MDMA-Related Deaths: Stop Calling Them Overdoses

MDMA-Related Deaths: Stop Calling Them Overdoses
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  1. Brian Gilbert

    You really hit every single point on the head with this article Emanuel & Missi, FANTASTIC job!

  2. Leslie Dieguez

    I loved this article. Great way to spread awareness. How can the public help dance safe?

  3. Post author

    A therapeutic dose of MDMA is between 70 and 125 milligrams. Recreational users often push this up into the 150mg range. More than that is typically not going to have beneficial effects, but rather just increase the side effects.

  4. Bawb

    I have been going to raves and taking ecstasy since 1996, granted I don’t go out or roll very often (maybe 10 times a year). Generally if I’m rolling I take around 500mg-800mg in a night sometimes more (not all at once each dose is an hour apart), too much? Maybe for some people, I’ve been doing this a long time and know how much I can do. At a recent festival I took 500mg a night for 3 days straight, personally I think it was too much and a waste since the second night I barley felt anything and the third nothing at all. Its all about knowing your limits, buying from a trusted source, and for gods sake test your pills, its not 100% effective, but at least its better then nothing. Thanks to Dancesafe for approaching the subject of drugs from an intelligent stance and understanding that people will do what they want, the least that can be done is reduce harm.

  5. Alec

    Everything that needed to be said was, and an excellent approach to this writer in particular. Very well done! 🙂

  6. Magnus Krogsfeldt

    Black market MDMA is notoriously impure. Chances are that you would need way less if you had the clean product.
    If your MDMA has odour or miscoloring, for example a liqurice-like smell and a brownish appearance, you can be 100% sure that your MDMA is not 100% pure.

  7. Mike

    I can assure you in years of responsible use I have never seen anybody use so small an ammount as 150mg, except when it’s their first time. Most people I know would not even think of taking less than 250mg and will have 500mg on them. This will be taken in 100mg doses between, say, 11pm-3am.

  8. Post author

    Mike, I think what you are saying is true. However, I think the reason is that most Molly these days is methylone, not MDMA, and the dose level for methylone is higher. A 250mg dose of pure MDMA would be way too much for most people, beginners or not.

  9. Marcus

    Exactly! Dosage depends on purity. If you have heavily cut product, you will obviously need to be taking more to get high.

  10. christian

    I think they might be referring to 1 dose as around 100 mg, which is a tenth of a gram, or a point

  11. AmericanWoman

    Going back to the Avicci incident where lots of people had to be taken to the hospital. Were there any that had not taken ecstasy or had they all taken ecstasy?

    If you are saying that E is not the reason for these incidents, that it is heatstroke or other medical issue, then it should be obvious by simply determining if all affected people had E in their system or not.

    If there are people who did not take E, then your theory is correct. E can not be the single reason for these incidents, but if the only people who ended up in need of medical assistance had E in common, then it’s pretty hard to not blame E.

  12. Post author

    Many drugs can increase the risk of heatstroke. MDMA is one of them. At Avicii, as is always the case, the heatstroke emergencies resulted from a combination of factors. We don’t know how many people hospitalized at Avicii had taken MDMA or not, but we do know that heatstroke emergencies are common at EDM events even when the person had not taken any drugs. High ambient temperature, aerobic activity like dancing, and dehydration (not drinking enough water) are primary (and often sufficient) factors contributing to these emergencies. MDMA is very often a contributing factor too, but it is rarely the sole factor. This is why it is so important that venues have chill rooms and easily accessible drinking water, that dancers take breaks from dancing and stay hydrated and cool, especially if they are using MDMA (or any drug).

    The point is that blaming the drug alone doesn’t help educate anyone on how to stay safe if they are going to use MDMA. Blaming the victim who suffers a heatstroke emergency by saying, “they shouldn’t have been using MDMA in the first place,” isn’t helpful. There are easy ways to prevent heatstroke (while using MDMA or not), and we all have a collective responsibility to help prevent these emergencies.

  13. Josh

    This deserves to be very widely read. Fantastic article. I’ll be sharing it, I hope others do to. It’s important that the reaction to all the misinformation from explicitly anti-drug sources doesn’t provoke an equal and opposite reaction that MDMA is risk-free if you take it right. The one thing I’d add is that users should also think about the (admittedly uncertain) possibility of mild but persistent after-effects on memory and other things from overuse, as well as the severe rare effects like death that get most of the attention. The possibility that a drug might hold you back from your full potential in education, career etc, even just by a taking away a couple of percent of your performance, might matter as much to some as the very small chance of death.

