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Rationale. The effects of MDMA on driving behaviour are not clear, since the direct effects of MDMA on cognitive performance are reported as not generally negative. Objectives. To assess in an advanced driving simulator acute effects on simulated driving behaviour and heart rate of MDMA, and effects of polydrug use. Methods. A group of young participants who had indicated that they regularly used MDMA were asked to complete test rides in an advanced driving simulator, shortly after the use of MDMA, just before going to a party. They were tested again after having visited the "rave", while they were under the influence of MDMA and a number of different other active drugs. Participants were also tested sober, at a comparable time at night. Separately, a control group of participants was included in the experiment. Results. Driving performance in the sense of lateral and longitudinal vehicle control was not greatly affected after MDMA, but deteriorated after multiple drug use. The most striking result was the apparent decreased sense for risk taking, both after MDMA and after multiple drug use. This was clear from gap acceptance data, while the ultimate indicator of unsafe driving, accident involvement or even causation, was increased by 100% and 150%, respectively. Conclusions. Driving under the influence of MDMA alone is certainly not safe; however, driving back (home) after a dance party ("rave") where MDMA users regularly combine MDMA with a host of other drugs can be described as extremely dangerous. [ABSTRACT FROM AUTHOR]