What is Ecstasy?

According to the Home Office Statistics Survey on drug misuse, the drug Ecstasy is the third most common drug reported to have been used by someone at least once in their lifetime, behind cannabis (30.2%) and cocaine (10.7%). The survey showed that 9.9% of respondents had used ecstasy at some stage.

Most of the reported ecstasy takers aged between 16 and 59 reported having taken the drug once or twice in a year rather than more regularly, with 3.5% saying they used it more than once a month. Another government survey reported that between 2018 and 2019, 4.7% of 16- to 24-year-olds had used the drug within the last 12 months. So, what is Ecstasy exactly?

What is ecstasy?

Ecstasy has many names. It is commonly known today as MDMA, which is short for its long chemical name of 3,4 Methylenedioxymethamphetamine. Ecstasy, or MDMA, is a synthetic drug which acts as a hallucinogen and stimulant. This makes it unique in comparison to other illicit drugs which are usually one or the other.

MDMA gives the user an energising effect and allows them to experience heightened enjoyment from their senses including distorting their perception and time. It is also described by some as an entactogen, which is a drug that increases a person’s empathy and self-awareness.

MDMA is often referred to as ecstasy when it is in tablet form. This is the most common way that users take the drug. The name ecstasy is derived from the feelings that one gets when taking it.

Many ecstasy tablets do not just contain MDMA – there are many combinations of drugs or compounds within the tablets that are harmful. These can include caffeine, anaesthetic ketamine, methamphetamine, heroin, cocaine, phencyclidine (PCP), ephedrine (the diet drug), dextromethorphan (the over-the-counter cough medicine) and more besides.

There are other street names for the drug too. Molly, which is slang for molecular, refers to MDMA when it is in powder form. Other names include E, dolphins, brownies, doves, eckies, Edward, love doves, fantasy, M and Ms, sweeties, tulips, XTC and X. Many of these names reflect the appearance of the drug as the tablets are often imprinted with logos or designs on them. This is why some ecstasy tablets have resulted in being given nicknames like teddy bears or Mitsubishis.

Is ecstasy addictive?

It is not really known if ecstasy is a drug that is easy to become addicted to. Many users report that it is difficult to stop taking it, which seems to indicate that psychological dependence is a possibility.

As with other drugs and substances, it is possible for a person to build up tolerance levels. As such, the person may need to take increased amounts of the drug to feel the same effects. They take larger and larger doses which also increases the intensity of unwanted and rather unpleasant side effects. This, in turn, is what causes some people to spiral into taking other drugs such as cannabis or benzodiazepines to combat the effects.

There is support and treatment available for those who misuse ecstasy, especially those who are keen to stop. Often, treatments do not work unless someone has the desire to stop taking a drug.

Treatments for ecstasy misuse and/or addiction include:

• Group therapy.
• Individual counselling.
• Detoxification programmes.
• Peer support.

Is ecstasy illegal in the UK?

In the UK, drugs are classified into three categories: Category A, B and C. Ecstasy is a Class A drug in the UK. This means that it is the most dangerous type of drug that is likely to cause the most harm. They also carry the most serious of penalties. In sum, ecstasy is an illegal substance.

There are several laws that govern the use of drugs in the UK. These are the Misuse of Drugs Act (1971), the Medicines Act (1968) and the Psychoactive Substances Act (2016). The first of these, the Misuse of Drugs Act, is there to try to prevent the non-medicinal use of some drugs. Drugs that fall into this category do not need to be medicinal but ones that are, are classed as controlled drugs. The majority of drugs do have medicinal uses.

The following are offences against this Act:

• Possession of a controlled drug.
• Possession with intent to supply.
• Production, cultivation or manufacture of controlled drugs.
• Supplying another person with a controlled drug.
• Offering to supply another person with a controlled drug.
• Importing or exporting a controlled drug.
• Allowing your premises to be used to consume drugs, or supply and/or produce any controlled drug.

The offences listed above apply to ecstasy given that it is a controlled and illegal substance in the UK. Different penalties apply for each of these offences. The penalties also depend on the amount that a person has in their possession and where it was found.

The maximum sentence for possession of a Class A drug like ecstasy is seven years in prison and/or an unlimited fine. Less serious offences of possession usually result in going to the magistrates’ court, with sentences not exceeding six months and fines of no more than £5,000.

Despite this, usually only around one in five people who are convicted of possession receive a custodial sentence, with even fewer still actually going to prison. Most fines are less than £50. Most convictions are for possession, with fewer for supply, production and so on.

How is ecstasy used?

Ecstasy is used by people who are seeking a ‘high’ and want feelings of euphoria. The effects of it usually last between three and eight hours. It has a reputation for being a ‘fun-loving’ drug.

