MDMA

How is MDMA used?

MDMA is usually swallowed but can also be injected, snorted or inserted rectally.²

Effects of MDMA

Use of any drug can have risks. 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.^{2, 3} The height of this experience is sometimes known as ‘peaking’.²

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).^2-5

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.^{2, 4, 5}

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.⁶

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.⁶

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.⁷
• 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.⁷
• 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.^2-5

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.^2-4

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.⁸

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.^9,10

MDMA + antidepressants: Drowsiness, clumsiness, restlessness and feeling drunk and dizzy.¹¹

Reducing Harm

• Try a smaller dose first and wait 2 hours before taking more
• Avoid taking high doses. Higher doses are more likely to cause an unpleasant, overwhelming experience (particularly for first time use)
• Avoid mixing with other drugs including alcohol as this can cause dehydration
• Some medications interact with MDMA, always check first before taking
• Take regular breaks to cool down and drink around 250-500ml of water per hour
• Let a friend know what you’ve taken so they can help if you’re unwell
• Avoid taking MDMA too frequently. According to some people who use MDMA, if taken too frequently, MDMA can stop working which can result in taking more to get the same result.^{12, 13}

Withdrawal

Giving up MDMA after a long time is challenging because the body has to get used to functioning without it. Withdrawal symptoms should settle down after a week and will mostly disappear after a month. Symptoms include:

• cravings for MDMA
• aches and pains
• exhaustion
• restless sleep
• agitation
• trouble concentrating
• anxiety and depression.¹⁴

Getting help

If your use of MDMA is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a loved one, you can find help and support.

Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs

Help and Support Services search

Find a service in your local area from our list. Simply add your location or postcode and filter by service type to quickly discover help near you.

If you're looking for other information or support options, send us an email at druginfo@adf.org.au