  14. Josh

    Yes, but actually, appearance is not a very useful guide. In the UK at the moment, some of the better stuff (near-pure MDMA) is nowhere near white, and the stuff that is beautiful white crystals is methylone, not MDMA at all.

  15. Cat r pillar

    I believe they are very open in saying these are MDMA-related incidents… We aren’t trying to argue that. Only that these are side effects from any dose and not just an overdose

  16. SerotoninStation

    I have so many questions!

    1. How can you judge the amount of mg you are taking of MDMA? For a first time user, how could you be sure you are taking 100mg or 500mg?

    2. If you are taking substances such as MDMA or Molly in a calmer environment than an EDM concert, like with some friends in an apartment or garage, how can you be sure that you are staying hydrated but not too hydrated?

    3. What if you want a buzz stronger than caffeine but not as potentially dangerous as MDMA or Molly?

    4. When using the test kits to determine MDMA from Molly there is a lot of chemistry terms used to identify the drugs in a tablet, capsule, or powder. How can someone who isn’t that knowledgeable on the subject understand the results?

    5. Do EDM concerts allow you to take your own water and Gatorade since, it sounds like from this article, that they don’t necessarily provide them?

    6. Are there other less risky substances to get “turnt” on at EDM concerts and clubs? Would someone be better off taking shots of Bacardi or Ciroc?

    7. The girl who died at the Boston house of blues apparently took 6 hits of Molly, how much is that? Is a hit of Molly more or less potent than MDMA?

  17. Sally

    How much water would you recommend a teenage female drinking with one dosage of 125mg during a rave?

  18. Post author

    Hi Sally,

    Here is our page on heatstroke:

    It is always best to drink gatorade or a sports drink as this will replenish electrolytes. How much depends on how much a person sweats. Two cups per hour is a good rule of them. Most importantly, if a person chooses to use MDMA at a dance event, they should take frequent breaks from dancing and pay attention to their body temperature.

  19. Post author

    1. Unfortunately, there’s no way to be 100% sure of how many mg you are getting with any illicit drug, since powders can easily be cut. Always err on the side of caution and take less. That said, using the reagent testing kits, the more pure a product is to more quickly most of the reactions will take place, but again this should not be used as any definitive test. Sending some of the powder to will give you all the actual ingredients in it, but unfortunately it will not tell you the purity. (This is because of DEA regulations regarding anonymous lab testing of illicit drugs.)

    2. It’s always safer to take MDMA in a home environment at normal room temperature than at a hot rave where you will be dancing. In those cases, if you are not engaging in aerobic activity and are not sweating a lot, you probably don’t need to consume anymore water than you normally would if you were not using MDMA. In fact, you should probably consume a little bit less, since MDMA causes moderate, temporary water retention, and too much water can be dangerous. A few tall glasses of water or sports drink should be fine spaced out over 4-6 hours in such a context. But again, this is just a rule of thumb.

    3. This isn’t something we can answer for you. What we suggest is to always introspect carefully as to your intentions for wanting to use any drug. What is your goal? Is it to feel good? Is it to learn something? Etc. It’s always good to know your motivations if you are considering using a drug.

    4. What terms are you referring to specifically? We think the testing kit instructions are fairly straight-forward. It’s always important to educate yourself as much possible. The most important thing to remember about the reagent kits is that they do not detect purity. They are only able to identify the presence of a limited number compounds. So a positive test for the presence of MDMA does not mean there are no other drugs in the pill. Only be sending a sample into can you tell everything that is in the pill.

    5. This depends on the event. Most probably don’t, since they would be worried about GHB and other liquid drugs being brought in. That said, most EDM concerts do provide water, though it may not be free or easily accessible.

    6. All drugs contain inherent risks. The type of risk also differs depending on the drug. It’s not appropriate for a harm reduction organization to categorize drugs as “more risky” or “less risky,” since we do not want to give the false impression that any drug is “safe.” Also, risks can be different depending on the constitution of the individual. Some people just react differently to different substances. Knowing yourself is very important. If you choose to use any drug, starting off with a very small dose to see how your body reacts is always a good idea.

    7. You’re speaking of Olivia Rotondo. A recent article quotes her family saying that the claim she texted that she took “six hits” is false. That said, most “molly” comes in powder form and hence there’s no such thing as a “hit.” If consuming pills or pressed tablets, someone might refer to each as a “hit.” In an illegal market, there’s no way of knowing how much of a drug is in any powder, pill or tablet. If you are curious as to appropriate dose levels for various drugs (MDMA, methylone, etc.), visit And lastly, There is no such thing as “Molly.” The word is not a technical term that refers to any actual drug, even though most people think it is supposed to refer to MDMA. Between 2011 and 2013, over 80% of the Molly seized by the DEA in the northeast US did not contain any MDMA. Most of it was methylone.

