MDMA

MDMA

MDMA, also known as ecstasy or molly, is a drug that has stimulant and minor psychedelic properties. It’s an empathogen–entactogen, meaning it has the ability to enhance feelings of empathy and connection.
MDMA has been used in studies to treat post-traumatic stress disorder (PTSD) and social anxiety in autism spectrum disorder. It was once used in therapy to treat PTSD, but its use was stopped after it was prohibited. It was later reintroduced in the early 2000s, and there were experimental protocols in Switzerland and Spain to treat PTSD and other psychiatric conditions. However, there are currently no MDMA-containing medications that are authorized or sold. 
 
Some side effects of MDMA include: 
 
  • Bruxism (grinding and clenching of the teeth)
  • Dehydration
  • Diarrhea
  • Erectile dysfunction
  • Hyperthermia
  • Increased wakefulness or insomnia
  • Increased perspiration and sweating
  • Increased heart rate and blood pressure
  • Increased psychomotor activity
  • Loss of appetite
  • Nausea and vomiting
  • Visual and auditory hallucinations (rarely)

What is MDMA?

Note: Drugs sold as MDMA (ecstasy) may not always contain pure methylenedioxymethamphetamine (MDMA). They can be a mixture of amphetamine, paramethoxyamphetamine (PMA), ketamine, NBOMe, synthetic cathinones or other substances.

MDMA (methylenedioxymethamphetamine) is an empathogen — a drug that increases an individual’s ability to feel empathy and kindness, and to connect socially with those around them.

MDMA is commonly called ecstasy. However, some pills labeled as “ecstasy” may contain little or no MDMA, and instead may be filled with a range of other drugs and “fillers.” This makes it hard to know exactly what effects to expect and whether harmful side effects may follow.

What does MDMA look like?

MDMA is typically found in tablets or capsules, although it can also appear as a powder or crystal. The pills come in a range of colours and sizes and often feature a picture, symbol, or logo. Importantly, two pills with the same logo or symbol may have different ingredients, depending on their source.

Other names

Ecstasy, caps, Eckies, E, XTC, pills, pingers, bikkies, flippers, molly, M&M

 

 

Other Types of Empathogens

Some drugs that produce effects similar to MDMA (empathogens) include:

MDMA: How Drugs Affect You

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How is MDMA Used?

MDMA is usually swallowed, but it can also be:

  • Injected
  • Snorted
  • Inserted rectally

Effects of MDMA

Using any drug carries risks. It’s important to be careful and well-informed when using MDMA or any other substance.

The effects of MDMA can differ from person to person, depending on factors such as:

  • Size, weight, and health
  • Whether the person is used to taking it
  • Whether other drugs are taken at the same time
  • The amount taken
  • The strength of the drug (this varies from batch to batch)
  • Environment and surroundings (where the drug is taken)

The effects of MDMA typically start about 20 minutes to 1 hour after taking it and last for around 3–4 hours. The peak of the experience is sometimes called “peaking”.

Possible effects may include:

  • Euphoria
  • Feeling energetic and confident
  • Dilated (enlarged) pupils
  • Jaw clenching and teeth grinding
  • Heightened senses (sight, hearing, and touch)
  • Excessive sweating and skin tingling
  • Muscle aches and pains
  • Reduced appetite
  • Fast heartbeat
  • Increased blood pressure
  • Dehydration
  • Heatstroke
  • Drinking large amounts of water (in rare cases, this can be fatal)

Large amounts or strong batches of MDMA may also cause:

  • Floating sensations
  • Perceptual changes, such as visual and auditory hallucinations
  • Out-of-character irrational behaviour
  • Anxiety
  • Irritability, paranoia, and aggression
  • Vomiting
  • High body temperature
  • Racing heartbeat
  • Convulsions

MDMA, Dehydration, and Overheating

MDMA is often taken at festivals, parties, and nightclubs — environments where people are physically active, frequently dancing and socializing. The combination of MDMA and strenuous activity can raise body temperature to dangerous levels.6

It’s important to take breaks to cool down and drink water regularly — about 250–500 ml per hour.

However, drinking too much water while on MDMA can be dangerous. Deaths have occurred from dilutional hyponatremia, a condition where the brain swells due to overhydration, and this can lead to coma.6

Impact of Mood and Environment (Set and Setting)

Drugs that affect a person’s mental state — psychoactive drugs — can produce different effects depending on set and setting:

  • Set: This refers to a person’s state of mind, previous experiences with psychedelic drugs, and their expectations. For example, feeling stressed or anxious beforehand may result in a more unpleasant experience.7

  • Setting: The environment in which MDMA is taken — whether it’s a comfortable, familiar space with close friends or a noisy, crowded venue — can influence the experience. A calm, quiet setting can help foster a more enjoyable experience, while a hectic or overwhelming setting may contribute to a negative one.7

Using MDMA when you’re in a good state of mind, surrounded by trusted friends, and in a comfortable environment can help reduce the risk of having a bad experience.

Mixing MDMA with Other Drugs

The effects of taking MDMA alongside other drugs  including over-the-counter or prescription medication  can be unpredictable and dangerous.

  • MDMA + Alcohol:
    Increases the risk of dehydration and drinking too much water.8

  • MDMA + Ice (methamphetamine), Speed (amphetamine), or Cocaine:
    Raises the risk of anxiety and reduced brain function due to dopamine depletion.
    Puts enormous pressure on the cardiovascular system and can lead to stroke.9, 10

  • MDMA + Antidepressants:
    May cause drowsiness, clumsiness, restlessness, and a feeling of drunkenness and dizziness.11

Polydrug Use

Polydrug use refers to the use of more than one drug at the same time or in close succession.
This can involve a combination of illicit drugs, prescription medication, and alcohol.

[Read more about Polydrug use]

Harm Reduction

Here are some strategies to help reduce harm when using MDMA:

  • Try a small dose first and wait 2 hours before taking more.
  • Avoid high dosages. Higher amounts are more likely to cause an unpleasant or overwhelming experience, especially for first-time users.
  • Avoid mixing drugs, including alcohol. This can contribute to dehydration and other health risks.
  • Some medications may interact with MDMA  always check first.
  • Take breaks to cool down and drink 250 500 ml of water per hour.
  • Let a friend know what you’re taking in case you need help.
  • Avoid frequent use. Some people find MDMA loses its effects if taken repeatedly, which may lead to consuming more.12, 13

Withdrawal

If you discontinue MDMA after heavy or sustained use, you may experience withdrawal symptoms. These typically resolve after a week and diminish over a month. Symptoms may include:

  • MDMA cravings
  • Aches and pains
  • Exhaustion
  • Restless sleep
  • Agitation
  • Trouble concentrating
  • Anxiety and depression14

Read more about withdrawal

Getting Help

If MDMA use is affecting your health, relationships, education, employment, or other aspects of your life — or you’re worried about a friend — help and support are available.

Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free, confidential advice, information, and counselling.

Search for services near you by entering your location or postcode and choosing the service you need.

If you’d like more information or support, you can email us at druginfo@adf.org.au.

Path2Help

Not sure where to start?
Path2Help is an interactive tool designed to match you with tailored support and services.

MDMA and the Law

MDMA Statistics

Explore Empathogens on the Drug Wheel

![Diagram of Empathogens on the Drug Wheel]