The Risks of MDMA: Know Your MDMA Risks
Many studies today claim that MDMA, also known as the party drug Ecstasy, has the potential to assist psychotherapy and help heal PTSD, depression, addiction, and other mental health concerns. While these reports naturally make many people curious, MDMA can also be dangerous, particularly if you don’t know what you’re doing.
Becoming aware of MDMA side effects, risks, and recommended dosages can help you avoid adverse effects.
Rules of Thumb Regarding Mdma Side Effects
Common Mdma Side Effects
Common MDMA side effects include:
- Reduced appetite
- Blurred vision
- Jaw clenching and/or teeth grinding
Additional Side Effects
Side effects that aren’t as common, but someone who takes MDMA may experience, include:
- Chills or hot flashes
- Disorganized thinking
- Difficulty with urination
- Restless legs
Risks of High MDMA Dosage
Moderate to high doses of MDMA can interfere with the body’s ability to regulate its body temperature. Coupled with the fact that many people take MDMA as a party drug, it can lead to dehydration and increased body temperature (hyperthermia) as they dance for hours in hot, cramped conditions. While some try to compensate for the rise in temperature by drinking a lot of water, this can lead to electrolyte imbalance.
Effects of an MDMA overdose can include panic attacks, faintness, and high blood pressure. In more severe cases, a person may experience seizures, lose consciousness, or even risk their life.
What Is a High MDMA Dosage?
- In one study on MDMA-assisted psychotherapy for PTSD, a full dose was 125 per user, with a low amount being 75 mg.
- The harm reduction site Rollsafe recommends taking 1.5 mg of MDMA per kg of body weight, with a maximum of 120 mg per session.
Ecstasy typically comes in pills and is hard to measure out. Tablets may have a high variation in the dosage they contain. If one is consuming Ecstasy pills, it’s essential to start with a quarter or half a pill. One should always go slow and see how they feel before taking more.
How Often Can You Take MDMA?
MDMA works by rapidly increasing dopamine, norepinephrine, and serotonin in your brain. Then, during the days after taking the drugs, serotonin levels in the brain are depleted, leading to an “Ecstasy hangover” or “weekday blues.” Chronic MDMA use can lead to severe serotonin depletion. The brain needs time to recover its serotonin storages between MDMA use. Taking MDMA every weekend does not give the brain time to recover and replenish. The more one can wait between doses, the better.
One study found that serotonin levels returned to normal levels 12 months after MDMA use. Ideally, wait at least three months between MDMA doses. Taking MDMA more than once a month can be extremely dangerous and cause long-term damage. Taking MDMA regularly can also lead to “losing the magic,” - meaning that one may take MDMA but not feel any positive effects.
Short-Term vs. Long-Term Risks of MDMA
Short-term MDMA risks include:
- Muscle tension
- Fatigue and depressed mood during the days and weeks after consumption
Many MDMA users report experiencing a comedown in the days or weeks following their use. Common symptoms of an MDMA comedown include anxiety, insomnia, and occasionally even more severe emotional distress and panic attacks.
Taking MDMA regularly can cause long-term risks. Long-term MDMA risks can include memory deficits, sleep issues, changes in neurohormonal activity, and neurocognitive impairment.
MDMA Use During Pregnancy
Pregnant women who take MDMA risk harmful long-term effects on their developing fetus. For example, infants who were exposed to MDMA during pregnancy had motor delays. Another study found milestone delays in infants who were exposed to MDMA during pregnancy.
Mixing MDMA With Other Drugs
One study found that 90% of MDMA-related ER visits included mixing MDMA with alcohol or other drugs. For example, mixing alcohol with MDMA can increase the chances of dehydration and heatstroke. Alcohol is a diuretic, which means that it will make you pee more.
Even legal drugs can be problematic to mix with MDMA. SSRIs and other prescribed antidepressants can increase the odds that one will experience serotonin syndrome due to high serotonin levels. Serotonin syndrome can cause agitation, confusion, and seizures. It can even be fatal.
The Risks of Dying From MDMA
One Australian study found 392 MDMA-related deaths from 2001 to 2018. Of these fatalities, two-thirds were linked to drug toxicity (of which half involved other drugs). The remaining third were deaths contributed to causes such as MDMA-related car accidents.
Another way people can die from drug overdoses is by choking on their own vomit.
Heatstroke and other issues related to hyperthermia (high body temperature) are some of the main risks for MDMA-related deaths.
Don’t take MDMA if...
- If you’re pregnant. MDMA can harm your baby.
- If you have high blood pressure.
- If you are on antidepressants. SSRIs and SNRIs are medications that increase your serotonin. MDMA also increases serotonin. Mixing MDMA with anti-depressant medication or other medication that raises your serotonin may cause serotonin syndrome.
Are You Really Taking Mdma?
One study found that out of 529 Ecstasy pills tested, only 60% actually contained MDMA. That means that you may be mixing MDMA with other substances without even knowing about it, or not even taking MDMA at all. Another example of this is a drug called MDA (Sally) which is commonly sold as an alternative for MDMA.
How Can You Know if You Are Taking MDMA?
It is crucial to know if what you are taking is MDMA or something else. Street drugs are often mixed with other drugs. Street Ecstasy, for example, is often combined with caffeine or amphetamine. You can buy kits online that can test your drug and tell you what you have in front of you.
The Risks of Using MDMA in Psychotherapy
Due to increased research through organizations like the nonprofit MAPS (Multidisciplinary Association for Psychedelic Studies), there is a lot of focus on the benefits of MDMA-assisted psychotherapy. Not as much attention has been granted to the potential harm of using MDMA in psychotherapy to treat serious conditions like depression and PTSD.
MDMA is being used in psychotherapy to confront painful memories and beliefs in a safe setting. However, one can’t always control the memories and emotions that will come up during an MDMA session. And while MDMA increases feel-good hormones such as oxytocin, it can also increase cortisol, which can cause stress and be counterproductive.
Overall, How Dangerous Is MDMA?
How Likely Is Mdma Addiction?
In a report by the Australian government examining drug treatment services, MDMA was a drug of concern in just 2% of the cases. It was the principal drug of concern in under 1% of cases. The same report showed that the treatment took place outside of residential facilities and that education was enough for cessation of use in most cases.
That said, psychological dependence is still likely with MDMA. Like many other drugs, MDMA causes users to feel better on the drug than off of it. This causes mood fluctuations and other effects, such as neurocognitive impairment.
How Can One Reduce the Risks of MDMA?
The only way to completely avoid any MDMA risks is not to take MDMA at all. If you do decide to take MDMA, it is important not to go over the recommended dose. Measure your dosage by your body weight, and don’t go over 125 mg per session. 125 is considered a high dose. Start with a smaller dose and be mindful. You can take more later, but you can’t take less than you already took.
Do some research on supplements you can take along with MDMA to reduce the chances of neurotoxicity and comedown. Make sure to stay hydrated and prevent overheating. Remember that over-drinking is a risk, so keep an eye on the amount you drink.
Never mix MDMA with alcohol. Doing so will increase your risk of harmful effects such as dehydration and overheating. Do not take MDMA if you are taking antidepressants or other medication. Reduce the time you spend dancing in crowded conditions. Stay in air-conditioning or shaded areas when possible. It’s essential to give your brain and body time to recover between MDMA sessions. Wait several months before retaking MDMA. A standard recommendation is to wait three months between MDMA sessions, with a minimum of three weeks.
When taking MDMA or any other substance, it’s important to be mindful. Be aware of your limits. Be cautious - it’s better to take too little instead of too much.