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What Are the Side Effects of Ecstasy? Physical & Mental

Ecstasy side effects include emotional warmth, hyperthermia, heart problems, and potential overdose. Long-term use can cause anxiety, depression, and memory issues. Factors like dosage, health, and drug purity impact its effects. Quitting is essential to avoid severe health risks.

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Ecstasy’s side effects include increased talkativeness, hyperthermia, heart issues, kidney problems, and overdose.

Ecstasy drug dealers don’t provide helpful handouts with their drugs, so it’s hard to know what’s inside each pill and how your doses will impact you. Know that every ecstasy dose causes side effects. But since the pills are often contaminated, it’s hard to know exactly what might happen. 

Ecstasy’s Immediate Side Effects

Most people feel the impact of an oral dose of ecstasy within about 45 minutes. The effects typically last for three to four hours.

Ecstasy causes profound psychological changes, including the following:

  • Euphoria
  • Increased sense of energy
  • Confidence
  • Affectionate feelings
  • Hallucinations
  • Heightened senses
  • Anxiety
  • Paranoia

Ecstasy can also cause physical changes, such as the following:

  • Large pupils
  • Jaw-clenching and tooth-grinding
  • Tingling in the hands and feet
  • Sweating
  • Nausea or vomiting
  • High blood pressure and fast heartbeat
  • Aching muscles

Ecstasy is commonly tainted with other drugs, and some of them work faster or slower than ecstasy. For example, doses tainted by synthetic amphetamines can take much longer to get started. Some people take repeated doses, as they feel the first dose wasn’t working.

Factors That Impact Ecstasy’s Effects

Some people feel ecstasy’s changes quickly, while others need more time. Your onset of symptoms can vary depending on the following factors:

  • Drug-taking method: The majority of ecstasy users swallow the drug. However, snorting or injecting ecstasy typically makes active ingredients take hold quicker than letting pills dissolve in your digestive tract.
  • Organ health: Ecstasy is processed by organs like your liver. If they’re damaged, the drug could persist in your body for longer and its effects may be felt more quickly. Regular ecstasy users could encounter this problem, as the drug has been linked to liver failure and other organ health issues.
  • Your dose: Taking more could mean feeling the impact quicker. Taking the drug for long periods can compound its effects. If you take a stronger dose, it’s likely to cause more side effects than a weaker dose might. Researchers say pills can contain MDMA doses ranging from zero to well over 100 mg, and users may never know how much they’re taking.
  • The drug’s purity: If your drug dose is contaminated with a stronger substance (like fentanyl), it could make the effects come on quicker or last longer. Laced ecstasy can be very unpredictable since users don’t know which substances are present. Unfortunately, contamination is common. In 2022, for example, the Los Angeles County Health Department identified three overdose deaths tied to ecstasy pills laced with fentanyl.
  •  The setting: Ecstasy is often used in settings involving vigorous activity in a hot room (like a dance club). Side effects like an increase in body temperature could be even more dangerous in these locations. They might also be harder to detect, leading people to take more ecstasy, as they don’t think the first dose is working.

Breaking Down the Effects of Ecstasy 

While people may only notice ecstasy for a few hours after they take it, the long-term consequences can be more significant.

Mental Health

MDMA forces the release of serotonin, and in time, this critical neurotransmitter is depleted. Poor mental health is a consequence of this depletion, and it’s common in long-term ecstasy users.

Common problems seen in long-term ecstasy abusers include the following:

  •       Anxiety
  •       Confusion
  •       Depression
  •       Low attention
  •       Paranoia
  •       Poor memory

Physical Health

Regular users also strain their heart muscle tissues with each episode. If they’re using ecstasy in warm environments (such as dance clubs), the damage is more severe. Exerting a weakened heart leads to problems that are hard to reverse or treat. You could develop significant cardiac problems that require a lifetime of care due to your drug abuse.

Regular MDMA use is also associated with risky sexual behaviors, including having sex without a condom or connecting with multiple partners. These choices can lead to unintended pregnancies or sexually transmitted diseases like HIV.

Ecstasy often causes users to clench their jaws and grind their teeth. People may engage in these behaviors without even noticing them. However, repeated episodes of drug use can lead to tense jaw muscles or cracked teeth.

While it’s rare, researchers say repeated ecstasy use can also cause liver failure. It’s not clear why the drug causes such harm. Studies suggest that higher doses of the drug taken over long periods increase the risk. Liver failure is difficult to treat, and sometimes, people need organ transplants to get better.

Recovery & Reversibility

The more you use and the longer the abuse lasts, the more likely it is that you’ll experience these health issues and the more severe they might be.

If you’re abusing ecstasy now, talk to your doctor about how to quit. This drug comes with serious consequences that you can avoid if you get help now. The sooner you stop using it, the better your body will be able to repair the damage done.

Updated January 22, 2024
Resources
  1. What Are the Effects of MDMA? (September 2017). National Institute on Drug Abuse.
  2. Ecstasy. Frank.
  3. MDMA Abuse Research Report. (September 2017). National Institute on Drug Abuse.
  4. What Are MDMA's Effects on the Brain? (September 2017). National Institute on Drug Abuse.
  5. MDMA and the Brain: A Short Review on the Role of Neurotransmitters in Neurotoxicity. (July–August 2020). Basic and Clinical Neuroscience.
  6. Effects of Acute MDMA Intoxication on Mood and Impulsivity: Role of the 5-HT2 and 5-HT1 Receptors. (July 2012). PLOS ONE.
  7. MDMA (Ecstasy). Health Direct.
  8. A Case of Ecstasy-Induced Acute Hepatic Injury. (October 20220. Cureus.
  9. The Pharmacology and Toxicology of Ecstasy (MDMA) and Related Drugs. (October 2001). Canadian Medical Association Journal.
  10. LAC DPH Health Alert: Contaminated Ecstasy and Accidental Drug Overdoses. L.A. Care.
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