties. Lifestyle changes are essential for sobriety from all substances, particularly so for MDMA.”

Furthermore, ecstasy use and abuse can also lead to a risky lifestyle that makes abuse of other substances more likely. Seeking early intervention can help prevent negative legal and health consequences. To learn more about seeking treatment, read our ecstasy rehabilitation guide, which provides a comprehensive look at resources for starting this process.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention

1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.