Ecstasy Withdrawal

Ecstasy, or MDMA, is a synthetic “club drug” with both stimulant and hallucinogenic properties.¹ People often take ecstasy because of its energizing effects and ability to alter a person’s perception of their environment and senses.¹

Research is inconclusive about whether ecstasy is addictive; however, some people report experiencing ecstasy withdrawal symptoms, which is one of the criteria for a substance use disorder (SUD).^1,2

What Is Ecstasy Withdrawal?

Drug withdrawal happens when a person suddenly reduces or completely stops using a substance.³ Withdrawal symptoms can vary depending on the substance used and may involve several uncomfortable physical and emotional symptoms.² Ecstasy withdrawal symptoms have been reported by some people and may occur if a person suddenly stops using ecstasy.^1,2,4

Experiencing withdrawal symptoms is one of the diagnostic criteria for substance use disorders in the Diagnostic and Statistical Manual of Mental Disorders (5th edition), which is used by clinicians to help diagnose SUDs.²

Some withdrawal symptoms may be more safely managed with supervision and medication for co-occurring conditions during a detox phase of treatment.^3,7

Ecstasy Withdrawal Symptoms

Withdrawal syndromes are not typically associated with hallucinogens, to which ecstasy or MDMA has similar properties.³ Clinicians often pay attention to residual effects related to hallucinogen use and intoxication like anxiety, flashbacks, and psychotic symptoms when a person stops using those substances.³

The primary symptoms associated with ecstasy withdrawal include:^1,4

• Fatigue.
• Loss of appetite.
• Depression.
• Struggles to concentrate.

Risks of Ecstasy Withdrawal

The withdrawal process from ecstasy or MDMA is not considered to be life-threatening. However, people who are experiencing severe emotional distress are at risk for harm, and people withdrawing from ecstasy may benefit from professional assistance.³

People struggling with ecstasy misuse or other substance use disorders may be at risk for physical or mental health consequences.⁸ People with co-occurring physical or mental health conditions may potentially experience additional withdrawal risks or complications related to ecstasy or other drug withdrawal.⁸

One of the primary risks is associated with contaminated MDMA. Pills and tablets often contain other drugs like ketamine, methamphetamine, cocaine, or bath salts.¹ These drugs can be dangerous when mixed with MDMA.¹ People who routinely use MDMA with other drugs may be putting themselves at higher risk for experiencing negative health effects.¹

Ecstasy Withdrawal Timeline

There is no formal identified timeline associated with ecstasy withdrawal. The effects of ecstasy typically occur within 30 to 45 minutes of taking a pill and can last from 4 to 6 hours.⁵ Withdrawal symptoms from ecstasy may occur after the effects begin to wear off.

The severity of withdrawal symptoms may be influenced by several factors, including:

• How long a person has been using ecstasy.
• How much ecstasy a person used.
• The use of other drugs with ecstasy.
• Differences in individual metabolism and psychological resiliency.

Causes of Ecstasy Withdrawal

Ecstasy increases the activity of 3 neurotransmitters: serotonin, dopamine, and norepinephrine.¹ After use, the brain is depleted of serotonin, and a person may experience withdrawal symptoms such as confusion, depression, sleep problems, and anxiety.¹

There is conflicting evidence on whether ecstasy causes physical dependence and addiction. Patterns of ecstasy use and its effects are still being researched.³

• Some research studies have revealed that animals will self-administer ecstasy or MDMA, which is typically a sign of high abuse potential. However, they don’t self-administer ecstasy to the same extent as they do highly addictive drugs, such as cocaine.¹
• The Drug Enforcement Administration (DEA) classifies ecstasy as a Schedule I controlled substance, indicating that the drug has a severe potential for abuse, may lead to psychological or physical dependence, and has no medicinal purposes.⁵

Treatment for Ecstasy Misuse

People who are struggling with ecstasy or MDMA use disorder may benefit from support while going through withdrawal and recovering from problematic use. Depending on the substances used and other factors like genetics, co-occurring disorders, and polysubstance use, a person may experience discomfort during withdrawal, which can be eased while providing a safe environment for withdrawal.³

There are no FDA-approved medications to treat MDMA use disorder; however, effective treatment may include behavioral therapy, which can help change a person’s thinking about their drug use and establish new, healthy behavior patterns.⁶

People who want support after ecstasy withdrawal may consider the following interventions:

• Therapy for substance use disorders.
• Participation in mutual support groups, like Narcotics Anonymous.
• Dual diagnosis treatment for any co-occurring disorders and access to clinical services for medical conditions.

Detoxification and withdrawal are often part of the first phase of recovery from drug misuse and addiction. Continuing treatment after detox may help support people in remaining abstinent in the long term.⁷

The following are options that may be appropriate when recovering from MDMA use disorder or other substance use disorders:^7,8

• Inpatient rehabilitation programs where a person stays in the facility during treatment, which may include several interventions to help you recover like detox, therapy, treatment for co-occurring disorders, and group counseling.
• Outpatient rehabilitation programs where a person visits the facility on a regular schedule to receive treatment, which may include detox services, therapy, drug counseling, case management, and medication for co-occurring disorders.
• Mutual support groups like Narcotics Anonymous can help a person connect with and relate to other people who struggle with addiction. You can receive peer support and participate in a structured program of recovery.
• Dual diagnosis programs, or co-occurring disorder programs, treat substance addiction and mental health disorders simultaneously. Many people who struggle with substance misuse also struggle with mental health disorders. Treatment should address both conditions at the same time, which may include medication to help manage mental health condition(s).

There Is Hope for Recovery

Addiction is treatable, and a life of freedom is possible. Connect with drug and alcohol treatment centers that specialize in your specific needs, from holistic care to medication-assisted treatment. Don’t wait another day to get help; find a recovery program that works for you.