3,4-Methylenedioxymethamphetamine (MDMA) is a synthetic drug possessing both stimulant and mild hallucinogenic properties. On the street it is known as Ecstasy, XTC, E, X, Beans, and Adams. Adolescents and young adults use it to promote euphoria, feelings of closeness, empathy, sexuality, and to reduce inhibitions. It is considered a "party drug" and obtained at "rave" or "techno" parties. However, its abuse has expanded, to include other settings outside of the rave scenes, such as a college campus.

There is no legitimate medical use for MDMA in the United States.

MDMA, a ring substituted derivative of phenethylamine, having a pharmacological profile similar to amphetamine and mescaline. MDMA increases motor activity, alertness, heart rate, and blood pressure. It also induces perceptual changes, including enhancement of tactile sensations. Other effects include: euphoria, increased energy, increased (sexual) sensual arousal, increased "need" to be touched (i.e., hugged) and increased need for stimulation.

Abuse of MDMA can cause psychological and physical damage. Psychological effects associated with MDMA use include confusion, anxiety, depression, and paranoia. These effects may last weeks after ingestions. High doses of MDMA can interfere with the ability to regulate body temperature, resulting in a sharp increase in body temperature (hyperthermia), leading to liver, kidney, and cardiovascular failure. Other effects include tremors, involuntary teeth clenching, muscle cramps, and blurred vision.

Studies suggest chronic use of MDMA can produce brain damage in humans. Brain imaging techniques have revealed a reduction in serotonin nerve terminals and transporters in former MDMA abusers. Clinical studies suggest that MDMA may increase the risk of long-term, perhaps permanent, problems with memory and learning.

MDMA is mainly self-ingested orally in tablets (50-150 mg). Other methods of abuse are crushing and snorting or injecting. MDMA abusers usually take MDMA by "stacking" – taking three or more tablets at once; or by "piggy-backing" – taking a series of tablets over a short period of time. One trend among young adults is "candy flipping," the co-abuse of MDMA and LSD. The onset of action after oral ingestion occurs within 30 to 45 minutes and lasts 4 to 6 hours.

Abusers are adolescent and young adults. After a period of rapid increase in use, the Monitoring the Future survey revealed that ecstasy use is decreasing after peaking in 2001 among 8th, 10th, and 12th graders. From 2001 to 2003, annual prevalence use of MDMA decreased by more than half among 10th and 12th graders. By 2004, 2005, and 2006, use of MDMA among these grades had stabilized.

Seized MDMA in the U.S. is primarily manufactured in clandestine laboratories in the Netherlands and Belgium. MDMA destined to the U.S. from the Netherlands is transferred through Germany and Poland and smuggled into the U.S. via body carriers, by air/sea cargo, luggage, and by express mail. Another significant source country is Canada. Operation Candy Box identified an international drug trafficking organization through which up to one million MDMA tablets per month were smuggled into the U.S. A small number of MDMA clandestine laboratories have been identified operating in the U.S.

MDMA is mainly distributed in tablet form. Ecstasy tablets most often contain MDMA alone. Many so-called Ecstasy tablets may contain other substances (e.g., MDA, methamphetamine, ketamine, caffeine, amphetamine), either alone or in combination with MDMA. MDMA tablets are sold with logos, creating brand names for users to seek out. MDMA is also distributed in capsules, powder, and liquid forms. Prices for an Ecstasy tablet range from $3 to $45.

According to the System to Retrieve Information from Drug Evidence (STRIDE) database, DEA forensic laboratories analyzed 3,904 MDMA exhibits from 1,008 cases in 2001. Since then total number of MDMA exhibits analyzed declined: 2002: 813 cases involving 2,490 exhibits; 2003: 653 cases involving 1,904 exhibits; 2004: 561 cases involving 1,838 exhibits; 2005: 577 cases involving 1,711 exhibits, and 2006: 692 cases involving 2,302 exhibits.

MDMA is available in every region of the country, principally in large metropolitan areas. Los Angeles, CA, Miami, FL; and New York, NY are the primary market areas for MDMA smuggled into the U.S. from Western European source countries. Florida leads the nation in MDMA seizures. International traffickers use south Florida as a base of operations for the importation and distribution of MDMA.

According to the National Forensic Laboratory Information System (NFLIS) database, MDMA was the most common among club drugs analyzed in 2006 by state and local forensic laboratories across each region; 88% (7,534 out of 8,513) in the South, 71% (1,781 out of 2,520) in the Northeast, 92% (3,721 out of 4,027) in the West, and 92% (3,767 out of 4,093) in the Midwest.

In 1988, MDMA became a schedule I controlled substances under the Federal Controlled Substances Act.