Designer drugs, also called synthetic drugs, are substances made in clandestine laboratories. Most are stimulants derived from amphetamine, and the best known is MDMA, sold as ecstasy in pill form or as crystal or powder. Their danger has two sides: what they do to the body, and the fact that the person taking them hardly ever knows for sure what the pill or powder really contains.
What designer drugs are and the forms they come in
This name covers substances from different chemical families. The most widespread are:
- MDMA: taken as ecstasy (pills) or as crystal or powder, sometimes called ‘MD’.
- MDEA, known as ‘Eve’ (‘Eva’ in Spain).
- MDA, sometimes sold as ‘love pills’.
The pills often have bright colours and eye-catching logos, and on the street in Spain they are called ‘pastis’ or ‘pirulas’. Two pills that look the same can contain very different amounts of the active ingredient or include other substances, so the logo guarantees nothing. New substances that mimic their effects are also constantly appearing, and even less is known about them.
They are relatively cheap and are mainly taken in groups, at weekends and in party settings, with the aim of lasting longer, feeling closer to others and losing inhibitions.
Effects of MDMA and ecstasy
What people are looking for
People who take ecstasy are looking for energy, euphoria, wanting to talk and a feeling of closeness and empathy with others. Tiredness, hunger and sleepiness also decrease, which makes it possible to dance for many hours.
Physical effects
- A faster heart rate and higher blood pressure.
- Raised body temperature and sweating.
- Clenched jaw, teeth grinding, dry mouth and nausea.
- Blurred vision.
Effects on perception and mood
Sounds, light and touch are felt more intensely, and colours, textures and the sense of time can be distorted. Concentration and coordination decrease, which is especially noticeable when driving. Some people experience confusion, anxiety, irritability or aggression.
The comedown in the following days
When the effect wears off, it is common to feel exhausted, sad, irritable, unable to concentrate and to have trouble sleeping for one or several days. That discomfort pushes some people to use again to get rid of it, and so a cycle begins to form.
Risks of ecstasy and synthetic drugs
The idea that they are ‘clean’ or not very dangerous drugs is widespread. This is not the case: some of their risks can appear the very first time.
- Heatstroke: the rise in temperature, combined with dancing, heat and enclosed spaces, can cause severe hyperthermia, with a drop in blood pressure and circulatory collapse.
- Water and salt imbalances: both dehydration and drinking too much water in a short time can be dangerous.
- Heart and brain problems: arrhythmias, heart attacks and brain haemorrhages.
- Liver damage.
- Mental health effects: anxiety attacks, depression and psychotic episodes, especially in vulnerable people.
Particularly dangerous combinations
They are often combined with alcohol, cannabis or tobacco. With alcohol the risk of dehydration increases, and vomiting, a racing heart, dizziness, nervousness and even paranoid thoughts can appear. Taking them together with other stimulants, such as cocaine, multiplies the strain on the heart. And some medicines, especially certain antidepressants, can cause a serious reaction with MDMA: if you take medication, talk to your doctor.
Emergency signs: call 112
Get medical help immediately (112 is the European emergency number) if someone who has taken ecstasy or pills shows:
- A very high temperature, very hot skin or stops sweating.
- Severe confusion, disorientation or very disturbed behaviour.
- Seizures, chest pain or difficulty breathing.
- Loss of consciousness.
While help is on its way, do not leave the person alone, take them somewhere cool and, if they are unconscious but breathing, put them on their side. Tell the medical team what they have taken: it is not about judging, but about helping them give the best care.
Long-term effects and risk of addiction
Repeated use has been linked to memory and concentration problems, low mood, anxiety and sleep disturbances. Over time tolerance can develop (more and more is needed to feel the same) or, conversely, sensitisation (a stronger response than expected), and both increase the likelihood of adverse effects.
Not everyone who tries ecstasy develops an addiction, but use can gradually take up more space without being noticed. Some signs that it is becoming a problem:
- You can no longer imagine a party or a weekend without taking something.
- You use more often or in larger amounts than before.
- The comedown affects your work, studies or relationships.
- You increasingly combine it with alcohol, cocaine or other drugs.
- You have tried to stop and have not managed to.
If your use goes together with other substances, you may want to read about cocaine addiction or alcohol addiction.
When to ask for help
There is no need to wait until you ‘hit rock bottom’. If you recognise yourself in any of the signs above, or if you are worried about a son or daughter, your partner or a friend, talking to professionals will help you assess the situation. At the free first appointment with FSC in Barcelona, we review your history of substance use and your health and decide whether it is best to start with detoxification and whether treatment can be outpatient or in a residential centre. You can call +34 93 424 04 00. If the person is young, the adolescent programme also involves the family.
Frequently asked questions
What is the difference between ecstasy, MDMA and crystal?
MDMA is the substance. When it is sold as pills it is called ecstasy, and when it comes as crystals or powder it is usually called crystal or ‘MD’. In practice, none of these forms guarantees how much it contains or whether it is mixed with other substances.
How long do the effects of MDMA last?
The main effects last a few hours, although this varies with the person, the amount and what else has been taken. The comedown afterwards, with tiredness and low mood, can last several days.
Is it dangerous to take ecstasy only now and then?
Yes, it can be. Heatstroke, reactions with medicines or a pill stronger than expected can happen with one-off use. The fact that nothing happened before is no guarantee that nothing will happen next time.
Can you mix ecstasy with alcohol?
The combination increases the risk of dehydration, vomiting, a racing heart, dizziness and anxious or paranoid reactions. In addition, alcohol masks some of the effects and makes it easier to take more than intended.
What should I do if a friend feels unwell after taking pills?
If they have a very high temperature, are very confused, have a seizure, have chest pain or lose consciousness, call 112. Do not leave them alone, take them somewhere cool and tell the medical team what they have taken.