Ecstasy is a stimulant and mild hallucinogenic. It is widely abused in the U.S.
Ecstasy is the most common street name of the drug 3,4-Methylenedioxymethamphetamine. Other street names include MDMA, E, XTC, X, beans, Adam, and Eve.
Ecstasy is generally sold in hard pills that can be cut with cheap and potentially dangerous chemicals. It is rare for ecstasy pills to be pure and only contain MDMA.
Molly is simply a form of ecstasy or MDMA. It is usually sold as a gel capsule that contains a liquid form of MDMA. Assuming they are not cut with different chemicals, Molly and ecstasy are essentially the same drug in different forms.
Some claim Molly is purer than ecstasy. The accuracy of such claims is difficult to determine as illegal drugs can only be analyzed if seized, and illicit producers cannot be properly regulated.
Police seizures have shown these claims of Molly’s purity are at least partially inaccurate. Molly is also sometimes cut with various chemicals.
Ecstasy is a widely used party drug, commonly taken at raves and similar events. It reduces inhibitions and causes feelings of euphoria, closeness, and empathy with others.
It tends to cause strong feelings of sexual arousal. In combination with its effect of wanting to be touched and close to others, using it leads to sexual activity. Ecstasy can also cause enhanced sensory perception, meaning such activity may feel more pleasurable than usual.
Whether ecstasy is indeed physically addictive is up for debate, but individuals can easily grow psychologically dependent on it. A report from the National Institute on Drug Abuse (NIDA) notes a survey of ecstasy users in which 43 percent met the criteria for dependence on drugs. One of the key components of these criteria is that users understand the dangers of continued abuse of the drug in question and still intend to continue use.
This same report mentions that animal studies showed evidence that ecstasy is addictive. Monkeys that were given the ability to self-administer ecstasy chose to do so — something they do not do for nonaddictive drugs.
Ecstasy can also trigger withdrawal effects when usage stops. These symptoms include fatigue, loss of appetite, depression, and trouble concentrating.
Teens and young adults are the primary abusers of ecstasy.
According to data collected by NIDA, 4.1 percent of 12th graders in 2018 had used some form of MDMA within their lifetime. Meanwhile, a national survey showed 7 percent of all people over the age of 12 had used MDMA at least once in their lifetime. Of those who are 12 or older, 0.9 percent has used ecstasy within the past year.
Adults aged 18 to 25 were the most likely to have used MDMA, with 12 percent having used it at least once in their lifetime and 3.5 percent having used it at least once in the past year. From this age group, 0.7 percent reported using it within the prior month.
According to NIDA, ecstasy can have many negative health effects. In the short term, it can lower inhibitions, increase heart rate and blood pressure, and cause muscle tension. Ecstasy can also cause nausea, a sense of faintness, chills, or excessive sweating.
Most notably, ecstasy can cause hyperthermia. This is overheating of one’s body temperature. In serious cases, this rise in body temperature can damage the kidneys and even lead to death.
There is conflicting evidence about whether ecstasy is chemically addictive. Regardless, ecstasy is known to have several long-term effects.
The DEA’s official documentation notes that MDMA can cause confusion, anxiety, depression, and paranoia even weeks after use. There is also evidence that the drug damages serotonin nerve terminals and transporters in regular MDMA abusers. This damage is noted in former MDMA users who had already stopped their use of the drug. The DEA notes it is possible ecstasy use may result in permanent memory and learning issues.
The severity of a dose of MDMA can be unpredictable. It is not presently known why severe reactions can sometimes come from mild doses, and vice versa. While there are some theories that it simply varies on an individual basis or extreme reactions are primarily due to the chemicals the MDMA has been cut with, more information is needed.
Many of the most serious cases of users overdosing on ecstasy are complicated by the fact that other drugs are also involved in the incidents (as seen in studies such as this one by the CDC). This can cause a series of symptoms that are not linked to one specific drug but to many.
Regardless, overdose from ecstasy is possible. As noted earlier, ecstasy can cause hyperthermia which can lead to kidney failure and death. The more ecstasy one takes, the greater the risk of hyperthermia and related damage.
