Mixing ecstasy with other drugs can have serious consequences on your health.
If you take ecstasy with another drug, such as opioids or alcohol, the effects of each substance are increased exponentially. Depending on the additional substance, undesired interactions can occur.
Combining Ecstasy With Other Drugs
On its own, ecstasy can increase body temperature and heart rate, which may lead to dehydration, hyperthermia, and even a heart attack or stroke. It can also trigger undesirable symptoms like anxiety or paranoia. When other substances are added to the mix, these negative effects can intensify.
Are you or someone you know struggling with addiction?
Ecstasy users are most likely to combine ecstasy with alcohol, though it’s also common to combine ecstasy with cocaine, inhalants, GHB, and opioids. Ecstasy is often viewed as “safer” than other illicit drugs, such as cocaine or heroin, so someone may begin by using ecstasy and later progress to these other substances. In this way, ecstasy serves as a type of gateway drug to “harder” substances.
Once someone is combining ecstasy with other substances, the effects become more unpredictable. On its own, the effects of ecstasy can be somewhat erratic since users never truly know what they are getting when they purchase ecstasy on the street. The drug is often laced with other substances, such as amphetamines or opioids like fentanyl.
Below, we’ve outlined what to expect when you combine ecstasy with certain other substances of abuse.
Ecstasy & Stimulants
Taking ecstasy with stimulants like cocaine or amphetamines can result in an increased risk of overheating and dehydration. On its own, ecstasy spikes your body temperature, and its stimulant effect burdens the heart.
When you add in the additional effects of more stimulant drugs, this can increase that load on the heart. All of this can lead to organ failure and death.
Ecstasy & Depressants
Taking ecstasy with depressants like GHB or Xanax can be very dangerous. It can lead to slowed breathing, overdose, and even death.
Ecstasy & Marijuana
Ecstasy users often combine the drug with marijuana, as both are considered social drugs and commonly used at parties.
Memory impairment is more likely when the drugs are combined. While ecstasy disrupts long-term memory functioning, marijuana impairs the use of short-term memory.
Cognitive deficits worsen when ecstasy and marijuana are taken together. This can increase the likelihood of risk-taking behavior and the chances of being a victim of a crime.
Combining the two drugs may also exacerbate mood disorders. While the comedown from ecstasy often leads to depression, coming down from marijuana worsens feelings of anxiousness.
If someone has a pre-existing mental health disorder, substance use can compound those symptoms. Since marijuana and ecstasy are already linked to depressive symptoms, this can be particularly troubling when these substances are combined.
Ecstasy & Opioids
Ecstasy is rarely found in its pure form, even though the substance Molly is often touted as being a “pure” form of ecstasy. Instead, ecstasy pills are frequently laced with fentanyl and other opioids.
Using ecstasy that is laced with fentanyl can significantly slow the respiratory system, even leading to overdose and death. Fentanyl can cause a fatal overdose in very low doses. While people can use fentanyl testing strips to check their ecstasy for the presence of fentanyl, there is a wide margin of error since every portion of the pill must be tested.
If someone overdoses on an ecstasy pill that is laced with fentanyl or another opioid, give them naloxone (Narcan) as soon as possible and call 911. Naloxone can temporarily reverse an opioid overdose, thus saving their life.
Ecstasy & Alcohol
Alcohol is the substance most commonly combined with ecstasy, and this combination is dangerous. Users frequently consume both ecstasy and alcohol at raves, nightclubs, and bars.
Here is what you can expect when these substances are mixed:
- Ecstasy causes serotonin levels to surge in the brain. When the drug wears off, users experience depression because the natural level of serotonin is reduced. This depression can linger for days after ecstasy use.
- Like ecstasy, alcohol increases serotonin temporarily. It also impacts the calming effect of gamma-aminobutyric acid, or GABA, on the user. As a result, the long-term use of alcohol can reduce a person’s ability to handle stress.
- If people combine ecstasy and alcohol together for a long time, they may experience a notable degree of cognitive impairment. This may result in problems learning new things or recalling past events. While much of the cognitive damage can be repaired once use stops, some damage may be permanent.
- Combined use of ecstasy and alcohol may trigger high blood pressure, inflammation, and an irregular heart rate. When you use both substances at the same time, it places added stress on the heart, and this can contribute to a potential heart attack.
- Dehydration is a common effect of alcohol and ecstasy consumption, so overheating is possible when combining the substances, particularly since they are used in hot environments to begin with, such as dance clubs and raves. Hyperthermia (a dangerous overheating of the body that can result in death) is a significant risk when alcohol and ecstasy are combined.
Do Not Mix Alcohol & Ecstasy
Ecstasy is a powerful psychoactive drug that can have dangerous effects when taken with other drugs or alcohol. Mixing ecstasy with other drugs can increase the risk of dehydration, overheating, and heart problems. It can also lead to anxiety, paranoia, and psychosis.
In the best-case scenarios, this combination may produce an undesirable experience for the user. In the worst-case scenarios, mixing ecstasy and other drugs can result in overdose and death.
- Ecstasy and Gateway Drugs: Initiating the Use of Ecstasy and Other Drugs. (January 2007). Annals of Epidemiology.
- Cognitive Function and Mood in MDMA/THC Users, THC Users and Non-Drug Using Controls. (March 2006). Journal of Psychopharmacology.
- Fentanyl Drug Facts. National Institutes on Drug Abuse.
- The Effect of the Ecstasy 'Come-Down' on the Diagnosis of Ecstasy Dependence. (June 2014). Drug and Alcohol Dependence.
- Serotonin’s Role in Alcohol’s Effects on the Brain. (1997). Alcohol Health and Research World.
- Hard Boiled: Alcohol Use as a Risk Factor for MDMA-Induced Hyperthermia: A Systematic Review. (September 2021). Neurotoxicity Research.
- Effects of Alcohol (BAC 0.5‰) and Ecstasy (MDMA 100 mg) on Simulated Driving Performance and Traffic Safety. (November 2011). Psychopharmacology.
- Naloxone for Opioid Overdose: Life-Saving Science. (June 2021). National Institute on Drug Abuse.
- Chronic Cognitive Impairment in Users of 'Ecstasy' and Cannabis. (October 2003). World Psychiatry.
- How Stimulants May Affect Your Heart. (February 2022). Harvard Health Publishing.
- Ecstasy Laced With Fentanyl: Georgia's Growing Party Drug Problem. (October 2022). RadioFreeEurope.