The combination of unregulated labs and unpredictable ingredients makes taking ecstasy extremely risky. Ecstasy is made in illegal laboratories, often hidden from law enforcement because making the drug is illegal in most countries. Even though parts of MDMA come from plants, the drug itself is not considered natural and can have very unnatural, and sometimes deadly, effects on the body. The drug is made in illegal labs without any safety regulations, meaning that harmful chemicals can get mixed in.

Risks of MDMA use

In animals, MDMA causes neurotoxicity, as evidenced by anatomical changes in axon structure and a persisting reduction in brain serotonin levels. Other chemical names include N,α-dimethyl-3,4-methylenedioxyphenethylamine or, less usually, N-methyl-1-(1,3-benzodioxol-5-yl)-2-propanamine. Information provided by NIDA is not a substitute for professional medical care or legal consultation. However, the FDA has designated MDMA a breakthrough therapy to expedite research for it as a treatment for post-traumatic stress disorder. However, to be diagnosed with a substance use disorder, a person must meet specific diagnostic criteria for continued substance use despite negative consequences. Studies have also shown that animals will self-administer MDMA—an important indicator of a drug’s addictive potential.

MDMA is more likely to lead to a serious emergency, like an overdose, if it’s been cut with another drug. As is common with unregulated drugs, MDMA available for purchase is sometimes combined, or “cut,” with other drugs. The drugs methamphetamine and cathinone (bath salts) are also part of this group. However, some researchers are studying ways that MDMA might be useful as a treatment for certain mental health conditions. MDMA is classed as a Schedule 1 controlled substance and is illegal in the United States. MDMA is often called molly or ecstasy and is frequently taken in pill or capsule form.

Therapeutic uses of MDMA

Ecstasy is a synthetic drug, meaning it’s made in a lab. You will begin to feel its effects within 30 to 45 minutes. How long does it take for ecstasy to kick in?

• Between the 1970s and the mid-1980s, this network of MDMA users consumed an estimated 500,000 doses.
• This makes ecstasy use incredibly dangerous, especially in social settings where multiple doses might be taken throughout the night.
• While not addictive like heroin or cocaine, ecstasy use may lead to dependence.

In 2023, an estimated 0.4% of eighth graders (13 years old) said they used ecstasy in the last year. An estimated 75,000 kids aged 12 to 17 reported using ecstasy in 2023. In 2023, more than 1.5 million adults in this age group used ecstasy compared with about 520,000 adults aged 18 to 25. The federal survey found that ecstasy was most popular among adults aged 26 and older.

Detection in body fluids

Most commercial amphetamine immunoassay screening tests cross-react significantly with MDMA or its major metabolites, but chromatographic techniques can easily distinguish and separately measure each of these substances. However, MDA shows much more potent and efficacious serotonin 5-HT2A, 5-HT2B, and 5-HT2C receptor agonism than MDMA. Like MDMA, it acts as a potent and well-balanced SNDRA and as a weak serotonin 5-HT2 receptor agonist. (R)-MDMA is more potent and efficacious as a serotonin 5-HT2A and 5-HT2B receptor agonist than (S)-MDMA, whereas (S)-MDMA is somewhat more potent as an agonist of the serotonin 5-HT2C receptor. In addition, both (S)-MDMA and (R)-MDMA are weak agonists of the serotonin 5-HT2 receptors.

This article is purely informational and not intended to be a substitute for professional medical advice, diagnosis, or treatment. And Widdop, B, (eds.) (2004), Clarke’s analysis of drugs and poisons, 3rd edn, Vol. (eds.) (2004), Clarke’s analysis of drugs and poisons, 3rd edn, Vol. Street terms for MDMA include Adam and XTC, but often reflect the imprinted logo, e.g.

• Mostly known as a ‘party drug,’ MDMA may also have use in therapy for PSTD, anxiety, eating disorders, and more.
• NIDA is a biomedical research organization and does not provide personalized medical advice, treatment, counseling, or legal consultation.
• People assume that molly is safer than ecstasy because it’s supposed to be just MDMA, without the extra harmful substances often found in ecstasy pills.

