How to take MDMA (Molly/Ecstasy)

How to take MDMA, Molly, or Ecstasy: A RollSafe Guide

MDMA can be done more or less safely. Emphasizing safety makes the experience more enjoyable, lessens negative comedowns, and reduces the risk of adverse reaction.

Remember, no drug use is perfectly safe. But you can take MDMA in a safer manner.

This guide is designed to increase the safety of MDMA for recreational users who will consume the drug regardless but are willing to consume it in a safer manner - to “roll safer.”

MDMA has risks and is illegal. If you’re taking MDMA, do your research and be as safe as possible.

We do not promote the use of illegal psychoactive substances. This content has been created strictly for harm reduction purposes, and you should note that the only way to be perfectly safe using MDMA is to not take it at all. The same is true with alcohol, skydiving, and sex - the only way to be perfectly safe in these activities is to not do them.

Do you prefer watching videos to reading text? Many people prefer text, and many people prefer video. It’s a personal preference. If you prefer video, watch this excellent video on How to use MDMA Safely on YouTube.

☑️ Safer and more enjoyable usage checklist

• 👨‍⚕️ 1. I have no pre-existing health conditions that make MDMA less safe
• 💉 2. I'm not taking medicines or supplements that may interact with MDMA
• 🔬 3. I have tested my MDMA with a reagent test
• 💊 4. I have my optional supplements ready
• 📅 5. I haven't rolled in at least the last ~5 weeks, ideally longer
• ⚖️ 6. I'm aware of the dosage guideline: your weight in kg + 50 = total dosage in mg for the night. I'm aware that a study found that positive effects are maximized between 81-100 mg.
• 💦 7. I'll drink 250-500 ml/h (1-2 cups), definitely no more than 500 ml/h (2 cups), and ideally Gatorade instead of water
• 🔥 8. I'll stay cool to avoid heat stroke
• 🏠 9. I'll take MDMA in a safe, cool and positive environment
• 😊 10. I'm aware that MDMA can bring to the surface issues that I may be emotionally struggling with
• 🚑 11. I know the signs of heat stroke and agree to pay attention to the friends I am rolling with
• 🎯 12. I know my intention for taking MDMA, even if it is just to have fun, and I will state it out loud to the people I plan to roll with

🚫 The main risks to watch out for

Short-term risks:

1. Consuming a substance that is not MDMA. Many tablets and powders are fake and/or adulterated with other drugs.^{1 2 3 4}

2. Heat stroke and/or serotonin syndrome. Like all serotonergic drugs, MDMA increases heat stroke risk due to its effects on the hypothalamus, the part of our brain that helps us regulate body temperature.⁵

3. Hyponatremia. Generally caused by drinking too much water. MDMA causes water retention.⁶ Dancing aerobically in hot environments causes dehydration. Overcompensating by drinking too much water can be fatal.

Long-term risks:

1. Used too frequently, MDMA can temporarily exacerbate symptoms of depression in people who suffer from clinical depression (Sferios).

2. High and/or frequent doses of MDMA have been shown to be neurotoxic in laboratory animals.⁷ However, no properly controlled studies have shown cognitive impairments in human users after a period of abstention long enough to rule out temporary effects of MDMA, polydrug use, and a partying/unhealthy lifestyle. Normal therapeutic doses of SSRI’s like Prozac, taken with MDMA or on the comedown, have been shown to be neuroprotective in animals, though we don’t recommend this due to SSRIs having their own side effects and risks.^{8 9} “For reducing risk of neurotoxicity, limiting dose amount and taking supplements may be most important (BM).”

3. Losing the magic. “Losing the magic” is when people who use MDMA find that over time, they get less and less of the special effects of MDMA. This is unfortunate, especially considering that MDMA is on a path to be used as a prescription medicine to assist therapy.

From side effects.

👨‍⚕️ 1. Avoid MDMA if you have any of these pre-existing health conditions

⛑ Helps avoid acute risks.

