Ecstasy, driving and traffic safety

  • Kim P.C. Kuypers
  • Wendy M. Bosker
  • Johannes G. Ramaekers


Ecstasy (methylenedioxymethamphetamine, MDMA) is a synthetic drug which is popular among clubbers who love it for its euphoric and energizing effects. These subjective effects are experienced approximately between one and four hours after intake. It is also shown that MDMA affects driving-related behavior, as measured by performance tasks and simulated driving, as well as actual driving as assessed by on-the-road driving tests. Under optimal conditions that are during daytime, moderate doses, and with no co-use of other substances MDMA exerts stimulating effects on reaction time performance, tracking and weaving. However, when MDMA is combined with alcohol or sleep deprivation, these stimulating effects are no longer observable. Combined use of MDMA with cannabis or alcohol is common among ecstasy users. In addition, they usually take the drug at night and drive in the morning after a night of partying and sleep loss. Experimental data have shown that the stimulating effects of MDMA are not of sufficient magnitude to compensate for the impairing effects of sleep loss. Moreover, subjective data have shown that ecstasy users are not able to accurately estimate their objective impairment when under the influence of MDMA. Their lack of judgment during intoxication can put them at risk when engaged in traffic. Epidemiological studies and case studies have also shown that MDMA at normal doses (75 mg) is able to impair driving performance which is characterized by reckless behavior such as speeding and jumping red traffic lights. In addition, in a number of fatalities, ecstasy was detected in the blood of the driver. In sum, MDMA can exert stimulating effects on some aspects of driving when given at low doses. However MDMA is likely to produce driving impairment in combination with other drugs or during a night of sleep loss as is often the case in regular ecstasy users.


