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  • MDMA (Molly) Dosage | The Dangers Of High-Dose MDMA

    MDMA, also known as ecstasy, is often considered a safe part of the culture of modern festivals and raves. But this drug is a harmful substance of abuse. 

    Its use can cause permanent physical harm and it does kill some who take it, especially when supplies of the drug are unusually concentrated.

    As with all illicit substances, when you take MDMA there is no perfect way to know the amount of MDMA present, or what else might be mixed in. This uncertainty can be dangerous.

    What Is MDMA?

    3,4-Methylenedioxymethamphetamine (MDMA) is an entactogen, a synthetic chemical stimulant, and psychedelic hallucinogen that became popular in the 1980s in party scenes and raves. 

    Today, it is often found in youth and music-centric settings where it is known as:

    • Ecstasy
    • E
    • Eve
    • X
    • Molly
    • Adam
    • Beans

    MDMA is used in tablet, pill, gel capsule, and powder form, with solid varieties often brightly colored and pressed into a variety of logos or shapes. Drug administration is usually oral, though MDMA may also be snorted or, occasionally, smoked.

    When taken orally, the effects of MDMA are commonly felt within thirty to forty-five minutes, and peak after one hour. After two to three hours the effects of a single dose will begin to drop off, often leading to re-dosing.

    Why Are Some Batches Of MDMA Stronger Than Others?

    As an illicit drug, ecstasy is produced in laboratories with no regulatory oversight and passed through the hands of distributors and dealers who may further tamper with the product.

    As a result, any two doses of MDMA may vary wildly in strength and composition. 

    One may be cut with harmless filler compounds to increase the bulk and weight of the product while another is laced with substances like caffeine, cannabis, bath salts/synthetic cathinones, amphetamine, methamphetamine, ketamine, and opioids including heroin or fentanyl.

    The side effects of these adulterated tablets are extremely unpredictable.

    However, because drug distribution is competitive, some suppliers may choose to focus on quality and purity. This can lead to the occasional ‘double strength’ batch of MDMA with a much higher dose (two to five times) compared to other tablets or pills. 

    These high-dose MDMA pills come with their own risks to the body and brain.

    What Are The Risks Of High-Dose MDMA?

    High-dose MDMA increases the risk that an individual who has taken low-dose tablets in the past will accidentally take too much of the drug and experience adverse events, including serotonin syndrome, elevated neurotoxicity, and other MDMA overdose symptoms.

    However, the baseline risk of MDMA overdose does not increase steadily or predictably as MDMA dosage increases.

    Your body uses certain enzymes to break MDMA down in your liver. However, one of the byproducts of MDMA metabolization is known to interfere with a prominent liver enzyme for more than a week after your last dose.

    This means that the more MDMA you take, the more trouble your body will have processing the drug safely, leading to dramatically different physical and mental effects (including dangerous overdoses) once certain dosage thresholds are passed.

    MDMA Overdose Effects

    MDMA overdose effects include:

    • agitation
    • elevated heart rate or abnormal heart rhythms (tachycardia, arrhythmia)
    • elevated body temperature (hyperthermia)
    • hallucinations
    • hypertension (high blood pressure)
    • nausea and vomiting
    • seizures
    • loss of consciousness

    Fatal MDMA Overdoses

    Death due to MDMA overdose is most common after redosing or if it is taken with other drugs and/or alcohol. Death may occur due to:

    • liver failure
    • heatstroke
    • dehydration
    • heart attack (cardiac arrest)
    • water intoxication (SIADH)

    If you suspect an individual has overdosed on MDMA or any other substance, immediately contact emergency medical services.

    Reducing MDMA Risk

    If you take MDMA you can lower your risk of overdose and other harmful effects by:

    • testing your MDMA with harm reduction kits to identify adulterants
    • not redosing
    • never mixing MDMA with other drugs or alcohol
    • not being alone when you take the drug
    • properly hydrating and taking breaks when dancing

    However, the best and only surefire way to prevent harmful effects is to avoid use of MDMA altogether.

    How Is MDMA Abuse Treated?

    While physiological MDMA dependence is extremely rare, addiction treatment programs can help you overcome compulsions and withdrawal symptoms related to illicit hallucinogen use. 

    Comprehensive rehab programs provide psychotherapy for co-occurring mental health disorders and other psychological factors that underlay harmful patterns of drug use.

    Inpatient or outpatient programs are highly personalized and involve a mix of individual counseling and group therapy, as well as supportive services and aftercare.

    To learn more, contact an Ark Behavioral Health specialist today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Centers for Disease Control and Prevention (CDC) - Ecstasy Overdoses at a New Year's Eve Rave --- Los Angeles, California, 2010
    Drug Enforcement Administration (DEA) - Drug Fact Sheet: Ecstasy/MDMA
    National Institute on Drug Abuse (NIDA) - MDMA (Ecstasy) Abuse Research Report

    Medically Reviewed by
    Davis Sugar, M.D.
    on July 3, 2022
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