Ecstasy Addiction: Signs and Symptoms

Dr Matthew N. Parker
Calendar icon Last Updated: 11/7/2023

Reading Time: 7 minutes

It’s important to spot the signs early if someone you know is struggling with ecstasy addiction.

Ecstasy, or MDMA, is considered a synthetic “club drug” that acts as a stimulant or hallucinogen. Ecstasy use can have both short-term and long-term consequences, and in some severe cases, ecstasy addiction may occur.

What Is Ecstasy?

Ecstasy or MDMA, otherwise known as 3,4-methylenedioxy-methamphetamine, is a synthetic psychedelic drug that produces distorted feelings of pleasure, increases energy, and acts similar to a stimulant and hallucinogen. It is most common in pill form, but some snort it or take it in liquid form.

MDMA often goes by the nickname “Ecstasy” or “Molly.”2 MDMA became popular in the club scene and is generally misused by teenagers and young adults. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), “In the United States, 1.8 % of individuals age 12 years or older report using hallucinogens in the past year.”3

People often mix ecstasy with marijuana and/or alcohol, as MDMA can cause dehydration, making you thirsty. It is not uncommon for MDMA to contain other harmful drug combinations, especially those tablets purchased on the street.3 There is an increased risk of psychosis if you misuse poly-substances or mix MDMA with other drugs.4

Common ecstasy side effects may include:

  • Depression
  • Anxiety
  • Irritability or Aggression
  • Sleep disorders
  • Confusion
  • Cravings
  • Decreased interest in pleasurable activities2,4

How Ecstasy Works

Effects of ecstasy differ from other substances in that they (artificially) increase feelings of empathy, love, and sexual arousal. People on ecstasy report feelings of overwhelming love and joy and often want to express it. Your senses are also heightened on ecstasy, causing sensitivity to touch, sight, sound, and smell. Many people take ecstasy at “raves” or all-night dance parties where electronic house music is often played. Once ingested, the effects of MDMA can last from 3-6 hours.4

Ecstasy works on three brain chemicals:

  • Dopamine: Produces euphoria and acts in the reward system to reinforce behaviors
  • Norepinephrine: Increases heart rate and blood pressure, which is risky for people with heart problems
  • Serotonin: Affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust; the release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA2

Using MDMA to Treat Other Substance Use Disorders

Interestingly, a fairly new body of research shows promise for the use of MDMA in treating substance use disorders. Data from early studies found that some people reduced or eliminated their substance use after receiving MDMA, especially in a therapeutic setting.8

Participants who received MDMA-assisted psychotherapy were not motivated to seek out ecstasy and tested negative in random drug tests during follow-up in one study.8 This would apply to a short-term intervention, not the long-term recreational use of MDMA. Long-term use can contribute to fewer serotonin transporter sites and impaired verbal memory,8 essentially changes in brain chemistry that can have a long-term impact on overall functioning.

Regardless, if you are using ecstasy for recreational use or otherwise, it can be a slippery slope when occasional use crosses over into a full-blown ecstasy addiction. If you know someone who exhibits signs of ecstasy addiction, help is available. Call 800-681-1058 (Info iconWho Answers?) to explore your options.

How Common is Ecstasy Addiction?

It’s easy to understand how ecstasy addiction can occur, especially if the ecstasy drug is laced with other illicit drugs like heroin. Ecstasy releases a huge surge of dopamine and norepinephrine in the brain, which produces instant feelings of elation. However, that doesn’t mean that everyone who uses ecstasy will become addicted.

In fact, according to the National Institute on Drug Abuse, “Research hasn’t definitively answered whether MDMA is addictive, although it affects many of the same neurotransmitter systems in the brain that are targeted by other addictive drugs.”5 Ecstasy could have a psychologically addictive potential, like most other illicit drugs. The main issue with ecstasy is the extreme lows that happen directly after the drug wears off. Individuals will often go into states of deep depression, in severe cases becoming suicidal.

Signs of Ecstasy Addiction

Generally, there are common psychosocial qualifiers for a substance use disorder (SUD) and/or addiction. If you think you or someone you know may be struggling with ecstasy addiction, look for these common signs:6

  • Changes in friends or social circles
  • Inability to meet personal responsibilities
  • Distancing from family or friends who do not use MDMA
  • Lying, stealing, or other deceptive behavior
  • Financial or legal difficulties related to substance use
  • Inability or unwillingness to stop taking the drug despite serious consequences
  • Impaired cognitive functioning or adverse health problems

Short-Term and Long-Term Effects of MDMA

Many people misuse MDMA for the desired effects, but the drug also has many unwanted, dangerous side effects. MDMA affects the brain by altering neurotransmitters, which produces the distorted feelings of euphoria or drug “high.” MDMA also raises body temperature, which may be dangerous if one is not properly hydrated.2 According to The National Institute on Drug Abuse, “MDMA also releases norepinephrine, which is likely the cause of the increase in heart rate and blood pressure that often accompanies MDMA use.”4 Heart failure has been reported in some cases of MDMA use.4

