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Alcohol, Tobacco, and Other Drugs

What is Ecstasy?

Ecstasy is the name for MDMA (3-4 methylenedioxymethamphetamine). It is a synthetic, psychoactive drug that is similar to methamphetamine and mescaline. Ecstasy causes a rush of serotonin, a neurotransmitter that plays a role in regulating mood, aggression, sexual activity, sleep, and sensitivity to pain. The rush of serotonin leads to a euphoric high, and users report an emotionally relaxed and physically exhilarated state. The effects of Ecstasy make it a common "club drug," popular among teenagers and young adults at bars, clubs, concerts, and parties.

Ecstasy is typically ingested orally in tablet form, but it can also be snorted or injected. The strength and contents of Ecstasy tablets cannot be known accurately because all Ecstasy available on the street is produced in unregulated laboratories. While some tablets have symbols on them (such as clover leafs, horseshoes, or smiley faces) this does not mean that the pill is pure or safe.

Street names for Ecstasy include: XTC, X, and E.

What are the short-term consequences of using Ecstasy?

It is important to realize that pills sold as Ecstasy may not be Ecstasy at all. There are a number of drugs chemically similar to MDMA that are sold as Ecstasy, and these may be neurotoxic or create additional health risks to the user. Often, Ecstasy tablets are laced with other substances, such as ephedrine, dextromethophan, ketamine, caffeine, cocaine, methamphetamine, atropine, heroin, and rat poison.

As a stimulant, Ecstasy increases heart rate and elevates blood pressure. Users of Ecstasy report a number of side effects including: muscle tension, involuntary teeth clenching, nausea, blurred vision, hyperthermia, faintness, and chills or sweating.

Users of Ecstasy may experience a number of psychological effects including confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during and sometimes days or weeks after taking MDMA. Chronic users of Ecstasy also perform more poorly than nonusers on certain types of cognitive or memory tests. Some of these effects may be due to the use of other drugs in combination with MDMA, among other factors.

The party environment in which people use Ecstasy can lead to additional health risks. Increased body temperature and heart rate from drug usage, along with the physical activity of dancing at a rave or club, can lead to hyperthermia (heatstroke) and dehydration. Consuming alcohol and/or other drugs while taking Ecstasy increases the risk of adverse effects. Alcohol is also dehydrating; and because of the stimulant properties of Ecstasy, users of alcohol may drink more than usual and misjudge how intoxicated they are.

There is evidence that MDMA exposure might be linked to long-term damage to neurons that are involved in mood, thinking, and judgment. A study in nonhuman primates showed that exposure to MDMA for only 4 days caused damage to serotonin nerve terminals that was evident 6 to 7 years later.

What are the long-term consequences of using Ecstasy?

According to the National Institute of Drug Abuse, animal studies have shown that Ecstasy can damage serotonin-containing neurons and that these effects can be long-lasting. Studies have also shown that Ecstasy users can experience long-lasting confusion, depression, and selective impairment of working memory and attention processes associated with a decrease in serotonin.

Is Ecstasy addictive?

Ecstasy can be addictive. Users of Ecstasy report diagnostic criteria for addiction, including continued use despite knowledge of the dangers, development of tolerance to the drug, and withdrawal symptoms.

Is Ecstasy illegal?

Ecstasy and its possession, use, manufacture, and sale are illegal.

How do I know if I have a problem with Ecstasy?

Each person is different, but some warning signs are:

  1. More frequent use
  2. Needing more and more to get the same effect
  3. Spending time thinking about using the drug
  4. Spending more money than you have on it
  5. Missing class or failing to finish assignments because of Ecstasy
  6. Making new friends who do it and neglecting old friends who don't
  7. Finding it's hard to be happy without it

Cognitive behavioral interventions are often used to modify the patientís thinking, expectancies, and behaviors about the drug and to increase coping skills. Support groups are often used to supplement individual counseling. While no medications exist for the treatment of Ecstasy addiction, antidepressants are sometimes used to address the withdrawal symptoms one might experience.

Where can I get help?

Join Together, a project of the Boston University School of Public Health, maintains a searchable database on treatment facilities so that you can find one convenient to you. Visit and click on "Find Help."