Both cocaine and ecstasy stimulate the central nervous system.

When these drugs are combined recreationally, a small amount of either drug can result in dangerous effects.

Ecstasy (Molly, MDMA)

Ecstasy or Molly is also known as MDMA (3,4-methylenedioxymethamphetamine).

The substance was initially developed for the treatment of psychiatric disorders. It is currently being fast-tracked by the U.S. Food and Drug Administration for its ability to treat resistant post-traumatic stress disorder, or PTSD. At the time of this writing, research regarding its effectiveness in this capacity is encouraging, but it is not yet approved for this purpose.

MDMA has both stimulant and hallucinogenic properties, meaning it can alter one’s perception of reality and also increase the activity of the nerves in the peripheral and central nervous systems.

Even though it is being researched for its utility to address PTSD, it is still classified as a C I (Schedule I) controlled substance by the U.S. Drug Enforcement Administration (DEA). This means that it cannot be prescribed for any medical issue at this time, and it is illegal to possess any amount of this drug unless one has permission from the federal government.


Cocaine is often viewed as an illicit drug, but it actually retains some medical uses in special situations. It is classified in the C II category by the DEA. The drugs in this classification can be prescribed for medical uses, but they are at the highest level of control for medications that can be prescribed.

Prescriptions of cocaine for private individuals are extremely rare. It is typically only used in hospitals or clinics.

Abuse of cocaine reached its peak in the 1980s to 1990s. It then declined as prescription medication abuse increased.

Despite its potential medical utility, it remains a significant drug of abuse. There has been a mild rise in cocaine abuse, as more controls are placed on prescription medications. Cocaine is a very potent central nervous system stimulant.

What Happens When You Mix MDMA and Cocaine?

According to the National Institute on Drug Abuse (NIDA), substances sold as ecstasy or Molly may contain very little MDMA. They are often cut with other drugs like methamphetamine, cocaine, other hallucinogens, or similar substances. This can complicate any instances of mixing drugs of abuse.

Scientific research cited by NIDA indicates that because both MDMA and cocaine are central nervous system stimulants, their effects are enhanced when they are mixed. This means that far less of either will produce significant effects compared to taking larger amounts of either drug alone.

The results associated with the enhancement of these effects include.

Increased Potential for Overdose on Either Drug

The most serious ramification of combining powerful stimulants is a substantial increase in the potential for overdose.

Symptoms of an overdose on either drug include extreme confusion, psychosis, irritability, aggressiveness, decreased judgment, catatonia, heart attack, stroke, and/or seizures. Overdoses on these drugs can result in major brain damage, which may not be reversible.

Higher Risk for Dangerously High Body Temperature

Hyperthermia (increased body temperature) is a potential side effect of MDMA as well as cocaine. Dangerously increased body temperature can lead to cardiovascular issues, seizures, dehydration, and brain damage.

Stimulant Psychosis

Central nervous system stimulants can produce psychotic effects in people who take them recreationally. The experience of hallucinations and/or delusions can also be a side effect of the medicinal use of stimulant medications.

When you combine two powerful stimulants like ecstasy and cocaine, it increases the risk of hallucinations and/or delusions. Because MDMA also has hallucinogenic properties, the potential for psychosis is further increased.

Uncontrollable Issues with Hyperactivity

Far less of either drug is required to produce hyperactivity. This can include pressured speech, racing thoughts, insomnia, increased heartbeat, hypertension, and other physical and mental symptoms.

Increased Effects of the Crash

Abuse of stimulant drugs is notorious for resulting in a massive increase of neurotransmitters while you are taking the drugs and then a massive depletion of these neurotransmitters after you stop. The depletion of neurotransmitters is associated with a physical and emotional “crash” that can be quite devastating. It can be experienced as severe depression, apathy, and lethargy.

Artificially inducing massive neurotransmitter release followed by a massive depletion of neurotransmitters can result in significant changes in the pathways of the brain. This can lead to further issues down the road with emotional control, the ability to experience pleasure, and the capacity to make rational judgments.

Potential Long-Term Effects

If you were to chronically combine MDMA and cocaine over the long run, you could experience serious issues as a result of this practice.

Cardiovascular Disease

Long-term abuse of stimulants can be associated with serious cardiovascular disease, including problems with hypertension, the development of arteriosclerosis, and increased risk of developing a stroke or heart attack.

Liver Disease

Chronically abusing these two drugs together will place a significant burden on the liver. This can lead to serious liver damage.

Neurological Issues

As mentioned above, when you continue to use stimulants, you may also alter the pathways in the brain, resulting in neurological problems. These can include tremors, problems with movement, and significant issues with cognition and emotional control.

Other Organ System Damage

Other organ systems, such as the skin, gastrointestinal system, kidneys, and lungs, may be damaged as a result of combining these two drugs over the long term.

Higher Chance of Mortality

Chronically abusing a combination of stimulant medications is associated with early mortality, lower levels of personal achievement, and lower levels of overall life satisfaction.

Physical Dependence and the Development of a Substance Use Disorder

The practice of combining MDMA and cocaine can rapidly result in the development of tolerance to one or both drugs, followed by the development of a withdrawal syndrome when use of either drug is stopped.

Withdrawal symptoms associated with these medications are primarily emotional or psychological in nature.

They are not considered to be potentially serious in most cases, but they are uncomfortable and can lead to engaging in extreme efforts to use these drugs.

Continuing to abuse these drugs can lead to the development of stimulant use disorder, a substance use disorder that indicates significant impairment in numerous areas of life and/or distress associated with drug use.

This is a real mental health disorder that requires professional intervention and years of treatment in most cases.

Is There a Safe Amount?

MDMA and cocaine are controlled substances at very high classifications. This means no one should casually use them.

They should only be used for specific purposes under the supervision of a physician. At the current time, MDMA cannot be prescribed for anything, but it can be used in research studies under the supervision of a physician.

There is no safe amount of MDMA and cocaine to use together. There is no way you can safely combine these two drugs.

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