Ecstasy Detox, Withdrawal and Treatment Options

Ecstasy withdrawal is the name for the process by which a person’s body and mind respond to the absence of ecstasy – MDMA – in the system after a dependency has developed, and the symptoms produced as part of that response.

Dependency results when a user takes ecstasy regularly over a sufficiently long period, and in sufficiently large quantities, for their body (in particular the brain) to become accustomed to the presence of ecstasy in the system and to adjust accordingly, as though that level of ecstasy is now “normal”; when ecstasy use suddenly ceases, the user’s brain reacts to the newly “abnormal” circumstances in a variety of ways, producing symptoms until it has once again adjusted, this time to life without ecstasy.

Ecstasy dependency is predominantly psychological, and this means that so too are the majority of withdrawal symptoms which may manifest in a user as they go through detoxification (the process of “cleansing” the body of ecstasy). Each case of withdrawal is unique, and the type, severity and duration of symptoms will be influenced by a number of factors including the user’s physiology, the duration of their addiction, and the quantities of ecstasy they have been taking.

Some typical symptoms of ecstasy withdrawal include:

Cravings: they may feel an all-consuming need to consume more ecstasy.
Exhaustion: they may feel extremely tired even after doing nothing strenuous.
Lethargy: they may feel unable to summon the energy to perform basic tasks.
Insomnia: despite their exhaustion, they may find sleep impossible.
Hypersomnia: alternatively, they may spend very long periods asleep.
Agitation: they may find themselves extremely agitated and unable to settle or even to sit still.
Restless leg syndrome: they might suffer from an irresistible urge to shake their limbs.
Vivid nightmares: if they are able to sleep they may suffer from terrifying dreams.
Fluctuating appetite: they may feel unable to eat for long periods at a time, or conversely may feel hungry despite having eaten large quantities of food.
Muscle pain: aches and pains throughout the body may occur seemingly at random.
Anhedonia: they may be unable to take pleasure from previously very enjoyable activities.
Anorgasmia: they may be unable to achieve orgasm, even through masturbation.
Depressed libido: their sex drive may disappear.
Anxiety: even superficially minor things may make them very anxious, whilst serious issue may prompt panic attacks.
Depression: they might feel a profound unhappiness and a lack of optimism.
Suicidal ideation: thoughts of suicide may surface as a way of escaping withdrawal or unpleasant realities.
Psychosis: a condition known as Amphetamine Withdrawal Psychosis may affect a minority of recovering addicts.

Certain of these symptoms can have a compounding effect on one another – for example, depression may be worsened by anhedonia (and indeed most other symptoms), while nightmares may lead to increased insomnia as the addict tries to avoid sleep out of fear.

In the case of ecstasy, because of the extreme euphoria created by the drug and the exciting, intense environments in which it is often taken (nightclubs, raves, festivals etc), “normal life” may seem mundane by comparison and a user may struggle to believe that without ecstasy they will be able to find experiences which give them anywhere near as much pleasure, exacerbating feelings of negativity and pessimism.

Ecstasy Withdrawal Timeline

Even when a user hasn’t developed a dependency on ecstasy, the days following consumption of the drug can see them experiencing an unpleasant “comedown” as the brain deals with depletion of serotonin and dopamine, chemicals associated with happiness and pleasure (especially if, as is often the case, other drugs have also been consumed alongside ecstasy).

Long-term use can see this experience become more drawn out and pronounced; however, exactly how long a person will feel withdrawal for, or when each symptom may present itself, varies from one person to the next.

