Ecstasy Abuse Signs, Withdrawal & Treatment

Ecstasy is the common name for the drug MDMA, which is short for 3,4-methylenedioxy-methamphetamine. It’s also often called Molly, which is short for “molecular,” due to its appearance as pure, fine powder in a small capsule that is taken orally. This synthetic drug has properties of both stimulants and hallucinogens, producing feelings of euphoria, bursts of energy, feelings of warmth and happiness, and sensory perception distortions.

PillsThis substance is well known for its popularity among Caucasian attendees of “raves” as well as among the gay nightclub scene. It’s frequently taken with other stimulants like cocaine, methamphetamine, and ketamine, and many gay and bisexual men report taking it with the erectile dysfunction drug Viagra as part of their sexual experiences.

Ecstasy stands out from other illicit substances for its ability to heighten feelings of empathy, love, and sexual arousal in those who take it. People on ecstasy report feeling love for everyone in the room and overwhelming joy. They also often experience distortions in the way time passes and may be delighted by their senses, enjoying bright colors and soft textures.

It’s easy to see how this drug could be addictive. MDMA causes the brain to produce an overload of serotonin, dopamine, and norepinephrine. These chemicals are all known to create feelings of happiness and pleasure, and reduce depression and anxiety. However, once the drug leaves the body, the brain compensates by producing less of these agents, and people often experience depression, anxiety, confusion, sleep problems, and cravings for the drug after coming down, even after the first time trying it. The heavier the abuse, the longer these aftereffects last, though some long-term effects may be due to mixing ecstasy with other substances.


For years, ecstasy use was mostly confined to the nightclub culture of Caucasian adolescents and young adults. However, it’s recently been gaining some popularity among African American adults and other non-Caucasian groups. It still remains popular at raves – long nighttime dance parties that typically include electronica music, brightly colored clothing and lights, and glow sticks. These parties are mostly attended by young people, particularly college-age young adults.

The use of “club drugs,” a group of drugs that includes ecstasy, among adults age 18-29 who regularly attend nightclubs is alarmingly high. In one study, the sample group reported a 70 percent rate of lifetime use, with 22 percent reporting taking club drugs recently. In comparison, only 9.4 percent of the population are current users of any illicit substance.

Ecstasy use and abuse have been increasing significantly for the past couple decades. Each year, there are hundreds of thousands of new “initiates” to the drug, meaning those who try the drug for the first time, according to the 2013 National Survey on Drug Use and Health.

The average age of first use is 20 years, though it has a higher rate of abuse among underage individuals than many other drugs.

People who take ecstasy are also very likely to be regular users of other intoxicants. These individuals are referred to as “polydrug” users. When it comes to MDMA, according to a study in the American Journal of College Health, 46 percent of college students who used this drug also used cocaine, compared to 2 percent of college students who did not use MDMA. In addition, of those who used MDMA, 38 percent also used inhalants, another 38 percent also used LSD, and 17 percent also used heroin.

Due to its status as a Schedule I Substance, according to the U.S. Drug Enforcement Administration, MDMA is not used in medical treatment. However, some recent research has found it to be effective in treating the symptoms of post-traumatic stress disorder (PTSD) due to its calming and joy-inducing effects. These studies have been successfully replicated, but research is still ongoing, and the drug has not been approved for any non-experimental use in psychiatric patients.

Signs of Addiction

Not all people who go to raves take ecstasy, and not all people who take ecstasy will become addicted to it. However, it does have a high potential for both psychological and physical addiction.

It can be difficult to spot signs of ecstasy use due to the fact that it is so often taken with other intoxicants, which alters the symptoms. There are, however, some key effects of ecstasy that will give this particular drug away. These include:

  • Euphoria
  • Unusual feelings and expressions of love
  • Increased capacity for empathy
  • Increased joy in the senses, particularly sight and touch
  • Teeth clenching (often alleviated by the use of pacifiers)
  • Increased thirst
  • Impulsiveness
  • Reduced anxiety and depression

Just using the drug does not mean addiction has occurred. However, one study found that 43 percent of surveyed ecstasy users fit the criteria for dependence. Psychological dependence requires frequent cravings, preoccupation with the substance, and unease when it’s not available.

