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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. In 2003, an estimated

470,000 people in the U.S. age 12 and

older used MDMA in the past 30 days,

a significant decrease from 2002.*

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.

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.

Health Hazards ———

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.

This can lead to a sharp increase in body

temperature (hyperthermia), resulting in

liver, kidney, and cardiovascular system

failure.

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. 

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.

MDMA (Ecstasy)
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 ———

Community Epidemiology Work

Group (CEWG)**

CEWG members monitor drug use data

sources for 21 metropolitan areas nationwide. In many of these 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.

The number of MDMA emergency department (ED) mentions decreased in nine

CEWG areas from 2001 to 2002, with a

significant increase reported only in New

Orleans. The highest numbers of MDMA

ED mentions in the 2002 period were in

Philadelphia, Los Angeles, New York,

Miami, San Francisco, Atlanta, Boston,

and Detroit.

2004 Monitoring the Future

Survey (MTF)***

Tenth-graders showed significant changes

in MDMA use and related attitudes from

2003 to 2004. They reported an increase

(+3.0 percent) in perceived harmfulness

of occasional MDMA use, and lifetime****

use decreased, from 5.4 percent to 4.3

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* 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

1-800-729-6686.

** CEWG researchers meet twice yearly to share emerging trends in drug abuse for 21 major U.S. metropolitan areas.

This report was based on data published in the CEWG Advance Report for December 2003. CEWG reports are on

NIDA’s Web site at www.drugabuse.gov. 

*** These data are from the 2004 Monitoring the Future Survey, funded by the National Institute on Drug Abuse, National

Institutes of Health, DHHS, and conducted 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 an individual’s drug use at

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

during the month preceding their response to the survey.

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.

percent. In addition, both 10th- and 12thgraders reported significant increases in

their disapproval of trying MDMA once

or twice over the same period.

For more information, please visit

www.ClubDrugs.org and

www.Teens.drugabuse.gov.