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MDMA (Ecstasy, Molly, GHB): Risks & Side Effects

MDMA is a synthetic drug that works like both a stimulant and a hallucinogen. Risks of MDMA include a spike in body temperature (resulting in liver, heart, or kidney failure, leading to death), sleep problems, depression, and anxiety, among others.

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What Is MDMA?

In clandestine laboratories all around the world, chemists make MDMA. The powder is transformed into products people can buy, share, and store for later use. Two major forms of MDMA exist. 


People who buy Molly expect pure MDMA wrapped in clear capsules. Experts say this is a marketing gimmick, as capsules tested by police often have many other ingredients inside them. Molly is not in fact pure.


Chemists press MDMA powder into tablets dressed up with bright colors and stamped with logos, smiling faces, clover leaves, or cartoon characters. These pills may look like candy, but they can be incredibly powerful and dangerous. 


The club drug GHB is sometimes confused with MDMA. While it’s true that both substances are often available at parties, GHB is a sedative drug.

GHB won’t deliver a high or a sense of pleasure like MDMA will. But GHB can incapacitate people who take it, leaving them vulnerable to sexual assault. 

MDMA & Your Brain

Whether you take pills or capsules, MDMA moves from your digestive system into your bloodstream. From there, molecules move into your brain and make changes there. 

MDMA increases three chemicals inside your brain:

  1. Dopamine: This so-called “feel-good chemical” is responsible for the burst of happiness that sets in after your hit. That sensation may make you return to the drug repeatedly.
  2. Norepinephrine: This chemical is tied to organ regulation. More of it means your heart rate and blood pressure increase. 
  3. Serotonin: This chemical increases feelings of closeness and intimacy. It also controls appetite and sleep, so it could make you feel hungry and wired. 

While the effects of your MDMA dose may wear off after a few hours, brain chemicals remain elevated for much longer. And sometimes, those big bursts can change your brain.

You may be unable to respond to natural doses of dopamine in the days following your use, for example. You could be left depressed even after doing something that once made you joyful. This can prompt you to take MDMA again, leading to a cycle of abuse.

Why Is MDMA So Dangerous?

Taking illicit drugs is never smart. But MDMA comes with unique risks that other drugs can’t match. 

MDMA Is Often Contaminated

When police officers seize ecstasy or Molly, they test it for purity. Often, they find other chemicals, such as these:

  • Ephedrine
  • Cocaine
  • Heroin
  • Ketamine
  • Methamphetamine
  • PCP

You have no idea what’s inside the next pill or capsule you take. Drugs sold on the street don’t have any kind of quality control to ensure they are what dealers say they are.

The next dose you take could be more harmful than anything you’ve taken before. 

MDMA Overdoses Are Real

While it’s rare for people to overdose on MDMA, it happens. The drug can cause massive spikes in blood pressure, and some people have seizures.

Since ecstasy and Molly often contain other substances, you could potentially overdose from something that is combined with MDMA, often without your knowledge.

With quick treatment, you could recover from an overdose. But sometimes, people just don’t get help soon enough. 

MDMA Side Effects Are Scary

Even if you don’t overdose on Molly, you could experience a dangerous spike in your body temperature. You won’t feel the change, especially if you’re doing something like dancing under hot lights.

That rising temperature can harm vital organs like your kidneys, liver, and heart. Some people die from these side effects. 

Signs of MDMA Use

Some people are quick to tell their friends and family members that they use Molly. Others try to hide their use.

Telltale signs of MDMA use include the following:

  • Secretiveness, including paranoia about people being in their personal space 
  • Borrowing or stealing money 
  • Sudden mood changes
  • Unusual emotional reactions, including extreme cuddliness
  • Exhaustion or depression after a night out 
  • New friends who also seem drugged
  • Evidence of pills or wrappers 

People who see these signs should speak up. MDMA is too dangerous for regular use.

How Is MDMA Addiction Treated?

No FDA-approved drugs are available to treat MDMA addiction. But therapy programs using cognitive behavioral therapy, family therapy, and other forms of “talk therapy” can help people stop using Molly for good.

While the road to recovery isn’t always easy, it’s worth it. You can embrace a brighter, healthier future when you get the right help.

Updated March 31, 2023
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  7. MDMA (Ecstasy). (May 2018). Nemours.
  8. How Are MDMA Use Disorders Treated? (September 2017). National Institute on Drug Abuse.
  9. ‘Ecstasy’ as a Social Drug: MDMA Preferentially Affects Responses to Emotional Stimuli With Social Content. (March 2014). Social Cognitive and Affective Neuroscience.
  10. MDMA (Ecstasy) Abuse Research Report. National Institute on Drug Abuse.
  11. Reasons for Not Using Ecstasy: A Qualitative Study of Non-Users, Ex-Light Users and Ex-Moderate Users. (May 2012). BMC Public Health.
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