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Note: Drugs sold as MDMA (ecstasy) may not contain any methylenedioxymethamphetamine (MDMA); they can be a mix of amphetamine, paramethoxyamphetamine (PMA), ketamine, NBOMe, synthetic cathinones or other substances.

What is MDMA?

(MDMA) Methylenedioxymethamphetamine is an empathogen, which increases an individual’s feeling of empathy and kindness, and increases feelings of being socially accepted by and connected to others. It effects are very similar to magic mushrooms.

MDMA is commonly known as  ecstasy. However, some pills sold as ecstasy may only have a small amount of MDMA or none at all. Other drugs and ‘fillers’ are often used instead. This makes it hard to know what reactions to expect after taking MDMA or if negative side effects will be experienced.

What does MDMA look like?

MDMA is commonly found in tablet or capsule form but can also be a powder or crystal. The pills come in different colours and sizes and often have a picture, symbol or logo. When sold in pill form, two pills with the same logo or symbol may have different effects — they can come from different sources and have different ingredients.

Other names

Ecstasy, caps, Eckies, E, XTC, pills, pingers, bikkies, flippers, molly, M&M

Other types of empathogens

• Ethylone
• Mephedrone
• PMA and PMMA

How is MDMA used?

MDMA is usually swallowed but can also be injected, snorted or inserted rectally.

Effects of MDMA

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

MDMA affects everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• environment (where the drug is taken).

The effects of MDMA are usually felt about 20 minutes to an hour after it’s taken and last for around three to four hours. The height of this experience is sometimes known as ‘peaking’.

You may experience:

• euphoria
• feeling energetic and confident
• dilated (enlarged) pupils
• jaw clenching and teeth grinding
• heightened senses (sight, hearing and touch)
• excessive sweating and skin tingles
• muscle aches and pains
• reduced appetite
• fast heartbeat
• increased blood pressure
• dehydration
• heat stroke
• drinking extreme amounts of water (can cause death).

If you take a large amount or have a strong batch of MDMA, you may also experience:

• floating sensations
• perceptual changes, such as visual and auditory hallucinations
• out-of-character irrational behaviour
• anxiety
• irritability, paranoia and aggression
• vomiting
• high body temperature
• racing heartbeat
• convulsions.

MDMA, dehydration and overheating

MDMA is taken by some people at festivals, parties, and nightclubs. In these environments, people using MDMA are likely to engage in dancing, which in combination with MDMA can raise body temperature to a dangerous level.

It is important people take regular breaks to cool down and drink around 250-500ml of water per hour.

Drinking too much water while taking MDMA is dangerous. Deaths have occurred from dilutional hyponatremia — this is a condition where a person’s brain swells from drinking too much water and can lead to coma.

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’):

• Set: a person’s state of mind, previous encounters with psychedelic drugs, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using MDMA may result in an unpleasant experience.
• Setting: the environment in which someone consumes MDMA – whether it’s known and familiar, who they’re with, if they’re indoors or outdoors, the type of music and light. For example, using MDMA in a calm, quiet and relaxed environment can lead to, or contribute to, a pleasant experience but being in a noisy, crowded place may result in a negative experience.
• Being in a good state of mind, with trusted friends and a safe environment before taking MDMA reduces the risk of having an unpleasant experience.

Coming down

In the days after MDMA use, you may experience:

• restless sleep and exhaustion
• anxiety, irritability and depression
• paranoia (feeling extremely suspicious and frightened)
• difficulty concentrating.

The use of depressant drugs such as alcohol, benzodiazepines or cannabis to help with these ‘come down’ effects, may result in dependence on both types of drugs.

Long-term effects

Regular use of MDMA may cause:

• colds or flu
• depression
• needing to use more to get the same effect
• dependence on MDMA
• memory and concentration problems
• liver problems
• financial, work and social problems.

Mixing MDMA with other drugs

The effects of taking MDMA with other drugs − including over-the-counter or prescribed medications − can be unpredictable and dangerous:

MDMA + alcohol:  Increased risk of dehydration and consequently drinking too much water.

MDMA + ice, speed or cocaine: Increased risk of anxiety and reduced brain functioning due to dopamine depletion. Enormous strain on the cardiovascular system and other parts of the body, which can lead to stroke.

MDMA + antidepressants: Drowsiness, clumsiness, restlessness and feeling drunk and dizzy.