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MDMA (Ecstasy/Molly): Addiction Signs & Symptoms

Written by Megan Hull

& Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS, CACP

Medically Reviewed

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This article was reviewed by a medical professional to guarantee the delivery of accurate and up-to- date information. View our research policy.

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Last Updated - 12/29/2022

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Updated 12/29/2022

Key Takeaways

  • MDMA is an addictive substance with a high potential for abuse
  • MDMA can produce a wide range of physical and psychological side effects
  • People who start abusing MDMA will devote a greater and greater portion of their time to drug use
  • MDMA is dangerous by itself, but it may be mixed with more dangerous substances like methamphetamine
  • MDMA addiction is treatable, and if you suspect addiction in yourself or a loved one, treating it early may help an addiction from becoming severe or life-threatening

The party drug MDMA is more addictive than many realize. It increases levels of dopamine, which causes drug-seeking behavior.

MDMA is short for 3,4-methylenedioxymethamphetamine, a drug popular at clubs and rave parties. Slang terms for the drug include ecstasy, Molly, X, XTC and E. People use MDMA because it produces feelings of both a stimulant and a hallucinogen (psychedelic). Stimulants increase energy and make people feel euphoria.

Hallucinogens change how a person senses things by changing the experience of sights and sounds. For example, colors may be brighter, and music may be more vivid. MDMA is also known to increase extroversion and feelings of empathy and closeness to others.

The effects of MDMA last between three and six hours for most people and portions of the drug take between one and two days to fully metabolize in the body.

Is Ecstasy (Molly) Addictive?

Yes, MDMA is addictive. It is classified as a Schedule I controlled substance in the United States. Schedule I substances are federally illegal and have no recognized medical use. They also have a high potential for abuse and addiction.

MDMA (or Molly) addiction stems from the changes it makes to chemistry in the brain. MDMA increases the effects of many neurotransmitters, which are chemical signals that brain cells use to communicate with each other.

One of the neurotransmitters that MDMA increases is dopamine. In the brain, dopamine signals to other brain cells that a behavior is good and we should continue partaking in it. MDMA increases dopamine to levels beyond what we naturally experience, reinforcing its use. We perceive the feeling of high levels of dopamine as euphoria.

Another property of MDMA that increases its addiction potential is the “MDMA comedown.” MDMA is well known to cause anxiety and depression symptoms for a few days after using it.

Dopamine and other neurotransmitters deplete, creating these feelings of depression. Some people may try to alleviate symptoms of the crash by retaking MDMA, capturing them in a cycle of euphoria, crash, and craving.

Symptoms of MDMA Use

Since MDMA is both a stimulant and a hallucinogen, it can produce a wide range of side effects. Side effects can include those that impact the body (physical) and those that impact the mind (psychological).

Physical Effects

  • Dehydration
  • Dilated pupils
  • Dry mouth
  • Excessive sweating
  • Headache
  • Low appetite
  • Muscle tension
  • Nausea and vomiting
  • Sweating
  • Teeth or jaw clenching

Psychological Effects

  • Desire to be touched
  • Emotional warmth
  • Enhanced sense of well-being
  • Euphoria
  • Increased empathy
  • Increased extroversion
  • Mild confusion
  • Reduced fatigue and increased energy
  • Restlessness
  • Talkativeness

Signs of MDMA Abuse

To spot MDMA abuse, a person should look for the physical and psychological symptoms of MDMA. A person may exhibit these signs outside of club and party situations, indicating that drug use may be occurring on a regular basis.

People developing an addiction may become more secretive, and their hygiene habits may change. They may start eating and sleeping at odd times and not keep a regular schedule.

Ecstasy Abuse Statistics

The National Survey on Drug Use and Health (NSDUH) 2017 reports information about general drug abuse, including ecstasy statistics. About 7% of people aged twelve and older have used MDMA in their lifetime. The group with the highest reported lifetime use of MDMA is 18–25 at 12%, with 3.5% of this age group reporting that they used MDMA in the last year.

Is MDMA Dangerous?

Yes, MDMA use can be very dangerous. By itself, MDMA affects both physical and mental health. MDMA often includes a mixture of several drugs, not just MDMA. In fact, a recent study showed that among drugs sold as Molly and tested, only about 60% even contained MDMA.

