MDMA, or Molly, is a synthetic stimulant with psychedelic effects. It can produce feelings of energy, distortions in time and perception, heightened sensory stimulation, empathy toward others, increased sexual drive, and a sense of wholehearted happiness.1, 2 Pure MDMA may be found as a pale crystalline powder form, though pressed pills are also used. Ecstasy is the term (or the “brand” for an illicit product, essentially) commonly used to designate a pill form of MDMA, which often contain other substances like methamphetamine, ketamine, cocaine, or caffeine—substances which can further lead to unpredictable effects and consequences.1
MDMA/ecstasy is a common club and party drug due to its euphoric and energizing effects. The effects of ecstasy begin approximately 30 to 45 minutes after you take the pill and can last as long as six hours, depending on the concentration and purity of the drug.1 The immediate effects of MDMA vary from person to person, especially if it is combined with other substances, as it often is with ecstasy pills.
MDMA creates its effects primarily by altering the activity of three central chemicals in the brain:2
- Serotonin, which is related to mood, sleep, appetite, and sexual arousal.
- Dopamine, which affects energy and activity levels, as well as euphoric feelings.
- Norepinephrine, which increases a person’s heart rate and blood pressure.
While once considered a relatively benign drug, a number of incidents involving MDMA use have demonstrated some serious risks involved with abuse of the drug: MDMA/ecstasy was involved in 22,498 emergency department visits in 2011.3
Despite the undeniable medical risks, rates of MDMA use remained stable from 2002 to 2014, with 609,000 people reporting past-month use in 2014.4 Clearly, while MDMA use may seem like a simple way to have a good time, the potential consequences can be disastrous.
SHORT-TERM SIDE EFFECTS OF MDMA/ECSTASY
The pleasurable effects of MDMA go hand-in-hand with the potentially risky side effects, and not everyone who tries ecstasy will have a good experience. Aside from the desired euphoric high, those who abuse ecstasy and MDMA may experience a number of undesirable health effects.
Some users may find themselves suffering from:5
- Muscle cramps.
- Blurred vision.
- Excessive sweating.
- High body temperature.
One of the most dangerous effects of an MDMA high is the drastic increase in body temperature, also known as hyperthermia, which can ultimately lead to liver, kidney, and cardiovascular failure—and in some instances, death.1
The days following MDMA use can be difficult for some users. Nearly 80% of users experience exhaustion and depression in the days following use, likely due to serotonergic depletion.6 These short-term effects can be uncomfortable, but the long-term risks are where MDMA’s danger truly lies.
WHAT ARE THE LONG-TERM SIDE EFFECTS?
When used long-term, MDMA can have severely detrimental effects on the user. One of the biggest concerns is neuronal damage. Very high single doses and successive moderate doses have demonstrated damaging effects on serotonergic neurons in higher brain regions like the neocortex of animals like rats and primates.6
Neuronal changes due to long-term MDMA abuse might help to explain a number of the associated unpleasant side effects, including:2, 6
- Sleep problems.
- Decreased appetite.
- Lower sexual drive.
In addition, some studies have found cognitive performance deficits in long-term, heavy users.6
There is some question as to whether the cognitive impairments are due to MDMA use alone or to heavy drug use in general, since many MDMA users also engage in other substance use.6 There is evidence that the persistent cognitive impairments seen in moderate MDMA users are no more severe than those seen in heavy drug users in general, but that poly-drug use in conjunction with MDMA might increase these risks.7