Ecstasy Addiction: Mental, Physical & Behavioral Effects of Ecstasy

What Is Ecstasy?

Ecstasy is the name commonly used to describe 3,4-methylenedioxymethamphetamine, or MDMA.¹ It’s an illegal, synthetic drug, with properties of both a stimulant drug like amphetamines and a hallucinogenic substance such as LSD.² Classified as a Schedule I drug by the Controlled Substances Act means that ecstasy has a high potential for misuse and currently has no approved medical purpose.³

Sometimes referred to as Molly, ecstasy is often contaminated with other substances such as methamphetamine, heroin, and the over-the-counter cough suppressant dextromethorphan.¹

The Effects of MDMA Use

MDMA produces stimulant effects, such as increased energy, as well as hallucinogenic effects like changes in perceptions of reality.¹ Not everyone who uses ecstasy experiences the same effects or the same severity of these effects. That’s because numerous factors impact how the drug affects an individual, including:¹

• Their age when use began.
• Their gender.
• Their dosage.
• Various environmental factors.
• Their frequency and intensity of use.
• Their concomitant use of other drugs and alcohol.

Additionally, contaminants such as other drugs, bath salts, caffeine, and cough suppressants—all found in samples of MDMA—can produce unpredictable effects.¹

Ecstasy Effects Timeline

Ecstasy’s effects are typically felt 45 minutes after an individual ingests the drug and last for about 3-6 hours.² However, in some cases, a person might feel some effects of MDMA for longer, about a week or so.¹

Physical, Mental, and Behavioral Effects of MDMA

When a person uses ecstasy, there are several types of physical, mental, and behavioral side effects that can occur, including:^4,5

• Increased heart rate and blood pressure.
• Increased body temperature.
• Muscle tension.
• Nausea.
• Feeling faint.
• Chills or sweating.
• Increased energy.
• Lowered inhibitions.
• Changes in sensory perception.
• Increased empathy towards others.
• Wanting to be physically close to others.
• Elevated mood.
• Increased sexual arousal.

Ecstasy and the Brain

Ecstasy’s impact on the brain partly involves the way it impacts serotonin and causes the brain to release large amounts of this neurochemical, which helps regulate mood, sleep, appetite, and pain.¹ This release of serotonin is likely the cause of the elevated mood people experience after taking MDMA.¹ However, some studies suggest that ecstasy negatively impacts serotonin levels in the brain, leading some individuals to experience psychological side effects for several days after taking MDMA.¹

These effects, which may last for a week or more may include: ¹

• Aggression.
• Anxiety.
• Irritability.
• Depression.
• Problems with memory.
• Issues with paying attention.

Long-Term Effects and Dangers of Ecstasy

While overdose from ecstasy use is rare, other dangerous side effects can occur, particularly related to elevated body temperature (hyperthermia).¹ The rise in an individual’s body temperature caused by ecstasy can be further aggravated when combined with intense physical activity—such as dancing or jumping—and warm, crowded environments like nightclubs and raves.¹ In these conditions, an individual risks developing hyperthermia, which can quickly result in sodium imbalances that can lead to kidney failure and even death due to brain swelling, especially in women.¹

Other potential long-term effects of regular ecstasy use may include:^1,4

• Low libido.
• Sleep disturbances.
• Impulsiveness.
• Anxiety.
• Confusion/memory issues.
• Depression.
• Problems with concentration.
• Heart disease.

Ecstasy Addiction, Treatment, and Outlook

It is not yet known if ecstasy is truly addictive.¹ However, continuing to use ecstasy despite its negative consequences could lead to a substance use disorder.⁶ The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) classifies a substance use disorder from MDMA use as part of Other Hallucinogen Use Disorders.⁶ A person diagnosed with this disorder would show at least 2 of the following symptoms in a 12-month period:⁶

• The hallucinogen is taken in larger amounts or for a longer period than intended.
• There is a desire or unsuccessful attempt to cut down or stop using hallucinogens.
• A lot of time is spent trying to obtain, use, or recover from the effects of the hallucinogen.
• An individual experiences cravings or strong urges to use the hallucinogen.
• Recurrent use of the hallucinogen leads to a failure to fulfill major role obligations at home, school, or work.
• An individual continues to use the hallucinogen despite having persistent or ongoing personal problems either caused by or made worse by the effects of the hallucinogen.
• Important social, recreational, or occupational activities are reduced or given up due to the use of the hallucinogen.
• The individual uses the hallucinogen in situations where it is physically hazardous.
• An individual continues to use the hallucinogen despite knowing that an ongoing or recurring physical or psychological problem is either caused by or worsened by use.
• Tolerance can mean either needing increasing amounts of the hallucinogen to get intoxicated or get the desired effects or taking the same amount of the hallucinogen and having notably diminished effects from using it.

Some studies suggest that long-term ecstasy use could result in permanent cognitive and memory damage.⁵ However, further research is needed to draw more certain conclusions on the long-term effects and permanency of these impacts on brain functioning.⁷

Treatment for a hallucinogen use disorder, including MDMA, typically involves behavioral therapy, as there are currently no FDA-approved medications to treat substance use disorders involving these drugs.¹

Cognitive-behavioral therapy, or CBT, is commonly used to help individuals learn to change their thinking and behaviors around drug use and to help them learn new coping skills to identify triggers, manage stressors, prevent relapse, and remain MDMA-free.¹ Additionally, mutual-help groups may be beneficial to individuals in recovery from MDMA use.¹

If you or a loved one struggles with MDMA use, call one of our compassionate admissions navigators to verify insurance coverage and start treatment today.