Ecstasy / MDMA

What is ecstasy / MDMA?

MDMA (3,4-methylenedioxymethamphetamine) is the chemical name for the active ingredient in ecstasy pills. So when we are talking about XTC or ecstasy, we are talking about MDMA as well and vice versa.

MDMA is a stimulating drug with consciousness changing effects. MDMA is sold as a pill, powder and crystal.

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Effects

The effect of a drug depends on the characteristics of the drug itself, but also on the set and setting of the user. Here we describe the general effects of MDMA.

MDMA has  stimulating and consciousness changing effects. The stimulant effect keeps you awake, sharp and give you the feeling you can think fast. The consciousness changing or entactogenic (get into contact with the inner you) effects could be described as a relaxing feeling. You feel open and in connection with others.

Mind you: pills or powders that are sold as MDMA can contain other drugs than MDMA. The effect will then be different.

Positieve effecten	(negatieve) Bijwerkingen
Euphoria, feelings of love This substance can make you feel euphoric, like you are in love. You feel comfortable in your own skin and can experience things as pleasant more quickly.	Decreased ability to concentrate Decreased ability to concentrate.
Increased empathy You feel more connected to others. It is easier to connect to others and to empathize with the feelings that someone else experiences.	Forgetfulness Forgetfulness. Short term, failure to remember events shortly after ingestion.
Entactogenic Strong sense of connectedness to others or your environment. You can connect more easily with others and notice less inhibitions than you might normally experience in social contact. For example, it may be easier to speak openly about the things that are bothering you.	Confusion Not fully understanding the environment and situation. Temporarily impaired orientation with respect to time, place, or person.
Need for contact, conversation and intimacy Having a good conversation with someone, or cuddling, can be very pleasant and interesting.	Paranoia and delusions Anxiety, paranoia and delusions (e.g. the idea that people are talking about you).
Energetic feeling You have feelings of being energized. Sitting still is sometimes more difficult and this energetic feeling is often expressed through the urge to dance or move.	Tingling Tingling sensation in the body or parts of the body.
Alertness This drug can make you more active than usual. You are feeling sharp, awkae and it is easy to focus your attention on the things that are happening around you.	Decreased appetite Stimulation of the fight-or-flight response in the body can suppress appetite.
More intense music experiences Music can be experienced louder or more intense. For example, it can feel as if you are completely ‘absorbed’ in the music or that you feel the low tones from the music go through your body more intensely.	Increase in blood pressure and heart rate Due to increased cardiac stimulation, heart rate and blood pressure rise.
	Increased body temperature Stimulants cause increased activity in muscles, and increase the “base temperature” of the body. This causes the body temperature to increase.
	Difficulty urinating Your body releases a lot of antidiuretic hormone (ADH) causing you to retain more fluids. There is also more tension in the muscles in your urinary tract, which makes relaxing (and therefore urinating) more difficult.
	Dry mouth Stimulation of sympathetic pathways decrease saliva production, this causes the mouth to feel dry.
	Dilated pupils Due to an increased noradrenaline level in the body after taking certain drugs, the pupils become larger. The pupil size is influenced by many different processes. Increase in noradrenaline plays a role in some of those processes.
	Increased muscle tension Tense muscles and jaws (biting your tongue or cheek)
	Jaw clenching Increased muscle tension can cause the jaws to clench together. As a result, the teeth are firmly pressed together and it is possible to bite your tongue and/or cheeks.
	Difficulty sleeping After using stimulants or psychedelics it can be difficult to sleep. For more information on sleeping check here.
	Nystagmus Fast back and forth moving eyes. This often makes it difficult for you to read.
	Nausea/vomiting An uneasy and tense feeling in the abdomen, which may cause discomfort. Nausea often precedes vomiting.
	Increased sweating In response to the increased stimulation and changes in body temperature, the skin will start to secrete sweat to cool the body temperature back to normal levels.
	Hallucinations In hallucinations you perceive things that are not there. It really is an observation that seems to be real. For example, you may hear sounds (auditory hallucinations) or see something or someone (visual hallucination). This is in contrast to a change in sensory perception where normal perception is distorted. Think of a person’s voice that sounds higher or lower or a face that seems to have a big nose. Hallucinations can be both desirable effects (with psychedelics) and unwanted side effects (with high doses of MDMA, or with being awake for too long).

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Dose and route of administration

MDMA is sold as a pill, powder, crystal and capsules. Sometimes it is also available as a liquid mixture (blue 69).

Ecstasy pill

MDMA is most commonly used as a pill. Some people take a whole pill at once, others break them in halves or quarters. Because the content of a pill differs widely, you never know how much you take when you think in halves or quarters.