  20. SerotoninStation

    Thanks a bunch!
    As for question 4. I looked more into the instructions on dancesafe and the information on ecstasydata and I saw what it was the kits test for and how they are color coded. Thanks again.

  21. James

    Another safe precaution dancesafe should invest in, a temperature bracelet, necklace or patch. To tell you your temp and when you should cool off or slow down. Random thought if this is invented give me some credit! 😉

  22. Sally

    We also need to teach others better first responder techniques. Learn to recognize the symptoms of hyperthermia in others. If you’ve been to a party, and seen that person who was going ham on the dancefloor, suddenly sitting near the bathroom or in a corner hugging their knees, staring wildly, clearly in shock, unresponsive, don’t assume they are just “rolling really hard”. You are looking death in the face.
    Get them water, take them into the bathroom away from noise or outside where the lighting is normal and it’s quieter. All the sensory overload of a dancefloor creates anxiety which aggravates their condition. Don’t expect them to talk to you. I know it’s awkward to see a stranger behaving this way (sometimes scary) because they appear to be responsive (awake, alert, can walk or stand) but that doesn’t mean their arteries and vital organs aren’t shutting down slowly. but we all need to put the phones down and pay attention to eachother.

    This happened to me in the 90s at a party. I saw him sitting by the bathroom, eyes staring wildly with confusion. He looked at us as we walked by and it felt creepy. I just thought he was really fucked up and it would pass. He died by that bathroom, because the venue was so small, dark and crowded he couldn’t find an exit or his friends. They shut the party down, and my friend who threw the party was beside himself. The city enforced new ordinances that venues couldn’t exceed certain capacity, their had to be clearly marked exits, and access to water.

    I still see that kid, in my mind, the look in his eyes i thought was “high as fuck” was really fear. And we weren’t educated or encouraged back then about overheating.

    Be prepared that if you go to a party you can get high, but you may need to help someone. And it’s a fucking buzzkill, but better that than watching someone die.

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  25. Jack Sheit

    I just love it when people try to demystify one drug while further mystifying another in the process.

    HELLO DRUG HARM REDUCTIONISTS ARE YOU LISTENING?! Most OPIATE overdoses are not true overdoses either. And “calling them overdoses is dangerous and negligent. It sends the message that ‘you will be okay as long as you don’t take too much,’ which is simply not true.”

  26. floyd

    you said :

    A normal dose of MDMA raises body temperature about one degree and also inhibits the body’s natural thermoregulation. This increases the risk of heatstroke . . .

    but then you said :

    . . . the inaccurate claim that dehydration is a “side effect of MDMA.” (It’s not.

    so it raises the body temperature but does not increase your need for water?

    uh . . . I lost interest in your article at this point

  27. Timothy

    One thing I was hoping this article would touch but didn’t…

    Wouldn’t it be likely that many reactions from taking Molly come from adulterated product? Product that isn’t pure or contains other dangerous chemicals? I thought it was common that the most dangerous element of taking Molly is not getting molly in what you take?

    Can you elaborate?

  28. Justin

    Very nice article. I thought it was interesting that the hospital visits were not overdoses of the drug but the proper dosage.

    However, I’m a little confused on your next conclusion that this is justification to regulated usage. It would seem that a drug that the proper dosage results in all the potential health difficulties you mentioned that we should focus on removing the drug and creating awareness on the health consequences. Informing people if they have an unprescribed drug at an unprescribed dosage or an unprescribed drug at an unprescribed dosage seems like a false security, only empowering usage.

    It was a wonderful article and I enjoyed reading it, truly informed me. It just left me scratching my head a little.

  29. John Label

    Half a gram overdose? I’ve seen people go whole points and farther and not die. Theyre pretty fucked in the head though.

  30. cb

    It might not necessarily be the purity of the pill but the fact that you had no serotonin left for your brain to release. MDMA doesn’t get you high, it triggers chemicals (serotonin) in the brain to be released that give you the high. Therefore, if you are using 5-800 mg of MDMA to get high its obvious that unless you replenish your serotonin levels, you won’t feel anything, which is what happened in your case.