Other drugs commonly found in Molly and ecstasy include cocaineketaminemethamphetamine and synthetic cathinones (bath salts).

MDMA by itself can cause both long and short-term effects:

Short-Term Side Effects of Ecstasy

High blood pressure, drug interactions that lead to seizures, anxiety, loss of consciousness and kidney damage because of dehydration or overhydration.

Long-Term Side Effects of Ecstasy

Depression, strange or disorganized thoughts, panic attacks, muscle breakdown, and coma.

Common Adulterants in Molly

People selling Molly may mix in other drugs for a variety of reasons. This practice makes using the drug more dangerous. Examples of other substances that may be mixed into Molly include:

  • 3,4-Methylenedioxyamphetamine (MDA)
  • Caffeine
  • Cocaine
  • Dibutylone (bk-DMBDB)
  • Dextromethorphan (an over-the-counter cough suppressant)
  • Ketamine
  • Methamphetamine
  • Methylone (MDMC)
  • Synthetic cathinones (“bath salts”)

Ecstasy Brain Damage

MDMA causes brain damage because of something called excitotoxicity. The drug works by making brain cells to release excessive amounts of serotonin, dopamine, and norepinephrine. High levels of neurotransmitters like these can stimulate brain cells so much they get stuck in an “on position.” This is called excitotoxicity.

Research in animals has shown that MDMA can cause temporary and sometimes permanent damage to brain cells because of this effect. The effects on animals impacted brain systems that are involved in memory and mood, and the findings are consistent with studies in humans that show regular MDMA use causes confusion, depression, paranoia and problems with attention.

MDMA Overdose Symptoms & Treatment

Symptoms of MDMA can include any of the above-listed side effects of MDMA. At increasing doses of MDMA, it begins to impact organ systems like the heart, brain, and kidneys.

Notable symptoms of ecstasy overdose include:

  • Apnea, or stoppage of breathing
  • Convulsions and seizures
  • Hyperthermia, or dangerously high body temperature
  • Muscle pain and tension
  • Unconsciousness

Signs of Molly Addiction

Clinicians use eleven different criteria to diagnose substance use disorder (SUD). The criteria are:

  • Giving up important activities to use MDMA instead
  • Inability to manage commitments like work and school because of MDMA use
  • Increased tolerance
  • Spending a lot of time obtaining, using or recovering from MDMA use
  • Using MDMA even when it causes problems with friends and relationships
  • Using MDMA even when it makes physical or psychological problems worse
  • Using MDMA even when it puts one in danger
  • Using MDMA more than or longer than intended
  • Wanting to stop or cut down but being unable to
  • Withdrawal symptoms

Am I Addicted to MDMA (Ecstasy/Molly)?

Someone with two or more of the above symptoms may be developing a mild SUD involving MDMA. A person with four or more symptoms is classified as having moderate SUD. People with six or more symptoms have substance use disorders that are classified as severe. If you find yourself exhibiting two or more of the symptoms in the section above, you may be at risk of MDMA addiction.

View Sources

Figurasin, Rick, and Nicole J Maguire. “3,4-Methylenedioxy-Methamphetamine (MDMA, Ecstasy, Molly) Toxicity.” 2019. Accessed Aug 14, 2019.

McLellan, A Thomas. “Substance Misuse and Substance Use Disorders: Why Do They Matter in Healthcare?” Transactions of the American Clinical and Climatological Association, 2017. Accessed Aug 14, 2019.

National Institute on Drug Abuse. “MDMA (Ecstasy/Molly).” 2019. Accessed Aug 14, 2019.

National Institute on Drug Abuse. “What Are MDMA’s Effects on the Brain?”, 2019. Accessed Aug 14, 2019.

Saleemi, Sarah, et. al. “Who Is ‘Molly’? MDMA Adulterants by Product Name and the Impact of Harm-Reduction Services at Raves” Journal of Psychopharmacology, 2017. Accessed Aug 14, 2019.

‌Ramcharan, S, et al. “Survival after Massive Ecstasy Overdose.” Journal of Toxicology. Clinical Toxicology, 1998, pp. 727–31. Accessed Aug 14, 2019.