Can you die from taking ecstasy?

Possibly. More here on the risks of pure vs. “cut” ecstasy here, with a section at the end for your questions.

minute read

Yes, people have died taking ecstasy.

While pure ecstasy rarely triggers major serious side effects, it can be dangerous for certain people with pre-existing health conditions. Plus, most versions of ecstasy sold on the street or at clubs are cut with other ingredients. It is these “cut” versions of ecstasy which most often provoke serious problems like hallucinations, heatstroke, and death.

We review the risks of taking ecstasy here. Then, we invite your questions, comments, or feedback in the section at the end. In fact, we try to respond to all legitimate questions with a personal and prompt reply.

Dangers of ecstasy ingredients

Ecstasy was initially popular among young adults in the nightclub scene or at “raves” (long dance parties). So, how dangerous can ecstasy be?

Ecstasy is a synthetic, psychoactive drug that has similarities to both the stimulant amphetamine and the hallucinogen mescaline. It produces feelings of increased energy, euphoria, emotional warmth and empathy toward others, and distortions in sensory and time perception. What’s in ecstasy, exactly?

Ecstasy is a slang name for the chemical substance methylene dioxy methamphetamine, or MDMA. MDMA is chemically similar to the synthetic stimulant methamphetamine. While pure ecstasy affects certain people adversely, street “Ecstasy” could contain just about anything. Ecstasy tablets have been found to contain anywhere from 0-50% MDMA. It is generally manufactured in clandestine labs by criminal drug dealers, not chemists.

One of the most dangerous additives commonly found in “Ecstasy” is DXM (dextromethorphan,) a cough suppressant. In the doses usually found in these less pure versions (ten times the amount found in cough syrup), DXM can cause hallucinations. DXM inhibits sweating, so it can cause heatstroke and death. Another dangerous adulterant is PMA (paramethoxyamphetamine), an illegal drug that is a potent hallucinogen. Like MDMA, PMA causes an elevation in body temperature, but at an even more drastic rate.

Serious adverse side effects of ecstasy

Because of its stimulant properties and the environments in which it is often taken, MDMA is associated with vigorous physical activity for extended periods. Dancing and movement can lead to one of the most significant, although rare, acute adverse effects: a marked rise in body temperature (hyperthermia). Treatment of hyperthermia requires prompt medical attention, as it can rapidly lead to muscle breakdown, which can in turn result in kidney failure.

Other potential adverse health effects of ecstasy can include:

  • arrythmia
  • blurred vision
  • chills
  • dehydration
  • heart failure
  • high blood pressure
  • involuntary jaw clenching and teeth grinding
  • kidney failure
  • marked rise in body temperature (hyperthermia)
  • muscle cramping
  • nausea
  • sweating

The usual “recreational” dose of MDMA produces blood levels in the range of 0.1-0.25 mg/L. Most of the cases of serious toxicity or fatality have involved blood levels ranging from 0.5-10 mg/L, that is, up to 40 times higher than the usual recreational range. However, some have had levels as low as 0.11–0.55 mg/L, that is, overlapping the “normal” range and a little above it. This is an important point, because it demonstrates the degree to which the seriousness of the effects can be dependent on environmental factors other than the drug concentration.

How do people die on ecstasy?

The varied causes of death associated with ecstasy look like those seen with amphetamine and with PMA. Dehydration, hypertension, and heart failure may occur in susceptible individuals who take ecstasy (even once) or those with cardiovascular problems. MDMA can also reduce the pumping efficiency of the heart, further complicating these problems.

In addition, there have been deaths due to “ecstasy”-induced depression that was severe enough to cause suicide, or to pre-existing depression in which the drug was used as the means of suicide. There have also been several deaths due to accidents resulting from bizarre risk-taking behavior while under the acute influence of the drug, or to motor vehicle accidents involving either drivers or pedestrians impaired by MDMA.

Signs of ecstasy overdose

Ecstasy can produce a variety of adverse health effects. But how do you know when someone needs medical attention for an ecstasy overdose? Ecstasy overdose signs can include:

  • high blood pressure
  • faintness
  • loss of consciousness
  • panic attacks
  • seizures

How to treat ecstasy overdose

Ecstasy and MDMA overdose treatment focuses on assessing and monitoring overdose symptoms and then treating the patient accordingly. Depending upon a number of factors, including the individual’s age, the nature and severity of the use patterns, and the presence of any co-occurring conditions. An overdose usually requires emergency room attention.

Are you taking too much ecstasy?

The topic of ecstasy neurotoxicity is a complicated and controversial one. There is little concrete data about exactly how much is ok (if any) and how much is too much. That said, taking ecstasy 1-2 times a week or more than 3-4 times per month is considered heavy us.e The drugs quite possible repetitive use could cause serious problems, including:

  • anxiety
  • confusion
  • craving
  • depression
  • paranoia
  • sleeplessness

Further, reported undesirable effects of MDMA can occur up to one (1) week post-dosing, or longer. These might include:

  • aggression
  • anxiety
  • impulsiveness
  • irritability
  • lack of appetite
  • reduced interest in and pleasure from sex
  • restlessness
  • sadness
  • significant reductions in mental abilities
  • sleep disturbances
  • thirst

Some recommendations says that you should leave at least 4-6 weeks between uses in order to allow the brain’s neurochemistry a chance to return to normal. There is no question that high enough doses of ecstasy can cause neurotoxicity. Limiting the number of pills taken in an evening is an important factor…use as little as possible to minimize dangers.

FDA warnings about ecstasy

The Food and Drug Administration (FDA) currently warns consumers not to purchase or consume a liquid product called Green Hornet. This product is promoted on the Internet, and sold in stores, as a herbal version of the illegal street drug “Ecstasy.” The FDA considers this product to be an unapproved new drug since it contains, among other ingredients, the undeclared active ingredients diphenhydramine and dextromethorphan, found in over-the-counter (OTC) drugs.

Help for ecstasy use or misuse

If you think that you’re using too much ecstasy, know that treatment centers are more successful at helping people quit ecstasy than users who attempt to stay clean and sober on their own. These rehab settings offer intensive individual and group counseling sessions that get to the root causes of why MDMA is so attractive.

Questions about ecstasy?

If you still have questions about the dangers of taking ecstasy, share them with us at the bottom of the page. We`ll do our best to give you a personal and prompt answer.

Reference sources: U.S. Department of Justice: Fast Facts on MDMA
NIH: DrugFacts: MDMA (Ecstasy or Molly)
NCBI: The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs
NIH: MDMA (Ecstasy) Abuse
FDA:FDA Warns Consumers Not to Purchase Green Hornet, Promoted as Herbal Version of “Ecstasy”
Ask Erowid
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
I am ready to call
i Who Answers?