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When people die as a result of MDMA/E/Ecstasy use, it's often because of dehydration — not directly because of the drug, but because it can make you dance yourself to death as you forget to stay hydrated. That is, MDMA can make you do dumb things that hurt your body.

The primary reason that people say MDMA causes excessive swelling of oral piercing is because people on E tend to play with the piercing far too much. As far as actually being pierced while on E, one reader writes,

"I got my nipples and navel pierced while high on E at a rave, and I have to say it was a FABULOUS experience despite the moronic factor. I don't generally enjoy being pierced all that much (duh, it hurts!), but these hurt in a GOOD way. I would definitely be open to doing a play piercing session while high, but only with someone I could really trust (haven't found that person yet unfortunately)."

As far as tattooing, another reader writes,

"I did watch a friend who was on E get tattooed. She said it didn't hurt....she could just feel the sensations and the nerve twitching more. But she said it felt kinda good. Although....the moron tattooing her was on E too....needless to say....that tattoo turned out kinda fucked up. Drugs and mods together are bad."

And E mixed with body modification of course leads to the occasional funny story, as another reader recounts,

"One time I was playing with my lobes and this girl on E asked me something. I couldn't hear her so I leaned in so I could hear her, and I ended up with a tongue through my lobe! Needless to say the look on her face was priceless; I've never tasted my own ear cheese, but EURGH!!!! What she'd actually asked was 'What does it feel like when someone sticks their tongue through your lobe?'... I would have stopped her if I had known."

It would probably be best to avoid E until the piercing is fully healed. If for some reason you do decide to get pierced or tattooed while on E, you should absolutely inform the artist and more importantly you should know and trust them to optimize your safety and experience.

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