Drug Guide

Ecstasy (MDMA)

By Anthony McDaniel, M.D.

MDMA (3,4-Methylenedioxymethamphetamine) – colloquially known as ecstasy, often abbreviated "E" or "X" – is an entactogenic drug of the phenethylamine and amphetamine class of drugs. MDMA can induce euphoria, a sense of intimacy with others, and diminished anxiety and depression. Many, particularly in the fields of psychology and cognitive therapy, have suggested MDMA might have therapeutic benefits and facilitate therapy sessions in certain individuals, a practice which it had formally been used for in the past. Clinical trials are now testing the therapeutic potential of MDMA for post-traumatic stress disorder (PTSD) and anxiety associated with terminal cancer.

MDMA is criminalized in most countries under a United Nations (U.N.) agreement, and its possession, manufacture, or sale may result in criminal prosecution, although some limited exceptions exist for scientific and medical research. MDMA is one of the most widely used recreational drugs in the world and is taken in a variety of contexts far removed from its roots in psychotherapeutic settings. It is commonly associated with dance parties (or "raves") and electronic dance music. There have been debates within scientific, health care, and drug policy circles about the risks of MDMA, specifically the possibility of neurotoxic damage to the central nervous system (CNS). Regulatory authorities in several locations around the world have approved scientific studies administering MDMA to humans to examine its therapeutic potential and its effects. Continuing to study the substance in clinical trials, the Multidisciplinary Association for Psychedelic Studies released the following statement in October 2008, "We found that low doses of MDMA (between 50 and 75 mg) were both psychologically and physiologically safe for all the subjects. Future studies in larger samples and using larger doses are needed in order to further clarify the safety and efficacy of MDMA in the clinical setting in subjects with PTSD."

The European Monitoring Centre for Drugs and Drug Addiction notes that although there are some reports of tablets being sold for as little as €1, most countries in Europe now report typical retail prices in the range of €3 to €9 per tablet. The United Nations Office on Drugs and Crime claimed in its 2008 World Drug Report that typical U.S. retail prices are lower, costing 10 to 15 dollars per tablet, or from 4 to 6 dollars per tablet if bought in batches. MDMA is expensive in Australia, costing AU$20–AU$50 per tablet, but in the Asian community it is AU$20–30 depending on the size. In terms of purity data for Australian MDMA, the average is around 34%, ranging from less than 1% to about 85%. The majority of tablets contain 70–85 mg of MDMA. Most ecstasy enters Australia from different markets, the Netherlands, the UK, Asia and the U.S. The primary effects attributable to MDMA consumption are predictable and fairly consistent amongst users. Generally, users report feeling effects within 30–60 minutes of consumption, hitting a peak at approximately 1–1.5 hours, reaching a plateau that lasts about 2–3 hours, followed by a comedown of a few hours which may be accompanied by fatigue and minor effects.

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