MDMA is an alpha-2 adrenergic agonist (similar to clonidine, agmatine, CBG)

[Allylbenzene]

According to this paper, MDMA activates α2-adrenergic receptors.

Other alpha-2 adrenergic agonists include:

• agmatine (endogenous NMDA antagonist)
• CBG (cannabigerol)
• Clonidine
• Guanfacine
• myrcene (possibly)

Alpha-2 adrenergic agonists are able to produce sedation, analgesia, euphoric effects and partially block acute withdrawal symptoms in chronic opioid users.
...
Adding an α2-adrenergic to a sedation regimen reduces opioid requirement by 50–75% and benzodiazepine requirement by upwards of 80%.

Anesthesia Progress

Anesthesia Progress is the official publication of the American Dental Society of Anesthesiology. The journal invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.

doi.org

MDMA might also be an imidazoline receptor agonist:

MDMA
4.00 Imidazoline1, 3.64 5ht2b, 3.26 Ca+Channel, 3.21 Alpha2C, 3.09 Alpha2B, 3.07 M3, 2.94 Alpha2A, 2.54 M5, 2.43 M4
— 0.00: 5ht2c, 5ht1d, D2, 5ht1e, 5ht1a, 5ht2a, Alpha1A, Alpha1B, 5ht5a, 5ht6, 5ht7, D1, Beta2, SERT, DAT, NET, 5ht1b, H1, H2, D3, KOR, Beta1, M1, M2, D5, D4, CB1, NMDA, MOR
— ND: DOR, Sigma2, CB2, Sigma1
https://doi.org/10.1371/journal.pone.0009019

Although this paper confirms MDMA does block SERT, DAT and NET (unlike the above receptor profile quote):

SDA and SDMA showed similar profiles to MDMA at the serotonin transporter (SERT), while both inhibited dopamine (DAT) and norepinephrine (NET) transporters more potently...

https://doi.org/10.1021/acschemneuro.5c00782