Avoid if you have any of these contraindicated conditions:

• Cardiovascular disease^{10 11}
• Cerebrovascular disease¹⁰
• Uncontrolled hypertension¹⁰
• Malignant Hyperthermia, anhydrosis, central core disease, or any condition that increases the risk of heat stroke or hyperthermia. This includes if you currently have a fever or if you know you are particularly heat sensitive.
• Susceptibility to seizures¹²
• Liver problems¹²

Malignant hyperthermia is a rare genetic disorder. Many individuals with the condition do not know they have it. If either of your parents have it, or if you have any first or second-degree relatives who have had an adverse reaction to anesthesia, you may have it.¹³ If this is true, you should not take MDMA.

💉 2. Know the drugs that interact dangerously with MDMA

⛑ Helps avoid acute risks.

Avoid:

• If you’ve taken any MAOIs (e.g. Nardil, Parnate, Marplan, Ayahuasca) within the last 3 weeks due to potential risk of death¹⁰
• There is no high quality evidence that 5-HTP is dangerous to combine with MDMA, though there are rumors that this is a bad combination. If you know of good evidence either way, please send it to us.
• If you’ve recently taken St John’s wort. SJW has a high potential for drug interactions, some of which may be serious.^{14 15}
• If you’ve recently taken any CYP2D6 inhibitors¹⁶
• In combination with drugs that increase heart rate or blood pressure (e.g. many asthma medications, stimulants like cocaine, amphetamine,^{17 16} caffine¹⁸), DXM (Robitussin),¹⁷ stomach acid mediciations,¹⁶ sedatives (alcohol, opioids),¹⁷ due to an increased risk of serious adverse effects.
• If you’re concerned about neurotoxicity risk, do not consume at the same time as classic psychedelics like LSD, 2C-B, or shrooms, as this combination increased neurotoxicity in rodents¹⁹

SSRIs like Prozac, Paxil and Zoloft are not reported to interact dangerously with MDMA, though MDMA might make SSRIs less effective and SSRIs may make MDMA less effective.¹⁰²⁰ Increasing your MDMA dosage to compensate is not a good idea. Read here for more.

🔬 3. Avoid if you’re not confident your MDMA is pure

⛑ Helps avoid acute risks and 😁 helps maximize positivity.

87% of “Molly” analyzed by the DEA between 2009 and 2013 contained 0% MDMA, instead mostly containing “bath salts.”¹ Use a test kit to reduce some risks, but know that even test kits cannot guarantee purity.

Read about testing your MDMA and the recommended test kits.

💊 4. Prepare your optional MDMA Supplements

May help reduce neurotoxicity risk and 😁 may help maximize positivity.

In short, supplements may help protect your brain on MDMA, and hypothetically if tolerance and “losing the magic” are related, supplements may reduce the risk that you’ll lose MDMA’s effects (“the magic”) over time.

For example, Alpha Lipoic Acid. Research found that in rats, Alpha Lipoic Acid “fully prevented the serotonergic deficits and the changes in the glial response induced by MDMA.”²¹

Read which supplements are recommended, supplement dosage and timing on the page for MDMA Supplements.

Again, the only way to be perfectly safe with drugs is to not use drugs at all.

📅 5. Wait as long as possible between rolls, perhaps 3 - 5 weeks at absolute minimum

😁 Helps maximize positivity.

In short: The less often the better. Research organization MAPS uses three MDMA doses to treat PTSD, spaced 3 - 5 weeks apart, generally in people who have never used MDMA before and are unlikely to use it again.²² If you’re going to use more than 120 mg or going to use more than 3 times in your life, you should consider longer usage breaks. Three months is a reasonable anecdotal-based (Ann Shulgin) rule of thumb, and waiting longer than three months is always better, from a safety perspective.

MDMA researcher Matthew Baggot: “In ten years from now, MDMA may be legally available and used in therapy. You don’t want to be unable to save your marriage or fail to come to terms with trauma because you rolled too much in your youth and now can’t feel MDMA.”

