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MDMA Addiction, Effects & Treatment

By February 13, 2019 June 15th, 2023 No Comments
mdma addiction treatment

Ecstasy or MDMA is usually used as a “party drug” due to its stimulant and hallucinogenic effects. While it is not as physically addictive as drugs such as alcohol or opioids, it can be very psychologically addictive.

How MDMA Works

MDMA increases the activity of neurotransmitters (chemicals in the brain), primarily serotonin, dopamine and norepinephrine. The drug increases levels of these neurotransmitters and can block reuptake, the process in which the cells which have produced the chemicals reabsorb them. This process creates feelings of euphoria, energy and a feeling of connection to others. After these effects have worn off, users often feel very depleted, depressed or anxious. MDMA accelerates the activity of the central nervous system, including respiratory function, heart rate and metabolism. This can lead to overdose.

Initial Effects

The initial effects of MDMA usually last around three-to-six hours. However, the drug is often taken repeatedly over a period of time in order to sustain its effects and delay the after effects. These after effects, often referred to as the “come down,” come as a result of reduced levels of the neurotransmitters activated by MDMA. This leads to a range of symptoms that usually include feelings of sadness, anxiety and fatigue. The pattern of continually taking MDMA to sustain the initial effects and delay the after effects can be highly addictive.

Researchers are still carrying out studies to define the effects of MDMA more precisely. This blog will discuss some of the most common effects, the addictive potential of the drug, and treatment for MDMA addiction.

Central Nervous System

MDMA impacts motor activity and the central nervous system. This can lead to increased heart rate and blood pressure, which can be very dangerous. The drug can also be very dehydrating. It also enhances and distorts the senses. Users often experience intense visual and aural effects.


MDMA’s influence on serotonin is one of its most important features. Serotonin plays a central role in the regulation of mood, sleep, pain, appetite and cognitive function. This is why MDMA produces feelings such as euphoria, heightened energy and increased connection with others. After releasing large amounts of serotonin quickly, the brain is depleted for several days after. This means that users may experience feelings of depression, anxiety and fatigue during these days.

Users may also experience difficulty sleeping and impaired cognitive function during this period. Their concentration, decision making, problem-solving and memory may be negatively affected. Users’ learning, emotional processing, motor function and sensory processing may also be impaired. While in most cases these effects reduce after a few days, in some cases they can remain for much longer. The effects will also generally become more pronounced the more of the substance is used, although other factors, which will be discussed later, are also influential.

Short-Term Effects

There are a range of common short-term effects associated with MDMA. As well as the feelings or euphoria, energy and connectedness discussed above, there are a number of more distressing and potentially dangerous side effects. These include the following:

  • Increased body temperature, hot flashes, chills
  • Restlessness, agitation
  • Dehydration (some users also overhydrate due to persistent thirst, which can also be dangerous)
  • Electrolyte imbalance, which can cause irregular heart beat, nausea, confusion and in some cases seizures
  • Heightened blood pressure
  • Lack of appetite
  • Insomnia
  • Confusion or incoherent thoughts or speech
  • Involuntary jaw clenching or teeth grinding
  • Muscle or joint stiffness
  • Excessive sweating
  • Effect on senses potentially including dilated pupils, hallucination and increased sensitivity to light or sound

While some of these side effects are only unpleasant and will usually pass relatively quickly, some can be very dangerous. In the case of an overdose, MDMA can cause seizures, loss of consciousness or even heart attack. The after effects mentioned above such as depression and anxiety can also be extremely serious.

Severe Side Effects

There are a number of less common but very dangerous potential side effects of MDMA use. These include the following:

  • Panic attacks
  • Loss of consciousness
  • Seizures
  • Kidney failure
  • Brain swelling
  • Psychosis
  • Severe respiratory effect
  • Extreme dehydration

Users are also likely to experience impaired judgement, which can lead to risky behaviour such as driving, engaging in unprotected sex or other activities with a high risk or injury to themselves or others. If used during pregnancy, MDMA can also effect the development of the fetus.

If you experience any of these side effects, or observe someone else who may be experiencing them, it is essential to seek medical support immediately.