Look for these common signs of substance addiction:

  • Changes in social circles
  • Sudden difficulty in meeting daily responsibilities
  • Reluctance to attend social or family events where the drug will be unavailable
  • Lying or secretive behavior
  • Financial or legal difficulties related to substance abuse
  • Inability or unwillingness to quit even when substance abuse causes serious problems
  • Hiding the drug around the home

Physical addiction involves the emergence of withdrawal symptoms when the addicted individual stops taking the substance. Depending on the length of time the substance has been abused, how heavy the abuse is, and which drug is involved, withdrawal can be very unpleasant to nearly unbearable. In some cases, it can even be deadly.

Ecstasy withdrawal comes with mostly psychological symptoms, and it is not dangerous in and of itself. However, hallucinations and psychosis can cause the detoxing individual to display erratic, aggressive, or dangerous behaviors.

Treatment Options

Ecstasy is a relatively new drug. Therefore, there isn’t as much information on how abuse and addiction occur or how to best treat dependence, and there are no specific treatments for ecstasy abuse. However, due to the fact that withdrawal symptoms are mostly caused by a deficiency in neurotransmitters like serotonin, drugs that work to increase the amount of these chemicals in the brain can help quite a bit with the detox process. For example, selective serotonin reuptake inhibitors (SSRIs) can be used to alleviate the depression, anxiety, and panic attacks that are common with ecstasy withdrawal.

It’s also important to keep in mind how often ecstasy is used alongside other intoxicants. This can complicate the treatment process as it’s possible the individual could be addicted to multiple substances at once. Because of this, it’s even more important to ensure a treatment plan for a person addicted to ecstasy is tailored to that individual’s unique situation.Dramatic image of a sad teenage girl crying

Other than that, ecstasy addiction treatment protocols typically follow the same formula as with any other addictive substance. Inpatient or outpatient services can be used depending on what works best for the client and should be followed with participation in long-term therapy and addiction support groups. Relapse rates without this continuous treatment are high. It’s also highly recommended that individuals undergo certain lifestyle changes. Continuing to attend raves and spend time at nightclubs is not advised as they are very likely to include access to the drug, creating a high level of temptation. As it is, drug addiction relapse rates are 40-60 percent.

Detox and Withdrawal

 There is no easy part to quitting an addictive substance, but detox can be a huge hurdle. Withdrawal symptoms can be a significant deterrent from even trying to quit since they can be so unpleasant and so easily relieved by taking the drug that the body is craving.

Ecstasy withdrawal symptoms include:
  • Anxiety and depression
  • Confusion
  • Depersonalization
  • Insomnia
  • Fatigue
  • Irritability
  • Mood swings
  • Loss of appetite
  • Difficulty concentrating
  • Panic attacks
  • Paranoia
  • Memory problems
  • Muscle stiffness
  • Hallucinations
  • Delusions
  • Psychosis

Withdrawal symptoms usually start within 12 hours of the last dose, and the most intense symptoms typically pass within a few days.

However, depending on how long and severe ecstasy abuse has been, it can take weeks or even months for the serotonin, dopamine, and norepinephrine receptors to return to normal functioning. Long-term effects of this can include heightened depression, anxiety, irritability, and sleep issues. Even after these fade, cravings can always be triggered by stress, availability of the drug, or sensory reminders of the high.

To handle the initial, intense symptoms, it’s recommended to seek medically supervised detox services. With medical detox, the client is checked into a medical facility, and symptoms and vital signs can be closely monitored. In addition to immediately addressing any severe distress, even lesser symptoms can be quickly treated. The goal of medically supervised detox is to make the process as easy as possible so the temptation to immediately return to the drug is significantly minimized.

With proper treatment and long-term commitment to attending support meetings and/or therapy, anyone can get on and stay on the road to recovery and life a balanced, happy life.

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