Sleep Deprivation Ecstasy User Drug Alcohol Depend 
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  1. 1.
    ter Bogt TFM, Engels RCME (2005) “Partying” hard: party style, motives for and effects of MDMA use at rave parties. Subst Use Misuse 40: 1479–1502CrossRefGoogle Scholar
  2. 2.
    Milroy CM (1999) Ten years of “ecstasy”. J R Soc Med 92: 68–71PubMedGoogle Scholar
  3. 3.
    Furr Holden D, Voas RB, Kelley Baker T, Miller B (2006) Drug and alcohol-impaired driving among electronic music dance event attendees. Drug Alcohol Depend 85: 83–86CrossRefGoogle Scholar
  4. 4.
    Riley SCE, Hayward E (2004) Patterns, trends, and meanings of drug use by dance-drug users in Edinburgh, Scotland. Drugs: Education, Prevention and Policy 11: 243–262CrossRefGoogle Scholar
  5. 5 EWDD (2007) Jaarverslag 2007. Stand van de drugsproblematiek in Europa. In: EWvDe Drugsverslaving (ed). Bureau voor officiele publicaties der Europese Gemeenschappen, LuxemburgGoogle Scholar
  6. 6.
    McCambridge J, Mitcheson L, Winstock A, Hunt N (2005) Five-year trends in patterns of drug use among people who use stimulants in dance contexts in the United Kingdom. Addiction 100: 1140–1149PubMedCrossRefGoogle Scholar
  7. 7.
    Franken IH (2001) Prevalence of MDMA (ecstasy) use and neurotoxicity. Eur Psychiatry 16: 508–509PubMedCrossRefGoogle Scholar
  8. 8.
    Riley SC, James C, Gregory D, Dingle H, Cadger M (2001) Patterns of recreational drug use at dance events in Edinburgh, Scotland. Addiction 96: 1035–1047PubMedCrossRefGoogle Scholar
  9. 9.
    van de Wijngaart GF, Braam R, de Bruin D, Fris M, Maalste NJM, Verbraeck HT (1999) Ecstasy use at large-scale dance events in the Netherlands. Journal of Drug Issues 29: 679–702Google Scholar
  10. 10.
    Barrett SP, Gross SR, Garand I, Pihl RO (2005) Patterns of Simultaneous Polysubstance Use in Canadian Rave Attendees. Subst Use Misuse 40: 1525–1537PubMedCrossRefGoogle Scholar
  11. 11.
    Topp L, Hando J, Dillon P, Roche A, Solowij N (1999) Ecstasy use in Australia: patterns of use and associated harm. Drug Alcohol Depend 55: 105–115PubMedCrossRefGoogle Scholar
  12. 12.
    Winstock AR, Griffiths P, Stewart D (2001) Drugs and the dance music scene: a survey of current drug use patterns among a sample of dance music enthusiasts in the UK. Drug Alcohol Depend 64: 9–17PubMedCrossRefGoogle Scholar
  13. 13.
    Hausken AM, Skurtveit S, Christophersen AS (2004) Characteristics of drivers testing positive for heroin or ecstasy in Norway. Traffic Injury Prevention 5: 107–111PubMedCrossRefGoogle Scholar
  14. 14.
    Duff C, Rowland B (2006) “Rushing behind the wheel”: Investigating the prevalence of “drug driving” among club and rave patrons in Melbourne, Australia. Drugs: Education, Prevention and Policy 13: 299–312CrossRefGoogle Scholar
  15. 15.
    Logan BK, Couper FJ (2001) 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) and driving impairment. J Forensic Sci 46: 1426–1433PubMedGoogle Scholar
  16. 16.
    Logan BK, Couper FJ (2003) 3.4-Methylenedioxymethamphetamine-effects on human performance and behavior. Forensic Sci Rev 15: 12–28Google Scholar
  17. 17.
    Schifano F (1995) Dangerous driving and MDMA (“Ecstasy”) abuse. Journal of Serotonin Research 1: 53–57Google Scholar
  18. 18.
    Bost RO (1988) 3,4-Methylenedioxymethamphetamine (MDMA) and other amphetamine derivatives. J Forensic Sci 33: 576–587PubMedGoogle Scholar
  19. 19.
    del Rio CM, Gomez J, Sancho M, Alvarez FJ (2002) Alcohol, illicit drugs and medicinal drugs in fatally injured drivers in Spain between 1991 and 2000. Forensic Sci Int 127:63–70CrossRefGoogle Scholar
  20. 20.
    Drummer OH, Gerostamoulos J, Batziris H, Chu M, Caplehorn J, Robertson MD, Swann P (2004) The involvement of drugs in drivers of motor vehicles killed in Australian road traffic crashes. Accid Anal Prev 36: 239–248PubMedCrossRefGoogle Scholar
  21. 21.
    Hall AP, Henry JA (2006) Acute toxic effects of “Ecstasy” (MDMA) and related compounds: overview of pathophysiology and clinical management. Br J Anaesth 96: 678–685PubMedCrossRefGoogle Scholar
  22. 22.
    Kalant H (2001) The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ 165: 917–928PubMedGoogle Scholar
  23. 23.
    Brookhuis KA, de Vries G, de Waard D (1991) The effects of mobile telephoning on driving performance. Accid Anal Prev 23: 309–316PubMedCrossRefGoogle Scholar
  24. 24.
    Al-Shihabi T, Mourant, R.R. (2001) A framework for modeling human-like driving behaviors for autonomous vehicles in driving simulators: Fifth international conference on Autonomous agents. ACM New York, NY, USA, Montreal, Canada, 286–291CrossRefGoogle Scholar
  25. 25.
    Janssen WH (1979) Routeplanning en geleiding: Een literatuurstudie: Report IZF 1979 V.13. Institute for perception TNO, Soesterberg, The NetherlandsGoogle Scholar
  26. 26.
    Lamers CT, Ramaekers JG, Muntjewerff ND, Sikkema KL, Samyn N, Read NL, Brookhuis KA, Riedel WJ (2003) Dissociable effects of a single dose of ecstasy (MDMA) on psychomotor skills and attentional performance. J Psychopharmacol 17: 379–387PubMedCrossRefGoogle Scholar
  27. 27.
