Recreational use of MDMA (ecstasy) increases cortisol levels, a marker of stress, both immediately and over longer periods. In laboratory settings, acute use raises cortisol by 100-200%, while dance clubbers combining the drug with dancing experience an 800% increase. Abstinent users' three-month hair samples show cortisol levels 400% higher than controls. Chronic users exhibit heightened cortisol in stressful settings, deficits in complex cognitive tasks, and altered brain activation patterns suggesting increased mental effort. Mood deficits include more daily stress and higher depression in susceptible individuals. Changes in the hypothalamic-pituitary-adrenal (HPA) axis may explain these neuropsychobiological stress effects.
Recreational use of cannabis and MDMA, beyond the period of intoxication, can negatively influence psychological responses to a multitasking stressor. In three studies, cannabis users became less alert and content after acute stress, while MDMA users became less calm. Unexpectedly, the stressor increased calmness ratings in cannabis users. Both cannabis and MDMA users reported needing more resources to complete the multitasking framework compared to controls. These findings suggest that such drug use may impair real-life situations that place high demands on cognitive resources.