Medically reviewed on May 18, 2014 by L. Anderson, PharmD.
Common or street names: MDMA, E, Adam, XTC, Clarity, Essence, Hug Drug, Love Drug
What is Ecstasy?
Ecstasy (MDMA ,3,4 methylenedioxymethamphetamine) is a synthetic, psychoactive drug chemically similar to the stimulant methamphetamine and the hallucinogen mescaline. Street names for MDMA include Ecstasy, Adam, XTC, hug drug, beans, and love drug. Ecstasy is an illegal drug that acts as both a stimulant and psychedelic, producing an energizing effect, as well as distortions in time and perception and enhanced enjoyment from tactile experiences.
Ecstasy exerts its primary effects in the brain on neurons that use the chemical serotonin to communicate with other neurons. The serotonin system plays an important role in regulating mood, aggression, sexual activity, sleep, and sensitivity to pain.
Research in animals indicates that Ecstasy is neurotoxic; whether or not this is also true in humans is currently an area of intense investigation. Ecstasy can also be dangerous to health and, on rare occasions, lethal.
Health Hazards of Ecstasy Use
For some people, Ecstasy can be addictive. A survey of young adult and adolescent Ecstasy users found that 43 percent of those who reported ecstasy use met the accepted diagnostic criteria for dependence, as evidenced by continued use despite knowledge of physical or psychological harm, withdrawal effects, and tolerance (or diminished response), and 34 percent met the criteria for drug abuse. Almost 60 percent of people who use Ecstasy report withdrawal symptoms, including fatigue, loss of appetite, depressed feelings, and trouble concentrating.
Effects of Ecstasy Use
Chronic users of Ecstasy perform more poorly than nonusers on certain types of cognitive or memory tasks. Some of these effects may be due to the use of other drugs in combination with Ecstasy, among other factors. Research indicates heavy Ecstasy may cause persistent memory problems in humans; however, a 2011 study has reported limited cognitive decline in users of Ecstasy.1
Physical Effects: In high doses, Ecstasy can interfere with the body's ability to regulate temperature. On rare but unpredictable occasions, this can lead to a sharp increase in body temperature (hyperthermia), resulting in liver, kidney, and cardiovascular system failure, and death.
Because Ecstasy can interfere with its own metabolism (breakdown within the body), potentially harmful levels can be reached by repeated drug use within short intervals.
Users of Ecstasy face many of the same risks as users of other stimulants such as cocaine and amphetamines. These include increases in heart rate and blood pressure, a special risk for people with circulatory problems or heart disease, and other symptoms such as muscle tension, involuntary teeth clenching, nausea, blurred vision, faintness, and chills or sweating.
Psychological Effects: These can include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during and for days or weeks after taking Ecstasy.
Neurotoxicity: Research in animals links Ecstasy exposure to long-term damage to neurons that are involved in mood, thinking, and judgment. A study in nonhuman primates showed that exposure to Ecstasy for only 4 days caused damage to serotonin nerve terminals that was evident 6 to 7 years later. While similar neurotoxicity has not been definitively shown in humans, the wealth of animal research indicating Ecstasy's damaging properties suggests that Ecstasy is not a safe drug for human consumption.
Hidden Risk - Drug Purity: Other drugs chemically similar to Ecstasy, such as MDA (methylenedioxyamphetamine, the parent drug of Ecstasy) and PMA (paramethoxyamphetamine, associated with fatalities in the U.S. and Australia) are sometimes sold as Ecstasy. These drugs can be neurotoxic or create additional health risks to the user. Also, Ecstasy tablets may contain other substances in addition to MDMA, such as ephedrine (a stimulant); dextromethorphan (DXM, a cough suppressant that has PCP-like effects at high doses); ketamine (an anesthetic used mostly by veterinarians that also has PCP-like effects); caffeine; cocaine; and methamphetamine. While the combination of Ecstasy with one or more of these drugs may be inherently dangerous, users might also combine them with substances such as marijuana and alcohol, putting themselves at further physical risk.
Extent of Ecstasy Use
The National Institute on Drug Abuse (NIDA) funds the Monitoring the Future survey (MTF), which is conducted by the University of Michigan's Institute for Social Research. In 2010, 4.6 percent of 12th-graders, 4.7 percent of 10th-graders, and 2.4 percent of 8th-graders reported they had used Ecstasy in the past year. In 2000, 8.2 percent of 12th-graders, 5.4 percent of 10th-graders and 3.1 percent of 8th-graders reported they had used Ecstasy. African American students showed considerably lower rates of Ecstasy use than white or Hispanic students in the 2010 MTF survey.
In 2010, the Substance Abuse and Mental Health Services Administration published the Results from the 2010 National Survey on Drug Use and Health. Among persons aged 12 to 49, the average age at first use for Ecstasy was 19.4 years. In 2010, an estimated 695,000 Americans aged 12 or older were current (past month) Ecstasy drug users, meaning they had used an Ecstasy drug during the month prior to the survey interview. The 2010 current use estimate is similar to that from 2009. The rate of current Ecstasy use among youths aged 12 to 17 declined to 0.3 percent in years 2004 through 2007, but increased to 0.5 percent in 2009 and 2010. To put overall Ecstasy use in perspective, in 2010 the illicit drug category with the largest number of current users among persons aged 12 or older was marijuana use (2.4 million), followed by abuse of pain relievers (2 million), tranquilizers (1.2 million), Ecstasy (0.9 million), inhalants (0.8 million), and cocaine and stimulants (0.6 million each).2
For more information, please visit The National Institute on Drug Abuse
- Bath Salts
- Devil's Breath
- Gray Death
- PCP (Phencyclidine)
- Psilocybin (Magic Mushrooms)
- Speed (methamphetamine)
- Synthetic Marijuana (Spice or K2)
- TCP (Tenocyclidine)
- U-47700 (Pink)
1. Halpern, J. H., Sherwood, A. R., Hudson, J. I., et al. Residual neurocognitive features of long-term ecstasy users with minimal exposure to other drugs. Addiction 2011;106: 777-86.
2. Substance Abuse and Mental Health Services Administration, Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2011.