It amplifies the senses, including the perception of light and sound. It gives the user energy, enabling them to keep active or dance for hours without feeling tired. A user’s empathy is also increased with its use, meaning it serves to bond people as a group.

For this reason, it is probably most popular on the party scene and at music festivals where there are large groups of people all looking to have a good time. Young people are particularly prone to taking ecstasy at such events, especially given their younger, more risk-averse mindsets.

At these events, people take ecstasy to enhance and prolong their experience.  Quite often, a person’s first experience with ecstasy is at such events. However, there is also a growing trend for its use at home rather than at parties. In June 2022, teenager Lila-Grace Smith from Keighley, West Yorkshire, died after taking the drug at a sleepover.

It follows another teenage death in 2019 in Northallerton, North Yorkshire, where 15-year-old Leah Heyes was supplied with the drug in a car park and subsequently died of a cardiac arrest later in hospital. The use of ecstasy outside of the party scene is certainly growing.

How does ecstasy work?

Ecstasy works by stimulating the nervous system within the body. In our bodies, it is our central nervous system that comes into action when we are frightened or stressed, preparing us for fight or flight. Our natural response to danger is to release adrenaline and other hormones. Our heart rate may increase as does our blood pressure. Blood flow is also redirected to our muscles and away from our stomachs.

Because ecstasy stimulates the central nervous system, the brain is tricked into activating the fight or flight response and therefore the body receives a burst of energy. It also distorts the senses so that perceptions of sounds and light are altered.

The elevation of chemicals within the body also causes feelings of love, empathy and … ecstasy. This could be because neurotransmitters (such as dopamine, norepinephrine and serotonin) flood the brain. MDMA enhances their release as well as blocks their reuptake.

Serotonin plays a very important role in regulating a person’s sleep, pain, mood, appetite and some other behaviours. The fact that MDMA causes it to be released in excess means that the person’s mood is elevated considerably. However, because so much of the neurotransmitter floods the brain after taking ecstasy, in the subsequent days, the user feels a dramatic ‘come down’ as the supply of serotonin is greatly depleted.

What are the different forms of ecstasy?

Despite its many, many street names, there are usually very limited ways in which people take ecstasy. The most common way is in tablet form, with pills appearing in different shapes, sizes, colours and with different logos, as mentioned. It is also possible to get ecstasy in capsule form.

Another form of ecstasy is powder, which tends to be referred to as Molly (as mentioned above, this is slang for ‘molecular’). The powder form is considered by many to be a ‘purer’ form of ecstasy, but there’s little proof of that. The crystalline powder is often combined with other substances too including bath salts (synthetic cathinone).

Today, ecstasy tends to be made in illegal laboratories, often without a robust set-up. This means that those who make the drug often have little idea of its strength or effects. Some pills may contain little MDMA and instead include other chemicals and ‘fillers’ – including household products! Of course, such chemical combinations can have disastrous and harmful consequences.

Ecstasy is usually taken as a single pill although many users go on to take a second pill once the effects start to wear off. Some people may snort the powder version of the drug up their nose. It is possible to inject or smoke ecstasy too, though this is rarer.

How does ecstasy affect the body?

The effects of ecstasy are dependent on different factors.

These include:

• The strength of the ecstasy.
• The amount taken.
• A person’s physical make-up.
• A person’s state of mind.
• An individual’s response (whether they are a regular or first-time user).
• Whether the person has taken other drugs.

Usually, a person will feel the effects of taking ecstasy within 20 minutes and the effects will last between three and four hours.

The effects of taking ecstasy include:

• Feelings of euphoria.
• High energy levels.
• Increased confidence.
• Accelerated breathing and heart rate.
• Blood pressure increase.
• Dehydration and sweating.
• Nausea.
• Teeth grinding and jaw clenching.
• Restless legs.
• Chills or hot flashes.
• Faintness.
• Panic attacks.
• Loss of appetite.
• Dilated pupils.
• Sleep problems.
• Heightened senses.
• Increased libido (sex drive) and/or feeling affectionate.
• Excessive thirst (this may lead to excessive drinking which can lead to death).
• Losing one’s inhibitions.
• Illogical and disorganised thoughts.

Some of the more pronounced effects after someone has taken a large dose include:

• Hallucinations.
• Irrational behaviour including paranoia and aggression, which may be out of character.
• Irritability and anxiety.
• Vomiting.

What are the risks of taking ecstasy?

Any drug that has not been prescribed by a medical professional is a risk. However, taking ecstasy carries the additional risk of it not being controlled or produced in legal laboratories. As mentioned, ecstasy tablets and MDMA powder are often found to include other chemical substances and, as such, taking any form of ecstasy is seriously risky.

People with certain health conditions are often even more at risk. This includes disorders such as epilepsy, heart disease, kidney disease, high blood pressure, diabetes, and psychiatric or mood disorders.

