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MDMA (3-4 methylenedioxymethamphetamine), also known as ecstasy or molly, is a synthetic psychoactive substance that increases levels of certain hormones in the brain, altering the individual’s mood and energy. Caffeine, a natural stimulant found in coffee, tea and energy drinks, stimulates the central nervous system and boosts energy and alertness.
In certain cases, people may combine MDMA and caffeine to enhance the effects of the drug, or they may do so unknowingly. However, the combination of MDMA and caffeine has been shown to have an extremely hazardous outcome and pose a danger to both the heart and the brain.
In this article, we take a closer look at how these drugs affect the body, both independently and when combined.
Understanding MDMA and Caffeine
What Is MDMA?
MDMA was first discovered in Germany in 1912 by Anton Kollisch, a chemist at the pharmaceutical company Merck. It gained popularity during the 1980s and was commonly used at large music festivals and raves.
A study from 2023 showed that in the previous year, just under 1% of people used this substance. Those aged 34 and under had the highest prevalence of use, and those aged 50 and over were the least likely to report using MDMA.
MDMA produces a feeling of connectedness and euphoria, increases extroversion, energy and empathy, and it can sometimes produce mild hallucinations.
Aside from inducing positive feelings, the drug comes with many adverse effects:
- Rapid heartbeat
- Sweating
- Jaw clenching
- Nausea
- Extreme thirst
In higher doses, it can also lead to:
- Muscle cramping
- Extreme sweating
- Fainting
- Seizures
- Heart failure
- Death
Using MDMA causes a surge in serotonin, which is one of the “feel good” neurotransmitters. It essentially uses up the storage of serotonin, which can require days to a week to replenish after taking the drug. During this period, individuals may experience negative side effects such as low energy, depression and anxiety. Moderate to high doses of MDMA can also lead to long-term nerve cell damage in the brain.
What Is Caffeine?
Caffeine is a stimulant naturally found in fruit leaves, coffee beans and cacao. It has a rich history and has been consumed by humans worldwide for thousands of years for medicinal and recreational use. It’s found in some pain medications, beverages such as energy drinks and coffee, and foods such as chocolate. It can also be purchased in the forms of powder, patches, mints, gum and tablets.
Caffeine increases the level of activity in the brain and nervous system. It also increases the circulation of stress hormones such as cortisol and adrenaline. In small doses, it can improve alertness and cognitive function, and people often use it as a work or study aid. However, excess use can lead to undesirable outcomes such as insomnia, anxiety, and restlessness. The Food and Drug Administration recommends consuming no more than 400 mg of caffeine per day (about two to three 12-ounce cups of coffee).
Why Do People Combine MDMA and Caffeine?
The MDMA–caffeine combination may occur for a variety of reasons. Individuals may perhaps take a molly and Red Bull in hopes the mixture will result in an increased high. Others might combine them unknowingly. Caffeine is an integral part of the human diet; we consume it frequently in teas, coffees, energy drinks and more. An individual could take MDMA without realizing they’ve exceeded the recommended daily amount of caffeine.
Perceived Benefits
- Prolonging energy levels at social events
- Combating MDMA-induced fatigue
- Enhancing focus during the “roll”
Accessibility
- Prevalence of caffeine in everyday beverages
- Lack of awareness about potential risks
The Physiological Impact of Combining MDMA and Caffeine
Combining two stimulating drugs can have hazardous effects, so understanding how they interact with one another is essential for safe use.
Cardiovascular Effects
Together, MDMA and caffeine can cause an increased heart rate and drive up blood pressure. Both of these substances are stimulants that work by increasing activity in the nervous system. This causes the body to release chemicals such as norepinephrine, causing blood vessels to constrict. Using caffeine is also shown to provoke the adverse reactions associated with MDMA use. It also increased the MDMA fatality level from 22% to 34%.
Neurological Implications
MDMA causes a surge in serotonin levels. When someone takes this drug with caffeine in their system, the caffeine can heighten this effect and potentially lead to serotonin syndrome. This is a life-threatening condition that causes confusion, high fever and rapid heart rate.
