||It's impossible to say what you need to know, but things that come to mind off the top of my head include the following:|
Most people enjoy MDMA. All of the above comments and cautions are within the context of a drug that is well liked by most people who try it and has possible future use in the treatment of post traumatic stress disorder because it can make people feel very safe and positive, even when thinking about or expressing difficult and painful topics.
- Ecstasy is the street name for what one hopes is MDMA (or MDE or MDA), but practically, things sold as "ecstasy" can contain a wide variety of drugs and drug combinations. Beware. See EcstasyData.org for analysis of street ecstasy tablets.
- MDMA is an amphetamine-type stimulant, with empathic and psychedelic effects. It can trigger the release of powerful emotional responses in many people in many different contexts. Those who try it should pick a location where a strong reaction will be OK.
- It's a euphoric recreational drug. When I hear about people enjoying a particular activity while on MDMA, I often joke that hitting oneself with a hammer could be enjoyable while on MDMA. Because they feel so good and open, some people make bad choices while under its effects. These choices may be related to sex or risky activity or telling people things one wouldn't normally have and later regretting it.
- MDMA often generates feelings of mental and physical safety and promotes a desire to share. People often find themselves saying things like "I've always wanted to tell you..." or becoming talkative about matters they normally would not discuss. Touching and hugging other people as well as generally reduced personal space (people stand or sit closer together than normal) are common.
- It can facilitate bonding. MDMA can cause a strong sense of connection with the people whom one is with, the location one is in, or the physical items present during the experience. Similarly, it can cause people to feel more trust than normal for those around them. These are usually considered good effects, but can obviously be a problem if those around are untrustworthy or shouldn't be bonded with.
- It can create an increase in perceived intensity of sensation. Users sometimes play with sensation toys: touch (soft or fuzzy cloths), smell (Vicks VapoRub), visual (glow sticks), sound (music), etc.
- Overheating is the number one cause of serious injuries related to the use of ecstasy. A person can get high, stimulated, and hot and not be aware that their body needs rest, fluids, and electrolytes.
- Obsessive over-drinking of water is another way people hurt themselves because they are concerned about overheating. An appropriate amount of fluids should be drunk, ideally with electrolytes.
- It causes short-term appetite suppression. The dry mouth and amphetamine shift can make it very hard to eat during the effects and after effects. This contributes to the problem of over-hydrating, in that people often don't eat for 4-8 hours. Electrolyte drinks, light snacks, soup, and small amounts of fresh fruit like citrus, berries, or apple are often about as much as people can eat and are a good way to get some nutrition while on ecstasy. People with diabetes or hypoglycemia are probably more at risk of having unpleasant problems if they don't manage their blood sugar effectively.
- Risks associated with other amphetamines/stimulants apply, including cardiovascular (heart) risks and possible interactions with pharmaceuticals. MDMA's effects are reduced by SSRIs but can be dangerously increased by other drugs such as MAOIs.
- It can cause memory scrambling, making it difficult to keep track of time and to later remember what order things happened in. This is especially true at higher doses or when mixed with other drugs. Sometimes external cues or notes will trigger memories or feelings from the experience that cannot be recalled voluntarily.
- MDMA can cause nystagmus (eye wiggle), making it difficult to focus the eyes. Planning to read or do fine tasks on high doses of MDMA is not usually recommended.
- MDMA can cause jaw tension and teeth grinding. This can be problematic for people with tooth issues, crowns, etc., if they are not careful to avoid grinding their teeth together. People who are susceptible to jaw tension on amphetamines, ephedrine, or even high doses of caffeine will likely experience substantial facial muscle tightening with MDMA. One of the annoyances people report is chewing on the tongue or cheeks without realizing it until they come down. These effects are generally not overwhelming at moderate doses, but increase with dose and especially if one re-doses (takes a second or third dose).
- MDMA/ecstasy is an analgesic. People report that it suppresses pain sensations, though it is unclear how much of it is direct reduction in pain or just that pain is less likely to be noticed through the euphoria and other primary effects. In relation to jaw tension, people sometimes don't realize they've chewed on their cheeks or tongue until the effects wear off.
