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  • MDMA: effects, consequences and harm reduction

    Let’s talk about MDMA – a very popular club drug.

    We do not promote psychoactive substance use, it is never completely safe. The safest choice is to never use drugs.

    MDMA is a substance popular among young people, especially among the fans of clubs, nightlife and raves. However, its popularity goes far beyond this, and even those who have never been to a club, at least heard of MDMA, also known as ecstasy.

    MDMA (methylenedioxymethamphetamine, 3,4-methylenedioxy-N-methamphetamine) is a semi-synthetic psychoactive substance, first synthesized in 1912 by the German chemist Anton Kölisch, who was looking for new drugs to improve blood clotting.

    MDMA became widely popular in the late 1970s. The active dissemination in the club subculture began in the 1980s.

    Known slang names for MDMA are ecstasy and molly. Although, in fact, MDMA is not the same as ecstasy is. MDMA is an active component. Ecstasy is the general name for various drugs in the form of pills (mainly), crystals and powder containing the substance MDMA + various additives.

    Here you can read about how to test MDMA.

    MDMA is one of the most widespread illegal substances in the world. In terms of popularity, it ranks third after cannabinoids and cocaine.Compared to many other surfactants, MDMA is quite well studied.

    Chemically it is a substituted amphetamine, structurally close to mescaline and stimulants (amphetamine and methamphetamine).

    Nowadays, scientists claim that MDMA has medical potential. In particular, new clinical studies show that MDMA in combination with speech therapy successfully treats the symptoms of severe post-traumatic stress disorder (PTSD).


    Pure MDMA is a light brown or white crystalline powder. Ecstasy are pills of different colors and shapes. MDMA is usually taken orally, although other ways are possible if its’s in powder form.

    The dosage for oral consuming:

    • Light dose: 40-70 mg
    • Common dose: 70-140 mg
    • Strong dose: 140-180 mg

    There are also different formulas that allow you to pay attention to various individual factors and more accurately calculate the safe dose.

    One of them is:

    human weight in kilograms + 50 = total dose in milligrams

    For example, if a person weighs 70 kg, then, according to this formula, 70 + 50 = safe dose is a maximum of 120 mg.

    Another formula is: 1.5 mg per 1 kg of body weight.

    Do not take a dose higher than 140 mg, even if according to these formulas it’s permissible.


    The effects of MDMA are revealed in 20-40 minutes. If a person consumes ecstasy on a full stomach, this time can last up to an hour or even longer. The main effects last up to 4.5-5 hours, post-effects are felt for more than a day.

    MDMA can be detected in the blood within 24 hours, in the urine within 1-4 days.



    • removal of prohibitions and barriers, openness
    • simplification of verbal communication
    • empathy, a sense of intimacy with other people, accompanied by pleasure from physical contact
    • feeling of inner peace, happiness and harmony
    • novelty of perception of traditional sensations
    • deterioration of verbal, spatial, visual and working memory


    • distortion of visual perception
    • dry mouth
    • fast heart rate and respiration
    • increase in blood pressure
    • hyperhidrosis and dehydration
    • nausea
    • bruxism
    • loss of appetite
    • pupils dilation, deterioration of their response to light
    • hyperthermia
    • difficulty urinating
    • loss of coordination, muscle pain or convulsions (in case of overdose)

    Long-term continued consumption of MDMA can have the following consequences:


    The substance can impair the functions of the hippocampus, the area of the brain responsible for spatial thinking and the transition from short-term to long-term memory. There is every reason to believe that MDMA destroys serotonin neurons in the brain, the regeneration of which can take many years.

    While the neurons responsible for serotonin synthesis are renewed, we can observe the following effects of its reduction:

    • depression
    • anxiety
    • decreased activity
    • sleep disorders
    • obsessive or manic states
    • irritation
    • feeling of tension
    • craving for sweets or loss of appetite
    • slow movement of muscles and tongue
    • decreased interest in sex
    • panic attacks, phobias
    • migraines
    • decreased immunity

    Cognitive abilities, memory processes, visual memory deteriorate.

    These effects are dose-dependent: the more and longer a person takes MDMA, the stronger they may be.


    Mitochondria are the nuclear power plants of our cells. There are especially many of them in the places with the highest energy expenditure: liver, muscles, brain. The work of all organs in the body depends on the state of mitochondria and their ability to perform their functions.

    Mitochondria can divide and merge. The balance between fusion and distribution is one of the most important mechanisms for maintaining cell health and, consequently, human health.

    A number of studies have shown that the use of MDMA causes a disruption of this mitochondrial balance in the brain, making it less productive and making it age faster.


    Studies in rats have shown that MDMA depletes glutathione in the liver and adenosine triphosphate (ATP) produced by mitochondria. This causes the death of hepatocytes, and the liver begins to perform worse.


    Ecstasy damages testicular tissue, it reduces sperm production and affects their quality.

    Over time, this can lead to reduced fertility and infertility.


    MDMA impairs sleeping quality for 5-6 days after use.

    Bad sleep, in turn, makes us anxious, increases the level of chronic stress, slows down reactions. Immunity, productivity and motivation may also decrease.

