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What Are the Long-term Risks of Ecstasy Use?

intake_processEcstasy use was once restricted to a very small group of people.

These people took the drug when they were attending dance parties or concerts in order to enhance the experience of those events, and they did not use the drug during times when they were not at concerts or dance parties.

Much has changed since then. Now ecstasy, or Molly as it is sometimes known, has a fairly widespread fan base of people who appreciate the drug’s ability to boost feelings of connectedness and pleasure. These users might also appreciate Molly’s cost, as PBS reports that a pill can be purchased for as little at $10 in some places.

But people who hop on the Molly craze may find that they develop ongoing health problems, especially if they continue to take the drug over a long period of time.

Immediate Damage with Long-term Consequences


Molly works by boosting the production of a brain chemical known as serotonin. That boost is responsible for the feelings of connectedness and goodwill people experience when they take ecstasy. However, this chemical can also work on other organs in the body, including the body’s internal temperature system.

As the National Institute on Drug Abuse (NIDA) points out, people who take Molly can experience rises in body temperature that can swell to lethal levels. Organs like the kidneys and liver cannot handle this spike in temperature, and those organs can begin to experience cell death.

Organs like this can, at times, regenerate and produce new cells. But repeat users may overheat their bodies over and over again. The damage done to these organs may be so serious and so severe that it is difficult or impossible to account for it.

Similarly, people who abuse ecstasy often feel the need to touch one another, and they may feel a boost in a feeling of arousal or connectedness. That could prompt people to engage in risky sexual practices, which could lead to diseases like hepatitis or AIDS. These are lifelong medical conditions that can be treated but not cured, and longtime abusers of the drug could experience them due to their repeated risky behaviors.

Possible Long-term Damage


Researchers suspect, based on studies done on primates, that Molly has the ability to cause long-term damage to the cells of the brain. NIDA reports that animals treated with Molly have altered levels of brain chemicals that persist for quite some time after the animals were exposed to the drug. Some have not recovered for seven years after the exposure, NIDA says.

NIDA suggests, as a result, that even one exposure to Molly could be considered toxic to the cells of the brain. This is a study that should be repeated on humans before people can make good and long-term decisions. Those studies have not yet been completed.

What Should You Do?

depressionMany other drugs, including cocaine and heroin, come with very real risks that are easy for anyone to understand. Molly is a little different. Researchers just are not sure how safe or how dangerous it is, and that could leave people feeling a little confused about the drug. Should they use it? Is it safe?

The organization Dance Safe puts it plainly by saying that the safest way to use drugs is to avoid them altogether. Molly comes with so many risks that it simply cannot be considered safe for users to take, either in the long-term or over the short-term. The drug causes damage, and it can cause pain. It is best for people to avoid this drug altogether. Since Molly’s risks tend to grow worse with repeated exposure, it is best for people with a longstanding habit to stop as soon as they can.

Treatment programs can help. While there is no medication or specific therapy that has been designed to assist with an ecstasy abuse issue, teams are able to help people understand how addictions develop and how they are typically treated. Therapy programs can be customized to help people understand their addiction risks and their addiction recovery path. There are support groups that are made specifically for people who have a history of abusing drugs like Molly. The right treatment team can help people to recover, even if the abuse has been ongoing for quite some time. It really is possible.

MDMA, the parent chemical in ecstasy, increases the activity of three neurotransmitters: dopamine, serotonin, and norepinephrine. By increasing how much of these chemicals the brain produces and uses, ecstasy increases pleasure and physical energy, improves mood, increases heart rate and blood pressure, raises the risk of anxiety or paranoia, and can potentially induce hallucinations. People who struggle with ecstasy addiction are at risk for several short-term and long-term problems, including side effects from increased aggression, dehydration, and organ damage.

What Are the Signs That a Person Is High on Ecstasy?

