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NIDA. (2005, January 1). NIDA's Latest Research Report Focuses on MDMA (Ecstasy) Abuse. Retrieved from

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January 01, 2005

The most recent issue of NIDA's Research Report Series highlights the current science on 3,4-methylenedioxymethamphetamine (MDMA, or "Ecstasy"). The series is part of NIDA's continuing effort to provide science-based information to the public. Each report focuses on a particular drug abuse topic of national interest. For the complete Research Report and for additional information on illicit drugs, please visit Research Reports.

Because of its use by young adults at all-night dance parties, or "raves," MDMA is classified as a "club drug." In the past few years, however, MDMA abuse has spread to a wide range of other settings and demographic subgroups. Despite growing evidence of its potential harmful effects, MDMA still has a deceptive reputation as a "safe" drug among its abusers. The latest findings in the Research Report highlight dangers, effects, and addiction potential.

Potential Dangers. Because of its stimulant properties and the environment in which it is often taken, MDMA is associated with vigorous physical activity for extended periods. This can cause a dangerous increase in temperature that can lead to cardiovascular failure. MDMA also can produce dehydration and increase heart rate, blood pressure, and heart wall stress. Other potential adverse health effects include nausea, chills, sweating, involuntary teeth clenching, muscle cramping, and blurred vision. MDMA overdose may be characterized by high blood pressure, faintness, panic attacks, and in severe cases, loss of consciousness and seizures.

Behavioral Effects. In the hours after taking the drug, MDMA significantly impairs memory and information processing. These deficits can interfere with performing skilled activities, such as driving a car. In the week following moderate exposure to the drug, many MDMA abusers report feeling anxiety, restlessness, irritability, and sadness that in some individuals can be as severe as clinical depression. Regular MDMA abusers demonstrate elevated anxiety, impulsiveness, aggression, sleep disturbances, lack of appetite, and reduced interest in and pleasure from sex.

Brain Effects. By releasing large amounts of serotonin, MDMA significantly depletes the brain of this important neurotransmitter, contributing to the negative behavioral effects that abusers often experience for several days. A number of studies show that long-term heavy MDMA abusers suffer persistent cognitive deficits, including problems with memory.

Possible Reproductive Effects. The potential adverse effects of MDMA on the developing fetus are of great concern. Behavioral studies in animals have found significant adverse effects on tests of learning and memory from exposure to MDMA during a developmental period equivalent to the third trimester in humans. However, more research is needed to determine the effects of MDMA on the developing human nervous system.

Potential for Addiction. For some people, MDMA can be addictive. A survey of adolescents and young adults found that 43 percent of those who reported MDMA abuse met the accepted diagnostic criteria for dependence—that is, the individual continues to use the drug despite withdrawal effects, tolerance, and knowledge of harm. More than a third (34 percent) met the clinical criteria used to diagnose a need for for drug abuse treatment. MDMA affects many of the same neurotransmitter systems in the brain that are targeted by other addictive drugs. Behavioral studies in animals corrorborate MDMA's potential for abuse. Rats prefer places associated with the drug and learn to self-administer MDMA, behaviors associated with most addictive drugs.


  • Substance Abuse and Mental Health Services Administration. Overview of findings from the 2002 National Survey on Drug Use and Health (Office of Applied Studies, NHSDA Series H-21 DHHS Publication No. SMA 03-3774). Rockville, MD.

The Extent of MDMA Use

It is difficult to determine the exact scope of MDMA abuse. It often is used with other substances and does not appear in some traditional data sources. However, the following snapshot emerges:

  • In 2002, more than 10 million Americans over age 12 reported having used MDMA at least once, up from 6.4 million in 2000.
  • Past-year MDMA use among people over age 12 decreased from 3.2 million to 2.1 million between 2002 and 2003. In this period, the number of past-month users fell from 676,000 to 470,000.
  • The initiation of MDMA use in the U.S. rose steadily from 1992 until 2000, when the number of new users reached 1.9 million. Following overall declines in hallucinogen use, the number of people initiating MDMA use fell from 1.8 million to 1.1 million between 2001 and 2002.
  • MDMA use decreased among 8th-, 10th-, and 12th-graders in 2003, continuing a decline that began in 2002. Past-year use among 8th-graders decreased from 2.9 percent to 2.1 percent; from 4.9 percent to 3.0 percent among 10th-graders; and from 7.4 to 4.5 percent among 12th-graders.
  • MDMA use extends across many demographic subgroups. Among 12th graders, for example, 6.4 percent of Whites, 5.3 percent of Hispanics, and 1.4 percent of African Americans reported using MDMA in the year prior to the survey.
  • Mentions of MDMA in hospital emergency departments increased 94 percent from 1999 to 2001 (from 2,850 to 5,542).