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For some people, this illicit drug can be addictive. A survey of young adult and adolescent users found that 43% 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% met the criteria for drug abuse.
Almost 60% of people who use ecstasy report withdrawal symptoms, including:
loss of appetite
Research in animals indicates that this drug, also referred to as MDMA or Molly, is neurotoxic; whether or not this is also true in humans is under investigation. It’s effect on cognition and memory is a concern. The drug can also be lethal on rare occasions.
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Chronic users of ecstasy 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 ecstasy, among other factors. Research indicates heavy ecstasy use may cause persistent memory problems in humans, although studies are conflicting.
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In high doses, ecstasy 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 it can interfere with its own metabolism (breakdown within the body), potentially harmful levels can be reached by repeated drug use within short intervals.
Users 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.
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Psychological effects can include confusion, depression, sleep problems, drug craving, and severe anxiety. These problems can occur during and for days or weeks after taking ecstasy.
Research in animals links ecstasy exposure to long-term damage in neurons that are involved in mood, thinking, and judgment. A study in nonhuman primates showed that exposure to the compound 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 on damaging properties suggests that the chemical is not a safe drug for human consumption.
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Other drugs chemically similar to ecstasy, such as MDA (methylenedioxyamphetamine, the parent drug of ecstasy) 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.
Ecstasy tablets may be further contaminated with 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 use of this agent by itself or with one or more of these drugs may be inherently dangerous, users might also unknowingly combine them with substances such as marijuana and alcohol, putting themselves at further physical risk.