MDMA, commonly known as "Ecstasy", is a psychoactive drug and member of the amphetamine chemical class. It produces entactogenic, psychedelic, and stimulant effects.
MDMA is one of the most widely used recreational illicit drugs in the world and is taken in a variety of contexts far removed from its roots in psychotherapeutic settings. It is commonly associated with the rave or electronica subculture and related genres of music.
There have been debates within science, health care, and drug policy circles about the risks of MDMA, specifically the possibility of neurotoxic damage to the central nervous system (CNS). Regulatory authorities in several locations around the world have approved scientific studies administering MDMA to humans to examine either its therapeutic potential, or, more commonly, simply its basic effects.
MDMA was first introduced clinically under the names "Adam" and "Empathy" when it was used in psychotherapy in the late 1970s and early to mid 1980s. Later on, upon making it into the recreational drug use scene, it came to be widely known as "Ecstasy”.

Pure MDMA comes as a white powder. However, due to the number of different labs and different processes that produce Ecstasy, appearance is very varied. Most commonly, Ecstasy comes as tablets or capsules. Ecstasy is also supplied as a powder, in wraps or bags. Tablets may be white, off white, yellow, speckled, rough, smooth, scored, imprinted with designs or plain.
Capsules come in many colours, including plain white, black and red, yellow and purple. The appearance of tablets or capsules often gives rise to their names; tablets imprinted with pictures of apples are called APPLES, those imprinted with doves were called DOVES and so on. This sort of branding, initially designed to make good E's distinguishable from bad ones, is no guide to quality. Once a brand is established, other producers copy the design, but may not copy the content.

Street Names
MDMA in its pure, powder, crystalline, or capsule form, is commonly referred to as "Molly". Various other nicknames have been used to describe MDMA as well, including "Clarity", "Essence", "Euphoria", "Magic", "Transcendence", and "Hug Drug", as well as "Love Drug", "Lover's Speed", or merely "Love", among many more.

Routes of administration
MDMA is occasionally known for being taken in conjunction with psychedelic drugs, such as LSD or psilocybin mushrooms. As this practice has become more prevalent, most of the more common combinations have been given nicknames, such as "candy flipping", for MDMA combined with LSD, and "hippie flipping" when combined with psilocybin mushrooms. Such combinations have the ability to produce an extremely powerful experience and may carry an increased risk of neurotoxicity, complications, and/or injury when compared to any individual substance. Many users use mentholated products while taking MDMA for its cooling sensation while experiencing the drug's effects. Examples include menthol cigarettes, Vicks and lozenges. This sometimes has deleterious results on the upper respiratory tract.
Ecstasy is usually swallowed, though it is theoretically injectable. MDMA powder is often snorted. Pills and powders have also been used rectally.

MDMA reaches maximal concentrations in the blood stream between 1.5 and 3 hours after ingestion. It is then slowly metabolized and excreted, with levels decreasing to half their peak concentration over approximately 8 hours. Thus, there are still high MDMA levels in the body when the experiential effects have mostly ended, indicating that acute tolerance has developed to the actions of MDMA. Taking additional supplements of MDMA at this point therefore produces higher concentrations of MDMA in the blood and brain than might be expected based on the perceived effects.
The primary effects attributable to MDMA consumption are predictable and fairly consistent amongst users. Generally, users report feeling effects within 30–60 minutes of consumption, hitting a peak at approximately 1-1.5 hours, reaching a plateau that lasts about 2–3 hours, followed by a comedown of a few hours which may be accompanied by fatigue and minor effects.

