Who is abusing
MDMA?

MDMA first gained popularity among adolescents and young adults in the nightclub scene or weekendlong dance parties known as raves. However, the profile of the typical MDMA user has been changing. Community-level data from NIDA's Community Epidemiology Work Group (CEWG), continued to report that use of MDMA has spread among populations outside the nightclub scene.

Reports also indicate that use is spreading beyond predominantly White youth to a broader range of ethnic groups. In Chicago, the drug continues to be predominantly used by White youth, but there are increasing reports of its use by African-American adults in their twenties and thirties. Also, indicators in New York suggest that both the distribution and use of club drugs are becoming more common in non-White communities.¹²

Other NIDA research shows that MDMA has also become a popular drug among urban gay males. Reports have shown that some gay and bisexual men take MDMA and other club drugs in myriad venues. This is concerning given that the use of club drugs has been linked to high-risk sexual behaviors that may lead to HIV or other sexually transmitted diseases. Many gay males in big cities report using MDMA as part of a multiple-drug experience that includes marijuana, cocaine, methamphetamine, ketamine, and other legal and illegal substances.¹³

What are the effects
of MDMA?

MDMA has become a popular drug, in part because of the positive effects that a person may experience within an hour or so after taking a single dose. Those effects include feelings of mental stimulation, emotional warmth, empathy toward others, a general sense of well being, and decreased anxiety. In addition, users report enhanced sensory perception as a hallmark of the MDMA experience.^1,2

Effects of MDMA

As noted, MDMA is not a benign drug. MDMA can produce a variety of adverse health effects, including nausea, chills, sweating, involuntary teeth clenching, muscle cramping, and blurred vision.² MDMA overdose can also occur—the symptoms can include high blood pressure, faintness, panic attacks, and in severe cases, a loss of consciousness and seizures.¹

Because of its stimulant properties and the environments in which it is often taken, MDMA is associated with vigorous physical activity for extended periods.² This can lead to one of the most significant, although rare, acute adverse effects—a marked rise in body temperature (hyperthermia).^3,4 Treatment of hyperthermia requires prompt medical attention, as it can rapidly lead to muscle breakdown, which can in turn result in kidney failure. In addition, dehydration, hypertension, and heart failure may occur in susceptible individuals. MDMA can also reduce the pumping efficiency of the heart,⁶ of particular concern during periods of increased physical activity, further complicating these problems.

MDMA is rapidly absorbed into the human bloodstream, but once in the body, MDMA metabolites interfere with the body's ability to metabolize, or break down, the drug.⁸ As a result, additional doses of MDMA can produce unexpectedly high blood levels, which could worsen the cardiovascular and other toxic effects of this drug. MDMA also interferes with the metabolism of other drugs, including some of the adulterants that may be found in MDMA tablets.

In the hours after taking the drug, MDMA produces significant reductions in mental abilities. These changes, particularly those affecting memory, can last for up to a week, and possibly longer in regular users. The fact that MDMA markedly impairs information processing emphasizes the potential dangers of performing complex or skilled activities, such as driving a car, while under the influence of this drug^2,14.

The Neurobiology of Ecstasy (MDMA)