Dear Alice,

I heard that the first reaction you have to taking ecstasy is to become violently ill, after which the party can continue. This sounds like an urban legend to me. Could you clarify please?

Dear Reader,

Kudos to you for doing a little research into the validity of what you've heard about a drug-related experience. Ecstasy (N-methyl-3,4-methylenedioxyamphetamine, also known as MDMA , Molly, X, or Adam) is a recreationally used synthetic and hallucinogenic amphetamine. The effects of one dose of X, usually taken in pill form, last for three to six hours. Research shows that people may experience nausea during the first 45 minutes of use, although this symptom eventually subsides. Along with nausea, chills, sweating, blurred vision, muscle cramps, an increase in blood pressure may also occur. As is the case with any substance, dosage, pre-existing health conditions, and drug combinations (including alcohol and prescription drugs) may all adversely impact a person’s experience using ecstasy. 

Before anyone finds themselves experiencing a party foul instead of a good time, here's some information that is key to know: Ecstasy is sometimes used as a companion at parties and nightclubs because it produces increased arousal, energy levels, pleasure, calmness, outgoingness, and sense of emotional warmth and empathy, as well as mellowing/relaxing effects, heightened self- and group-consciousness, altered perceptions of time, and enhanced sensory experiences. The drug (which is illegal in the United States) has been most associated with a rise in body temperature, which may result in acute dehydration or, in more severe cases, hyperthermia. Dancing for hours without enough breaks and water is pretty common while using X and can add to the risk of acute dehydration or hyperthermia. For more information on how to reduce the risk of both dehydration and over hydration when on ecstasy, consider taking a look at Water when on ecstasy? in the Go Ask Alice! archives. There's also the risk of overdose, particularly when ecstasy is taken with other substances such as cocaine or alcohol. According to research, an ecstasy overdose may result in heart failure or heat stroke, which could be fatal.

So how does this all occur in the body? Studies have shown that MDMA use results in the increased activity of three brain chemicals. First, this includes a rise in dopamine activity, which stimulates the brain’s reward system, and thus reinforces the use of ecstasy. Secondly, increased norepinephrine activity when using ecstasy is associated with a rising heart rate and blood pressure, which may put individuals with heart and blood vessel issues at risk. Lastly, ecstasy also uses serotonin, a chemical in the brain that affects mood, hunger, sleep habits, sexual arousal, and other body functions. Serotonin activity is likely associated with the increased sense of emotional warmth, empathy, and pleasure felt by users when high on ecstasy. However, after an initial high, users may feel tired, depressed, or moody as a result of this serotonin boost. The body will eventually produce more serotonin, but it may take some time to get it back to usual levels. So, after a weekend of heavy partying, someone who used ecstasy may have trouble getting up and going to class or work, and, once there, may be irritable. In addition to what has been outlined already, it may be helpful to consider other short-and long-term effects of ecstasy use. You can review the Q&As When Ecstasy is no longer ecstasy: Coming down and Ecstasy’s side effects – Are any permanent? to learn more about the effects of using ecstasy.  

Urban legends aside, for folks interested in trying ecstasy, it may be beneficial to explore your motivations for using. If you decide to use ecstasy, it may be worthwhile to ask someone you trust to look out for your physical and mental well-being. For additional information about ecstasy and other drugs that are sometimes used at parties, consider reading up on some resources such as Dance Safe, a peer-led harm reduction organization, or other related Q&As in the Go Ask Alice! Alcohol and Other Drugs archives.

Alice!

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