- Not everyone enjoys MDMA/ecstasy and not everyone who enjoys MDMA will enjoy it every time. In some people and especially in some instances, even pure MDMA can result in dysphoria (bad mood), alienation, paranoia and other effects that would generally be considered atypical and paradoxical.
- High people can do dumb things. Do not drive. Do not operate heavy machinery. Do not run around naked in the streets. Do not hit yourself with a hammer.
- Coming down can be hard. Some people experience coming down from MDMA as emotionally turbulent or difficult. Sometimes called "crashing", the emotional let-down as the effects wear off can be strong enough that some people choose not to use MDMA for this reason alone.
- Going up can be hard. Some people experience coming up on MDMA as physically and emotionally turbulent, including nausea, body tremors, overwhelming sensations of rushing energy, anxiety, panic, a strong need to defecate, etc. As with other things with psychedelic properties, the "plane can flip over on take-off" and people can spend their whole experience recovering from a difficult first 90 minutes.
- There is a hangover, but it can be mitigated with planning. Especially when taken at night in a way that interrupts normal sleep patterns or when redosing occurs, people report feeling both physically and emotionally worn out the next day. Many people recommend thinking of MDMA as a two-day experience. The first day, one experiences the high and the second day is used to recover, with low-energy activities like lying in bed, watching a movie, etc. Planning to have a full day and night's rest between coming down from MDMA and having work-type obligations can help prevent unwanted interference with one's daily life.
- There can be a mid-week low following use. A substantial number of people report feeling low or having depression-like effects in the days after they take MDMA. People can be less productive at work, perform worse at academic tasks, and may feel less motivated. This week-after low is another major reason people don't take MDMA.
- Mental health risks are a consideration. As with any strong psychoactive, those who have existing depressions, psychotic disorders, or family histories of either are at greater risk of having an MDMA experience trigger unwanted thoughts that can last longer than the acute effects of the drug.
- MDMA is illegal. Nearly anything you would get that's sold as "ecstasy" and has positive effects is a controlled substance and is illegal to possess or buy in most countries. Punishments for possession range from mild to life-ruiningly severe, depending on the jurisdiction.
- MDMA is socially disapproved in mainstream contexts. Parents, children, friends, co-workers, school administrators, and others will sometimes decrease their opinion of someone who is known to have used MDMA. With other people, especially in some subcultures, it can facilitate a sense of shared experience and actually promote good will towards someone who has used MDMA.
- Possible mild neurotoxicity. This issue is very complex. MDMA causes brain changes in rats and non-human primates at high doses and probably does the same in humans at high doses (or with repeated doses in a single session). The "neurotoxicity", if it happens in normal human users, causes small reductions in people's verbal memory scores and reduced overall mood. However, these effects are not always found and when found are normally in users who have taken ecstasy many times and at high doses. The main lesson with the neurotoxicity issue is that lower doses are safer doses and moderation and balance are healthier choices.
- There is a small but real risk of death. A small number of people react VERY poorly to even pure MDMA, including dangerous medical reactions like severe hyponatremia (low blood salt levels) not related to drinking too much water, or liver damage. A very small number of people have died after taking ecstasy even with no additional risk factors or obvious errors in use (dose, drug identification, etc.).
- Other things might seem less fun in comparison. The risks associated with this effect go from negligible to problematic addiction-triggering "What else should I take to make myself feel this good?!" drug-seeking behavior.
There's lots to know about MDMA/ecstasy. An older document, but one that is still useful to read, is the MDMA FAQ. You can learn a lot by poking around Erowid, Wikipedia, etc. Also, check out information on government and prohibitionist sites like DrugAbuse.gov or DrugFree.org. Don't just take the word of advocates or neutral parties, find out what those who campaign strongly against experimentation with ecstasy say about it.
This is not medical advice or in any way recommending anyone take ecstasy. I mean that: I'm not just being coy. Taking ecstasy might be the worst thing that's ever happened to you and your family, for psychological, physiological, spiritual, or legal reasons.
We (Erowid / EcstasyData) wind up being a hub for people describing both their best and worst experiences, so we don't have any single perspective on whether MDMA is overall a good thing for people or a bad thing for them. There are stories of people getting hurt mixed with stories of the Best Moment of My Life. One can make choices that steer towards the better scenarios, but people sometimes get sloppy and make bad decisions and mix drugs together in a way that results in badness.