    Kuypers KPC, Samyn N, Ramaekers JG (2006) MDMA and alcohol effects, combined and alone, on objective and subjective measures of actual driving performance and psychomotor function. Psychopharmacology 187: 467–475PubMedCrossRefGoogle Scholar
  28. 28.
    Kuypers KPC, Wingen M, Limbert N, Samyn N, Ramaekers JG (2007) Acute effects of nocturnal doses of MDMA on measures of impulsivity and psychomotor performance throughout the night. Psychopharmacology (Berl) 192: 111–119CrossRefGoogle Scholar
  29. 29.
    Parrott AC, Lees A, Garnham NJ, Jones M, Wesnes K (1998) Cognitive performance in recreational users of MDMA of “ecstasy”: evidence for memory deficits. J Psychopharmacol 12: 79–83PubMedCrossRefGoogle Scholar
  30. 30.
    Kuypers KPC, Ramaekers JG (2007) Acute dose of MDMA (75 mg) impairs spatial memory for location but leaves contextual processing of visuospatial information unaffected. Psychopharmacology (Berl) 189: 557–563CrossRefGoogle Scholar
  31. 31.
    Parrot AC, Lasky (1998) Ecstasy (MDMA) effects upon mood and cognition: before, during and after a saturday night dance. Psychopharmacology (Berl.) 139: 261–268CrossRefGoogle Scholar
  32. 32.
    Vollenweider FX, Gamma A, Liechti M, Huber T (1998) Psychological and cardiovascular effects and short-term sequelae of MDMA (“ecstasy”) in MDMA-naive healthy volunteers. Neuropsychopharmacology 19: 241–251PubMedGoogle Scholar
  33. 33.
    Ramaekers JG, Kuypers KPC (2006) Acute Effects of 3,4-Methylenedioxymethamphetamine (MDMA) on Behavioral Measures of Impulsivity: Alone and in Combination with Alcohol. Neuropsychopharmacology 31: 1048–1055PubMedCrossRefGoogle Scholar
  34. 34.
    Downing J (1986) The psychological and physiological effects of MDMA on normal volunteers. J Psychoactive Drugs 18: 335–340PubMedGoogle Scholar
  35. 35.
    Ramaekers JG, Kuypers KPC, Samyn N (2006) Stimulant effects of 3,4-methylenedioxymethamphetamine (MDMA) 75 mg and methylphenidate 20 mg on actual driving during intoxication and withdrawal. Addiction 101: 1614–1621PubMedCrossRefGoogle Scholar
  36. 36.
    Kuypers KPC, Ramaekers JG (2005) Transient memory impairment after acute dose of 75mg 3.4-Methylene-dioxymethamphetamine. J Psychopharmacol 19: 633–639PubMedCrossRefGoogle Scholar
  37. 37.
    Hernandez Lopez C, Farre M, Roset PN, Menoyo E, Pizarro N, Ortuno J, Torrens M, Cami J, de La Torre R (2002) 3,4-Methylenedioxymethamphetamine (ecstasy) and alcohol interactions in humans: psychomotor performance, subjective effects, and pharmacokinetics. J Pharmacol Exp Ther 300: 236–244CrossRefGoogle Scholar
  38. 38.
    Cami J, Farre M, Mas M, Roset PN, Poudevida S, Mas A, San L, de la Torre R (2000) Human pharmacology of 3,4-methylenedioxymethamphetamine (“ecstasy”): psychomotor performance and subjective effects. J Clin Psychopharmacol 20: 455–466PubMedCrossRefGoogle Scholar
  39. 39.
    Brookhuis KA, De Waard D, Samyn N (2004) Effects of MDMA (ecstasy), and multiple drugs use on (simulated) driving performance and traffic safety. Psychopharmacology (Berl) 173: 440–445CrossRefGoogle Scholar
  40. 40.
    O’Hanlon JF (1984) Driving performance under the influence of drugs: rationale for, and application of, a new test. Br J Clin Pharmacol 18 Suppl 1: 121s–129sPubMedGoogle Scholar
  41. 41.
    Ramaekers JG, Robbe HWJ, O’Hanlon JF (2000) Marijuana, alcohol and actual driving performance. Human Psychopharmacology Clinical and Experimental 15: 551–558PubMedCrossRefGoogle Scholar
  42. 42.
    Neale J (2001) Driving on recreational drugs: A qualitative investigation of experiences from behind the wheel. Drugs: Education, Prevention and Policy 8: 315–325CrossRefGoogle Scholar
  43. 43.
    de Almeida SP, Silva MT (2003) Ecstasy (MDMA): effects and patterns of use reported by users in Sao Paulo. Rev Bras Psiquiatr 25: 11–17PubMedGoogle Scholar
  44. 44.
    Parrott AC (2001) Human psychopharmacology of Ecstasy (MDMA): A review of 15 years of empirical research. Human Psychopharmacology Clinical and Experimental 16: 557–577PubMedCrossRefGoogle Scholar
  45. 45.
    Parrott AC (2005) Chronic tolerance to recreational MDMA (3,4-methylenedioxymethamphetamine) or Ecstasy. J Psychopharmacol 19: 71–83PubMedCrossRefGoogle Scholar
  46. 46.
    de la Torre R, Farre M, Ortuno J, Mas M, Brenneisen R, Roset PN, Segura J, Cami J (2000) Non-linear pharmacokinetics of MDMA (’ecstasy’) in humans. Br J Clin Pharmacol 49: 104–109PubMedCrossRefGoogle Scholar
  47. 47 DIMS (2005) DIMS Jaarbericht 2005. Trimbos institute Netherlands Institute of Mental health and Addiction, 1–4Google Scholar
  48. 48.
    Kuypers KPC, Wingen M, Ramaekers JG (2008) Memory and mood during the night and in the morning after repeated evening doses of MDMA. J Psychopharmacol In pressGoogle Scholar
  49. 49.
    Dawson D, Reid K (1997) Fatigue, alcohol and performance impairment. Nature 388: 235PubMedCrossRefGoogle Scholar

Copyright information

© Birkhäuser Verlag/Switzerland 2009

Authors and Affiliations

  • Kim P.C. Kuypers
    • 1
  • Wendy M. Bosker
    • 1
  • Johannes G. Ramaekers
    • 1
  1. 1.Experimental Psychopharmacology Unit, Department of Neuropsychology and Psychopharmacology, Faculty of PsychologyMaastricht UniversityMaastrichtThe Netherlands

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