±3,4-methylenedioxy-methamphetamine (MDMA) is a popular recreational drug that has also gained attention in the treatment of psychiatric conditions. Animal models and human neuroimaging studies consistently demonstrate that MDMA induces serotonergic neurotoxicity in a dose dependent manner. Therefore the adverse health consequences of the drug can only be estimated as a function of dose. However, due to the illicit status of the drug little is known about the dosing regimen of users. To address this issue we analysed data from the Global Drug Survey (GDS) to characterise MDMA use patterns. Furthermore we systematically compare their dosing habits with the dosing regimen of users who have participated in human studies. We found that the overwhelming majority of current human MDMA research have focused on excessive users of the drug. Our analysis provides context for the interpretation of the current research literature and implies that studies are likely to overestimate the serotonergic damage for typical recreational users. Furthermore we show that the typical recreational use pattern is similar to the dosing in the proposed medical applications of MDMA. We hope that our results will inspire further investigations into MDMA’s effect at lower drug exposure levels.