From 2011 onward the amount of MDMA in a pill has increased. Before 2009 a pill would contain 80 milligrams of MDMA on average. That average was already doubled in  2013 to 140 mg. High doses like 180 mg or more per pill are no exception any more. More MDMA for the same price sounds good. But with these high doses, the risks also increase. It is more difficult to dose correctly and easy to take more than you intended. Inexperienced users can get the idea that these high doses are normal. They can get into ugly situations if they think one pill is one dose. In 2020 and 2021 the testing service noticed that the amount of MDMA in a pill started to vary widely. One pill can contain 70 mg will another logo can contain 230 mg.
We suspect that the pressure on the First aid at big parties and festivals has to do with the increase in the amount of MDMA in pills. So, have your pills tested!

Also check the infographic ‘strength of ecstasy pills over the years‘ by the Drugsinfoteam.

MDMA powder

In the case of powder or crystals, users usually take small licks and build up their dose slowly. Or they put it in a capsule or roll it in a small piece of paper (bomb) to swallow it. Some users dissolve the powder in a drink. The powder can be snorted or smoked (rarely). MDMA has a negative influence on the enamel of your teeth. By putting it in a drink or by taking licks you increase the chance on damage to your teeth.

MDMA powder can differ in strenght and can be cut. So have your powders tested!

So an ecstasy pill and MDMA powder are essentially the same thing, they just look different.

Rectal use or snorting

MDMA can also be used rectally (through the anus), for instance as a powder in a capsule. This way, the substance can be absorbed in the body faster so the effects come on quicker. You need a smaller dose when you use it rectally, but it is quite an uncommon way to do ecstasy in the Netherlands.

Snorting MDMA is also possible but it is very painful. As with rectal use, the effects come on quicker and you need a smaller dose.

Dose

Ecstasy pills exist in all colours and logo’s. The outside does not tell you anything about what it contains. Which substances it contains and their doses. To learn about the content you have to bring it to a drug testing service.

All drug samples that are handed in at the drug testing services nationwide are sent to the DIMS (Drugs Information Monitoring System). This gives the DIMS good view on the drug markets. In case of a dangerous situation they have the option to set up a warning campagne.
On the website of the DIMS a list with extra risky pills can be found. They are extra risky, because the use of drugs in itself caries risks as well. On this list it is mentioned what the logo is, the colour and the date when the pill was handed in.

The amount of MDMA in a pill can vary widely. Some pills contain no MDMA, while others contain three times a usual dose. And there are pills that look like regular ecstasy but contain something else, like PMMA or mCPP. These are drugs that can be more damaging to your health than MDMA or that can have nasty side effects. MDMA powder and crystals can be tested at the drug testing service. If you test pills you get the result in mg per pill. If you test a powder you get the result in percentage of the powder that is MDMA.

If you ingest it, a recreational dose is between 1 and 1.5 mg MDMA for each kilogram body weight per occasion (or between 0.4 and 0.7 mg MDMA for each pound body weight). This means that when you weigh 60 kg (or 130 pounds), a recreational dose would be between 60 and 90 mg MDMA for the whole evening. Does your tablet contain more than 180 mg MDMA? In that case, a half tablet (or two times a quarter tablet with at least one and a half hour in between) should be enough for the desired effect. If you take more, you will especially experience more unwanted effects like jaw tension, forgetfulness, confusion and nausea. Don’t take it more often than once every 6-8 weeks. Of course the use of MDMA is never without risks, but if you follow this advice you can limit the risks and side effects as much as possible.

Oral dose
Low	0,5- 1 mg per kg bodyweight
Medium	1-1,5 mg per kg
High	1,5+ mg per kg

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Duration

After 20-60 minutes you will start to feel the first effects. Tingling through your body, a warm glow and a euphoric feeling as if you are in love. The effects become stronger quickly and that feels as if you are ‘hit’ by the MDMA. That hit usually lasts for about 5 minutes. You might feel nauseous or maybe you have to vomit. After about 2 hours the effects will start to wear off. And after about 4-6 hours most people will feel fairly sober again.

Many users choose to redose to keep the buzz going. But that doesn’t always work. You won’t get the feeling back from the start of the buzz and the unwanted side effects will increase. Expect a dry mouth, forgetfulness, tense muscles and grinding of your teeth. This is often the moment when people think there is speed (amphetamine) in their pill. And people often become more introverted and have difficulty speaking.

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Risks

Severe health incidents rarely occur, but when they do they can be fatal. Serious problems or even death are mostly caused by a combination of the pharmacological properties of the MDMA (the interaction between the substances) and the surroundings in which the drug is used (environment temperature, water intake, physical activity and other drug use, including alcohol).

Short-term risks

Long term risks

Brain damage

Animal studies show that MDMA can cause damage to certain brain cells. Similar damage can be seen in the brains of heavy MDMA users. Unfortunately, it is not clear what this damage means and whether or not you can fully recover from it. It has been shown, however, that when you use two ecstasy pills every weekend for a couple of years, this will have a negative effect on your memory. It is not certain with which exact dose this is the case. Therefore, it is important to be extra careful.