Read more at MDMA frequency of use.

⚖️ 6. Dosage guideline: your weight in kg, plus 50 = total dosage in milligrams for the session.

😁 Helps maximize positivity, helps reduce neurotoxicity risk, and ⛑ helps avoid acute risks.

1. Guideline: your weight in kg, plus 50 = total dosage in milligrams for the session. (1.5 mg/kg with a 120 mg max may be more optimal, but the weight + 50 is a good rule of thumb)

2. If finger dipping powder: ideally switch to weighed doses, but if not that, use “crush, dab, wait.”

3. If using tablets and you haven’t taken a tablet from this exact batch before, start with half, or less.

4. Low doses may be particularly important for your first few uses, as you might unknowingly have a health condition like malignant hyperthermia that makes MDMA more dangerous.

5. A study found that MDMA desirable effects are maximized, and undesirable effects minimized, at doses between 81-100 mg.²³

6. If you’re unwilling to use these dosage guidelines, please make extra sure your friends are aware of the signs of heat stroke and heat exhaustion, and pay extra attention to keeping cool.

7. “I think there’s no “safe” dose if you have a preexisting health condition contraindicated with MDMA.” For example, malignant hyperthermia, which you may have but be unaware of.

8. A small female died soon after consuming 500 mg of 91% pure MDMA. It is highly probable that they had a health condition that interacted dangerously with MDMA, but this shows why it’s important to pay attention to dosage.

9. This dosage advice is only relevant if you actually have MDMA! 87% of “Molly” analyzed by the DEA between 2009 and 2013 contained 0% MDMA, instead mostly containing substances like methylone and mephedrone.^{1 24}

10. 46% of Ecstasy tablets analyzed in a study contained 0% MDMA.⁴

11. There’s a reasonable chance it may take a user 90 minutes to feel MDMA’s effects, and though rare it’s not unheard of for the effects to take 2-2.5 hours to kick in. Particularly if it’s one of your first 5 times using MDMA or you had recently eaten a large meal, please wait at least 3 hours before concluding that your dose didn’t work.

12. Avoid taking any booster doses or redoses if possible.

Read our page on MDMA (Molly/Ecstasy) dosage for: why you should consider less than 80 mg for your first real roll, why you ideally shouldn’t take more than 1.5 mg/kg and 120 mg in a session, and the dosage of MDMA that research found maximizes desirable effects (81-100 mg).

If possible, you should weigh your MDMA dosage out using a milligram scale, or if you have pills, get them tested at a lab or at minimum look online to estimate how much MDMA they contain.

💦 7. Drink up to 1 cup per hour (250 ml) of electrolyte containing fluids, or up to 2 cups (500 ml) if you are dancing or in a hot environment

⛑ Helps avoid acute risks.

“When dancing in hot conditions the most serious dangers are dehydration (loss of water) and heatstroke, which can be fatal.” “However, excessive water consumption after taking ecstasy can also lead to medical complications and some deaths have occurred.”²⁵

If you’re dancing or in a hot environment: 2 glasses of fluid, ideally part electrolyte containing (e.g. sports drinks) per hour. If drinking water only, make sure to eat a reasonable quantity of salty foods.

If you’re not dancing: No more than 1 regular sized glass of fluid per hour. Ideally Gatorade or another electrolyte beverage. If drinking water only, keep up sodium levels by eating some salty snacks.²⁵

MDMA makes you feel thirstier than you actually are by increasing saliva production and increasing temperature.¹⁰

Consuming isotonic or electrolyte containing fluids helps prevent hyponatremia which is caused by low sodium, and hyponatremia has been the cause of some MDMA-related deaths in women.²⁶ Hyponatremia “can be deadly and the symptoms of overhydration (headache, nausea) are hard to tell from those of dehydration.”²⁷

“Hyponatremia means a low concentration of sodium in the blood and can pose a real threat to survivors who exert themselves in a hot environment. It’s caused by lost sweat, (salt and water) being replaced by only water (no salt) thus diluting the sodium in the bloodstream, a phenomenon commonly experienced by ultra-endurance runners.” Excerpt From: Cody Lundin. 98.6 Degrees.

