MDMA (or “ecstasy“) is a psychoactive drug commonly used at dance clubs, music festivals, and other social events. Known for its euphoric, empathogenic effects, it has become a symbol of the rave culture, causing some to consider it a “club drug“. MDMA acts on some of the same reward pathways in the brain as certain other stimulants and drug of abuse, leading some to consider it a “party drug“. In addition to its popular recreational use, MDMA is becoming increasingly accepted as a potential psychopharmaceutical and is being investigated as a possible treatment for anxiety and PTSD. MDMA works by increasing the activity of three neurotransmitters: dopamine, norepinephrine, and serotonin. This produces both psychological and physical effects, such as feelings of pleasure, emotional warmth and closeness, mental stimulation, and distortions in perception of time and space.
MDMA involves an increase in the production of three chemicals in the brain – dopamine, norepinephrine, and serotonin – which leads to a heightened sense of awareness and pleasure.
- Dopamine—produces increased energy/activity and acts in the reward system to reinforce behaviors
- Norepinephrine—increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems
- Serotonin—affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust. The release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.
Other health effects include:
- sweating
- chills
- blurred vision
- involuntary teeth clenching
- muscle cramping
- nausea
As with other drugs, the amount of time that MDMA remains detectable in a person’s system depends on a number of factors, including the person’s age, weight, and metabolism, as well as the amount ingested. Generally, MDMA can be detected in the body for up to three to four days after use.
The main metabolite of MDMA, 3,4-methylenedioxyamphetamine (MDA), can be detected in the body for up to four to eight days after use. Blood tests are the most sensitive tests for detecting MDMA, and can detect it within hours of use. Urine tests can detect MDMA up to three days after use. Hair tests can detect MDMA up to three months after use.
The exact amount of time that MDMA remains in a person’s system depends on the amount taken, as well as a person’s individual body chemistry. If a person has taken an especially large dose, it could remain in their system longer than the usual three to four days. As well, regular users of MDMA may have the drug stored in their system for longer than a person who has only taken it once.
It is important to remember that body temperatures can continue to climb after the effects of MDMA wear off, even if the user has stopped taking the drug. Medical attention should be sought if someone begins to experience high body temperatures, dizziness, nausea, or rapid heartbeat. These are all possible indications of overheating and should not be taken lightly.
Clinical trials have reported craving and addictive behavior for MDMA while others have reported no such issues. Some users can take MDMA occasionally without reporting adverse effects, while others find themselves facing greater challenges when attempting to quit. Overall, research suggests that MDMA can be addictive, with the drug’s addictiveness varying from user to user depending on individual biochemistry and motivations.
Some people report signs of addiction, including the following withdrawal symptoms:
- fatigue
- loss of appetite
- depression
- trouble concentrating
Unfortunately, there is currently no specific medical treatment for MDMA addiction. Many people have turned to behavioral therapy to treat their addiction. Behavioral therapy can help individuals identify triggers for using MDMA, learn better coping mechanisms for difficult situations, and avoid further drug use. Studies suggest that behavioral therapy may help reduce cravings and relapse rates, although more research is needed to determine the effectiveness of this treatment. As a whole, the best approach to treating MDMA addiction is through a combination of behavioral therapy and medications such as antidepressants, which can help relieve symptoms of depression and anxiety that are often associated with MDMA use.