However, the reality is that MDMA-related medical emergencies and even deaths can and do occur. MDMA use may be riskier than many people realise and this may include the risk of overdose.
In this article we will take a look at the overdose risks associated with MDMA, potential warning signs and when to seek help.
Can You Overdose on MDMA?
The short answer is, yes, you can overdose on MDMA.
In medical terms, there is a distinction between poisoning and overdose. Poisoning refers to ‘the state resulting from the administration of excessive amounts of any pharmaceutical agent’, while an overdose is ‘the use of a quantity of drug in excess of its intended or prescribed dose’.
In common usage, however, the term ‘overdose’ is generally taken to refer to serious health consequences related to taking too much of any drug. The people behind International Overdose Awareness Day use the simple definition that an ‘overdose’ occurs when there is more of a drug – or a combination of drugs – in the system than the body can cope with, leading to harm or death.
On either of these definitions, it is certainly possible to overdose on MDMA, but the results do not always look the same as with opioids or other drugs. There may also be confusion on the issue of MDMA overdose because it is often taken with other substances or contains other substances, because responses to the drug can be very unpredictable and because overdose symptoms can vary quite widely.
How Does MDMA Affect the Body?
The main effect of MDMA on the body is as a central nervous system stimulant. In this respect, it can have an effect similar to amphetamines. It can provide a sense of energy and euphoria, but this can be accompanied by physical effects including elevated heart rate and increases in blood pressure, as well as jaw clenching, teeth grinding, muscle tension and excessive sweating. Crucially, MDMA can also affect the body’s ability to regulate its own temperature.
MDMA can also have mild hallucinogenic effects, such as heightened sensory perceptions, and affect the mood. Typically, it increases empathy and positive feelings toward others.
What Causes an MDMA Overdose?
Taking an amount of MDMA that is enough to cause harm is what causes an MDMA overdose.
However, MDMA can have very different effects on different people depending on a number of factors including dosage, purity, whether the MDMA is ‘cut’ or being deliberately taken with other substances and individual health factors. These are some of the reasons why some people may experience severe reactions after amounts that others appear to tolerate.
Why Is MDMA More Dangerous Than Many People Realise?
Illicit drugs can be very unpredictable. The mechanisms that MDMA uses are very complex and can affect individuals who take them very differently. Drugs sold as MDMA can also have a range of adulterants or ingredients that can have different effects.
Repeated dosing can also increase the risks, while environmental factors such as being in a hot club can also increase the chances of overheating.
What Are the Signs of an MDMA Overdose?
The signs of an MDMA overdose can vary, as the overdose can take a number of different forms. Signs of potentially dangerous side effects from MDMA can include:
- Confusion and/or anxiety
- Uncontrolled body movements
- Headache
- Blurred vision
- Irregular or rapid heart rate
- Chest pains
- Abdominal cramping, nausea and vomiting
- Elevated body temperature
- Excessive sweating
One of the main risks associated with MDMA overdose is a sharp increase in body temperature known as hyperthermia. This can happen when the drug affects the body’s ability to regulate its own internal temperature.
Symptoms can escalate rapidly, so it’s important to respond and seek help quickly.
MDMA, Overheating and Water Intoxication: The Hidden Dangers
Hyperthermia or extreme overheating from MDMA can result in liver, kidney and cardiovascular system failure. In rare cases, it can be fatal.
Water intoxication is another serious risk. The user may drink more because they are hot, but MDMA also increases the release of antidiuretic hormone (ADH), which makes the body retain water. Drinking more water than your body can process can lead to symptoms, including:
- Headache
- Nausea or vomiting
- Fatigue
- Confusion
- Muscle cramping or weakness
As with hyperthermia or overheating, water intoxication can sometimes prove fatal.
Does Mixing MDMA With Other Substances Increase the Risk?
Mixing different drugs can sometimes compound their effects or have unexpected results. For example, mixing MDMA with another stimulant such as cocaine or even caffeine can increase the strain on the cardiovascular system.
As the product sold as MDMA is often cut with other substances to begin with, potential effects can be even more pronounced or unpredictable. Polydrug use can also complicate medical emergencies if medical professionals do not know exactly what they are dealing with.
What Should You Do If Someone Is Overdosing on MDMA?
If you believe someone is overdosing on drugs including MDMA you should try to get them to a quiet, cool space and stay with them.
Call 999 or 112 for emergency help and tell them that you suspect drug poisoning.
Do not give them coffee or put them in a cold bath.
If they are unresponsive, unconscious or having difficulty breathing, you should call 999 immediately, put them into the recovery position and stay with them until help arrives.
Can Regular MDMA Use Lead to Addiction?
MDMA is generally described as non-addictive but there are cases where people have developed dependency. This generally takes the form of psychological addiction or dependency, rather than the type of physical dependency that can develop with substances such as alcohol and opioids.
A psychological dependency can still be very difficult to quit without expert help and can increase the risks as usage may become more regular or heavier.
When Is It Time to Seek Help for MDMA Use?
It may be time to seek help if MDMA use is affecting other areas of your life, such as work, education or relationships. If you have tried unsuccessfully to stop or cut down, find yourself using MDMA more frequently or continue to use the drug despite negative consequences, you may have a problem that needs addressing.
Treatment and Recovery for MDMA Misuse
MDMA misuse can be very harmful, and dependency can be very hard to recover from. With the right professional help and treatment programme, however, it is possible to make a full and long-lasting recovery. An MDMA rehab programme could involve a range of therapies, relapse prevention sessions and comprehensive aftercare support.
Despite its reputation as a ‘safer’ drug, it is possible to overdose on MDMA, and the consequences can be severe. You should always seek professional support if MDMA use is becoming difficult to control.
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