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Does taking MDMA cause ‘holes in the brain’?

“My Dad keeps telling me that taking ecstasy or MDMA can cause you to get holes in the brain. He says that he saw the story on a TV program a long time ago and has never forgotten it. He says that it can happen even if you take the drug just one time. Is that true?”

It is likely that your Dad did see this story a number of years ago when research was published that claimed that just one dose of ecstasy (MDMA) might cause permanent brain damage. To support these claims images of the brain were released that appeared to show what looked like a series of holes that were apparently caused by the use of MDMA. These findings made headlines around the world and many people, just like your Dad, still remember it.

What many do not know is that a year later the researcher had to admit that he had got it wrong. The research had meant to involve injecting monkeys and baboons with MDMA and then observe the response, but somehow a powerful amphetamine was used instead. To make matter worse, extremely high doses of the drug were used.

So, does taking ecstasy or MDMA one time cause holes in the brain? No, there is no evidence to say that is true. Does that mean that it doesn’t have any negative effects on the brain?

MDMA affects serotonin levels in the brain. Serotonin is the ‘feelgood’ transmitter, a chemical affecting things like mood, appetite and sleep. Animal research has found that MDMA can damage the brain cells that produce serotonin.  For that reason MDMA is regarded as a ‘neurotoxin’. There is great debate however about what this ‘damage’ actually means.  Some believe that a change in the brain does not necessarily mean that it has to be bad. Others believe that it could result in some people experiencing long-term problems such as depression and anxiety.

There do appear to be a number of factors that affect the toxicity of MDMA on the brain. Firstly, the more you take, the greater the risk. Secondly, the user’s core body temperature plays a role, so it is important that people try to stay as cool as possible if they choose to use the drug. The temperature of where MDMA is taken can also impact on the level of toxicity. Finally, the risk of damage appears to be greater for females, and adolescents appear to be more vulnerable than adults.

Whatever the change to the brain actually means, there is one thing that all the experts agree on – it does occur.  Whether these changes will result in serious repercussions for people who use ecstasy or MDMA is not known.

First published: July 2021

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