We advise you not to use MDMA more often than once every six to eight weeks, and not to use more than 1 to 1.5 mg MDMA per kg body weight (or between 0.4 and 0.7 mg MDMA for each pound body weight). These quantities are based on research carried out by Unity. Do you take MDMA every weekend? Then your use is becoming dangerous. With laboratory animals, the brain damage increased as the temperature was higher. Therefore, make sure you cool down sufficiently: rest frequently, don’t wear warm clothes, drink a soda or water regularly.

Depression

Some heavy MDMA users can be left with a depression in the long-term. There is a relationship between how often and how much MDMA you use together with your sensitivity for depression, and how great the chance is that you may feel depressed after MDMA use. If you are prone to depression, don’t use too much MDMA.

Damage to the teeth

If you use MDMA often, this has consequences for your teeth. This is because people often firmly clamp their teeth together during MDMA use, grind their teeth or chew a lot of chewing gum which can cause tooth wear. MDMA also reduces saliva production. This means bacteria have more chance to multiply, causing your gums to become infected more easily. It is therefore advisable to always use sugar free gum and to take good care of your teeth in order to reduce the risks. Also make sure the MDMA does not get in contact with your teeth.

Addiction

It is possible to become psychologically dependent on MDMA. Most often this dependence means that you do not enjoy going to a party any more without using MDMA or that it becomes really hard to say no to it when others are using the drug.

There is no such thing as physical dependence on MDMA. Tolerance to the effects of MDMA does occur, however. This means that your body becomes accustomed to the use of MDMA. When you use it often, the typical MDMA “love” feeling lessens, while the stimulant effect stays. If this is the case for you, you should not use MDMA for two to three months to experience the “love” feeling again.

If you’re wondering whether your MDMA use is becoming a problem, you could ask yourself the following questions:

• Is it hard to get in a good mood without using MDMA?
• Am I mentally preoccupied with the drug?
• Has the use of MDMA changed me as a person?
• Do I have to use more and more to achieve the same effect?
• Have I been using more MDMA lately? Do I take a higher dose, in more different places and on various occasions?
• Do I use more than I planned beforehand?
• Do I suffer from withdrawal symptoms when I don’t use, such as sleeping poorly, moodiness, shaking, headaches, dizziness, nausea and sweating?
• Do I sometimes use MDMA to eliminate negative effects from the last use, such as a hangover?
• Does it take me a long time to recover from using?
• Do I spend more and more money on it?
• Do I use it despite the fact that I have important things to do? Do I neglect hobbies and work?
• Does using lead to more and more problems with people around me, for instance friends and family?
• Do I use MDMA constantly, even though I know it causes damage to both my body and my social life?

The more times you answer these questions with “yes”, the more dangerous your use of MDMA has become.

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Interactions

Combining different types of drugs can be risky and unpredictable. When you combine drugs you can have a higher risk of health problems. In the following paragraphs you can read about the effects and the risks of a number of combinations that occur frequently and also a about few that are extra hazardous. Also check our theme combining drugs.

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Unity tips:

• Only use drugs when you feel physically and mentally well.
• Rest well before and after use.
• Eat healthy before, during and after.  Especially anti-oxidants and vitamines (blue berries, raspberries, blackberries, grapes, raisins, oranges, kiwi, broccoli).
  This is perhaps the most important tip! It’s hard to eat during and after MDMA use, but try it anyway. Eating well clearly reduces the hangover! If you don’t get solid foods, think juices, breakfast drinks, smoothies.
• You can take extra vitamins and antioxidants before and after MDMA use.
• If you have pills, powder or crystals tested, you will know exactly what and how much is in them.
• Do not use when you have: diabetes, weak heart, high blood pressure, pregnancy, epilepsy and mental complaints or in combination with medicines (especially not with MAO inhibitors and asthma medicines).
• Do not use more than once every 6-8 weeks. Do not take more than 1-1.5 mg of MDMA per kg of body weight.
• Do not drink more than 1 glass of water or soda per hour, otherwise the risk of water intoxication increases.
• Make sure you don’t get too hot while taking MDMA: rest every now and then, don’t wear warm clothes, no headgear, and drink water or soft drinks every now and then.
• Do not combine with alcohol and other drugs.
• Do not participate in traffic.
• MDMA evokes feelings of intimacy. In combination with a carefree mood, safe sex can sometimes be missed. Be prepared and have a condom with you.
• There is no real safe use of MDMA, but the risks can be limited.

More info

Check out this short video about the history of ecstasy and MDMA, and why there’s so much confusion about what those two terms mean.

FAQ

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