Moreover, many people take ecstasy in combination with other stimulants or drugs such as alcohol, amphetamines and even prescription medications like antidepressants. The combination of different drugs and stimulants is extremely dangerous. No one knows how their body will react to the tablet before taking it, even if they have taken similar pills before.

Signs and symptoms of an ecstasy overdose

Many people accidentally overdose on ecstasy either because they did not realise the strength of the pills they have taken or because they have enjoyed the feelings and then take more when they begin to wear off or in anticipation of this.

Some of the serious symptoms of ecstasy overdose include:

• Vomiting and seizures.
• Loss of consciousness.
• Sudden increase in blood pressure.
• Sudden increase in body temperature.
• Heart palpitations.
• Muscle cramps or twitching.
• Brain swelling.
• Kidney failure.

Ecstasy use can also cause serious illness and death including cardiac arrest, kidney failure, stroke, dehydration, overheating and dilutional hyponatraemia – where a person drinks too much water and effectively ‘drowns’ their brain.

If you suspect someone has taken ecstasy and they are showing any of these symptoms it is important to call for help immediately. In these circumstances, you should not worry about the person (or you!) potentially getting in trouble with the police for drug offences. Time is of the essence, and it is crucial that the person is treated before it is too late.

Short-term and long-term effects of ecstasy

As mentioned, ecstasy has many short-term effects including feelings of euphoria, increased sensory awareness, increased heart rate and blood pressure, and high energy levels, to mention a few. The short-term effects are what appeal to users.

It makes it seem like a ‘fun’ experience. However, what naïve drug users often don’t realise is that ecstasy starts its long-term destructive mission right from the first use. It can cause a surprising amount of damage quickly, which often does not appear until much later.

It is often harder to see these effects as they are primarily ones of psychological harm, at least initially. Indeed, research shows that even a short amount of time being exposed to ecstasy can lead to longer-term effects, lasting several weeks.

However, there are some even longer-term effects of taking the drug. Having said this, there is unfortunately very little research into what the long-term effects of ecstasy use may be.

Some studies do show, however, that a person who takes ecstasy regularly may suffer from some long-term effects including:

• Depression and/or anxiety.
• Paranoia.
• Attention difficulties.
• Sleep disturbance.
• Arrhythmia.
• Memory problems and issues with concentration.
• Cognitive impairment.
• Increase in viral illnesses like colds and flu.
• Increased risk of hepatitis, HIV, blood poisoning and skin abscess if ecstasy is used in injected form, especially with shared needle use.
• Risks associated with unprotected sex including unwanted pregnancy and STIs.
• Increased use of other drugs including cannabis, alcohol and benzodiazepines to counteract the side effects of taking ecstasy.
• Liver damage.
• Permanent damage in the brain to the cells that produce serotonin and other neurotransmitters. These are involved in mood regulation, appetite, sex drive and body temperature regulation.

Research has shown that prolonged use of the drug damages the serotonin-containing nerve cells in the brain. Indeed, primates exposed to MDMA showed that they had reduced numbers of serotonergic neurons even seven years after their exposure.

What are the signs of ecstasy abuse?

Ecstasy is an illegal substance in the UK and, as such, it is often abused.  Back in the 1990s, it surged in popularity at dance parties, raves and nightclubs. Now, it has spread to more sedate venues including university campuses and people’s homes. People who you would not necessarily suspect as being drug users may well be popping pills at parties and at home.

If you’re concerned about someone, there are signs that you can look out for.

Aside from finding the pills, signs of ecstasy use can include:

• An erratic sleeping schedule.
• A lack of awareness of pain.
• Frequent varied sexual partners or promiscuity (this is because ecstasy users often experience increased and heightened emotions and believe they are in love with people they have not known for long).
• Sucking on lollipops – this helps users to unclench their jaw muscles, which is a side effect of the drug.
• Unusual energy levels.
• Spending long hours awake.
• Acting overly (and abnormally) friendly compared to usual.
• Dancing for long periods (perhaps more noticeable at festivals etc.).
• Increased sensitivity to music and lights.
• Exaggerated pleasure from touching things/being touched.
• Dilated pupils.
• Sweating.
• Nausea.
• Chills.
• Blurred vision.
• Confident behaviour and boosted self-esteem.

Of course, aside from these particular signs, a person’s behaviour can also indicate that they’re abusing drugs, ecstasy or otherwise.

These signs include acting secretively, being overly private, seeming nervous, losing interest in things they used to be interested in, borrowing or asking for money, being overly forgetful, reduced performance at school/work, and seeming more apathetic about things they used to enjoy.

If you’re concerned about someone you love, it’s important that you tread carefully. You need to treat the matter seriously but show the person love and empathy at the same time. It’s also important to help the person find the right support from professionals when or if needed.