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MDMA (Ecstasy/Molly) Overdose

Written by Rob Alston

& Medically Reviewed by Dr. Sarah Dash, PHD

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Last Updated - 11/06/2020

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Updated 11/06/2020

MDMA is a popular party drug, but its illegal status makes it hard to know the dose or exact contents. Learn the risks and signs of MDMA overdose.

MDMA is a type of synthetic stimulant that has hallucinogenic and energy-producing effects. MDMA became popular in the music festival and rave scene and is also known as an empathogen, based on the feelings of empathy, self-awareness, and openness associated with its use.

MDMA is often distributed in pill or powder form, but as it is an unregulated substance, there is no way to know the exact dose or what other substances are in the pill or powder. This can make it easy to take a dangerous MDMA dosage and can increase the risk of overdose.

There are many misconceptions about MDMA and its use and safety. Because it is an illegal substance, there is no safe amount of MDMA. Learning the risks of taking MDMA can help people identify problematic use and become familiar with the treatment options available to help them stop.

What Is MDMA?

Because it is known by many names, people may wonder what MDMA is. MDMA, short for 3,4-methylenedioxymethamphetamine, is a synthetic drug similar to an amphetamine. It has become a popular party drug because of its ability to increase energy and enjoyment from sensory experiences like light and sound and to distort perception.

MDMA is referred to by many names — molly, ecstasy, or X — and it can be hard to know the differences between different types of MDMA and whether they have different effects or risks. The main difference between molly and ecstasy is the form it is taken in. Ecstasy is MDMA in pill form and is the most common way to take MDMA. Molly refers to MDMA in powder form or capsule form.

Without regulation and testing, it’s hard to know what MDMA is made of when it is sold and consumed recreationally. For example, a study that tested ecstasy pills online found that 15.5% included ‘unreported substances’ and that distributors often over- or under-reported the dose of the pill.

MDMA Use in Florida

MDMA is a Schedule I controlled substance in Florida, with no currently approved medical uses. As a result, possessing less than 10 grams of MDMA is considered a third-degree felony in Florida. The charges for molly possession in Florida can range from a suspended license to jail time.

In Florida, molly use is most common near big cities like Miami, Orlando, and Tampa. Its use is also popular in areas near large colleges or universities. Due to its popularity, MDMA is becoming increasingly easy to access in smaller towns as well. Regardless of location, MDMA use is typically tied to the party scene or large social gatherings.

MDMA Overdose Amount

One of the major risks of taking ecstasy or molly is that there is no clear overdose amount, and the dose that causes serious harm can vary significantly from batch to batch. This is dangerous because even people who take MDMA regularly are at risk for overdose.

Without safety regulations or monitoring, there is no way to know the exact dose or composition of an MDMA capsule or pill. Research has shown that some users do not realize that molly is a form of MDMA, given that it is often mixed with other substances. Some online distributors of MDMA will provide a dosage or composition report, but there is no guarantee that these are accurate. These reports can give people a false sense of confidence, and they may take too much.

Several factors can increase the chances of MDMA overdose. Taking MDMA with other drugs or alcohol can increase the chance of overdose. Also, high body temperature and dehydration — common problems at festivals or raves — can make an overdose more likely. Based on the risk of overdose, there have been calls for pill-testing at music festivals which is an evidence-based harm reduction strategy.

MDMA Overdose Symptoms

Knowing MDMA overdose symptoms can help to identify an overdose quickly and to seek urgent medical attention. MDMA overdose symptoms might not always be obvious, but it’s important to watch for changes in appearance or behavior. Some of the key overdose symptoms include:

Signs of MDMA Overdose

  • Increased body temperature
  • Jaw clenching
  • Loss of consciousness
  • Abnormal heart rate
  • Nausea and vomiting

It’s important to remember that because molly and ecstasy can include other substances, overdose symptoms may look different depending on what is contained in the pill or capsule. Knowing the MDMA overdose signs is helpful, but it’s also important to watch out for any other changes in behavior or physical appearance.

Effects of MDMA Overdose

The long-term effects of MDMA overdose can be serious and life-changing. For example, MDMA use can lead to neurological changes, heart complications or organ failure. A review of studies that looked at the brains of long-term MDMA users showed decreases in serotonin transporter density in the brain. This can change the way that serotonin is used in the brain and can impact mood in the long term.

MDMA overdose can also cause hyperthermia (overheating) and dangerously low levels of salt in the blood. Both of these symptoms can cause serious organ damage that can lead to long-term disability or death.

MDMA Overdose Treatment

MDMA overdose treatment can help to address the urgent and threatening symptoms of overdose, as well as keep a patient stable until the drug has left their system.

An important part of ecstasy overdose treatment involves cooling body temperature, re-hydration and balancing electrolytes. These are the most common causes of death in molly overdose and must be addressed urgently. Trying to regulate body temperature and providing fluids should be started while waiting for emergency services.

Other aspects of treatment can include maintaining a clear airway, monitoring vital signs and managing symptoms and discomfort. Once a person is stable, they may attend drug addiction treatment. A drug rehab program can help to address underlying reasons for abuse and overdose and help the person to develop strategies to stop using MDMA.

If you or a loved one is struggling with a substance use disorder and would like to get help, The Recovery Village Palm Beach at Baptist Health can help. Please contact us today to learn more about our comprehensive treatment options.

View Sources

Muller, Felix; Brandle, Raphael; Liechti, Matthias E; et al. “Neuroimaging of chronic MDMA (“ecstasy”) effects: A meta-analysis.” Neuroscience & Biobehavioral Reviews, January 2019. Accessed October 25, 2019.

Palamar, Josesph J.” There’s something about Molly: The underresearched yet popular powder form of ecstasy in the United States.” Substance Abuse, December 7, 2016. Accessed October 25, 2019.

Mohr, Robin. “Preventing Drug-Related Deaths at Music Festivals: Why the “Rave” Act Should be Amended to Provide an Exception for Harm Reduction Services.” Chicago-Kent Law Review, November 18, 2018. Accessed October 25, 2019.

Bora Feyza; Yılmaz, Faith; Bora, Taner. “Ecstasy (MDMA) and its effects on kidneys and their treatment: a review.” Iran J Basic Med Sci, November 2016. Accessed October 25, 2019.

Vrolijk, Ruben Q.; Brunt, Tibor M.; Vreeker, Annabel; et al. “Is online information on ecstasy tablet content safe?” Addiction, August 12, 2016. Accessed October 25, 2019.

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