Hyponatremia symptoms include: nausea, vomiting, headache, confusion, and fatigue.

Pay extra attention to hyponatremia and water/salt intake if you are taking: aspirin, ibuprofen (Advil), acetaminophen/paracetamol (Tylenol, Panadol), or similar anti-inflammatory medications.^{28 29}

To prevent hyponatremia, avoid over hydrating, and consume electrolyte containing fluids like Gatorade, coconut water, etc.

Electrolyte products:

• Amazon: Propel Electrolyte Powder
• iHerb: Ultima Powder Packets

🔥 8. Watch out for heat stroke

⛑ Helps avoid acute risks.

Heat stroke risk is increased by MDMA

Heat stroke is a risk on MDMA even if you are inside and not in the sun.

“When dancing in hot conditions the most serious dangers are dehydration (loss of water) and heatstroke, which can be fatal.”²⁵

“MDMA combined with aerobic dancing, a hot crowded environment and not drinking enough water, can become a lethal mix, sometimes resulting in heatstroke. A standard dose of MDMA raises body temperature about one degree, and also inhibits the body’s natural thermoregulation, increasing likelihood of heatstroke.”³⁰

Increased temperature increases neurotoxicity risk in rodents

See the rodent studies.^{31 32 33 34}

“I think the jury is out on the role of elevated body temperature in MDMA-induced neurotoxicity in non-rodents. We know it is important for rat toxicity, but it might not be for humans. So I don’t think I have a strong basis for a recommendation either way.”³⁵

😟 MDMA “Bad Trips”

Fact: MDMA can bring to the surface issues that you may be emotionally struggling with.

The good news: Anecdotal reports suggest that “bad trips” on MDMA are extremely rare. This may be due to the fact that MDMA is often consumed in a positive environment - dancing, with friends, and music that you enjoy.

It is possible to have bad experiences on Ecstasy, though we don’t know if the users studied here took pure MDMA.³⁶

“The findings suggest that most negative experiences with Ecstasy can be attributed to the interaction between two or more factors, nearly always involving set or setting.”³⁶

Fact: In some MDMA studies, 19% more of the people who received MDMA experienced some anxiety during the MDMA session compared to people who received placebo. This does not mean that they had a bad trip, it just means they experienced anxiety.¹⁰ Read more.

🏠 9. Find a safe, cool, positive environment

⛑ Helps avoid acute risks and 😁 helps maximize positivity.

Takeaway: Only consume MDMA in a positive environment to minimize the chance of a negative experience.

Being at home can be more enjoyable than being out. You can be as weird as you want without judgement, you can control the music, you can dance and then stop and sit around and talk because it’s not too loud, there are no aggressive people around to make you feel uncomfortable, etc.

As a bonus, MDMA is generally safer in a house instead of a club: being at home allows you to take frequent cool off breaks, to take your supplements easily, and means you can get electrolyte-containing fluids easily.

Don’t be with people that make you uncomfortable, and consider avoiding sober people that you don’t know. It can also be more enjoyable to avoid drunk people, even if you know them.

😊 10. Be conscious of your mindset before taking MDMA

😁 Helps maximize positivity.

MDMA can bring to the surface issues that you may be emotionally struggling with.

If you’re seeking a happy and euphoric experience, consider waiting until you’re in a consistently good emotional state.

🚑 11. Know the early signs of heat stroke and pay attention to your friends

⛑ Helps avoid acute risks.

