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Also known as: E’s | Pills | Xtc | Eccies | Bickies | Pingers

Ecstasy is the name given to methylenedioxymethamphetamine (MDMA). Ecstasy is part of the amphetamine group and has both stimulant and hallucinogenic properties. It is sometimes referred to as a ‘psychedelic amphetamine’.

Ecstasy does not always contain just MDMA. Ecstasy pills are often mixed with a variety of other substances including aspirin, caffeine and ketamine (a veterinary anaesthetic agent). Sometimes drugs containing no MDMA are sold as ecstasy. This makes it difficult for people to know what they are taking. For more information on ecstasy purity view an interview with Dr Dominic Reynolds.

Where does ecstasy come from? 

Methylenedioxymethamphetamine (MDMA) was first synthesised by Merck Pharmaceuticals in 1912. It was originally developed as an appetite suppressant, although it was never actually used for this purpose. In the 1970s, MDMA was used in American therapy classes to enhance communication. Ecstasy became available in Australia in the mid-1980s, and became an illegal drug in 1987.

How is ecstasy used?

Ecstasy comes in tablet form and is usually swallowed. When swallowed, the effects become apparent within 30 minutes and last for up to six hours. The hangover effects may last for up to 24 hours. Ecstasy is sometimes taken by suppository, snorting, smoking or injecting crushed tablets. As ecstasy usually comes in tablet form, it is not designed to be injected.

How many people use ecstasy?

The National Drug Strategy Household Survey 2016 reported that 3.2% of Western Australians aged 14 years and older had used ecstasy in the previous 12 months.

The effects of ecstasy will vary from person to person depending on the following:

  • Individual (user) – mood, physical size, health, gender, previous experience with ecstasy, expectations of the drug, personality, whether the person has had food and whether other drugs have been taken.
  • Drug – the amount used, its purity, and whether it is taken as a suppository, by snorting, smoking or injecting.
  • Setting (environment) – whether the person is using with friends, on his/her own, in a social setting or at home, at work or before driving.

Short-Term Effects of Ecstasy Use

Short-Term Effects of Higher Doses of Ecstasy

Long-Term Effects of Ecstasy Use

Enlarged pupils, jaw clenching, teeth grinding, dry mouth

Irrational behaviour


Reduced appetite, nausea

Dehydration, excessive thirst and urinary retention


Sweating, hot and cold flushes


Muscle aches

Increased energy, alertness and feeling of wellbeing


Loss of appetite

Increased confidence and talkativeness



Inability to sleep

Muscle meltdown (Rhabdomylysis)

Loss of concentration

Poor concentration and anxiety

Hallucinations and Paranoia


Increased body temperature, pulse rate and blood pressure




For more information on the effects of ecstasy view an interview with Dr Steve Allsop.

Method of use

There are also dangers associated with the method of use. Snorting can produce burns and sores on the membrane that lines the interior of the nose. Injecting ecstasy can result in major damage to the body’s organs, inflamed and blocked blood vessels, abscesses and blood poisoning. Bacterial infections can occur which may damage the heart valves, cause vein collapse, infection at injection site, bruising or more serious injuries if users inject into an artery or tissue.

See the Staying Safe section for information on protecting yourself.


Regular, heavy ecstasy use can lead to tolerance. This means that a person needs more of the drug to achieve the same effects they felt previously with smaller amounts. When this happens, users often take greater amounts of ecstasy and may begin to use other illegal drugs.


Regular, heavy ecstasy use can lead to dependence. This means that the drug becomes central to a person’s life and they feel they cannot function properly without it.

The after effects of ecstasy use and withdrawal

It is not common for regular ecstasy users to use every day. Rather, they are more likely to use continuously over several days stop for a period of time to recover and start again. This is called a binge-crash cycle.

The effects of the drug may include feelings of euphoria, reduced appetite and inability to sleep.

Of course, no-one can do without sleep indefinitely and when they do stop using they experience the opposite effects – they may feel very tired, hungry, anxious, paranoid, irritable and depressed, and a general feeling of being flat. These after effects may be heightened for users who have injected ecstasy or who have combined ecstasy with other drugs. This is sometimes called a crash. 

To respond to the crash the person might then start using again, and this can be commencement of the binge-crash cycle.


Overdose occurs when the level of intoxication from the drug reaches a point where it begins to produce physical and/or psychological harm. 

Overdose from ecstasy usually results from the body overheating and becoming dehydrated, which can cause muscle meltdown (rhabdomyolysis) and possible death from the failure of major organs such as the kidneys or liver. Overdose may also result from excessive water consumption and retention (hyponatraemia). This may cause cells in the body to swell, which can result in brain damage and death.