Short-term effects of MDMA misuse/addiction may include: 3,6

  • Nausea
  • Muscle cramping
  • Clenching of the jaw or grinding
  • Blurred vision
  • Dehydration
  • Memory loss
  • Chills or sweating
  • Heart palpitations
  • Tremors

MDMA can impact the body’s ability to regulate temperature and prolonged use may result in liver, kidney, heart failure, or even death.2,3 Also, because MDMA can promote a false sense of trust or bonding feelings with others, the drug may bring a higher risk of contracting HIV or other sexually transmitted diseases.1 Prolonged use of MDMA may result in other negative health conditions.

Long-term effects of MDMA misuse/addiction may cause:3,6

  • Neuro-toxicity
  • Schizophrenia
  • Seizure disorders
  • Hallucinogen-induced anxiety disorder
  • Migraines
  • Psychosis
  • Depression
  • Communicable diseases
  • Accidents/suicide

Some people who use MDMA do report symptoms of addiction, including continued use despite negative physical or psychological consequences, tolerance, withdrawal, and cravings. Physical addiction includes withdrawal symptoms when the individual stops taking the substance. Depending on the length of time the drug has been misused, the frequency of use, and the specific drug or drug combination used, withdrawal can be uncomfortable to intolerable.

Ecstasy withdrawal symptoms include:

  • Fatigue
  • Diminished appetite
  • Depression
  • Lack of focus2

Prevention and Treatment for Ecstasy Addiction

Quitting a substance may not be easy, but it is possible with the right treatment in place. Long-term use of ecstasy can cause brain damage, so if addiction is present, it is something to take seriously. Certain risk factors that speed up the onset of an addiction can include:

  • Family history of addiction
  • Mental health issues
  • Peer pressure
  • Lack of a support system
  • Using drugs at an early age
  • Taking highly addictive drugs6

Club drugs like ecstasy and molly are especially popular among youth. It’s typically a “party drug” and widely used and misused in the adolescent age group. Because youth have a higher susceptibility, prevention and intervention are important. Take these steps to help prevent drug abuse in your children and teenagers:2

  • Communicate: Don’t be afraid to talk about drugs with your kids.
  • Listen: Your child may be struggling but nervous to talk to you; it’s important to listen without judgment so you can best help them.
  • Enforce boundaries: Make sure your children understand what they can and cannot do while living in your home; illegal drug use is not acceptable.
  • Seek therapy: Adolescent or family counseling, where the entire family can attend, may provide an extra layer of support.

Treating Ecstasy Addiction

If you or someone you love is suffering from addiction, the first step is to seek the appropriate treatment. Detox may be the first step in the recovery process. Depending on how long and severe ecstasy misuse has been, it can take weeks or even months for the serotonin, dopamine, and norepinephrine receptors to return to normal levels in the brain.

Because withdrawal symptoms can be uncomfortable in ecstasy addiction, a medically-supervised detox may be required. The more short-term detox symptoms generally pass soon, but the long-term ecstasy effects, like depression, may take a bit longer to subside.

If the addiction is advanced, a longer-term program may be a good option. This can include outpatient care or inpatient (residential) treatment. Both types of care usually include:

Research shows that the most effective current treatments for patients with an MDMA use disorder are cognitive-behavioral interventions designed to help alter the patient’s thinking, expectancies, and behaviors and increase life coping skills. Recovery support groups may be effective in combination with behavioral interventions to support long-term recovery.7


  1. National Institute on Drug Abuse. (2017). What is the scope of MDMA use in the United States?
  2. National Institute on Drug Abuse. (2020). MDMA (Ecstasy/Molly).
  3. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition).
  4. National Institute on Drug Abuse. (2017). MDMA (Ecstasy) Abuse.
  5. National Institute on Drug Abuse. (2017). Is MDMA Addictive?
  6. Mayo Clinic. (2021). Drug addiction (substance use disorder).
  7. National Institute on Drug Abuse. (2017). How are MDMA use disorders treated?
  8. Jerome L, Schuster S, Yazar-Klosinski BB. (2013). Can MDMA play a role in the treatment of substance abuse? Curr Drug Abuse Rev. 6(1), 54-62.
Medical Reviewer
Dr Matthew N. Parker, MD
General Practitioner Physician
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Dr. Matthew N. Parker is a native of Lubbock, Texas and now lives in deep East Texas. He was trained at the University of Texas Health Science Center at San Antonio and the Conroe Family Medicine Residency in Conroe, Texas. He's spent 20 years as a practicing physician, 15 of which have been spent treating patients with substance use disorders.