Ecstasy/MDMA Overdose Treatment, Signs & Symptoms

While teens and young adults may view MDMA or “Molly” as a harmless party drug, it can have dangerous and potentially fatal side effects for some users.

3,4-Methylenedioxymethamphetamine is an illegal drug with stimulant and hallucinogenic effects. It has historically been popular among people at nightclubs and raves. Most people know it by its acronym, MDMA, and more still know it simply as ecstasy. More recently, people have used the slang term “Molly” to refer to this drug.

While the chances of a fatal ecstasy or Molly overdose are relatively low, dangerous symptoms and side effects are possible in the short term and with repeated overuse.

Can You Overdose on Ecstasy?

According to the most recent data, about 10,000 people under the age of 21 are treated in emergency rooms for problems related to ecstasy use each year. Furthermore, one study found that in 2016, there were 7,542 deaths from addictive psychostimulants, the category in which researchers placed ecstasy/MDMA.

But the answer to the question, “Can you overdose on ecstasy?” is not entirely straightforward. While it is possible to die as a result of ecstasy abuse, fatalities from this drug are not necessarily a result of taking too much ecstasy but rather due to the side effects of this drug.

According to experts, deaths from ecstasy use are typically due to overheating. The drug can interfere with the body’s ability to regulate temperature. When people are in warm environments or are overly active, as they might be when dancing in a club, the risk of overheating is higher. With hyperthermia, people are at risk of:

• Dehydration
• Swelling of the brain
• Muscle breakdown
• Electrolyte imbalances
• Organ failure

Additionally, many ecstasy “overdoses” are a direct result of impurities in the pills themselves. For instance, Molly pills may be laced with cocaine, ketamine, methamphetamine and bath salts, which can increase the health risks associated with ecstasy/MDMA. Recent data shows that the purity of ecstasy and Molly is declining, so users today are more likely to purchase an adulterated sample. 

Lethal Dose of MDMA: How Much Ecstasy Is Too Much?

According to experts, the typical recreational dose of ecstasy ranges from 50 to 150 mg, and users will typically consume one to two tablets over the course of an evening. Some people will take up to 10 pills at a time, which is when the drug can lead to toxic effects, such as overdose. 

In general, ecstasy consumption has to be quite high to create an overdose or fatality. Furthermore, it is rarely ecstasy on its own that causes a lethal overdose. According to experts, deaths from ecstasy alone are rare, and most cases of ecstasy overdose involve the co-ingestion of another drug.

Symptoms of an Ecstasy/ MDMA Overdose

Ecstasy use symptoms range in the affected body region and relative intensity. Because reaching overdose levels is so difficult, understanding other MDMA use complications and consequences is often more important. Common signs and symptoms of MDMA overdose can include:

• Cardiac arrest: Heart failure and malfunctions are among the most serious results of excessive ecstasy use. A rapid heart rate is a precursor to this.
• Chest pain: Ranging from mild to severe, such pain will radiate outward from the upper chest area.
• Restlessness: Grinding teeth, fidgeting, foot-tapping and more may occur.
• Confusion, paranoia and memory loss: The drug’s hallucinogenic effects can take hold and manifest in destructive and disorganized thought processes.
• Dilated pupils or blurred vision: Overstimulation can lead to erratic eye function.
• Dry mouth and locked jaw: Along with the aforementioned teeth grinding, other mouth symptoms are equally common.
• Dehydration: Dryness is not confined to the mouth. For these reasons, it is universally considered the premier party drug of the last few decades, a title once held by cocaine. Full-body fatigue can set in within a matter of hours, even minutes.
• Hyperthermia: According to experts, the most common complication associated with ecstasy use is hyperthermia. This occurs when a person’s body temperature becomes dangerously high, which is even more likely to happen in club environments where people tend to use ecstasy. Hyperthermia can cause liver, kidney and heart failure, which can be fatal. 

Every health complication from recreational drug use must be thought of as being terminal if not treated. MDMA is a social drug, so if you’re not the one exhibiting serious symptoms, someone you know likely is. Get friends and loved ones the help they need before consequences become more serious over time.

Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone contact Web Poison Control Services for online assistance.

Can You Reverse an MDMA Overdose? 

When ecstasy users arrive at a hospital or rehab center for care, their situation is a bit of an enigma. Physicians will not immediately know what percent of the pills they’ve ingested was MDMA as opposed to other additives. This requires blood toxicology examinations.

In the meantime, medical professionals will do their best to treat the underlying issues related to ecstasy misuse, namely, dehydration and overheating. Once a victim is rehydrated, cooled and stabilized, there is a high likelihood they will make a full recovery. That being said, some cases of ecstasy overdose can be fatal.

If you have been using ecstasy and find that it is difficult to stop, it is likely time to reach out for assistance. Don’t risk an overdose situation or a lasting addiction. The Recovery Village can help. Providing individualized drug and alcohol treatment programs, this renowned center can help you find the strength you need to leave a substance use disorder behind for good. To get started, call The Recovery Village today.

Editor – Abby Doty

Abby Doty graduated from Hamline University in 2021 with a Bachelor's in English and Psychology. She has written and edited creative and literary work as well as academic pieces focused primarily on psychology and mental health. Read more

Medically Reviewed By – Jenni Jacobsen, LSW

Dr. Jenni Jacobsen is a licensed social worker through the Ohio Counselor, Social Worker and Marriage and Family Therapist Board. She has over seven years working in the social work field, working with clients with addiction-related and mental health diagnoses. Read more