The risk of overdose generally increases with a larger dose. As the strength and content of street ecstasy is unknown it can be difficult to judge the dose, increasing the risk of overdose.

A drug overdose is life threatening. An ambulance should be called immediately (dial 000) if someone starts experiencing any of the symptoms of stimulant overdose.

Police will not be involved unless the ambulance officers are threatened or there is a death. 

Ecstasy use can cause anxiety, depression, paranoia and psychosis in those people who have a vulnerability to mental health issues.

Ecstasy can affect your brain long after the night you take it. View the Ecstasy and the brain video where Professor Daniel Fatovich talks about his research on the effect of ecstasy on the brain.

Most drugs cross the placenta, and therefore have some effect on the unborn child. There is only limited research on the specific effects of using ecstasy during pregnancy. However, there is potential to harm the child, especially if ecstasy is combined with other drugs. It is possible that miscarriage can result from using ecstasy. Injecting ecstasy also increases the risk of HIV infection and other infections for both the mother and the baby.

It is recommended that women check with their doctor (or other health professional) if they are using or planning to use drugs while pregnant or breastfeeding, including prescribed and over-the-counter medicines.

Using more than one drug at a time can have unpredictable and dangerous effects.  Ecstasy users sometimes take other drugs such as tranquillisers and alcohol to cope with some of the undesirable effects experienced after using ecstasy. They may also use ecstasy in conjunction with other drugs such as cannabis, amphetamines, LSD.

Using more than one drug increases the risk of complications and serious side-effects, and can lead to a variety of serious physical and psychological problems. For example, using ecstasy with other drugs that dehydrate the body, such as amphetamines and alcohol, can increase the problems associated with dehydration.

If ecstasy is combined with depressant drugs like alcohol, users may not feel the effects of the depressant drug straight away due to the masking effect that occurs. For example, if ecstasy is used with alcohol, Blood Alcohol Concentration (BAC) still goes up and motor skills such as coordination and reflexes are still impaired.

Combining ecstasy with other stimulants such as amphetamines or cocaine can greatly increase the negative side effects of both drugs. The effects can be greatly exaggerated and unpredictable and may be similar to taking a very large dose of stimulant drugs.

One of the major risks associated with illicitly manufactured drugs is that you won’t know what is in them, or the toxicity of the active substances. As part of the manufacturing process, dangerous by products can also be formed of unknown toxicity. Compounds used to manufacture the drug can cause them to be converted to other unknown compounds of unknown toxicity. This can result in accidentally mixing drugs and serious side effects.

Ecstasy and relationship problems

Drug use can lead to social and emotional problems and can affect relationships with family and friends. When people are under the influence of a drug, changes can occur in their behaviour depending on how they feel (e.g. euphoric, sick, energetic anxious, depressed or moody) which can lead to problems with friends and family.

Ecstasy and financial problems

The street price of ecstasy changes depending on availability and market trends. The cost of purchasing ecstasy can lead to financial problems for both occasional and regular users.

Ecstasy and the law

In Western Australia, under the Misuse of Drugs Act 1981, it is illegal to use, possess, manufacture or supply ecstasy. Offences under this Act carry heavy fines and/or prison sentences. Penalties range from a $2,000 fine and/or two years in prison to a $100 000 fine and/or imprisonment for 25 years. A person convicted of a drug offence can receive a criminal record, which can lead to difficulties in getting a job, health insurance, credit and/or visas for overseas travel.

Ecstasy and driving

In Western Australia, it is against the law for anyone to drive with the presence of an illicit drug prescribed within the Road Traffic Act 1974, or impaired by a drug.

It is dangerous to drive under the influence of ecstasy, as coordination and the ability to judge speed and distance can be impaired. It is also dangerous to drive before or after the ecstasy has taken affect. The user cannot predict when the ecstasy will take affect or if residual effects will impact on driving ability.

See the Testing section for information on roadside drug testing. 

There are a variety of treatment pathways available for people with ecstasy-related problems. The drug(s) used and the availability of services as well as the user’s health, desired outcome, support network and unique circumstances need to be taken into consideration. Deciding on the most appropriate treatment pathway is best done in consultation with an alcohol and other drug counsellor.

For up-to-date information about quitting Ecstasy, call the Alcohol and Drug Support Line or Parent  and Family Drug Support Line.

See the Staying Safe section for information on safer use.

Ecstasy getting the facts

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