Thermoregulation Issues
Combining MDMA and caffeine can negatively affect the body’s ability to regulate its temperature, leading to hyperthermia, or overheating. Both substances cause the blood vessels to constrict while also increasing the body’s metabolic rate and heat production. As a result, the individual may begin to sweat excessively and become vulnerable to dehydration. This effect can be dangerous, especially in hot environments.
Long-Term Risks
Due to their combined effects on the brain and body, MDMA and caffeine can have several long-term risks. Over time, these stimulants can lead to neurotoxicity. This refers to exposure to toxic substances, either manmade or natural, altering the normal activity of the nervous system. Neurotoxicity can disrupt and kill brain cells in the long run, which leads to interference in how the brain sends messages to other parts of the nervous system.
Many studies show MDMA has the potential to lead to serotonergic neurotoxicity in humans and laboratory animals.
Other risks include cognitive impairments, an increased risk of heart conditions, mental illnesses such as depression and anxiety, and long-lasting issues with body temperature control.
Psychological and Behavioral Effects
In addition to posing significant physical side effects, the combination of caffeine and MDMA can have undesired psychological and behavioral implications.
Amplified Risk-Taking Behavior
Combined, MDMA and caffeine enhance the release of neurotransmitters in the brain, inducing a sense of euphoria while reducing the individual’s inhibitions. By causing increased energy and alertness, caffeine amplifies the effects of MDMA, further encouraging risky and potentially dangerous behaviors such as drinking excessive amounts of alcohol with ecstasy or using another substance with MDMA such as marijuana.
Mood Swings and Emotional Instability
These substances’ combined effects on brain chemistry can cause significant mood swings in the individual. Initially, the person using MDMA may experience a sense of euphoria. However, once they come down from this, they may develop symptoms of depression and anxiety. Having caffeine in the bloodstream can worsen this crash by causing overstimulation.
Mitigation and Safety Recommendations
Because of the significant impact MDMA and caffeine can have on an individual’s physical and mental health, it’s important to know how to reduce the risk of harm. Understanding the impact of combining these substances, learning the signs of distress, and knowing when to get help can prevent serious health problems and promote safer use.
Education and Awareness
If you have caffeine in your system, knowing how using MDMA can bring on serious adverse effects can help you make informed decisions for your health. Before combining the substances, it’s important to understand the short- and long-term health risks.
If you suspect you may have taken too much MDMA, especially if you’ve combined it with caffeine, trust your instincts and seek medical help immediately. Because caffeine increases the adverse reactions of MDMA, the warning signs will be similar to a regular MDMA overdose. This may include profuse sweating, muscle cramping and seizures. If you experience these symptoms or feel you may have taken too much, seek help.
Harm Reduction Strategies
If you do use MDMA with caffeine, there are a few strategies you can use to reduce health risks. These include:
- Staying hydrated, but avoid drinking too much water; electrolyte drinks can help you maintain balance
- Monitor your temperature, and take breaks to cool down when necessary
- Stick to a single dose to reduce the risk of adverse effects
- Avoid using other substances along with MDMA and caffeine
- Have a plan for recovery
Seeking Help
Prevention is the best form of treatment. Simply knowing what each drug does to the body and the potential risks it carries can aid in making better choices. However, many people still use dangerous amounts of drugs despite knowing about their negative consequences. This is often the result of the addictive effects of drugs as adverse withdrawal effects can make it difficult to stop using.
For those who’ve developed substance use disorder or who use substances such as MDMA to manage untreated mental illnesses such as depression or anxiety, it’s important to seek professional support.
Conclusion
Combining caffeine and MDMA can lead to serious short- and long-term complications. Understanding the side effects of this potentially dangerous combination and knowing when to seek help can prevent serious health issues.
If you feel you’re suffering from drug dependence, addiction or mental health difficulties, contact us today. Our compassionate team of counseling professionals is standing by 24/7 to take your call and help you take the first steps of your journey to recovery.
