Ecstasy (MDMA)

What is ecstasy (MDMA)?

Ecstasy is the common name for the illegal synthetic drug called methylenedioxymethamphetamine (MDMA). It is classified as an empathogen, which means it increases feelings of empathy and compassion towards others. It also acts as a stimulant, since it speeds up the workings of the central nervous system and at high doses can also alter someone’s perception of reality giving it hallucinogenic qualities.

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', 'eckies', ‘pingers’ and ‘caps’. Ecstasy is usually swallowed as a tablet, but can come in powder form. Pills are usually different colours and have pictures or logos stamped on them. 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 3-4 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 (MDMA) 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, PMMA or ketamine), or ‘fillers’ (such as household products) which may have unexpected or dangerous side effects.

Ecstasy usually comes as pills (capsules or tablets), but can come as a powder or crystal. Most people take pills, but some may snort (inhaled through the nose), smoke or inject ecstasy.

How ecstasy (MDMA) works

When we are stressed or under threat, the central nervous system readies us for physical action and our bodies react in response. This 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 can distort your experience of reality by influencing perceptions of sight and sound.

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

Risks of ecstasy (MDMA)

People with certain conditions – 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 can be dangerous if it is mixed with other drugs including alcohol, cocaine, amphetamines, ice and some prescription medications (such as antidepressants).  

How ecstasy (MDMA) affects the body

The effects of ecstasy can vary from person to person and depend on factors such as:

• the amount and strength of the dose
• your physical make-up and state of mind
• how you respond to the drug (for example, a first-time user may experience different effects to someone who has used it before)
• whether it has been mixed with other drugs.

Generally, effects begin around 20 minutes and will last around 3-4 hours. They may include:

• euphoria and feeling energetic and confident 
• accelerated heart rate and breathing
• rise in blood pressure
• sweating and dehydration
• nausea
• jaw clenching and teeth grinding
• tingling skin and muscle aches and pains
• dilated pupils
• loss of appetite
• heightened senses
• sleep problems
• feeling affectionate and an increased sex drive (libido)
• loss of inhibitions
• excessive thirst – drinking large amounts of water (can result in death).

In addition to these symptoms, people who take ecstasy in large or strong doses,  may experience further effects such as: 

• changes in perception (such as hallucinations)
• irrational behaviour that seems out of character – aggression, paranoia
• anxiety and irritability
• vomiting.

'Coming down’ from ecstasy (MDMA)

After experiencing a ‘high’, coming down from ecstasy can be an unpleasant experience. Symptoms may last a few days and include:

• sleep problems and fatigue
• aching muscles 
• anxiety, agitation, depression
• trouble concentrating.

Symptoms of ecstasy (MDMA) overdose

If the strength of the dose is high or if ecstasy is taken in large amounts, it  can cause bad reactions or overdose. Signs to watch include:

• seizures (‘fits’) and vomiting 
• a sharp rise in body temperature and blood pressure
• dizziness and confusion
• muscle twitching or cramps
• heart palpitations. 

Ecstasy use can lead to serious harm or death

Ecstasy may also contribute to serious harm, 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 you suspect an overdose or  severe  reaction while using ecstasy, dial triple zero (000) to call an ambulance immediately. A quick response can save someone’s life.

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

Stay with the person until the ambulance arrives. Tell the ambulance officers as much as you can about what drugs were taken,  when they were taken and whether the person has a medical condition. 

Long-term effects of ecstasy (MDMA)

There has been little research on the long-term effects of taking ecstasy. Studies suggest that 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
• memory and concentration problems
• colds or flu
• depression
• risk of HIV, hepatitis, blood poisoning or skin abscesses – if ecstasy is injected using shared needles
• risk of unprotected sex, which increases the chance of contracting sexually transmissible infections (STIs)
• increased need to use other drugs (such as benzodiazepines, alcohol or cannabis) to balance the side effects of ecstasy. 

Ecstasy dependence, tolerance and withdrawal

It is unknown whether ecstasy is a drug of addiction. Many users say that it is hard to stop taking the drug and may indicate that it is possible to become psychologically dependent.

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

‘Liquid ecstasy’ isn’t 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 that has sedative and anaesthetic effects.

Synthetic ecstasy

In recent years, synthetic products, claiming to have similar effects to ecstasy, have also been available in Australia. The active ingredient in these products can   include chemicals – such as benzylpiperazine (BZP), mephedrone or methylenedioxypyrovalerone (MDPV), but it is difficult to know what exactly they contain. 

As a result, synthetic ecstasy effects can be unpredictable and  more harmful than ecstasy. 

Treatment for ecstasy (MDMA) misuse

Treatment options for drug use 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.

Ecstasy (MDMA) and the law 

Ecstasy is an illegal drug. Penalties apply under federal and state laws for anyone who:

• uses or keeps it in their possession 
• supplies or sells it to another person (this includes without their consent – such as drink spiking)
• drives under its influence.

Where to get help

• In an emergency, call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• DirectLine Tel. 1800 888 236 – for confidential counselling, information and referral to a registered methadone prescriber
• DrugInfo Tel. 1300 85 85 84 – for alcohol and other drug information
• Youth Drug and Alcohol Advice service (YoDAA), Victoria Tel. (03) 9415 8881 (9am to 5pm, Monday to Friday)
• Family Drug Help Tel. 1300 660 068 – for information and support for people concerned about a relative or friend using drugs.
• Family Drug Support Tel. 1300 368 186 (24 hours a day, seven days per week)
• SHARC (Self Help Addiction Resource Centre) Peer Support
• Victoria Legal Aid