People may combine MDMA with alcohol to prolong a high, but the combination of both drugs can cause dangerous side effects.

Here we look at the side effects and risks of combining MDMA and alcohol, precautions to take, and treatment options for recovery.

A concert in which concert-goers may take alcohol and molly.Share on Pinterest
The risk of overdose increases when a person uses a combination of MDMA and alcohol.

MDMA (3, 4-Methylenedioxymethamphetamine) is a drug that changes a person’s mood and has similar effects to stimulants and hallucinogens.

It is a synthetic drug made from safrole oil. It affects chemicals in the brain and increases the release of serotonin, which causes the elevated mood that people experience with MDMA.

People may take MDMA as a tablet, liquid, or snort it in powder form. Dealers may mix MDMA with other drugs and substances, such as cocaine, methamphetamine, or ketamine.

Other common names for MDMA can include:

  • molly
  • mandy
  • ecstasy
  • E
  • XTC

MDMA is an empathogen, which means it increases feelings of empathy and connectedness. According to the National Institute on Drug Abuse, MDMA causes an increase in the following brain chemicals:

  • Serotonin: This chemical affects appetite, mood, sleep, and other functions. It can also affect sexual arousal and trust. The release of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.
  • Norepinephrine: This increases a person’s heart rate and blood pressure.
  • Dopamine: This can increase energy and help reinforce behaviors

MDMA can also cause:

  • nausea
  • irritability
  • muscle cramping or stiffness
  • chills
  • jaw clenching
  • depression
  • anxiety
  • impulsiveness and aggression
  • blurred vision
  • sweating
  • memory and attention problems

MDMA tablets or powder can contain a mix of other drugs and filler substances. This can cause unexpected reactions and unpredictable side effects.

The side effects of alcohol may include:

  • decreased inhibition
  • loss of coordination
  • impaired judgment
  • high blood pressure
  • a decrease in reaction times and reflexes
  • nausea or vomiting
  • fainting
  • impaired vision
  • slower or slurred speech
  • memory loss
  • depression
  • dehydration

According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), people often take MDMA alongside alcohol. A 2016 review article in the Journal of Addiction Research & Therapy suggests that more than 95% of MDMA users also use alcohol.

People may combine MDMA and alcohol for various reasons, such as:

  • being in an environment where both are readily available, such as a nightclub or rave
  • wanting to prolong the high from MDMA
  • attempting to counteract the adverse side effects of one from the other

According to the American Addiction Centers, taking both MDMA and alcohol together poses a more significant health risk than taking them individually.

MDMA and alcohol both affect neurotransmitters, or chemical messengers, in the brain. The combination of MDMA and alcohol increases the levels of dopamine and serotonin in the brain.

Too much serotonin in the brain may result in serotonin syndrome, which causes a range of symptoms and can be life threatening without treatment.

The abnormally large release of serotonin may result in a depletion of the neurotransmitter when the high wears off, which can cause a low mood or depression.

Combining MDMA and alcohol can lead to someone taking more of either drug, particularly alcohol, which can result in an overdose.

This may be due to MDMA damaging dopamine reward pathways, which may encourage people to drink more alcohol. Both drugs can also cause dehydration, which may result in a person consuming more alcohol.

As the liver metabolizes both drugs, consuming alcohol may slow the removal of MDMA, resulting in a buildup and higher blood concentration of MDMA. This may lead to serious side effects or stronger adverse reactions to MDMA.

Combining both drugs may result in organ failure. A 2015 article in PLOS suggests that drinking alcohol with MDMA may increase stress to the heart and can lead to heart-related toxicity.

A 2017 study on rats also suggests that combining alcohol and MDMA may increase the risk of injury to the heart, liver, kidneys, and brain.

The long-term effects of taking MDMA and alcohol together can include:

Suicide prevention

  • If you know someone at immediate risk of self-harm, suicide, or hurting another person:
  • Call 911 or the local emergency number.
  • Stay with the person until professional help arrives.
  • Remove any weapons, medications, or other potentially harmful objects.
  • Listen to the person without judgment.
  • If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.

Time frames can vary for each individual, depending on the amount taken, age, weight, and health conditions.

MDMA can stay in the system and show up on a drug test up to 4 days after taking it, according to the Food and Drug Administration (FDA).

The American Addiction Centers state that tests can detect alcohol in the system up to 24 hours in the blood, breath, urine, and saliva, and for up to 90 days in the hair.

All drug use carries risks.

Both MDMA and alcohol cause dehydration. Although it is important to remain hydrated, it is essential not to drink too much water, as this can lead to hyponatremia, or water intoxication.

To avoid this, opt for drinks that replenish electrolytes, such as juices and electrolyte beverages, instead of water.

If people are in a crowded or energetic environment, taking regular breaks to cool off is crucial to help prevent a dangerous rise in body temperature.

In all states of the United States, the minimum legal drinking age (MLDA) is 21. This means only people over the age of 21 can legally buy alcohol.

The Drug Enforcement Administration (DEA) listed MDMA as Schedule I drug after the World Health Authority (WHO) Committee on Drug Dependence ruled that it had no medical use and a high potential for abuse.

If people overdose on MDMA and alcohol, treatment will depend on the severity of symptoms. Some people may need hospitalization.

Treatment for an overdose of MDMA and alcohol or both may include:

  • stomach pumping
  • activated charcoal, if a person has taken MDMA within the past hour
  • benzodiazepines, to treat anxiety if necessary
  • resting in a quiet environment
  • restriction of fluids if people have hyponatremia
  • intravenous fluids to balance water, blood sugar, and vitamin levels
  • help with breathing by using intubation

If people are seeking treatment for drug or alcohol use disorders, a research-backed program of therapy can help with long-term recovery.

Under medical supervision, people may first undergo a medical detox to help them come off both drugs without experiencing severe withdrawal symptoms, which could take 30 days or longer.

A doctor will also assess if people have any underlying physical or mental health conditions.

After medical detox, people must follow a treatment program to help manage drug cravings and learn how to prevent a relapse.

If a person thinks someone has overdosed on MDMA, alcohol, or both, they should seek medical help immediately.

If people think they, or someone they know, may have a drug or alcohol misuse disorder, they can try reaching out to an organization or support network for help and support.

Here are the contact details of some of these organizations:

Combining MDMA and alcohol increases the risk of adverse or severe side effects. In some cases, side effects can be fatal or cause long-term health problems.

Taking both MDMA and alcohol increases the risk of an overdose. If people think someone has consumed too much MDMA or alcohol or both, they should seek immediate medical help.

If people think they, or someone they know, may have a drug or alcohol misuse disorder, they can contact a healthcare professional or organization to receive support and treatment.

Long-term, evidence-based treatment can help people come off both drugs and prevent a relapse.