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Ecstasy Detox Guide: Symptoms, Timeline, and Effects

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person handing off ecstasy pill at clubEcstasy is a street designation for an illicit drug containing MDMA, or 3,4 methylene-dioxymethamphetamine.1,2 Ecstasy is chemically similar to both amphetamines and mescaline, a hallucinogenic found in the peyote plant.1,2 It is a Schedule I drug, found to have no medicinal value and high potential for abuse.1,2 Most people who use ecstasy take it orally, although some people snort it in powdered form. Users typically take ecstasy to decrease inhibitions, achieve states of euphoria, and increase pleasurable emotions.

People between the ages of 18 and 25 are by far the most common users of ecstasy; in fact, the 2015 National Survey on Drug Use and Health reports that around 13% of people in this age group have used ecstasy, with around 4% reporting use in the previous month.8 Furthermore, according to the 2016 Monitoring the Future study, an estimated 2.8% of high school students in 10th grade and 4.9% of those in 12th grade reporting having used ecstasy at least once.9 Unlike many drugs, ecstasy is not associated with pronounced physical dependence. Despite this, even weekend users of the drug may experience unpleasant “detox” effects that can last from a few days up to a few weeks.1 Ecstasy use can be particularly dangerous because you can never really be sure what drugs are actually contained in a tablet. Tablets may be cut with other substances, including cocaine, methamphetamine, and ketamine. Moreover, people often take ecstasy with alcohol or marijuana, which can be a dangerous mix.11

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Immediate Effects of Use

While ecstasy can produce desirable effects, such as euphoria, increased empathy, and physical sensitivity, many unwanted and potentially dangerous side effects can also occur.3

The short-term effects of ecstasy use may include:3,4

  • Muscle tension.
  • Anxiety or depression.
  • Paranoia.
  • Increased body temperature (as high as 108 degrees).
  • Increased blood pressure, heart rate, and respiratory rate.
  • Faintness.
  • Chills.
  • Sweating.
  • Nausea.
  • Heart palpitations.
  • Coordination problems.
  • Blurred vision.
  • Tremors.
  • Impaired judgment.
  • Depersonalization.
  • Derealization.
  • Hallucinations.

These short-term effects can have severe consequences, as changes in consciousness, such as hallucinations, depersonalization, and derealization, can lead to unpredictable and potentially hazardous behaviors.

Consequences of Long-term Use

Although research is inconclusive as to whether or not ecstasy is addictive, some users have reported withdrawal symptoms, such as fatigue, loss of appetite, and depression, when they tried to stop using.11 Additionally, research has revealed that animals self-administer ecstasy in lab settings, which indicates that the drug has potential for abuse and addiction.11 Withdrawal symptoms with cessation of use are just one overall sign of an addiction to ecstasy. Generally speaking, the longer a person uses, the more likely it is that they will develop an addiction and suffer long-term consequences of substance abuse.

Long-term consequences of ecstasy use can include:3,11

  • Confusion.
  • Sleep disturbances.
  • Severe anxiety.
  • Depression.
  • Paranoia.
  • Memory impairment.
  • Drug cravings.
  • Tolerance (you need a higher dose to produce the same effect).
  • Interpersonal problems, such as divorce or child neglect.
  • Financial issues.
  • Job loss or expulsion from school.
  • A loss of interest in hobbies or pleasurable activities.
  • Increased risk of engaging in risky sexual behaviors.

Chronic MDMA abuse can have dire results. Dangerously high body temperatures and dehydration can lead to heatstroke, especially for those dancing in hot clubs for extended periods of time. Without immediate treatment, heatstroke can lead to death. Furthermore, the additives and other substances people commonly mix with ecstasy can also increase the risk of overdose and death.3

Ecstasy Withdrawal Symptoms

In most instances, withdrawal symptoms occur only after someone has become physically dependent on a substance. As mentioned, though ecstasy seldom leads to this type of dependence, the associated “hangover” or after-effects of MDMA abuse are still distressing and unpleasant. They often resemble the type of “crash” associated with amphetamine or cocaine binges.2 Some common ecstasy withdrawal or detox symptoms include:1,2

  • Depression.
  • Mood swings.
  • Anxiety.
  • Irritability.
  • Poor concentration and memory.
  • Insomnia.
  • Extreme fatigue.
  • Muscle aches.
  • Headaches.
  • Loss of balance.
  • Loss of appetite.

Everyone experiences ecstasy withdrawal differently. The manifestation of ecstasy detox symptoms depends on a number of factors, including:3

  • The average dose taken.
  • The length of ecstasy abuse.
  • The presence of polydrug abuse.
  • The purity of the ecstasy (it is often cut with other drugs, such as ketamine, PCP, ephedrine, and caffeine).
  • Age.
  • Individual physiology.
  • Overall physical and mental health.

