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“It feels like a five-hour orgasm.”
                                                                            - Ecstasy user interviewed on The History Channel

ECSTASY FACTS * General * Effects * Short Term Risks * Long Term Risks
Harm Reduction * Debunking Myths

SHORT TERM RISKS

COMMON SHORT-TERM DANGERS

• Hyperthermia – This is the number one cause of death associated with MDMA use. Heatstroke (not overdose) has contributed to 100+ fatalities of MDMA users at raves and clubs. Published studies from 1998 found that MDMA can cause the core body temperatures of MDMA-administered rats to change drastically depending on the temperature of their environment. What this suggests is that MDMA inhibits bodily homeostasis when it comes to temperature, thus keeping a person from being able to regulate body temperature in response to external conditions. Someone on MDMA in a very cold setting may experience hypothermia and could freeze to death. Far more common, however, are users in hot crowded settings such as raves who are dehydrated, overheat, and experience seizures or strokes from fatally high body temperatures.



• Fake Pills – Depending on the adulterant, a fake pill may cause overdose, adverse reactions, adverse interactions with other drugs, or simply unexpected effects. The chart below includes some drugs that have been found in pills sold as MDMA. The differences between ecstasy and its adulterants illustrate the risks of consuming something of which its contents are not guaranteed. EcstasyData.org provides extensive results on the content of tablets sold as MDMA in the blackmarket.

  Drug (taken orally)	Category	Normal Dosage	Effects
  MDMA	Stimulant Entactogen	50-150 mg 30-60 min for onset Lasts for 4-6 hrs	Empathy & Happiness Physical Energy Enhanced Senses & Pleasures Lack of Body Temp Regulation
  Caffeine	Stimulant	50-150 mg 15-45 min for onset Lasts for 6-14 hrs	Increased Alertness & Energy Increased Heartrate & Respiration Sleeplessness
  Amphetamines	Stimulants	Dose varies widely 30-60 min for onset Lasts 8-20 hrs	Increased Alertness & Energy Sleeplessness Reduced Appetite Euphoria Compulsive Behavior
  Ketamine	Dissociative	75-300 mg 5-20 min for onset Lasts 2-3 hrs	Anesthesia Difficulty Moving Hallucinogenic Sensations
  PMA	Hallucinogen Stimulant	50 mg or less Onset Unknown Duration Unknown	Physical Energy Mild Visual Hallucinations Increased Pulse Rate Increased Blood Pressure Increased Body Temperature Nausea, Convulsions, Coma
  DXM	Dissociative	200-400 mg 30-60 min for onset Lasts 4-8 hrs	Dissociation of Mind vs. Body Suppresses Coughing Inhibits Sweating Nausea & Dizziness
  MDA	Stimulant Hallucinogen	25-100 mg 30-60 min for onset Lasts for 8-12 hrs	Euphoria & Physical Energy Enhanced Senses & Pleasures Mild Hallucinations

• Interactions w/ Medication – Many users have gotten sick or gone to the emergency room due to negative reactions between their intake of MDMA and medication drugs. For example, MAOIs (monoamine oxidase inhibitors) or any stimulants such as diet pills can trigger rising blood pressure and irregular heart beats if taken in combination with ecstasy, possibly leading to heart attacks or seizures. Many users who are also taking Prozac or Zolof also report a lack of effects from MDMA. This is because the major class of anti-depressants called SSRIs (selective serotonin reuptake inhibitors) bind to the same receptor sites in the brain as MDMA does, and for a much longer period, thus pushing MDMA to diffuse in the synapse before having an impact on the neurons. All of these interactions can occur with ecstasy as far apart as 4 weeks after taking the medication.

RARE SHORT-TERM DANGERS

• Hyponetremia – A few cases have been documented of overhydration. Excessive intake of water leads to low sodium levels in the blood. MDMA also suppresses kidney activity. Without urinating or replenishing electrolytes (through sports drinks or salty snacks), water toxicity occurs. What happens is that water from the diluted blood is absorbed through osmosis into the brain (and probably other organs) causing swelling (cerebral edema). This is what leads to seizures and to death if the swelling is so bad that the brain no longer keeps a person breathing. The best harm reduction tip is to reduce water/sport drink intake to 1/2 liter per hour. Even sports drinks could make water intoxication worse after the condition has begun.
• Serotonin Syndrome – This is a rare, possibly genetically-based condition where an excess release of serotonin leads to deregulation of heart rate and blood pressure, muscle rigidity, shakiness, impaired mental and physical coordination, which in turn may cause hyperthermia and death. Other drugs that release extra serotonin, such as cocaine and methamphetamine, can also produce this condition. Very few cases of hyperthermia, however, are caused by serotonin syndrome. MDMA-related heatstroke is almost always attributable to hot and crowded environments.
• Overdose – Most users do not bother taking more than three or four pills because they know it will not strengthen or prolong the desirable effects any further. The reason is while you can put as much MDMA in your bloodstream as your body can hold, there is only a certain amount of serotonin that can be produced by the brain at any given time. So after a certain point, increasing your dosage will not increase the intensity of your experience since there is no serotonin left for MDMA to release. As far as toxic levels of MDMA in the bloodstream, none is known right now. Again, most documented deaths were caused by hyperthermia. However, the liver enzyme CYP2D6 which breaks down MDMA is missing in 10% of Caucasian males. DXM, a common ecstasy adulterant, is also metabolized by CYP2D6, forming a dangerous interaction when taken with real ecstasy. If this enzyme is not available to break down MDMA for whatever reason, the chances of overdose is heightened.

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