Ecstasy doesn’t take effect for about 30 minutes if taken orally. Users may grow impatient and take more of the drug before feeling the effects of already ingested doses. This can quickly lead to overdose.
Signs of serious hyperthermia, more commonly seen in victims of heat stroke, include the following:
Serious side effects beyond those already listed could indicate an issue with the chemicals used to cut ecstasy.
To assist someone who is overdosing on ecstasy, follow these steps:
If you suspect a person who has taken ecstasy (or any other drug) is in danger. Give your location as clearly and accurately as possible.
Most states in the U.S. have Good Samaritan laws, which make it unlikely the caller or the person overdosing will be charged with a crime if seeking emergency aid. Do not hang up on this call. If you must administer aid, especially CPR, put another nearby person on the phone with the 911 operator.
If the person appears unconscious, make sure their heart is beating. Begin CPR if it is not. CPR is a priority above all else if there is no detectable pulse. Do not move the person or stop CPR unless their heart begins to beat again.
Get them to a cool place to combat hyperthermia. Place cold, wet cloths against the wrists, armpits, and/or groin. These are major sources of blood flow, and this will further help to combat hyperthermia.
If the person is able to drink safely, administer fluids like water or hydrating juices. Do not give the person alcohol or caffeine.
Once they have at least slightly stabilized, keep the person talking. This will allow you to monitor their mental state. If possible, learn all the drugs they have taken and the dosages.
Use a calm and soothing tone, as ecstasy can cause paranoia and panic attacks in some people. Inform the 911 operator of any relevant information, such as the drugs used, the person’s medical history, or any known allergies.
If the person’s condition is serious, even if they do not present with signs of hyperthermia, call 911 immediately and administer emergency aid or seek a medical professional in the immediate area. Do not attempt to move them.
Ecstasy is mainly taken in tablet form with the onset of the drug’s effects taking 30 to 45 minutes. These effects typically last three to six hours.
It then is measurably present in the body for several days after — about one to two days in blood, and three to four days in urine.
Ecstasy abuse has long-term and potentially permanent effects on the brain and serotonin reception. However, the sooner one stops abusing ecstasy, the less serious the risk and severity of such damage.
Initially, a person in recovery may be discouraged, as ecstasy abuse has been shown to severely impact the serotonin levels present in the neocortex within the early weeks of being off the drug. However, serotonin levels will begin to normalize over time. Though they may never return fully to their pre-ecstasy levels, they will be more comparable over time.
Recovery of these serotonin levels becomes increasingly difficult as one continues to abuse ecstasy. The sooner one chooses to seek help and begin the recovery process, the better.
There is some evidence that MDMA may have beneficial effects for people with PTSD or terminal illness.
In 2015, the DEA approved a study looking into its benefits for relieving terminally ill people of anxiety related to their condition.
A different study in 2016 on ecstasy’s effects for those with PTSD showed promising results, leading to the FDA greenlighting a Phase 3 trial on the matter. If such a trial shows promising results, it is possible some form of MDMA will become a legal but tightly controlled medicine in the U.S.
It should be noted that both the study into the benefits of MDMA for people with PTSD and those suffering from terminal illness were performed by medical professionals with tightly controlled doses. MDMA can potentially worsen some psychiatric conditions. One should never self-medicate for these or similar conditions with MDMA.
Ecstasy often called E, should not be confused with liquid E or liquid ecstasy, one of several street names for the common date rape drug gamma-hydroxybutyric (GHB). However, Ecstasy itself is still sometimes used as a date rape drug.
Heavy doses of ecstasy can cause confusion, intense sexual arousal, and difficulty with recall. Rapists can use these properties to subdue victims, either by secretly dosing drinks or food items or simply concealing their intentions from those who intend to engage in recreational use of the drug. It can be difficult for victims to resist or later remember the attack.
If you feel you cannot stop taking ecstasy despite the many risks involved with continued use, seek outside help through an evidence-based rehabilitation program. Addiction can be very tough to overcome without professional help.