Know Before You Roll: A Primer on MDMA

MDMA is a popular synthetic drug that comes in a pill or powder form. It causes altered mood and perceptions, feelings of euphoria, loss of inhibitions, and an increase in energy, empathy, and pleasure. It is structurally similar to both methamphetamine and mescaline. 

The most important factor in the safe use of MDMA is making sure that you have pure MDMA and that it does not include any toxic adulterants, an occurrence which is not uncommon.  

What should MDMA look like? MDMA should be either in powder form and look like white or light gray crystals or as pills, which come in many colorful shapes, sometimes with different stamps on them. Though MDMA is ranked as the fourth least harmful drug in a recent harm assessment survey, many other drugs, some of which are highly toxic and appear identical, are often sold as MDMA. The only way to know if what you have is indeed MDMA, and not some other potentially toxic substance, is to test it. You can buy kits here if you are in the US or here if you are in the EU. 

Read on to learn details about MDMA, the drugs it is often mixed with, known contraindications, and harm reduction habits to ensure safety when taking MDMA.

What is MDMA?

3,4-Methylenedioxymethamphetamine is the scientific name for the pure chemical compound known as MDMA. MDMA is a synthetic drug that is both a hallucinogen and a stimulant. The substance brings about feelings of self-confidence, euphoria, and peace. It is bitter to taste and has a chemical smell. MDMA is also commonly known as Molly and ecstasy.

  • MDMA is called molly if it is in powdered form or in capsules. The powder might be white or gray crystals, and it is a widespread belief that Molly is a safe and pure form of MDMA.  
  • MDMA is called ecstasy if it is in tablet form. The pills are small and come in various colors and shapes. They will sometimes have pictures or letters stamped on them to identify the type of experience linked to the pill. For instance, a stamp of the letter ‘A’ on a yellow pill might mean it has amphetamine or acid in the pill. 

There are also several other street names for MDMA, including the light-hearted monikers “disco biscuit”, “hug drug” and “lover’s speed”, as well as the more common names E, X, and XTC.

MDMA is not regulated therefore it is not uncommon for both powder or pill form to contain no MDMA at all, but instead other more dangerous drugs. The only way to know that what you are taking is MDMA is to test it.  ALWAYS TEST BEFORE YOU CONSUME!

Contamination and MDMA

MDMA often includes fillers, some of which are dangerous drugs that mimic the effects of MDMA. Accidental deaths have been reported from taking other compounds presented as MDMA. MDMA is not dangerous by itself, but the adulterants and fillers added to the drug can be fatal.  


One common contaminant of MDMA is para-Methoxyamphetamine (PMA). Adverse side effects of PMA include: irregular heartbeat, convulsions, confusion, and death. PMA causes a release of serotonin in the brain, but it prevents the body from reabsorbing the serotonin, which leads to adverse reactions. If you are taking medication that already impacts your serotonin levels, such as antidepressants, PMA is even more dangerous. Toxicity of PMA may occur at doses only slightly above the usual recreational dose and combining it with MDMA enhances its toxicity.


Another common substitute for MDMA is n-ethylpentylone, which comes from the cathinone (“bath salts”) group of stimulants. This stimulant has many of the same effects as MDMA, but they are not as pleasant. 

  • Physically, users experience high body temperature, convulsions, and rapid pulse. 
  • Psychological effects include psychosis, paranoia, and agitation. 
  • Also, there is a significant dosage difference between MDMA and n-ethylpentylone. With MDMA, the recommended dose is 100 milligrams, and n-ethylpentylone is only 30 milligrams. It is very easy to overdose


N-methoxybenzy (NBOMe) is not a single drug but a class of drugs that have an N-methoxybenzyl group. They are in the same phenethylamines class of drugs as MDMA. Though 9 different variants have been described, three are listed as schedule 1 drugs: 25I-NBOMe, 25B-NBOMe, and 25C-NBOMe. 25I-NBOMe is often called synthetic acid because it binds to serotonin receptors in the same way LSD does. It is also often deceptively sold on blotter papers as LSD.  

NBOMes have high potency compared to MDMA. A typical dose of MDMA is around 100-125mg, while a typical dose of 25I-NBOMe is only 0.5mg. NBOMe’s high potency, in combination with it being a common MDMA adulterant, increases the possibility of overdose. An overdose could result in anything from organ failure to cardiac arrest and death. NBOMes are known to have adverse effects on the cardiovascular system.

Click here for a complete list of common MDMA contaminants, and their potential effects. 

Harm Reduction and Safety

Most negative outcomes from ingesting MDMA come from consuming a mixture of other drugs, either intentionally (such as caffeine) or unintentionally (MDMA adulterants), as well as dehydration. Accidental deaths have been reported from taking other compounds that are presented as MDMA. 

You can reduce the likelihood of an adverse reaction by following these practices if you decide to use MDMA:. 

  • Make sure what you are taking is MDMA and does not contain dangerous adulterants.  The only way to know for sure is to test it yourself. You can buy kits here if you are in the US or here if you are in the EU.
  • Know the proper dosage to take, and use a scale to measure it out.
  • Be aware of harmful drug interactions with MDMA.
  • Know health conditions that pose a considerable risk to MDMA users.
  • Consider taking supplements to help prevent jaw clenching, protect your brain, and mitigate the undesirable effects of the “come down.”