Physical effects
A general and subjective alteration in consciousness
A strong sense of inner peace and self-acceptance
Diminished aggression, hostility, and jealousy
Diminished fear, anxiety, and insecurity
Extreme mood lift with accompanying euphoria
Feelings of empathy, compassion, and forgiveness towards others
Feelings of intimacy and even love for others
Feelings of insightfulness, introspection, and mental clarity
Improved self-confidence without the incidence of arrogance
The ability to discuss normally anxiety-provoking topics with marked ease
An intensification of perception, particularly tactile sensation or touch, as well as hearing and vision
Substantial enhancement of the appreciation for or quality of music
Mild psychedelia, consisting of mental imagery and auditory and visual distortions
As well as:
Stimulation, arousal, and hyperactivity (e.g., many users get an "uncontrollable urge to dance" while under the influence)
Increased energy and endurance
Increased alertness, awareness, and wakefulness
Increased desire, drive, and motivation
Hypersexuality and aphrodisiac effects (along with paradoxical sexual dysfunction (see below))
Analgesia or decreased pain sensitivity

The most common adverse side effects reported by users include:
Paradoxical anxiety and/or paranoia (though not social anxiety by any means)
Agitation or restlessness
Impaired attention, focus and concentration
Mild cognitive and memory impairment (primarily short-term memory loss)

Dizziness, lightheadedness, or vertigo
Blurry vision or involuntary and rapid eye movements
Pupil dilation
Dry mouth
Nausea and vomiting
Gastrointestinal disturbances such as diarrhea or constipation
Headache or migraine
Jaw clenching and/or Teeth grinding
Trembling or muscle tremors
Urinary retention
Sexual dysfunction, consisting of erectile dysfunction and inability to ejaculate
Anorexia or decreased appetite
Insomnia or inability to fall to asleep
Increased heart rate
Increased blood pressure
Increased body temperature
Increased perspiration or sweating
A water-electrolyte imbalance

Withdrawal Effects
The most common withdrawal or rebound side effects reported by users once the drug has worn off include:

Anxiety and/or depression, as well as potentially even suicidal ideation
Irritability and aggression, or even anger and rage
Malaise or lassitude and/or fatigue or lethargy
Agitation or restlessness
Impaired attention, focus, and concentration, as well as drive and motivation
Cognitive and memory impairment (especially short-term memory loss)
Residual feelings of empathy, emotional sensitivity, and a sense of closeness to others (afterglow)

Dizziness, lightheadedness, or vertigo
Gastrointestinal disturbances such as diarrhea or constipation
Headache, Migraine, Insomnia, Panic Attacks
Aches and pains, especially muscle and/or jaw soreness from excess physical activity (e.g., dancing).
These effects are typically reported to last 3 to 7 days.
Upon overdose, the potentially serious serotonin syndrome, stimulant psychosis, and/or hypertensive crisis, among other dangerous adverse reactions, may come to prominence, the symptoms of which can include the following:

Psychological :
•             Disorientation and/or confusion
•             Anxiety, paranoia, and/or panic attacks
•             Hypervigilance or increased sensitivity to perceptual stimuli, accompanied by significantly increased threat detection
•             Hypomania or full-blown mania
•             Derealization and/or depersonalization
•             Hallucinations and/or delusions
•             Thought disorder or disorganized thinking
•             Cognitive and memory impairment potentially to the point of retrograde or anterograde amnesia
•             Acute delirium and/or insanity

Physiological :
•             Myoclonus or involuntary and intense muscle twitching
•             Hyperreflexia or overresponsive or overreactive reflexes
•             Tachypnoea or rapid breathing and/or dyspnea or shortness of breath
•             Palpitations or abnormal awareness of the beating of the heart
•             Angina pectoris or severe chest pain, as well as pulmonary hypertension (PH)
•             Cardiac arrhythmia or abnormal electical activity of the heart
•             Circulatory shock or cardiogenic shock
•             Vasculitis or destruction of blood vessels
•             Cardiotoxicity or damage to the heart
•             Cardiac arrest, myocardial infarction or heart attack, and/or heart failure
•             Hemorrhage and/or stroke
•             Severe hyperthermia, potentially resulting in organ failure
•             Miscellaneous
•             Syncope or fainting or loss of consciousness
•             Seizures or convulsions
•             Organ failure (as mentioned above)
•             Severe neurotoxicity or brain damage
•             Coma and/or death

Potential incarceration, hospitalization, institutionalization, and/or death, on account of extreme erratic behaviour which may include acts of crime, accidental or intentional self-injury, and/or suicide, as well as illicit drug abuse, may ensue under such circumstances.

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