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MDMA (3,4 methylenedioxymethamphetamine) is a synthetic, psychoactive drug

chemically similar to the stimulant

methamphetamine and the hallucinogen

mescaline. Street names for MDMA

include Ecstasy, Adam, XTC, hug,

beans, and love drug. MDMA is an illegal drug that acts as both a stimulant

and psychedelic, producing an energizing effect, as well as distortions in time

and perception and enhanced enjoyment from tactile experiences.

MDMA exerts its primary effects in the

brain on neurons that use the chemical

serotonin to communicate with other neurons. The serotonin system plays an

important role in regulating mood,

aggression, sexual activity, sleep, and

sensitivity to pain.

Research in animals indicates that

MDMA is neurotoxic; whether or not this

is also true in humans is currently an

area of intense investigation. MDMA

can also be dangerous to health and, on

rare occasions, lethal.

Health Hazards ———

For some people, MDMA can be addictive. A survey of young adult and adolescent MDMA users found that 43 percent of those who reported ecstasy use

met the accepted diagnostic criteria for

dependence, as evidenced by continued

use despite knowledge of physical or

psychological harm, withdrawal effects,

and tolerance (or diminished response),

and 34 percent met the criteria for drug

abuse. Almost 60 percent of people who

use MDMA report withdrawal symptoms,

including fatigue, loss of appetite,

depressed feelings, and trouble concentrating. 

Cognitive Effects

Chronic users of MDMA perform more

poorly than nonusers on certain types of

cognitive or memory tasks. Some of

these effects may be due to the use of

other drugs in combination with MDMA,

among other factors.

Physical Effects

In high doses, MDMA can interfere with

the body’s ability to regulate temperature. On rare but unpredictable occasions, this can lead to a sharp increase

in body temperature (hyperthermia),

resulting in liver, kidney, and cardiovascular system failure, and death.

Because MDMA can interfere with its

own metabolism (breakdown within the

body), potentially harmful levels can be

reached by repeated drug use within

short intervals. 

MDMA (Ecstasy)
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Users of MDMA face many of the same

risks as users of other stimulants such as

cocaine and amphetamines. These

include increases in heart rate and

blood pressure, a special risk for people

with circulatory problems or heart disease, and other symptoms such as muscle tension, involuntary teeth clenching,

nausea, blurred vision, faintness, and

chills or sweating.

Psychological Effects

These can include confusion, depression,

sleep problems, drug craving, and

severe anxiety. These problems can

occur during and sometimes days or

weeks after taking MDMA.

Neurotoxicity

Research in animals links MDMA exposure to long-term damage to neurons

that are involved in mood, thinking, and

judgment. A study in nonhuman primates

showed that exposure to MDMA for only

4 days caused damage to serotonin

nerve terminals that was evident 6 to 7

years later. While similar neurotoxicity

has not been definitively shown in

humans, the wealth of animal research

indicating MDMA’s damaging properties

suggests that MDMA is not a safe drug

for human consumption. 

Hidden Risk: Drug Purity

Other drugs chemically similar to

MDMA, such as MDA (methylenedioxyamphetamine, the parent drug of

MDMA) and PMA (paramethoxyamphetamine, associated with fatalities in the

U.S. and Australia) are sometimes sold

as ecstasy. These drugs can be neurotoxic or create additional health risks to the

user. Also, ecstasy tablets may contain

other substances in addition to MDMA,

such as ephedrine (a stimulant); dextromethorphan (DXM, a cough suppressant that has PCP-like effects at high

doses); ketamine (an anesthetic used

mostly by veterinarians that also has

PCP-like effects); caffeine; cocaine; and

methamphetamine. While the combination of MDMA with one or more of these

drugs may be inherently dangerous,

users might also combine them with substances such as marijuana and alcohol,

putting themselves at further physical

risk. 

Extent of Use ————

National Survey on Drug Use and

Health (NSDUH)*

In 2004, an estimated 450,000 people

in the U.S. age 12 and older used

MDMA in the past 30 days. Ecstasy use

dropped significantly among persons 18

to 25—from 14.8 percent in 2003 to

13.8 percent in 2004 for lifetime use,

and from 3.7 percent to 3.1 percent for

past year use. Other 2004 NSDUH

results show significant reductions in lifetime and past year use among 18- to
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20-year-olds, reductions in past month

use for 14- or 15-year-olds, and past

year and past month reductions in use

among females.

Community Epidemiology Work

Group (CEWG)**

In many of the areas monitored by

CEWG members, MDMA, once used

primarily at dance clubs, raves, and 

college scenes, is being used in a number of other social settings. In addition,

some members reported increased use

of MDMA among African-American and

Hispanic populations.

Monitoring the Future Survey

(MTF)***

Lifetime**** use dropped significantly

among 12th-graders in 2005, from 7.5

percent in 2004 to 5.4 percent. The 

perceived risk in occasional MDMA use

declined significantly among 8th-graders

in 2005, and perceived availability

decreased among 12th-graders.

For more information, please visit

www.ClubDrugs.org and

www.Teens.drugabuse.gov.

Lifetime Prevalence of MDMA 

Use by Students

Monitoring the Future Survey,

2003–2005

2003 2004 2005

8th-Graders 3.2% 2.8% 2.8%

10th-Graders 5.4 4.3 4.0

12th-Graders 8.3 7.5 5.4

* NSDUH (formerly known as the National Household Survey on Drug Abuse) is an annual survey of Americans age

12 and older conducted by the Substance Abuse and Mental Health Services Administration. Copies of the latest survey are available at www.samhsa.gov and from the National Clearinghouse for Alcohol and Drug Information at

800-729-6686.

** CEWG is a NIDA-sponsored network of researchers from 21 major U.S. metropolitan areas and selected foreign

countries who meet semiannually to discuss the current epidemiology of drug abuse. CEWG’s most recent reports are

available at www.drugabuse.gov/about/organization/cewg/pubs.html. 
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National Institutes of Health – U.S. Department of Health and Human Services

This material may be used or reproduced without permission from NIDA. Citation of the source is appreciated.

*** These data are from the 2005 Monitoring the Future Survey, funded by the National Institute on Drug Abuse,

National Institutes of Health, DHHS, and conducted annually by the University of Michigan’s Institute for Social

Research. The survey has tracked 12th-graders’ illicit drug use and related attitudes since 1975; in 1991, 8th- and

10th-graders were added to the study. The latest data are online at www.drugabuse.gov. 

**** “Lifetime” refers to use at least once during a respondent’s lifetime. “Annual” refers to use at least once during

the year preceding an individual’s response to the survey. “30-day” refers to use at least once during the 30 days preceding an individual’s response to the survey.