MDMA is the acronym for the psychoactive pharmaceutical 3,4-methyl​enedioxy​methamphetamine, also commonly known as molly, e, or ecstasy.

The chemical encourages serotonin neurons across the brain to release large amounts of their neurotransmitter, promoting feelings of empathy, euphoria, and pleasure from tactile sensations. It also increases levels of dopamine and the energizing hormone norepinephrine.

Once the serotonin neurons are depleted, depression and tiredness can follow in what's referred to as a come-down, which typically lasts a few days.

MDMA is currently considered an illegal substance in most nations around the globe, with sale, use, and possession of the substance treated as an offence.

What are the risks associated with taking MDMA?

Thanks in part to the increased release of norepinephrine, MDMA can make it difficult for bodies to regulate their temperature as usual. Blood vessels beneath the skin can constrict, making it harder to lose heat.

Since people often take ecstasy under physically strenuous conditions – such as at outdoor social venues or during dance events – it's possible for people to experience heat stress. Compensating by taking in large amounts of water carries an added risk of diluting levels of sodium in the blood (hyponatremia), giving rise to headaches, fatigue, and confusion.

Although rare, recorded deaths exclusively attributed to MDMA are thought to be a result of heatstroke, as well as toxic effects from over hydration.

As an illicit substance, the production of MDMA is unregulated, raising the risk of unknown additives being included in manufacturing that come their own adverse health effects.

Are there long-term side effects of MDMA?

There is little evidence that MDMA should be considered a physically addictive substance, though its effects can encourage habitual use. Consistent, long term use of MDMA may also affect the functioning of systems based on serotonin neurons, leading to reduced effects and higher risk of mood disorders such as depression. Some degree of cognitive impairment and memory loss has been demonstrated, though the extent of these risks is still uncertain.

In addition to potential risks, MDMA has showed some promise as a therapeutic. Combined with suitable forms of psychiatric counselling, relatively small doses of the pharmaceutical have been found to assist alleviating symptoms of PTSD.

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