What is Ecstasy?

What is Ecstasy?

Ecstasy is a recreational drug.

Ecstasy is supposed to contain the substance MDMA, but this is not always the case.¹

What drugs does Ecstasy contain?

Sadly, a 2005 paper found that 61% of tested ecstasy tablets were adulterated with other drugs, in part due to the lack of regulation of the illegal market. And a massive 46% of Ecstasy pills contained 0% MDMA.¹

39% of Ecstasy pills contained only MDMA, 5% of Ectasy pills contained only MDA (similar substance to MDMA, though far less studied), 5% of Ecstasy pills contained only DXM (typically found in Robitussin, the cough medicine), 2% contained only caffeine, 1% contained only methamphetamine, 1% contained only psuedo-ephedrine (a stimulant found in cold and flu medicine), and the rest were unknown or mixed.¹

What are the biggest acute risks of Ecstasy?

1. Consuming a substance that is not MDMA. Many tablets and powders are fake and/or adulterated with other drugs.^{2 3 4 1}

2. Heat stroke and/or serotonin syndrome. Like all serotonergic drugs, MDMA increases heat stroke risk due to its effects on the hypothalamus, the part of our brain that helps us regulate body temperature.⁵

3. Hyponatremia. Generally caused by drinking too much water. MDMA causes water retention.⁶ Dancing aerobically in hot environments causes dehydration. Overcompensating by drinking too much water can be fatal.

See more at how to take MDMA.

Is Ecstasy (often containing no MDMA, or only some MDMA) safe?

Ecstasy, as consumed by people typically (i.e. often impure), is less safe than pure MDMA, and is perhaps a similar level of safety to horse riding.⁷

See this page for more info on side effects relative to other drugs.

For context, there are about 88,000 yearly alcohol-related deaths in the US per year, or about 0.05% of the 168 million yearly users of alcohol in the US.^{8 9}

Harm reduction expert Emanuel Sferios estimated that he believes there are around 20 Ecstasy-related deaths per year in the US, or about 0.0008% of users.

If Ecstasy contains only pure MDMA, is it safe?

Research organization MAPS states “in laboratory studies, pure MDMA has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses.”¹⁰

“Before you go out seeking ecstasy or molly sold on the street to treat whatever ails you, you should be aware that while these substances may contain MDMA, they’re also mixed in with uncertain and dangerous adulterants. In laboratory studies, it’s only pure MDMA that has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses.”¹¹

Is Molly safer than Ecstasy?

Molly might be less safe than Ecstasy - research suggests Molly may be even less likely to contain pure MDMA than Ecstasy. 87% of “Molly” analyzed by the DEA between 2009 and 2013 contained 0% MDMA, instead mostly containing “bath salts.”²

What does Ecstasy do to users and why do people take it?

The effects of Ecstasy depend on the purity and contents of the Ecstasy pill.

Pure Ecstasy, which should contain only MDMA, if “taken in a positive envrionment with a positive mindset, can make users feel like the world is perfect, with extreme euphoria, greatly enhanced touch and bodily sensations, and enhanced empathy and enhanced ability to have deeper and more understanding conversations with other people.”¹² Some common side effects of pure MDMA in research for PTSD during use (~7 hours), are jaw clenching, heavy legs, lack of appetite, thirst, impaired balance, anxiety, and feeling cold.¹³

Typical Ecstasy pills, which often contain other substances seemingly designed to mimic the desirable effects of MDMA,¹ may make users feel increased alertness, anxiety, and euphoria. Again, please note: “it’s only pure MDMA that has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses.”¹¹

Is Ecstasy legal?

No. Ecstasy was made illegal in the US in 1985, and worldwide in 1986.

Where is Ecstasy used?

Ecstasy is often taken at music festivals (often multi-day events with multiple artists), nightclubs, raves (large dance parties), or house parties.

How many people use Ecstasy?

About 2.66 million people used ecstasy in the US in 2015.^{14 15}

What makes Ecstasy dangerous?

• Users combine Ecstasy with other drugs¹⁶
• Ecstasy is unregulated, so users often don’t know what they are consuming¹
• People using Ecstasy haven’t always seen safety education, and so don’t know to avoid hot environments, to drink some electrolyte-containing fluids but not too much, how to test their Ecstasy, and what dosages are safest¹⁷

How could we make Ecstasy safer?

Treat it like driving. Accept that it can be dangerous in certain contexts (e.g. driving drunk, without a seatbelt, or speeding) and that people will do it anyway, and so educate people to minimize any risks.

Learn more

Read the page on MDMA (Molly/Ecstasy).

References