Signs of heat exhaustion:

• Heavy sweating
• Weakness
• Cold, pale, and clammy skin
• Fast, weak pulse
• Nausea or vomiting
• Fainting³⁷

If you experience or see early signs of heat exhaustion, move to a cooler location, lie down, loosen your clothing, and apply cool and wet cloths to as much of your body as possible. “If you have vomited and it continues, seek medical attention immediately.”³⁷

Signs of heat stroke:

• Hot, red, dry or moist skin³⁷
• Rapid and strong pulse³⁷
• Body temperature above 103 degrees F³⁷
• Seizures
• Possible unconsciousness^{38 37}

If you see any of the signs of heat stroke above, this is a medical emergency. Call 911, move the person to a cooler environment, use cool cloths or a cool bath. Do not give fluids.³⁷

🎯 12. Know your intention for taking MDMA, even if it is just to have fun, and state it out loud to the people you roll with

😁 Helps maximize positivity.

Recommendation by Emanuel Sferios. This is a good practice.

👍 Other general MDMA recommendations and tips

• Get 8+ hours of sleep the night before and after using MDMA
• Take the rest of the day after using MDMA, and the entire following day off, for rest, recovery and integration back into the world
• Don’t drive on classic psychedelics or MDMA. MDMA has been involved in traffic accidents.³⁹
• Create a document and track the dates/dosages of your MDMA usage. Also try and write down how you felt about the dosage. This way you remember and know what to do if you take it again.
• Hanging around with drunk people while on MDMA can be very odd/uncomfortable, even if you know them. Hanging around with sober people that you don’t know can also be uncomfortable.
• Don’t order food! Regular food is typically not very good while rolling. If you order pizza/takeout/make a big meal, it may feel like a good idea, but then when it arrives, you’ll likely regret it (your milage may vary and of course feel free to do this).
• Consider having a hearty and healthy meal ~4 hours before you take MDMA. This way, the food will be digested before you take MDMA, but you will also have food in your system which is good, particularly if you’re dancing and active.
• Many men find that MDMA makes them unable to get or maintain an erection during the ~6 h MDMA duration
• Have a buddy who will watch out for you
• Make sure you’re comfortable with the idea of taking a drug and temporarily altering how you think and feel.
• If you think you might be rolling more than you should, consider talking to friends or seeking help. MDMA is not a good long-term anti-depressant.

What are the best activities to do while rolling?

See fun activities.

What if I’m concerned about myself or a loved one’s use of MDMA?

While “research hasn’t definitively answered whether MDMA is addictive,”⁴⁰ there are certainly still people who may be concerned about their own use of MDMA or a loved one’s use of MDMA. This may be especially relevant for MDMA use that is particularly suboptimal - e.g. high doses, using more often than 1x per month, using in particularly unsafe or hot environments, etc.

Please read this free guide: the 20 minute guide. It’s for parents, but it applies to friends, etc. There’s also a separate version for romantic partners.

Alternatively, there’s a full book version of the same guide called “Beyond Addiction” which is excellent, or you can buy the PDF of the 20 minute guide.

If you prefer video content and have access to HBO, please watch the HBO Documentary ‘Addiction.’

Please start with the above resources, even if you’re ready for treatment.

Once you’ve gone through the above resources and your loved one is ready for treatment, the most effective treatment appears to be cognitive behavioral approaches, so seek out an addiction treatment provider who uses cognitive behavioral training.⁴¹ See the chapter on finding treatment in the book “Beyond Addiction” for more info.

Why is this important?

Millions of people take MDMA each year.

Follow the steps on RollSafe to be as safe as possible and have the best, most rewarding MDMA experience. Remember, no drug use is perfectly safe. But you can take MDMA in a safer manner.

MDMA Therapy

Check out our page on MDMA Therapy: Beneficial Things to Know.

On that page, we cover:

• What does MDMA therapy look like?
• Why does MDMA therapy help?
• Benefits of MDMA therapy
• MDMA & PTSD
• How to become an MDMA therapist
• Other beneficial resources related to MDMA therapy

Things to learn next

How Does Molly Make You Feel?

What Are MDMA’s Side Effects?

About MDMA

About MDMA for PTSD

What is Ecstasy?

What is Molly?

Drug Harm Reduction: A List of What You Should Know If You’re Considering Using Other Drugs, like Salvia, Tobacco, Alcohol, etc.

References