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MDMA (Ecstasy)

AKA: Mandy, Molly, E, ecstasy, pills.

  1. The basics
  2. Highs and lows
  3. Taking MDMA
  4. MDMA with other drugs
  5. Useful info
  6. MDMA and the law

The basics

MDMA is a derivative of amphetamine. It used to be better known as ecstasy, E or pills, and was more commonly found in tablet form.

As with all powdered drugs, MDMA is often cut with other substances.

How it’s used

MDMA tends to come as slightly off-white (yellow or brown) crystals, which can be crushed into a powder.

The powder can be snorted, wrapped in tissue and swallowed (bombed) or dabbed on the gums. If it’s a tablet, it’s likely to be swallowed.

There are ways to minimise the risk of taking some drugs.

Highs and lows of MDMA


About half an hour after taking MDMA – or longer, depending on how much you ate – you’ll start to ‘come up’. It’s now that your brain releases its ‘feel good’ chemicals dopamine and serotonin.

For up to four hours you might be buzzing with energy and feeling less uptight.

You may feel high and ‘loved up’. Sounds and lights can be enhanced, which is another reason for MDMA’s popularity with clubbers.


Jaw clenching, teeth grinding and sweating while high on MDMA are also common.

MDMA can sometimes cause anxiety or panic attacks, and leave you feeling disorientated or confused.

The drug can push up your body temperature to what could be life-threatening levels, which is made worse by hot clubs and dancing. Between 2013-18, 269 people died in the UK after using MDMA – either on its own or in combination with other drugs.

MDMA-related deaths are often due to heatstroke, heart failure or drinking too little or too much water.

Once your brain’s ‘feel good’ chemicals have been used up they take a few days to be replaced – so there’s little point taking more MDMA. Any extra buzz you might get will come from whatever the drug’s been cut with (and it’s often cut with things like speed, aspirin, caffeine or ketamine).

Taking MDMA

Sex on MDMA

MDMA can make you horny, with an increased sense of touch. But it can make it difficult to get a hard-on or to come. As the drug lowers your inhibitions it can make some people more likely to risk getting or passing on HIV.

MDMA is often taken with Viagra. This combination is used to get around the problem of getting and keeping a hard-on, however, this can be dangerous and lead to an erection that will not subside for more than four hours. If this happens, you need to seek urgent medical help.

Read more in our chemsex section ››

A long-term relationship?

Tolerance to MDMA can build up quickly, with more needed to get the same high.

Although MDMA has not been shown to be highly addictive, some people come to rely on the drug and can’t imagine clubbing without it. Some research suggests that prolonged MDMA use can cause long term memory loss, depression, anxiety, and cognitive problems.

MDMA with other drugs


Alcohol can deaden the effects of MDMA while MDMA masks the effects of the booze, making it difficult to tell how drunk you are.

Both dehydrate the body, put strain on the liver and kidneys, and raise body temperature. MDMA-related deaths often involve booze.

HIV drugs

Some of these – especially protease inhibitors such as ritonavir – could increase levels of MDMA to life-threatening levels in the body as they prevent it from being broken down in the liver. Check with your HIV doctor before getting high.


Taking MDMA when on a course of some antidepressants can be fatal, as it increases your risk of ‘serotonin syndrome’. This is a dangerous reaction with symptoms of agitation, sleeplessness, sweating, faster heartbeat and muscle spasms.

If this happens, you need to seek urgent medical help.

If you’re on antidepressants get medical advice before taking MDMA. An older type of antidepressants called monoamine oxidase inhibitors (MAOIs) mix particularly badly with MDMA.

Cocaine, speed, mephedrone, crystal meth

These stimulant drugs taken with MDMA can put the heart under a dangerous level of stress, leading to a risk of heart attack.

Viagra-type drugs

As well as possible extra stress on the heart, there have been a few reports of this combination possibly leading to erections that won’t go down for over four hours. If medical help isn’t found quickly, this can cause lasting damage to your cock.

Useful to know

You can avoid overheating and dehydration by drinking a pint of water for every hour that you’re dancing, and by taking breaks. But drinking too much water can be dangerous, so try not to exceed that amount.

If you’re hyperactive or dancing, take regular breaks to bring your body temperature down.

MDMA should be avoided by people with a history of mental illness or depression as it can trigger depression or make it worse if you have it already.

As MDMA pushes up blood pressure and heart rate, it should be avoided if you’ve got any of the following:

  • high blood pressure
  • heart, liver, or kidney problems
  • the eye condition glaucoma
  • a history of stroke.

MDMA and the law

MDMA is a Class A drug, so the sentence for possession is seven years plus an unlimited fine. Selling or supplying it carries a penalty of life imprisonment plus an unlimited fine.

Next drug: Ketamine ››

‹‹ Previous drug: Tranquilisers

Published: 17/08/2018
Next review: 17/08/2021