Long-Term Effects

Studies are still being carried out to establish more clearly the potential long-term effects of MDMA use. However, there is substantial evidence that certain effects can be long-lasting. These may include:

  • Cardiac aarhythmia or other heart problems
  • Depression
  • Anxiety
  • Lack of impulse control
  • Irritability
  • Decreased cognitive function such as impaired concentration or memory
  • Impaired memory
  • Sleep problems
  • Aggression

There is evidence that the long-term effects of MDMA use can be more pronounced when the drug is used alongside other substances. Any mental health disorders co-occuring alongside MDMA use can also influence the effects of the drug. MDMA use may also have the potential to do long-term damage to nerve cells.

While some of these effects can be serious and long-lasting, in most cases they can be addressed with evidence-based treatment such as cognitive behavioural therapy. Sustained MDMA use or addiction substantially increases the likelihood of sustaining damaging long-term effects. Evidence-based addiction treatment can help to identify and address these effects.

Addictive Potential

MDMA has a high potential for addiction. The “binge” pattern that users often engage in, continuing to use the drug to sustain its effects and delay the after effects, is very conducive to addiction. A user’s tolerance will also increase the more they use the drug, increasing the likelihood of both overdose and addiction. As MDMA can also reduce a user’s impulse control, they may also struggle to resist urges to use the drug. The likelihood of a person becoming addicted to MDMA may be influenced by factors including gender, metabolism, dosage, environment and genetics.

Environmental Triggers

Environmental triggers are also very common for regular users. As the drug is often associated with party scenes, certain types of location such as night clubs or bars, and particular groups of people may become very triggering for users.

Addictive Pattern

As the after effects of MDMA use, such as depression and anxiety, can be very difficult to cope with, users will also often return to the drug to ease these effects. This can quickly become an addictive pattern. Users may also find that their response to ordinary stimuli is decreases significantly due to the neurochemical effects of MDMA, meaning they must continue to use the drug to feel happy, excited or energetic.

Signs of Addiction

There are a number of signs to look out for if you are concerned that you are someone close to you has developed an addiction to MDMA. Constant thoughts of using and obtaining the drug is one of the clearest indicators or addiction. Using it repeatedly to delay the after effects is another clear indicator, as an increase in tolerance.

Common Problems

If a person starts to have difficulty fulfilling duties at work or at home as a result of their drug use, they have probably developed an addiction. Likewise, financial, legal, professional or familial difficulties caused by drug use suggest addiction. If a person’s social life largely revolves around using MDMA, they also may be dependent on the substance.

Disguising Use

If a person lies about or otherwise tries to disguise their use of MDMA, this is a strong sign of addiction. People will often lie about or understate their use of a drug to themselves and to others if they have become dependent upon it.


Becoming distressed or agitated when MDMA is not available is a clear indicator of addiction. If thinking about situations where the drug will not be available causes you discomfort, you are probably dependent.

Continuing Despite Negative Consequences

If a person continues to use MDMA despite negative consequences, they may be addicted. These consequences might be professional or personal. If those around that person raise concerns and the person rejects them, they may be in denial about the extent of their problem.

Physical Signs

There are also a number of physical signs of addiction, which can have devastating effects on those addicted to MDMA.


A person struggling with MDMA addiction will likely require dedicated, evidence-based treatment to achieve lasting recovery. Treatment should not address the addiction in isolation, but its underlying causes. Individual therapy, cognitive behavioural therapy and group counselling can help addicted people to identify these causes and consequences. It can also help them to develop methods for dealing with them in a healthy, progressive manner.

Rebuilding Cognitive Function

The brain will naturally repair some of the damage done by MDMA use over time. However, cognitive behavioural therapy and individual therapy can actively help to repair cognitive function. This will help a person to improve their focus, decision making, problem-solving and many other functions. It will also make them more resistant to cravings in the future.

Identifying Triggers

Treatment also help people to identify specific triggers for their drug use, and to develop methods for coping with them in a healthy manner. Aftercare services will also help people to maintain their focus on recovery and continue to develop recovery methods.

If you have any questions or concerns about MDMA addiction, contact Trafalgar Addiction Treatment Centres today.

Trafalgar Addiction Treatment Centres

Trafalgar Addiction Treatment Centres

We offer residential and outpatient rehab treatment programs for addiction and co-occurring mental health disorders.

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