• Ecstasy is an illegal synthetic drug that is both a nervous system stimulant and an hallucinogen.
  • In high doses ecstasy can cause seizures and vomiting.
  • Ecstasy may also contribute to death as a result of heart attack, stroke, overheating or if a person drinks too much water.
  • In an emergency, dial triple zero (000) to call an ambulance.
  • Plan ahead what you would do in an emergency and don’t delay seeking help because you think you or your friend might get into trouble.

What is ecstasy?

Ecstasy is the common name for the illegal synthetic drug called methylenedioxymethamphetamine (MDMA). It is both a stimulant and an hallucinogen, since it speeds up the workings of the central nervous system and alters the user's perception of reality. 

Ecstasy is commonly used as a mood enhancer at parties and nightclubs. In high doses, ecstasy can cause seizures and vomiting or may contribute to death.

Common slang terms for ecstasy include the 'love drug', 'E' and 'eckies'. Ecstasy is usually swallowed as a tablet, but can come in powder form. There have also been reports of crystal MDMA in Australia and Victoria in recent years. 

The effects of ecstasy are usually felt about 20 minutes to an hour after it is taken and last for around six hours. The comedown (or return to normal as the drug leaves the body) may last one to two days or up to a week. 

How ecstasy is used

MDMA was originally developed in Germany. Today ecstasy is generally made in illegal laboratories, which means the person taking it has no idea if the dose will be strong or weak, or even if it will contain any MDMA at all. It is possible for pills sold as ecstasy tablets to contain little or no MDMA. They may contain other chemicals such as amphetamines, PMA or ketamine, which may have unexpected or dangerous effects.

How ecstasy works

When we are stressed or under threat, the central nervous system readies us for physical action by creating particular physiological changes. These may include the release of adrenalin and other stress hormones. Key functions like heart rate and blood pressure may increase, redirecting blood flow into the muscles and away from the gut. 

As a nervous system stimulant, ecstasy works by prompting the brain to initiate this 'fight or flight' response and the user feels refreshed by a burst of energy. Ecstasy's hallucinogenic properties distort the user's experience of reality by triggering hallucinations of both sight and sound. 

Ecstasy is renowned for the feelings of peace and love it invokes. This could be caused by an elevation in particular brain chemicals, or neurotransmitters, such as serotonin and dopamine. 

Coming down from ecstasy is an unpleasant experience. Symptoms can include fatigue, aching muscles and depression.

Common effects of ecstasy

The effects of ecstasy depend on the strength of the dose and on the physical make-up and state of mind of the person taking the drug.

Generally, some of the immediate effects of ecstasy include:

  • feelings of confidence, happiness and empathy 
  • accelerated heart rate and breathing
  • rise in blood pressure
  • sweating and dehydration
  • nausea
  • jaw clenching and teeth grinding
  • loss of appetite
  • hallucinations
  • an increased urge for sex
  • loss of inhibitions.

Symptoms of ecstasy overdose

In high doses, ecstasy can cause seizures and vomiting. The symptoms of overdose include a sharp rise in body temperature and blood pressure, dizziness, cramps, heart palpitations and vomiting. People with certain disorders – such as epilepsy, high blood pressure, heart disease, diabetes, kidney disease or mood or psychiatric disorders – are at greater risk of harm if they take ecstasy.

Ecstasy may also contribute to death in a number of ways, including:

  • cardiac arrest
  • stroke
  • kidney failure
  • overheating (hyperthermia) and dehydration
  • dilutional hyponatremia, when the user 'drowns' their brain by drinking too much water.

In an emergency, call for help

If someone you are with overdoses or has an adverse reaction while using ecstasy, dial triple zero (000) to call an ambulance immediately. A quick response can save the person's life.

Don't delay because you think you or your friend might get into trouble. Ambulance officers are not obliged to call the police. 

Stay with the person until the ambulance arrives and tell the ambulance officers as much as you can about what drugs were taken, how long ago and any pre-existing medical conditions the person may have. 

Ecstasy dependence, tolerance and withdrawal

It is unknown whether ecstasy is physically addictive or not. Many users say that it is hard to stop taking the drug and this might indicate that it is possible to become psychologically dependent.

Like many other drugs, a user can build up a tolerance to ecstasy. This means they want to take larger and larger doses to try and achieve the same effect. However, this tends to increase the intensity of the unpleasant side effects instead.

Damage caused by long-term ecstasy use

There has been little research on the long-term health hazards of taking ecstasy. Studies suggest that some of the problems may include:

  • permanent damage to the brain cells that make the neurotransmitter serotonin, which is involved in mood regulation, body temperature, appetite and sex drive
  • liver damage
  • delusions
  • panic attacks
  • depression
  • risk of HIV, hepatitis infection, blood poisoning or skin abscesses if ecstasy is injected using shared needles
  • hallucinogenic flashbacks that can occur weeks, months or even years after taking the drug
  • susceptibility to having unprotected sex, which increases the risk of contracting sexually transmissible infections (STIs)
  • the need to use other drugs to balance the side effects of ecstasy. 

Liquid ecstasy is different to ecstasy

The drug known as 'liquid ecstasy' is a different drug to ecstasy. Liquid ecstasy is gamma-hydroxybutyrate (GHB), also known as grievous bodily harm (GBH) or fantasy. Unlike ecstasy, GHB is a depressant drug that has sedative and anaesthetic effects.

Synthetic ecstasy

In recent years, a wide range of synthetic products, claiming to have similar effects to ecstasy, have also been available in Australia. The active ingredient in these products can potentially be a number of chemicals, such as benzylpiperazine (BZP), mephedrone or methylenedioxypyrovalerone (MDPV), but it is difficult to know what exactly they contain. As a result, they can have more unpredictable effects and are potentially more harmful than ecstasy.

Help is available for ecstasy misuse

Treatment options for drug dependence include:

  • detoxification
  • individual counselling 
  • group therapy. 

Peer support – or talking to someone who has been in the same situation – can also be helpful. 

See your doctor for information and referral or contact an alcohol and other drug service in your area.

Where to get help

  • Ecstasy, 2018, Alcohol and Drug Foundation. 
  • Ecstasy, Family Drug Support, Australia. 
  • Ecstasy, National Drug and Alcohol Research Centre, UNSW. 
  • Freudenmann RW, Oxler F, Bernschneider-Reif S, 2006, ‘The origin of MDMA (ecstasy) revisited. The true story reconstructed from the original documents’, Addiction, vol. 101, no. 9, pp. 1241–45. 
  • Curtis M, Dietze P 2017, ‘Victorian trends in ecstasy and related drug markets 2017: Findings from the ecstasy and related drugs reporting system (EDRS)’ Victorian trends in ecstasy and related drug markets 2017, Australian Drug Trend Series No. 193, National Drug and Alcohol Research Centre, University of New South Wales. 

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Types of drugs

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This page has been produced in consultation with and approved by: Alcohol and Drug Foundation

Last updated: October 2018

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