  31. Anonymous

    I happen to be a professional organic chemist who likes to occasionally rave. Having access to sophisticated analytic equipment I often test my pills or my friends pills so we know what we are taking. After seeing the results of my tests, I rarely take random product and I encourage my friends to let me test their product. A few things to point out from what I have leared testing pills in the Bay Area:

    1) sometimes the purest looking stuff, nice colorless “moon rocks” isn’t MDMA at all. Actually only one time was it MDMA, almost always it has been methylone (bkmdma).

    2) almost all the Molly I have tested that is true MDMA has a slight color to it. Even stuff that has a brown color to it is 95% pure mdma. Do not judge purity by appearance, it only takes a small amount to add color.

    I have tested pills that have turned out to be meth aswell.

    Test your stuff. You never know wtf you have otherwise

  32. Post author

    Thanks for the comment, but we we want to be clear that color has nothing to do with it. Like you say correctly, “do not judge purity by appearance.”

  33. Post author

    It’s important once again to point out that anyone who takes 500mg or more as an initial dose of “Molly” and has an ok time is NOT taking MDMA. Most likely they are taking Methylone. 500mg of MDMA would be a serious overdose of MDMA for *anyone* who takes it.

    Prohibition has made the situation today very dangerous, because thousands of people (probably tens of thousands) have taken “Molly” many times and believe they have taken MDMA when they have actually only ever taken Methylone. And because the proper dose for Methylone is so much higher than MDMA, when they finally get MDMA unknowingly for the first time, they take way too much.

  34. Post author

    Hi John. You are definitely right, but in those cases it’s almost never MDMA they are taking. Most likely it is Methylone.

  35. Post author

    Thank you for your honest question. The problem is that the combined governments of the world have put hundreds of millions of dollars over the past three decades trying to stop the spread of MDMA and other recreational drugs, and they have failed. Decriminalization and strict regulation would actually lower overall use, especially among minors. It’s easier for minors to get a hold of “Molly” these days than alcohol. If pure MDMA were available to adults in regulated amounts (using nation-wide certification cards), this would dry up the illicit market (because there would be much less profit to be made via illegal production), and reduce the amount available to minors. Minors who *really* wanted it would find an adult to buy it for them, of course, but at least then it would be pure and the quantity would be known.

  36. Post author

    Hi Floyd,

    Yes this is a bit ironic, but it is nonetheless true. You see, although MDMA raises body temperature, it actually causes water retention. Under normal circumstances (room temperature, clinical environment), people who are given MDMA do not pee as much as people who were given placebo (meaning no drug at all). These results have been confirmed in numerous studies. This is why over-hydration is a problem. Many people have died after taking MDMA and drink TOO MUCH water. This is a very important irony to understand. MDMA increases body temperature and also inhibits the body’s natural ability to regulate temperature, increasing heat stroke risk. But it does not cause dehydration. It actually causes water retention. However, despite causing water retention, the #1 risk of pure MDMA is heat stroke (aka “hyperthermia)”. Keep in mind people still sweat normally while on MDMA. So if someone is dancing in a hot environment and sweating, they can become dehydrated easily (despite MDMA causing water retention in normal, room temperature circumstances).

    In short, the one degree that MDMA raises body temperature in clinical environments does not cause perspiration or sweating, and therefore does not lead to dehydration. Dancing in hot environments causes perspiration and leads to dehydration. And combined with MDMA this can be dangerous.

  37. Bass

    I started 200 mg of “molly”, eventually got a great connect (so don’t start with the “it’s probably not MDMA) and was keeping the same dose, it was just better. My friends and I have been doing for 2 years, built up a tolerance(we don’t always use, take a couple month or weeks off). I now take 300-350mg/dose. If I party hard, prob take 3/4 hits. This is not to sAy that’s normal (it’s not) but ppl stop saying this 100-200 mg is ideal and over that is horrible.

  38. Post author

    Bass, we still believe you are most likely getting something besides MDMA, or you are over-estimating your dose. 300-350mg of pure MDMA in an initial dose would be too much for almost anyone.

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  40. Adam

    If people just got a test kit then all these comments of ‘it must be methylone’ would be answered. I would say 250mg of MDMA, MDA, MDEA etc would be about most people’s max amount, that’s a double drop of something like a Sunrise from the 90’s (assuming they where real) which most contained about 125mg of MDXX. Some pills do have 250mg in them e.g. China Whites.

  41. Ghostwheel

    Felt being one of the older users here 46. I’d give my input. From my experience powdered crystalline mama is almost always better than pills. Most of the quality product I have had has been brown to a caramel colour. 0.08 to 0.15 will give most people a grate time dependant on purity, age and quality of product.

    Always try a little first in a safe environment with people you trust.