Detox Length

There is no set length of time it takes for one to completely detox from ecstasy. What we do know is that the drug is eliminated from the body somewhat slowly. It takes roughly 40 hours for 95% of the drug to be cleared from the body.2 As the drug leaves the body, a person may experience some of the acute withdrawal symptoms noted above for one to two days.2

Risks of Withdrawal

distressed woman with hands on her faceEcstasy can have long-lasting effects on a person’s physical and psychological functioning. It is not fully known whether the full range of these potential complications can be effectively treated and reversed.2 Some of the lasting effects once acute intoxication has resolved include:1,2

  • Damage to teeth, due to teeth clenching or grinding.
  • Muscle aches and pains, especially in the lower neck and back.
  • Impaired decision-making, reasoning, and problem solving.
  • Panic attacks, even after months of sobriety.
  • Psychotic episodes.
  • Recurrent paranoia.
  • Hallucinations.
  • Depersonalization.
  • Flashbacks.

You don’t have to experience ecstasy detox alone. Anyone experiencing these symptoms is strongly encouraged to seek the help of a medical or psychiatric professional who may be able to help.

Do I Need Ecstasy Detox? 

Young woman thinking about ecstasy detoxPeople may believe that ecstasy is not addictive, and because of this, they think detox is not necessary. This may be a common misconception, though. Just because ecstasy is not as addictive as other substances, such as cocaine and heroin, does not mean that a person cannot develop a problematic pattern of ecstasy abuse.

There are several signs and symptoms that you or someone you know has developed an addiction to ecstasy. MDMA addiction can negatively impact many different parts of your life. Some common signs of addiction include:4

  • Taking ecstasy in larger amounts or for longer than originally intended.
  • Failing to cut back on ecstasy use despite efforts to do so.
  • Spending an inordinate amount of time obtaining and using ecstasy, as well as recovering from its effects.
  • Having strong cravings to use ecstasy.
  • Continuing to use ecstasy despite failure to fulfill obligations at home, school, or work.
  • Continuing to use ecstasy despite interpersonal, social, physical, or psychological problems exacerbated by or caused by use.
  • Abandoning previously enjoyed activities in favor of ecstasy use.
  • Using ecstasy in dangerous situations, such as while driving.

Even if you are unsure as to whether you or a loved one is addicted to ecstasy, detox and substance abuse treatment could be an appropriate preventative measure. Ecstasy use is related to many harmful physical and mental health symptoms in the short and long-term. Detox and treatment may help prevent the development of physical problems like:5,6,7

  • Hyperthermia.
  • Dehydration.
  • Muscle cramping.
  • Blurred vision.
  • High blood pressure.
  • Irregular heart beat.
  • Kidney, liver, or heart failure.
  • Loss of consciousness.
  • Seizures.

Mental health symptoms are triggered by ecstasy abuse as well. Since the substance modifies the functioning of brain cells, adverse effects have been noted leading to:2,5,7

  • Panic attacks.
  • Agitation.
  • Depression.
  • Anxiety.
  • Delusions and paranoia.
  • Hallucinations.
  • Bizarre behavior.

Detox Options

Ecstasy detox may not be necessary for most people; however, if you have been using ecstasy for a long period of time or believe that you may be unable to quit using ecstasy on your own, seeking a drug detox program may be in your best interest. Detox programs provide a safe place for patients where their detox symptoms are monitored and medically addressed and stabilized. Some of the types of detox programs include:

  • Inpatient Facility: This type of detox is conducted at a residential facility in which you would remain in the facility during the detoxification process. Generally, residential facilities provide 24/7 medical support for patients.
  • Hospital Detox: Detox is conducted in a hospital setting. This type of service is similar to that of an inpatient facility; however, patients may be more closely monitored. Many people wind up detoxing in a hospital after experiencing a medical emergency related to ecstasy abuse.
  • Outpatient Facility: Going through detox in an outpatient setting means that you continue to reside at home while visiting the outpatient facility a few times per week to receive detox services.
  • Physician’s office: This is similar to attending an outpatient facility, but instead of visiting an outpatient facility for follow-ups, you instead visit with your primary physician or a psychiatrist to keep him or her updated on your progress.

It’s important to note that a drug detox program is not a substitute for a comprehensive MDMA addiction treatment program. Detox is a vital first step in the recovery process but follow-up treatment can be highly beneficial. Rehab can help you maintain sobriety in the long run by teaching you crucial relapse prevention skills and addressing any underlying issues. Once you complete an ecstasy detox program, it is worth considering transitioning into a recovery program.

Sources

    1. Substance Abuse and Mental Health Services Administration. (2002). Ecstasy: What’s all the rave about?
    2. Kalant, H. (2001). The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ: Canadian Medical Association Journal165(7), 917–928.
    3. Center for Substance Abuse Research. (2013). Ecstasy.
    4. American Psychiatric Association. (2015). Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, D.C.: American Psychiatric Association
    5. Drug Enforcement Administration. (2013). 3,4-Methylenedioxymethamphetamine.
    6. National Institute on Drug Abuse. (2016). What is MDMA?
    7. National Institute on Drug Abuse. (2006). What are the effects of MDMA?
    8. National Institute on Drug Abuse. (2015). National Survey of Drug Use and Health.
    9. National Institute on Drug Abuse. (2013). MDMA (Ecstasy/Molly).
    10. Patel, A., Moreland, T., Haq, F., Siddiqui, F., Mikul, M., Qadir, H., & Raza, S. (2011). Persistent Psychosis After a Single Ingestion of “Ecstasy” (MDMA). The Primary Care Companion to CNS Disorders, 13(6).
    11. National Institute on Drug Abuse. (2013). DrugFacts: MDMA (Ecstasy/Molly).

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