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Substance Use: Ecstasy

Accordion Content

  • MDMA (3,4 methylenedioxymethamphetamine), also known as ecstasy (E, X) or molly, acts as a synthetic psychoactive drug, primarily affecting the secretion of serotonin, dopamine, and norepinephrine in the brain. The drug causes an influx of these chemicals into the body resulting in feelings of openness, connectedness, energy, empathy, and euphoria. The mechanism by which MDMA affects the neurochemical concentrations is largely unknown. According to, the initial effects of MDMA include heightened sensitivity and the onset of emotional changes. The peak of an ecstasy high is associated with an intense emotional state where the user feels an overwhelming sense of empathy and a desire to engage in intimate conversations with friends or family. Exhaustion is masked by the release of serotonin leading to the energetic state that accompanies the emotional.

    The comedown from ecstasy involves a rapid decline in energy, which is mainly attributable to the lack of nourishment during the high. Besides the exhaustion, some users may find themselves dehydrated as their sense of thirst was masked via the effects of MDMA on the brain. It is important to drink water while high on ecstasy, especially due to the high temperature in the club and due to non-stop dancing. At the same time, however, it is dangerous to consume too much water, a condition known as hyponatremia, since it may result in death. However, most ecstasy related deaths occur due to overheating, generally a result of constriction of the blood vessels keeping the body’s core warm along with the club atmosphere.

    After getting high, exhaustion or depression may result for the next few days. Mood swings are common since the serotonin levels have dropped dramatically after the influx caused by MDMA. It takes up to a week to regain neurochemical balance within the brain. Some users may take 5-HTP, a supplement that is a precursor to serotonin, to replenish their serotonin supplies, but there is no proof that this in fact works to re-establish the baseline levels within the brain. Weekly users may come to experience cyclical emotions, with the "roll" being the peak of happiness and the few days after filled with depression. Often, this leads to mental addiction as individuals come to desire the high.

    The effects of MDMA are chemically similar to other drugs such as methamphetamine. Users experience similar immediate physical effects when using X such as increased blood pressure, increased heart rate, teeth clenching, muscle tension, nausea, blurred vision, chills, and faintness. On a longer-term scale, the damage done to the serotonin releasing neurons within the brain may ultimately affect users memory, thinking abilities, judgment, and mood. Memory may be lost in people who are even occasional users.

  • In 1914, Merck was granted the patent for MDMA. At this point in time, MDMA was not being used independently as a drug. Rather, it was merely an intermediate in the chemical synthesis of styptic, a drug used in the control of bleeding from wounds. Eventually, MDMA came to be used as a recreational drug and assistant in psychotherapy until it was made illegal by the DEA in 1985 through classification as a Schedule I drug. The use of MDMA for purely recreational purposes did not truly spread until the early ‘80s, first within the "yuppie" culture and then into gay dance clubs. It later became prominent within the rave scene, and with rave culture came use of MDMA by college- and then high school-aged youth. MDMA is currently being studied in clinical trials to re-assess the therapeutic effects of MDMA, including for treatment of PTSD and anxiety in autistic adults and patients with terminal illness.

  • Methylene-dioxymethyl amphetamine (MDMA), more commonly known as ecstasy, is classified as a synthetic stimulant and hallucinogen. While pure MDMA is a white powder, most ingested ecstasy comes in a colorful pill form. The pill itself typically consists of starch/talcum powder, food dye, and fewer than 100 mg of MDMA,. Taken in pill form, ecstasy is known by various other names as well, such as "E," "X," "XTC," "Adam," "hug," "beans," and "love drug."

    Street pills themselves may also be mixed with active substances, such as methamphetamine, caffeine, acetaminophen, ketamine, 2C-B, 2C-T-7, and ephedrine. Some pills may contain harmful hallucinogens or psychedelics, like PMA or DXM, or they may contain analogs of MDMA, like MDA, MBDB, or MDEA. In certain cases, it is even possible that the drug sold under the title ecstasy may not contain any MDMA at all and is instead composed of aspirin, amphetamine, or other drugs/innocuous substances. The pills normally have various names (Mitsubishi, Dolphin, Dove, etc) and stampings, which are intended to indicate quality. However, due to imitation, the stampings become virtually meaningless as inferior quality ecstasy competes with higher quality ecstasy of the same logo/name.

  • Ecstasy is ingested, typically in pill form. The process is commonly referred to as "rolling," "pilling," "dropping," or "thizzing." Never take more than two pills in one evening – the risks are too high – and never take two pills at the same time (it increases the risk of overheating and neurotoxicity)

  • Alcohol: Avoid alcohol as it may disrupt normal bodily temperature. The combination of MDMA with alcohol’s effects may increase the chance of death by overheating.

    Diet drinks: Avoid diet drinks as they may increase the neurotoxicity of MDMA.

  • Within the gay community, ecstasy has been widely used as a club drug since the ‘80s. However, the newest combination of ecstasy and Viagra, known as "sextasy" (or "trail mix," "hammer heading," or "cocktail pills") is a growing trend within the community. Sextasy can come in the form of two pills, a single pill containing both drugs, or it may be a snorted combination of the two.

    Within the gay community, ecstasy has been widely used as a club drug since the ‘80s. However, the newest combination of ecstasy and Viagra, known as "sextasy" (or "trail mix," "hammer heading," or "cocktail pills") is a growing trend within the community. Sextasy can come in the form of two pills, a single pill containing both drugs, or it may be a snorted combination of the two.

    This physically risky combination also has repercussions that may include getting AIDS or other STD’s. Ecstasy induces a sense of well-being that may prevent men from thinking about the necessity for safe sex. The euphoric state combined with Viagra, allows these feel-good feelings to be combined with the ability to engage in sex over a long period of time. With this care-free sexual attitude comes a much greater risk of getting AIDS or other STD’s as users of sextasy lose their sexual inhibitions, leading to multiple partners and barebacking when people would normally not engage in these behaviors. Users should make sure they keep condoms and lube in an easily accessible and convenient area so they are sure to use them while "rolling."

    For information about treatment and resources for help with an addiction please check out our resources page.