    Buy some pocket digital scales from Amazon accurate to 1000 of a gram. They cost about £6 and get ones that use AA OR AAA batteries. So they are easy to replace.

    Every misshap I have seen with moll was from people taking guessed doses with product of an in known qty.

    One accurate dose (my preferred) possibly followed by a smaller second or 2CB CHASER works well. And limits the nasty come down the day after.

    Taking HTP5 supplement every day running up to a dose of molly increase the level of seratonin available and gives a better high. Taking it after a roll for a couple of days reduces the bad come down and blues that can follow a roll. Do follow directions on htp5 possibly double up but no more as it can play havok with your guts.

    Leave gaps between nights rolling. The longer the better. You will be rewarded with a better high.

  42. Ben Loda

    Thanks for making this article. Im really glad I found it. I took “molly” for the very first time in my life at a music festival in November to what I thought was a standard dose (100mg-120mg) (I bought from inside).

    My friend split the capsule up for me into roughly 70% and 30% so it wouldn‘t be too strong for me. I took the 70% first and I felt the effects gradually coming on and it was good, then about 45 min passed and I took the rest (30%). Thats when i felt something I never expected. After 5 min of the 2nd dose it hit me, my vision blurred and I felt my heart race, all things when slow for a few seconds.

    That‘s when everything went downhill, due to those effects I got really scared, leading to difficulty breathing and eventually panic attacks. I quickly left the stage and went outside for fresh air. In my head I thought I was definitely going to OD. After about 20 min of panting and walking around My friend was able to calm me down and I began to feel the effects of mdma again and it was really good.

    I know that what I got was definitely not pure but im still puzzled as to my whole experience. Can MDMA have this sort of effect on people? Or is it another substance/chemical that triggered it? Has anyone else experienced this? I made sure i took regular sips of water and was not dancing too much.

  43. Jason

    Great article because it really shows the unbiased view dancesafe has. The thing with MDMA is it’s metabolism varies so much from person to person, it’s smart for any newer user to start small just to make sure they aren’t one of the unlucky few that can’t metabolize it properly. Then you got the fact that it doesn’t play nicely with ssri’s, something not as widely known as it should be.

    Btw 130mg is about as high as I’d go, anymore and your looking at a rough comeup. Besides a 50-70mg booster as soon as I can stomach it, any additional redoses are useless and waste of good product.

    One more thing I’d like to add as someone who’s tested a lot of product over the years. A quicker reaction doesn’t always mean a more pure product, when talking about MDMA shards. Mostly experience with mecke, impure product with residual oils will react quicker and violently, with a darker green that vanishes quickly to bluish/nearly black, whereas more pure will react a bit slower and steadier, turning turquoise for a moment or two before going bluish/nearly black. Just something to keep in mind for volunteers out there testing 🙂

    Much love guys

  44. damien

    SWIM in the 90’s recalls what they believe is MDMA use.Effects would last 6-8 hours.Jaw clenching was commonplace. And A very stimulated and confident mannerism combined with very hypnotic dancing.
    The Media took SWIM’s experiences and “marketed” as the mdma or (ecstacy) experience.
    As time passed SWIM studied and read books. Especially Phikal by Alexander Shuguin.
    Through the dark web, MDMA appears to be more accessible to SWIM now. But SWIM is aware that our current media trend is to recreate the glory days of the 90’s. Where in fact MDMA may of been MDA or including more caffine/anthetamine.

    100mg of MDMA provides swim with 4 hours of effects.But Not Smiley faced nostagia.
    MDMA allows swim to get into cult like trances. That eventhrough may have spirtual benefits will not sell DJ culture to the mainstream.150mg-180mg produce emotional pychosis and rebirthing.The idea of today’s youth being able to “roll” on the floor. embrace their inner child and compassion for the loveless society that tries to educate them gives SWIM hope for humanity.

    But to reproduce the golden smiley face age of the past.Anthetmine and MDMA mix will provide this much more throughly than hourly top ups of 100mg of MDMA.

  45. Davie

    Did it feel like your eyes were twitching or wiggling? This effect is called nystagmus For me personally it happens on higher doses of mdma, but I know it can happen with smaller doses too. Also increased heart rate is another effect of the mdma and I’ve noticed that when at a concert etc this effect is amplified and sometimes I feel worried because it seems like I can actually feel my chest thumping from my heart beating so hard. Hope this was a little help.

  46. matt

    Is there really such a thing as a “recreational drug” and also I believe that the doctors are the biggest “dealers” there are nowadays. There a few good honest ones out there but it’s all about the money in that business.

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