How risky is MDMA compared to other drugs?


As with all alcohol and other drug use, taking MDMA carries risks, albeit comparatively lower than most other drugs.1

For example, a 2010 study published in the prestigious Lancet journal was conducted to gauge the relative potential harms of drugs to both consumers and to society, and MDMA was found to be among the least risky.2

As you can see in the graph below, overall, alcohol was considered the most harmful drug, with heroin and crack in second and third places. You’ll find MDMA hovering just above the bottom of the scale with a significantly lower rating. Several other researchers have independently reported similar findings.3 It’s clear that a drug’s legal status has little relation to its potential for harm.

Relative Harms of Drugs

Source: Nutt, David J, et al., "Drug Harms in the UK: A Multicriteria Decision Analysis." The Lancet 376, no. 9752 (2010): 1558-65.


  1. D. W. Lachenmeier and J. Rehm, "Comparative risk assessment of alcohol, tobacco, cannabis and other illicit drugs using the margin of exposure approach," Sci Rep 5(2015); J. van Amsterdam et al., "European rating of drug harms," J Psychopharmacol 29, no. 6 (2015).
  2. David J Nutt, Leslie A King, and Lawrence D Phillips, "Drug harms in the UK: a multicriteria decision analysis," The Lancet 376, no. 9752 (2010): 1558-65.
  3. See e.g., Jan van Amsterdam et al., "Ranking the harm of alcohol, tobacco and illicit drugs for the individual and the population," European Addiction Research 16, no. 4 (2010): 202-7.

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People deserve accurate, non-judgmental information about MDMA and other drugs

In order to stay safe, we need to understand both the effects of drugs and the policies that surround them.

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Shelley's Story

Shelley’s Story

Shelley Goldsmith was 19 when she died after taking MDMA and going to a club in DC. Her mother, Dede Goldsmith, believes her death may have been preventable if drug education and harm reduction services were more widely available and accepted.

Learn more about Dede’s campaign and the work of DPA’s Music Fan program to promote compassionate, health-based responses to drug use at festivals, concerts and clubs.

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