Prevalence and Correlates of Past Year Ecstasy/MDMA Use in the United States.
Kevin H. Yang, Wayne Kepner, Anamika Nijum, Benjamin H Han, Joseph J Palamar
Journal of Addiction Medicine DOI: 10.1097/ADM.0000000000001188 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 315,661 |
| Population | Noninstitutionalized US individuals 12 years or older |
| Topics | MDMA |
| Citations | 11 |
| Key findings | Past-year ecstasy/MDMA use was reported by 0.9% of the US population, with higher odds among younger age groups, bisexual women, and Asian, Black, or multiracial individuals, as well as those with other substance use or misuse. |
Abstract
3,4-Methylenedioxymethamphetamine (MDMA) (also known as "ecstasy" or "Molly") has regained attention in recent years for its efficacy in treating posttraumatic stress disorder, and the drug was granted breakthrough therapy designation for such use by the US Food and Drug Administration in 2017. However, little is known about the current epidemiology of recreational ecstasy/MDMA use. We estimated past-year prevalence and correlates of ecstasy/MDMA use based on a representative sample of noninstitutionalized US individuals 12 years or older from the 2015-2020 National Survey on Drug Use and Health (N = 315,661). An estimated 0.9% (95% confidence interval [CI] = 0.9-1.0) of individuals used ecstasy/MDMA in the past year. Compared with those ages 35-49 years, all younger age groups were at increased odds for use, while those older than 50 years (adjusted odds ratio [aOR] = 0.14, 95% CI = 0.08-0.23) were at low odds for use. Compared with heterosexual men, those identifying as bisexual women (aOR = 1.32, 95% CI = 1.02-1.72) were at increased odds for use, and compared with White individuals, those identifying as Asian (aOR = 1.92, 95% CI = 1.42-2.59), Black (aOR = 1.70, 95% CI = 1.41-2.06), or multiracial (aOR = 1.61, 95% CI = 1.19-2.16) were at increased odds for use. Past-year use of other drugs (e.g., cannabis, ketamine), prescription drug misuse (e.g., pain relievers, stimulants), nicotine dependence (aOR = 1.21, 95% CI = 1.00-1.45), and alcohol use disorder (aOR = 1.41, 95% CI = 1.25-1.58) were also associated with increased odds for use. While use of ecstasy/MDMA continues to be relatively rare, findings from this study can help inform prevention and harm reduction strategies, especially among certain subpopulations that are at high risk for use.
Comparable studies
Other observational and cohort studies on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Subjective Reports of the Effects of MDMA in a Clinical Setting Individuals who took MDMA in a clinical setting | 1986 | Observational study | |
| Memory impairment in abstinent MDMA ("Ecstasy") users Abstinent MDMA users | 1998 | Observational cohort | |
| Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people | 2000 | Observational | |
| The Psychological and Physiological Effects of MDMA on Normal Volunteers Older, more educated, drug-experienced individuals | 1986 | Observational cohort | |
| Cognitive performance in recreational users of MDMA or 'ecstasy': evidence for memory deficits Young people who were regular or novice MDMA users, or non-users | 1998 | Observational cohort | n = 30 |
Citations in the library
Cited by 7
- Ecstasy, molly, MDMA: What health practitioners need to know about this common recreational drug. Disease-a-month : DM March 1, 2025
- Therapeutic Potential of Psychedelic Compounds for Substance Use Disorders. Pharmaceuticals November 5, 2024
- Prevalence and Correlates of Lifetime Ecstasy/MDMA Use Among Asian American and Pacific Islander Adult Populations in the United States, 2015–2020 Journal of Psychoactive Drugs March 3, 2025
- Hallucinogen use in the United States, 2021-2023: Diverging trends and subgroup patterns. Drug and Alcohol Dependence Reports March 1, 2026
- Lifetime MDMA use and associations with meaning in life in the context of childhood trauma Scientific Reports February 10, 2026
and 2 more in the library
Cites 15
- 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. The Lancet Psychiatry May 1, 2018
- MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology September 1, 2019
- Human psychobiology of MDMA or ‘Ecstasy’: an overview of 25 years of empirical research Human Psychopharmacology: Clinical and Experimental July 1, 2013
- First study of safety and tolerability of 3,4-methylenedioxymethamphetamine-assisted psychotherapy in patients with alcohol use disorder. Journal of Psychopharmacology February 18, 2021
- MDMA and Sexual Behavior: Ecstasy Users' Perceptions About Sexuality and Sexual Risk Substance Use & Misuse 2005
and 10 more in the library