    At the same time, the likelihood of overeating increases because lack of sleep stimulates the growth of ghrelin, the hunger hormone. We often want to satisfy this hunger not with healthy food, but with fast food.


    Mixing psychoactive substances is always more dangerous than using only one substance!

    You will find a calculator via this link where you can put in the names of substances and see the outcomes of combining them.

    MDMA + GHB/GBL: Risks of heavy strain on the cardiovascular system, nausea, physical discomfort. The sedative effect of GHB/GBL is temporarily neutralized; the risks of GHB/GBL overdose become higher.

    MDMA + cannabis: Cannabis enhances the overall effects of ecstasy. At the same time, marijuana can increase negative emotions and feelings, so the risk of a bad trip increases.

    MDMA + LSD: Either the empathogenic effects of MDMA, or the hallucinogenic effects of LSD, or both, may be exacerbated. This combination is known as candy-flip.

    MDMA + amphetamine, caffeine: Stimulants may potentiate the neurotoxic effects of MDMA.

    MDMA + cocaine: Cocaine may partially block some of the effects of MDMA and increase the risk of heart attack.

    MDMA + ketamine: Risks of increasing blood pressure. At high doses, the risk of physical injury increases.

    MDMA + 2C: In combination with MDMA, physical and cognitive effects (euphoria, visual hallucinations) are greatly enhanced. The synergy between these substances is unpredictable, so much lower doses should be taken than when these substances are used separately. The combination may strengthen the neurotoxic effects of MDMA.


    1. Very often in ecstasy pills the exact content of MDMA is unknown. Therefore it is necessary to dose carefully! Start with half a pill, if you are inexperienced – with a quarter.

    2. If you decide to add, take half of the initial dose. This can be done after the peak of the first dose, not earlier than 2 hours after the first dose.

    Do not add until the first dose has reached its peak effect. This is especially important to keep in mind when trying out a new sample of MDMA.

    3. Do not mix MDMA with other substances. Do not drink alcohol, do not use other drugs on this day, especially just before taking MDMA. Most people who seek emergency care after taking ecstasy have used other drugs and alcohol. There are also a number of medicines changing the experience.

    4. Drink enough water, but not too much: 300-500 ml per hour, not more than 500 ml per hour. Avoid alcohol. You can drink juices and isotonic drinks. At the same time do not forget to urinate regularly: the fluid should be excreted from the body.

    5. Avoid overheating! If you dance, be sure to take breaks from time to time: go outdoors if you’re in a club, or in the shade if you’re dancing outdoors during the day.

    6. Experiment only with people you know well. Never use psychoactive substances in unfamiliar companies.

    7. Before experimenting with MDMA, eat only light food and no later than 2 hours before taking the substance.

    8. Research information about the effects of the substance and possible unpleasant consequences. Remember about all the factors that may affect the experience: dose, exposure to other substances, general health state (both physical and psychological).

    9. People who have health problems that the substance may aggravate (such as cardiovascular disease, liver problems, depression) should avoid taking MDMA and any other psychoactive substances.


    If you have questions about what an overdose of various psychoactive substances looks like and how to provide first aid to a person with an overdose, you can contact the Telegram bot @OverdoseHelpBot. There you will find a lot of useful information.

    In case of acute MDMA intoxication, the effects pass in 3-6 hours after the last dose. Severe lethargy and depressive mood usually come 24-48 hours after the last intake. The well-known expression Suicide Tuesday is associated with this phenomenon.

    Symptoms of MDMA overdose (one or more of the following):

    • Uncontrolled body movements
    • Accelerated heart rate, high blood pressure
    • Increased sweating
    • Rising body temperature
    • Jaw compression (bruxism)
    • Nervous excitement, overactivity and anxiety
    • Dizziness, loss of coordination
    • Muscle spasms and strains
    • Dizziness, loss of consciousness

    Don’t be afraid to call an ambulance – somebody’s life may depend on it. If, for some reason, you are very afraid to call an ambulance, call the parents or relatives of the overdosed person.

    You can call a free ambulance via the phone numbers 103 or 112.

    There is no criminal liability for calling an ambulance in case of an overdose. Contrary to popular belief, ambulance doctors are not required to report to the police about the cases of drug use. Police is called only if the ambulance crew has witnessed a criminal offense involving drug use.

    Before the ambulance arrives:

    In the case of hyperthermia the intoxicated person needs to drink water, but not too much, not in one gulp! If possible, find an isotonic or a “sports” drink. You can stir two tablespoons of salt per 1 liter of water and drink in small sips.

    • If the intoxicated person has a fever, put some ice or a wet cloth on the temples. Try to prevent the intoxicated person from losing consciousness.
    • Make sure that the airways are clean and nothing is obstructing the breath. Loosen the intoxicated person’s collar, unbutton tight clothing.

    When the ambulance arrives, tell the doctors what the person consumed or could have consumed. This will help to more accurately provide special medical care.

    Read more about the effects of different psychoactive substances: GHB/GBL (butyrate), ketamine, alprazolam (Xanax), LSD, 2С-B, 2C-I, cannabis, bath salts, Alpha-PVP.


    #MDMA #extasy

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