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3,4-methylenedioxy-methamphetamine (MDMA) is a synthetic drug that alters mood and perception (awareness of surrounding objects and conditions). It is chemically similar to both stimulants and hallucinogens, producing feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception.

MDMA was initially popular in the nightclub scene and at all-night dance parties (“raves”), but the drug now affects a broader range of people who more commonly call the drug Ecstasy or Molly.

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How do people use MDMA?

People who use MDMA usually take it as a capsule or tablet, though some swallow it in liquid form or snort the powder. The popular nickname Molly (slang for “molecular”) often refers to the supposedly “pure” crystalline powder form of MDMA, usually sold in capsules. However, people who purchase powder or capsules sold as Molly often actually get other drugs such as synthetic cathinones (“bath salts”) instead (see “Added Risk of MDMA“).

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How does MDMA affect the brain?

MDMA increases the activity of three brain chemicals:

• Dopamine—produces increased energy/activity and acts in the reward system to reinforce behaviors
• Norepinephrine—increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems
• Serotonin—affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust. The release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.

Other health effects include:

• nausea
• muscle cramping
• involuntary teeth clenching
• blurred vision
• chills
• sweating

MDMA’s effects last about 3 to 6 hours, although many users take a second dose as the effects of the first dose begin to fade. Over the course of the week following moderate use of the drug, a person may experience:

• irritability
• impulsiveness and aggression
• depression
• sleep problems
• anxiety
• memory and attention problems
• decreased appetite
• decreased interest in and pleasure from sex

It’s possible that some of these effects may be due to the combined use of MDMA with other drugs, especially marijuana.

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What are other health effects of MDMA?

High doses of MDMA can affect the body’s ability to regulate temperature. This can lead to a spike in body temperature that can occasionally result in liver, kidney, or heart failure or even death.

In addition, because MDMA can promote trust and closeness, its use—especially combined with sildenafil (Viagra^®)—may encourage unsafe sexual behavior. This increases people’s risk of contracting or transmitting HIV/AIDS or hepatitis.

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