MDMA, also known as ecstasy, is a Class A drug which can bring about a whole range of dangerous short and long term side effects. This synthetic compound acts as a stimulant, giving users an energised feeling and often making sensory experiences feel more acute. Taken in capsule or tablet form, users will typically start to feel the effects after around 45 minutes and these effects can last for an average of three hours, although MDMA effects may still be felt days after the initial ‘trip’. While many people describe the effects of MDMA as ‘enjoyable’, there are serious health implications of taking the drug which can negatively impact your health and lead to permanent damage.

How long does ecstasy high last?

The length of an ecstasy ‘high’ will very much depend on the amount of the drug taken and the individual taking it. On average, users will start to experience the effects around three-quarters of an hour after taking the tablet, with highs lasting around three hours or more. Many people will take a second tablet once they begin to feel the effects of the drug wearing off, prolonging the experience but also increasing the risk of dangerous side effects. Some users will still experience the effects of MDMA several days after having taken the drug.

MDMA effects

MDMA hallucinations

One of the most common side effects of MDMA use is hallucinations. Those under the influence of the drug will often see, hear and feel things more acutely, with things around them seeming ‘hyper-real’. They may also see and hear things which do not actually exist, as the drug affects the chemical balance of the brain and causes visual or auditory hallucinations. MDMA hallucinations can be extremely dangerous, causing people to react in unexpected ways or making them take serious risks. Users experience reduced inhibitions and a reduced sense of self-preservation, particularly if they believe they are under threat and their hallucinations have made them less aware of the reality of their surroundings.

Frightening hallucinations causing a fight or flight response could put users at risk, commonly causing injuries and even deaths as they respond to the perceived threat. There is no controlling the nature of MDMA hallucinations, so users may experience both positive and negative ‘trips’. Negative experiences can be intensely traumatic, affecting users long after they have come down from their ecstasy high. As well as taking risks whilst under the influence, therefore, MDMA users may also experience longer-term psychological damage from what they have seen and heard whilst exposed to the drug.

MDMA also leaves users feeling they have increased energy levels, and their impulsivity is also likely to increase. Increased impulsivity and high energy can lead to risk-taking, particularly if hallucinations have altered an individual’s awareness of their surroundings.

MDMA depression

Long term effects of ecstasy drug use may include depression. MDMA causes a huge release of serotonin in the brain, creating feelings of happiness, relaxation and wellbeing. Sometimes described as the ‘happy hormone’, serotonin also plays a part in regulating sleep, appetite, pain and other types of behaviour. By releasing such large amounts of serotonin in one big rush, MDMA depletes the brain’s store of this vital neurotransmitter and can cause serious episodes of depression.

MDMA long term effects

Studies carried out on primates and rodents have found that MDMA causes significant damage to the nerve cells which contain serotonin, and MDMA long term effects can include severe depression. Similar studies in humans have found that regular users of MDMA experience a whole range of psychological problems, including low mood, confusion, memory problems, anxiety, paranoia and low attention spans. MDMA also limits cerebral blood flow, which can impact emotion formation, behavioural learning and motor or sensory functions.

By depleting and damaging the cells responsible for serotonin, MDMA can cause long-term mental health conditions such as depression and anxiety. Even relatively infrequent or moderate use of the drug has been proven to have an impact, elevating an individual’s chances of developing these serious psychological conditions.

MDMA dangers

The dangers of MDMA are clear. While users may experience the elation of a short-term ‘high’ and an increased sense of emotional and self-awareness, long term effects of ecstasy drug use can be serious. There are both physical and mental risks associated with taking MDMA. In the short term, hallucinations can be traumatic and cause those under the influence of ecstasy to take unnecessary risks as they respond to a perceived threat which doesn’t really exist. While some report feeling they are more aware and more finely tuned to their surroundings, such feelings are almost always illusory and users are more likely to have a false perception of their environment. This can lead them to engage in risky behaviour without them realising they are putting themselves in harm’s way.

Longer-term health impacts of MDMA abuse must also be taken seriously. Even moderate use of the drug can increase a user’s chances of developing anxiety, depression, memory problems, poor appetite, sleep disorders and a reduced attention span. By damaging cells in the brain, MDMA upsets the chemical balance and causes severe and irreversible psychological harm.

MDMA overdose

When taken in excess, MDMA can have serious effects on the body. Because users often take more than one tablet or a series of tablets, the effects can creep up on them slowly or they may experience a sudden onset. There’s also the risk that MDMA has been cut with other substances which may also cause harmful side effects. The signs of an MDMA overdose include mental confusion, paranoia, headaches, blurred vision and clenching of the jaw. Other symptoms might include an increase in temperature, sweating, abdominal pain, a rapid heart rate, chest pains and urinary retention.

In the worst cases, someone who has overdosed on MDMA may stop breathing and need to undergo CPR. Hospital treatments may include giving the user activated charcoal to neutralise the remaining drugs in their stomach. Once stable, a patient may require further inpatient treatment in hospital or be referred to a specialist drug rehabilitation centre.

Is MDMA addictive? The effects of ecstasy drug use

Studies carried out on animals have found that many will freely self-administer MDMA when given the option, offering some evidence that ecstasy is an addictive substance. While self-administration in animals is less common with MDMA than it is with other substances such as cocaine, there is strong evidence that ecstasy has long-term impacts on the brain’s chemical balance. Adaptations to the dopamine and serotonin systems are associated with substance use disorders, often leading to psychological conditions and short term behavioural problems such as hyperactivity and impulsivity.

Some people who use MDMA have self-reported experiencing feelings of addiction, with many persevering in taking the drug despite negative past experiences. Many people report cravings, withdrawal symptoms and increased tolerance to the substance, all indicators that MDMA can become addictive for certain individuals.

How is MDMA abuse treated?

The most common treatment for MDMA abuse is Cognitive Behavioural Therapy (CBT). CBT sessions are designed to lessen an individual’s perceived need for the substance, as well as teaching them to cope with the day to day stressors which might lead them into substance misuse. In addition to one-to-one behavioural interventions, users may be encouraged to take part in group therapy sessions with fellow substance users.

Although there are no medical treatments currently available to MDMA users, clinical trials are underway and it is hoped that medical practitioners will be able to support users with medication in the future.

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