Analysis shows that many pills that are sold as XTC pills are really not XTC at all. They don't contain MDMA, but for instance speed, MDEA or other substances with even bigger risks. And also the dose is often very different. MDEA has a more boosting effect than a hallucinogenic effect, and has a shorter duration: 3-5 hours and therefore looks more like speed. A user looking for a hallucinogenic effect is tempted more easily to take a second or even a third MDEA pill, and thus is taking a great risk. A person who uses XTC or any other stimulant experiences no fatigue, and can dance for hours. When it is hot and humid and the user doesn't drink enough water or soft drinks, the body can get overheated and dehydrate, resulting in failure of certain muscles and organs such as kidneys. Overheating is extremely dangerous and difficult to treat; a risk that can be reduced by enough ventilation and cooling in clubs and discos. XTC users turn out to be more sensitive to flu, cold and laryngitis; female users are more susceptible to bladder infection or infections of the urinary tract. Long-term use can cause depression, fear, panic reactions, sleeping problems and impotence.

People with asthma, a weak heart, high blood pressure, diabetes or epilepsy should definitely not use XTC. It can intensify depression, panic attacks and psychosis. XTC combined with other substances like alcohol and medicines is very risky. It makes the user overconfident and it can affect the ability of co-ordination. Therefore, it can be very dangerous in traffic.

Last, but not least, XTC is a fairly new product and the long-term risks are not yet known.