Testing Kits

A wide range of drugs are sold as MDMA, many of which are quite toxic. There is no way to know you are taking MDMA, regardless of the form it comes in, without properly testing it. People have died because they thought they were taking MDMA but instead it was something else. The more reagents you use to test your sample, the better idea you will have about what it contains. MDMA test kits commonly contain three reagents (Marquis, Simon’s and Froehde).

To use the kit, you take small amounts of the sample (one for each reagent) and place drops of each reagent on top of each of the samples and watch carefully for color changes. Each kit comes with a chart that lets you decipher if your sample contains adulterants and what they might be.   

It is important to keep in mind that:

  1. Just because a test comes back positive for MDMA doesn’t mean that it is “pure,” it just means that some amount of MDMA is detected.
  2. Testing kits don’t tell you the amount of MDMA contained in a pill, it only tests for its presence. So even after you test, you won’t know how much you are taking.
  3. Though test kits are designed to pick up common adulterants, more novel psychoactive drugs are being mixed in with MDMA that may not be flagged in tests.

For more information on testing, read this:, “How to Use a Pill Testing Kit, According to Experts.” 

How Much MDMA Should I Take?

In order to reduce potential harm, it’s important to get the dosing right. It can be really difficult to know how much MDMA you are taking, especially when it is in pill or powder form.  Many pills in the UK and EU are found to have very high levels of MDMA which can result in an unintentional overdose. Taking a smaller dose (half of a pill) and then giving yourself the option to take another dose two to three hours after the initial dose will help decrease risk. A good rule of thumb is to take 0.7 milligram MDMA per pound of bodyweight..

The following chart outlines different MDMA doses:

First time/sensitive user/small body stature60-90 milligrams
Average dose75-125 milligrams
Large dose/less sensitive user/large body stature110-150 milligrams
Strong dose150-200 milligrams
Heavy dose200 milligrams or more

How do people take  MDMA?

MDMA can be found in tablet, capsule, powder, and liquid form, but it is most commonly used in capsule or tablet form. The crystalline or powdered form of MDMA is often taken by dabbing onto the gums, or by wrapping it in a small piece of paper, such as cigarette rolling papers, and swallowing it. Some people also choose to snort crushed or powdered MDMA.

Interactions with Other Substances

Though some MDMA users may face unintentional drug combinations, other users intentionally take other drugs to enhance the experience. Part of harm reduction is being aware of the potential problems of those combinations beforehand. 

Some drug interactions with MDMA are described in the following chart: 

AlcoholThe combination of MDMA and alcohol makes the liver work harder to metabolize both substances. Also, alcohol increases the chance of serotonin syndrome.
LSDThe combination of these two drugs can create a more potent effect of taking them separately. Care should be taken.
MarijuanaCannabis and MDMA together can create a stronger effect compared to using these two drugs individually.
CocaineThe combination of these two drugs is dangerous and should be avoided. 

For more information on MDMA and drug interactions, click here.

MDMA Contraindications

Some medical conditions and prescription medications can create high-risk situations for MDMA users. The following chart details some common MDMA contraindications:

SSRIsSSRIs block the release of serotonin and can impede the effects of MDMA. Users will often take too much MDMA and overdose because of the weakened effect.
MAOIsThe combination of MAOIs and MDMA is dangerous because of the increased likelihood of serotonin syndrome, which could lead to death.
Liver ProblemsBecause MDMA is metabolized by the liver, having a current problem with the function of your liver can cause severe damage.
Psychiatric ConditionsIf you already have a known psychiatric condition, the use of MDMA could make the condition worse.
Central Core DiseaseIf you already have a disease that prevents the body from being able to cool off, taking MDMA can cause dangerous overheating of the body. 
SeizuresThose who have seizure disorders are far more likely to have a seizure while taking MDMA.

Harm Reduction While Taking MDMA

If you decide to take MDMA you can reduce the risk of adverse outcomes by:

  • Drinking water and maintaining electrolyte levels while under the influence of MDMA. Two to three glasses of water each hour will help prevent your body from overheating and dehydration. However, do not drink too much water because you could decrease the electrolytes in your body. Adding a little fresh citrus juice (lemon or lime) and salt to your water will help maintain electrolyte levels.
  • Giving your body a break to cool down from time to time. Dancing and movement cause the temperature of the body to increase as well, so be sure to incorporate rest times. 
  • Chewing gum or taking a magnesium supplement will help reduce jaw clenching and teeth grinding.
  • Avoiding immediate re-dosing. Be patient with the “come-up.” Taking another dose before the first one kicks in may lead to a bad experience, and taking more after the come down has begun will not increase pleasure, but will cause a more severe hangover.
  • Knowing the signs of an overdose. Look out for dizziness, headache, vomiting, increased heart rate and/or body temperature, shivering, twitching, and over-responsive reflexes.

What If Things Are Not Going Well?

If you find that you or a friend feel unwell after taking MDMA, get help immediately. When help arrives, be sure to tell them what the dose wasand when it was taken. Don’t be afraid to ask for help if you don’t feel well.

To Conclude

Whether the MDMA is in pill, powder, or crystal form, there is no way to know if it  contains harmful adulterants just by looking at it. Testing with either a designated test kit or through a third party gives you the best chance of knowing what you are consuming. Users can reduce risk by understanding how to test, how to dose, and having an awareness of the potential side effects. . Remember – start low, go slow.