Roughly speaking, a timeline for ecstasy withdrawal might look as follows:

Day 1: In the immediate aftermath of the drug a user might feel pronounced anxiety and emotionally very low. They might find it impossible to sleep even if they are physically very tired (perhaps from dancing). They may feel cravings for more ecstasy or for other substances to give them a “lift”.
Days 2-3: It usually takes around three days for ecstasy to leave your body and during that time extreme fatigue may set in; however, insomnia may still be a problem, as may an inability to focus, fluctuating appetite and ongoing anxiety. The most prominent symptom is likely to be depression: during this timeframe, suicidal ideation is most likely to occur.
Days 4-10: Occasional ecstasy users will usually feel more or less “normal” by this time; however, those who have developed a dependency will feel strong cravings, especially if depression is still being felt strongly. Feelings of anhedonia may be extremely troubling during this period, while sleep and eating abnormalities could continue.
Day 10 onwards: Typically, most symptoms will have subsided 10 or so days after the last dose. However, depression could still be felt prominently while sleep patterns could take time to regulate. Symptoms persisting long after Day 10 may be described as post-acute withdrawal symptoms (PAWS) and may need special therapy to be overcome.

Treatment Options

As with any addiction, a variety of different approaches to tackling ecstasy addiction are available. Effects and efficacy will vary from person to person; in general, though, a combination of residential rehabilitation and therapy is recommended to tackle both the immediate and the long-term implications of addiction and to help the addict stay away from relapse.

Rehab

Rehabilitation – “rehab” – is a general term used to describe the treatment processes by which a person recovers from addiction, but it is most commonly understood as referring to specific facilities which an addict can attend on either an inpatient or outpatient basis to get treatment.

Usually found in attractive and relaxing settings, rehab places confidentiality at its core; patients normally begin by going through a medically supervised detox before moving into therapy (both group and one-to-one). They will also have other aspects of their life addressed; for example, they will be given dietary and exercise plans to follow which will get them healthier and increase their self-worth – and thus leave them all the better prepared to resist the temptation to relapse.

Inpatient rehab keeps the patient onsite 24/7, giving them ready access to medical professionals and therapists and, crucially, ensuring that they do not have access to ecstasy (or any other substance of abuse). Outpatient rehab provides greater flexibility which may be very valuable for addicts with unavoidable work or family commitments but does not create the same degree of distance from the temptations represented by access to dealers and an addict’s drug-taking peer group.

Drug rehab for ecstasy: View our personalised treatment programme

Medication

There are, at present, no medications which tackle ecstasy dependency directly (ie, that will “cure” the addiction). However, doctors may prescribe medicine to deal with specific withdrawal symptoms; benzodiazepines such as diazepam can be used to tackle agitation, restlessness and some sleep disorders; antipsychotics can target amphetamine withdrawal psychosis (and some other symptoms); while a range of antidepressants are available to deal with depression (though it’s worth bearing in mind that these are unlikely to be prescribed to deal with short-term depression of the sort manifesting during acute withdrawal).

It’s vital to avoid self-medicating as some of the medications mentioned above may be unsafe for anyone with certain pre-existing conditions, and may also themselves be habit-forming (possibly leading to the emergence of another addiction). An addict seeking to tackle their ecstasy dependency should always begin by consulting their GP, who can discuss the implications of taking any specific medication and, if necessary, prescribe it. Going through detoxification without medical assistance can prove fatal.

Therapy

Dealing with a psychological addiction logically requires treatment of a psychological nature, and therapy is a critical component of any treatment whether inside or outside rehab. While some patients may initially feel reluctant to discuss personal issues with a stranger (let alone a number of strangers as is the case in group therapy) the sooner those feelings can be overcome the sooner genuine progress can be made towards a lasting recovery.

Each person may respond differently to different therapy models; although prominent methods such as cognitive behavioural therapy (CBT) and motivational therapy (MT) can prove extremely successful, it may be that an addict will need to try out a number of different forms of therapy before finding one which feels right for them. A good rehab will offer a variety of therapy models, while independent therapists specialising in addiction are to be found across the country.

Because ecstasy abuse is so widespread, an addict in group therapy will almost certainly find peers who are also recovering from ecstasy addiction and who can share useful learnings and advice based on familiar experiences. Ongoing group support can be found in the form of organisations such as Narcotics Anonymous which have branches across the UK and which can prove indispensable in helping with long-term recovery.