What Is Ecstasy?

Ecstasy is a semi-synthetic drug that acts as a stimulant of the central nervous system. It can be derived from the oil of the sassafras tree. Chemically, it is 3,4-methylenedioksy-methamphetamine (MDMA). Ecstasy is chemically related to amphetamine (a legal drug that increases alertness) and methamphetamine (meth, an illegal drug).

Ecstasy is illegal to posses or deal in most countries. The Drug Enforcement Administration (DEA) in US, categorize it as a Schedule I drug (has a high potential of abuse, is not legal even for medical use).

Ecstasy Forms and Use

Ecstasy Pills (Tablets)

A common form of ecstasy are small, round tablets of various colors and with various logos on them. Tablets usually contain 20-90 mg MDMA hydrochloride (2), which is often diluted (cut) with other substances, like caffeine or lactose, or drugs, like amphetamine (speed), ephedrine or ketamine (4). Tablets are intended for ingesting; in this form they are commonly used in disco clubs and rave parties. They have bitter taste. Some users insert the pill in the anus (this is called shafting), from where it is absorbed into the blood.

Ecstasy tablets may contain other substances than MDMA:

  • MDA (methylenedioxyamphetamine) has longer (8-12 hours) and stronger (hallucinations) effect than MDMA.
  • MDEA (methylenedioxyethylamphetamine) has milder effect than MDMA.

Street names (nicknames) for ecstasy tablets: Adam, brownies, clarity, Dolphins, E, Mitsubishi’s, Rolex’s, Stacy, X, XCT, and so on.

MDMA Powder

White crystalline MDMA powder (molly) may contain nearly pure MDMA hydrochloride or, if made from crushed tablets, 30-40% of MDMA, intended for snorting (sniffing), ingesting (as capsules), or smoking. Rarely, users dissolve MDMA powder in water and administer it in the vein by injecting.

MDMA Freebase

MDMA freebase is a non-salt form of ecstasy, in the form of oil, homemade (rarely) from MDMA powder, intended for smoking.

Common Combination of Ecstasy With Other Drugs

  • Ecstasy + psilocybin mushrooms (hippy flip) causes hallucinations
  • Ecstasy + ephedrine (the drug that widens breathing airways) has stronger stimulant effect than ecstasy alone
  • Ecstasy + ketamine (kitty flip) has a dream-like effect
  • Ecstasy + LSD (candy flip) causes hallucinations and other unpredictable feelings (‘bad trip’)

Ecstasy Without Ecstasy

  • Herbal ecstasy is a mixture of herbs and some legal psychoactive drug, like ephedrine, available as the over-the-counter (OTC) drug in the form of pills, or sold as herbal drinks or cigarettes. These products are not safe to use (3).
  • Liquid ecstasy is a term used for an illegal drug GHB (gamma hydroxybutyrate) that resembles ecstasy in its effects, but is chemically not related to MDMA in any way.

How Does Ecstasy Work?

Ecstasy stimulates release of serotonin, a substance in the brain, which increases alertness and good mood. Ecstasy also stimulates release of:

  • dopamine and norepinephrine, which add to the effect of serotonin
  • oxytocin, supposedly responsible for feeling of closeness with others
  • antidiuretic hormone (ADH), resulting in decreased urination

Short-Term Effects of Ecstasy

Initial effects of ecstasy occur 30-60 minutes after ingestion, peak at about 9o minutes and persist at peak level for few hours, and wear off within 24 hours (1). Ecstasy effects may include:

  • Euphoria
  • Empathy, intimacy, forgiveness, ‘love’ to other people, a desire to touch others (from here a term love drug or hug drug).
  • Enhanced or distorted sense of touch. Ravers tend to perform various rolling tricks (touching each other in certain special ways) to enhance feelings of pleasure. Non-drugged observers often find this a silly habit so they call ecstasy users etards.
  • Rarely, mild hallucinations (enhanced or distorted colors, sounds, distorted perception of time) may occur.
  • Afterglow- a feeling of completeness, warm memories, occurring when the initial effect of the drug wears of, and lasting from an hour to several days (or more).

Ecstasy Overdose (Intoxication) Symptoms and Signs

Ecstasy overdose symptoms may appear about 30 minutes after drug ingestion and may include:

  • Anxiety, restlessness
  • Widened (dilated) pupils, blurred vision
  • Dry mouth, sweating
  • Increased body temperature (hyperthermia), hot flashes
  • Jaw clenching and teeth grinding that may look like funny grimacing for a non-drugged observer
  • Rapid pulse, heart pounding (palpitations)
  • Increased blood pressure
  • Nausea
  • Chills
  • Difficulty passing urine (the so-called e-wee)
  • Difficulty sleeping

Life dangerous side-effects of ecstasy:

  • Ecstasy can be dangerous for people with asthma, heart disease, seizures
  • Hyperthermia- sharp increase in body temperature, which may cause liver or kidney failure and may be fatal. It occurs mostly after ingestion of PMA (para-methoxyamphetamine) or 4-MTA (4-Methylthioamphetamine), which are sometimes sold as ecstasy. A person who has taken ecstasy and feels unusually hot should get a medical care as soon as possible.
  • Dehydration may be due to hyperthermia, insufficient drinking of water, or drinking alcohol. WARNING: A combination of ecstasy and alcohol can result in severe dehydration.
  • Water poisoning after drinking large amounts of water. This occurs because of salt loss during sweating in a hot environment, and water retention caused by increased release of antidiuretic hormone. The resulting hyponatremia may lead to brain swelling. This can be prevented by drinking sport drinks that contain sodium. WARNING: after taking ecstasy, one should drink water to prevent dehydration, but not more than 1/2 liter each hour to prevent water poisoning.

Deaths from ecstasy are rare. Most ecstasy-related deaths are due to underlying disorders, like heart disease, rather than a single effect of the drug.

Ecstasy Withdrawal Symptoms

Pleasurable effects of ecstasy may be followed by unwanted after-effects, which typically occur 2-3 days after the weekend drug use and are known as blues or suicide Tuesday:

  • Depression, anxiety, panic attacks, paranoia
  • Problems with sleeping
  • Poor concentration
  • Fatigue
  • Loss of appetite
  • Craving for the drug

Long-Term Side Effects of Ecstasy

  • Sleep apnea
  • Brain damage – this is not yet confirmed with certainty

How Addictive Is Ecstasy?

Ecstasy can cause psychological addiction. Tolerance develops quickly in regular users, who may need more and more drug to achieve the same pleasurable effect.

Related Articles:

References:

  1. Ecstasy side effects, toxicity (emedicine.medscape.com)
  2. Ecstasy purity (emcdda.europa.eu)
  3. Herbal ecstasy products are not safe to use (denverda.org)
  4. Drugs and other adulterants in ecstasy pills  (ecstasydata.org)

Article reviewed by Dr. Greg. Last updated on April 26, 2014