Ecstasy is a powerful stimulant and sometimes hallucinogen. There are several symptoms of being high on ecstasy that are both mental and physical in nature. Physical signs of ecstasy intoxication include:

  • Fast heartbeat
  • Elevated blood pressure
  • Raised body temperature
  • Dilated pupils
  • Sweating
  • Reduced appetite, leading to rapid weight loss
  • Jaw clenching and teeth grinding
  • Nausea
  • Tremors

Mental and emotional signs that a person is high on ecstasy include:

  • Extreme pleasure and excitement
  • Increased sexual desire
  • Nervousness or agitation
  • Confusion
  • Anxiety or panic
  • Insomnia
  • Visual distortions
  • Hallucinations

What Does an Overdose on Ecstasy Look Like?
Because ecstasy increases the amount of serotonin in the brain and prevents the neurotransmitter from being easily reabsorbed, an overdose from ecstasy is essentially the same thing as serotonin syndrome. While milder versions of serotonin syndrome, like those associated with taking too much of an antidepressant, are not fatal, it is possible for a person to develop a high fever, irregular heartbeat, or faintness from blood pressure changes. In addition, the person could become unconscious or experience seizures. These symptoms can be deadly and require immediate medical attention.

The Substance Abuse and Mental Health Services Administration (SAMHSA) gathers information for the DAWN Report, and a 2013 report on ecstasy found an increase in emergency room admissions due to the drug between 2005 and 2011. The number of patients admitted to the ER who were under 21 years old increased 128 percent during this time.

Is Ecstasy Addictive?

There is little conclusive medical research regarding the addictive potential for ecstasy. Some studies report no physical dependence and no subsequent withdrawal symptoms from using the drug chronically, even after high doses. Other studies show that people who suddenly stop taking MDMA experience fatigue, loss of appetite, depression, and difficulty concentrating, which could indicate withdrawal. Some medical research shows that people who regularly abuse ecstasy, or who take substantial amounts of the drug, develop a tolerance to the substance.

Withdrawal, dependence, and tolerance are indicators of a potential addiction, but they are not the exclusive measurements. People who develop compulsions to take intoxicating substances like ecstasy are considered to have an addiction, especially when they want to stop but can’t. Many people have shown signs of being unable to stop taking ecstasy, taking more than intended, craving the drug when it is not in the body, and seeking out the drug to the detriment of work, school, family, or social responsibilities.

Changes in behavior indicate a potential addiction as much as changes to the body or brain. Ecstasy is a potent drug and should be treated as addictive.

What Can Happen if You Are a Poor Metabolizer (CYP2D6 Deficient) and Take Ecstasy?

The CYP2D6 enzyme is produced by the liver, and although it is a small part of overall liver function, recent studies have found that this enzyme is involved in metabolizing 20-30 percent of legal pharmaceutical drugs, including antidepressants, opioid drugs, and amphetamine-based drugs like Ritalin or Adderall. Since it is closely associated with drugs that affect serotonin and dopamine, CYP2D6 has also been found to be associated with the breakdown of MDMA-based drugs like ecstasy.

There are several levels of metabolism based on how much CYP2D6 the liver producespoor metabolizers are deficient in this liver enzyme, meaning their bodies have a harder time breaking down several kinds of drugs. People who are poor metabolizers are also more likely to suffer negative side effects from these classes of drugs, including ecstasy, because the chemicals rapidly build up in the body. Poor metabolizers who take ecstasy are more likely to experience dizziness, depression, sedation, changes in heart rate, and higher temperatures. With multiple doses, these symptoms can become lethal, with increased body temperatures, higher risk of seizures, and potential psychosis.

People who have enough, or even a surplus, of CYP2D6 can suffer similar effects. MDMA suppresses the secretion of CYP2D6, so taking a large dose, or multiple doses during several hours, means that the liver will stop producing CYP2D6, and ecstasy will build up to toxic levels in the body.

What Can Ecstasy Use Do to the Heart?

Ecstasy can damage the cardiovascular system, including the heart. Because it is a stimulant, this drug increases blood pressure and heart rate. In people susceptible to heart attacks, ecstasy can trigger a cardiovascular event. When ecstasy is abused for a long time, hypertension can damage the cardiovascular system, increasing the risk of blood clots, strokes, heart attacks, and similar events.