One mechanism by which tolerance to MDMA may occur is internalization of the serotonin transporter (SERT). Accordingly, MDA produces greater psychedelic effects than MDMA in humans and might particularly contribute to the mild psychedelic-like effects of MDMA. However, this proved not to be the case in a direct clinical comparison of (R)-MDMA, (S)-MDMA, and racemic MDMA, with equivalent hallucinogen-like effects instead found between the three interventions. Both (S)-MDMA and (R)-MDMA produce entactogen-type effects in animals and humans. Relatedly, (R)-MDMA shows weak or negligible stimulant-like and rewarding effects in animals. (S)-MDMA is much more potent as an SNDRA in vitro and in producing MDMA-like subjective effects in humans than (R)-MDMA.

Reporting countries

Before and during your time on ecstasy, drink one 16-ounce bottle of water for every hour that passes while on the drug. If you do use it, it’s important to know how to reduce the risk of overdose and other serious consequences. If you communicate your problems about ecstasy and express the desire for help, you can avoid substance use disorders. Although there are no medications to help you stop using ecstasy, some people who have had issues with ecstasy have reported that behavioral therapy can help.

What to do if you or someone you’re with overdoses on ecstasy Taking too much ecstasy can lead to a potentially fatal overdose. It’s important to know that the effects of ecstasy will be different from person to person. When you take ecstasy, the drug affects a variety of brain chemicals called neurotransmitters.

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MDMA’s toxicity in overdose may be exacerbated by caffeine, with which it is frequently cut in order to increase volume. MDMA overdose symptoms vary widely due to the involvement of multiple organ systems. Therefore, chronic use of MDMA at high doses can result in altered brain structure and drug addiction that occur as a consequence of ΔFosB overexpression in the nucleus accumbens. Tolerance Ecstasy ingredients to some of the desired and adverse effects of MDMA is expected to occur with consistent MDMA use. Some of these symptoms include fatigue, loss of appetite, depression, and trouble concentrating.

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Even small doses of ecstasy can harm your mental, physical, or emotional well-being. It increases levels of energy, happiness, and empathetic feelings toward others but also causes negative effects, from muscle cramps to depression to heart failure. Ecstasy — also known as Molly, Adam, and XTC, among many other names — is a synthetic drug, meaning it is made from lab-made chemicals.

Overdose

By inducing release and reuptake inhibition of serotonin, norepinephrine, and dopamine, MDMA increases levels of these neurotransmitters in the brain and periphery. To a lesser extent, MDMA also acts as a serotonin–norepinephrine–dopamine reuptake inhibitor (SNDRI). In contrast to the cases of serotonergic and noradrenergic agents, the dopamine D2 receptor antagonist haloperidol did not affect the cardiovascular responses to MDMA. The dual α1- and β-adrenergic receptor blocker carvedilol reduced MDMA-induced heart rate and blood pressure increases. The α1-adrenergic receptor antagonists doxazosin and prazosin blocked or reduced MDMA-induced blood pressure increases but augmented MDMA-induced heart rate and cardiac output increases. On the other hand, the robust NDRI methylphenidate, which has sympathomimetic effects of its own, has been found to augment the cardiovascular effects and increases in circulating norepinephrine and epinephrine levels induced by MDMA.

It’s possible that MDMA could be legal in certain medically approved situations in the future. These treatment methods show promise but need further study and haven’t yet been approved. Mostly known as a ‘party drug,’ MDMA may also have use in therapy for PSTD, anxiety, eating disorders, and more. While ecstasy may not be addictive, its use can be fatal.

About MDMA

The contributions of these metabolites to the psychoactive and toxic effects of MDMA are an area of active research. It is thought that brain serotonin levels are depleted after MDMA administration but that levels typically return to normal within 24 to 48 hours. Although MDMA and serotonin are not significant TAAR1 agonists in humans, TAAR1 activation by MDMA may result in SERT internalization, for instance in rodents in whom MDMA is a potent TAAR1 agonist.