Ecstasy Withdrawal Symptoms and Timeline
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Considering quitting Ecstasy, but not sure what to expect? Why do withdrawal symptoms appear at all?
What kinds of symptoms are likely to occur? When is their onset and how long will they last? Is there a risk of a relapse? What to do to make it easier? Here are the most commonly experienced MDMA withdrawal symptoms and answers to the above questions.
Table of Contents
Reasons For MDMA Withdrawal Symptoms
Withdrawal symptoms occur because Ecstasy causes a chemical imbalance in the brain. By artificially stimulating neurotransmitters to achieve the desired effects, the stock of these brain chemicals is used up much faster. So when the drug effects wear off, there fewer neurotransmitter molecules left to do their usual job and are less efficient in regulating physical and psychological functions. These are withdrawal symptoms.
The bad news is that withdrawal symptoms will last until the chemical balance in the brain is restored.
But the good news is that Ecstasy is considered to be less addictive and the withdrawal phase easier to handle than for other harder drugs (ex. cocaine) however this is not an indication of safety.
- Every subsequent dosage needs to be stronger to achieve similar effects to the previous one.
- Higher doses mean a greater danger of overheating and dehydration, liver failure, and heart arrhythmia.
- The comedown phase is also longer and more painful
For a while, this vicious circle continues, but eventually, the rush becomes difficult to reach. All that with the cost of immediate physical danger and inevitable harsh comedown consequences once the drug is used up by the body.
For some people, this realization is enough to decide to quit taking Ecstasy. Ex-users mostly quote concern for health as the primary reason for stopping. The body became used to functioning with the drug, and now it is adapting to operating without it. So this implies a series of possible Ecstasy withdrawal symptoms in the recovery period.
Ecstasy Withdrawal Symptoms Timeline
Some effects begin immediately after the drug becomes inactive. Some will last several days, others weeks. Both physical and psychological effects will come into force at some point in the withdrawal process. The physical symptoms will vary from case to case but should not be very draining, however users must be prepared for mental challenges.
Be persistent: the first week will be the most challenging, but all symptoms gradually fade.
The ‘Come-Down’ Phase
After 3-6 hours of MDMA, molecules stop working on the brain. The body suddenly finds itself deprived of the desired effects and signals its craving by sudden and uncontrolled behavior or sensations.
Unpleasant comedown effects happen every time after addictive substance use. What makes this phase especially challenging, is that it directly followed the “high” stage. The user perceives a considerable contrast between pleasant and unpleasant experiences. Many symptoms are psychological at this point:
- The person is confused and has trouble to distinguish reality from fantasy
- That can sometimes manifest in paranoia or other psychotic delusions. Visiting an inpatient clinic might be a good idea if one experiences them. They are well-equipped to make sure on is safe, and recovery goes well.
- Out-of-body perceptions can sometimes occur: the feeling of floating around one’s body
- Panic attacks can occasionally happen because of the sudden change from pleasure to pain
- Insomnia is the result of disrupting brain networks involved in the sleep and wake cycle
- Depression is the reaction to a chemical imbalance of serotonin. Almost every person on the path to recovery from an addiction suffers from it.
- Craving for more Ecstasy is a psychological reaction. One may wish to experience the euphoria again and to escape the pain.
First 3 Days
It takes up to three days for MDMA to exit the body.
While the system is working on getting rid of all molecules of this substance, here is what side effects this might induce:
- Insomnia, paranoia, and especially depression will continue.
- Anxiety appears likely due to both a chemical imbalance and strengthened by the helplessness of experiencing the other continuous or new painful effects. If the user has experienced anxiety before starting to take the drugs, they probably suffer from anxiety in general. One might consider handling it with professional help as well. That is helpful to prevent potential future relapses.
- Irritability and mood swings. Depleted Serotonin levels directly influence uncontrolled mood swings. Overall fatigue and sleep problems surely do not improve the mood. On the contrary, users will probably feel easily irritated.
- The body has been immensely strained during the drug rush, and also, it is in the middle of restructuring its functioning without the drug. All this takes lots of energy and body resources, which inevitably lead to physical weakness and fatigue.
- Similarly, being on withdrawal means actively experiencing painful or unpleasant physical and psychological changes. That might be a lot to handle in a short time, which is why people might feeling mentally tired as well.
- As a result, it might be quite challenging to concentrate at all.
- Sleep deprivation, fatigue, and poor concentration alone diminish cognitive capacities. When combined with MDMA, all of the above may contribute to memory impairment.
- Many people lose their appetite. That might be a side-effect of depression, where the person does not care about eating. Try to think of it that way: the way that drugs affect the body, food also affects the body. So to give the body the best chances for recovery – drink enough water and eat healthy food.
Now that the body ejected all traces of MDMA, it will try to go back to the way it worked before running on the drug.
The previous symptoms usually peak, and some people additionally experience:
- Muscle rigidity does not happen very often. But don’t be surprised if the muscles feel stiff and don’t worry, it will pass.
- Hallucination. On rare occasions, people see and hear things that are not there.
That is the most challenging phase where intensive adjustments take place in the body. But past this phase, all symptoms will weaken with time.
Do 90 days seem long? It is the average drug withdrawal period in general, and it does not mean one will stick in that phase for that long.
It all depends on the individual situation. Also, the more time passes, the more symptoms have vanished.
Cravings continue, but insomnia, concentration and memory problems eventually fade.
Depression is the most stable side effect. It is a mix of brain chemistry getting back to normal and the need to find a way of functioning in a drug-free environment. The person faces reality and needs to decide how to move on the drug and how to feel fully reinserted into society.
Factors Affecting Ecstasy Withdrawal Intensity And Length
Keep in mind that every user is in a unique situation. That is why it’s impossible to predict precisely, which symptoms one will experience how strongly.
- Dose. Typically, a dose ranges between 80-160 mg of an active substance in a pill. The amount of MDMA in a dose determines the quantity of serotonin (or other neurotransmitters) that are being artificially activated and so, used up. The higher the dose, the larger the imbalance of neurotransmitters in the brain.
- The frequency of use. It makes a huge difference, whether someone used 3 Ecstasy pills, one after the other, every night compared to someone who consumes it once a month. The higher the frequency, the more intense the withdrawal effects will be, because of increased chemical imbalance in the brain and damage to other organs.
- How long. The longer one has been using the drug, the longer it affects the body. After more abuse, the body needs more time to recover.
- Tolerance. After every MDMA intake, the brain prepares itself for the next dose. As a result, it increases its tolerance to drug effects, which is why each subsequent dose needs to be higher. Every brain is different, and some people can be naturally more tolerant (resistant) to drugs than others. The more invulnerable brain will need higher doses of a drug. That is why the higher the resistance, the more challenging the withdrawal phase will be.
- Overall health. The healthier the person is, the easier it is to go through the withdrawal process. What significantly influences this is notably physical strength and a healthy metabolism. Hypothyroidism slows down the metabolic processes in the body, and that can prolong the recovery. So this person would suffer from withdrawal symptoms longer than individuals with a well-functioning metabolism.
- Comorbidity. Similarly, some people may suffer from other independent mental disorders. They sometimes use MDMA to self-medicate for anxiety issues. The whole withdrawal process will be different, because of additional reasons to crave the drug. Withdrawal symptoms of ecstasy might be more intense, and the recovery process might take longer.
The Risk Of Ecstasy Relapse
There is always a risk, but it depends on the situation and how much time passed since one quits taking Molly.
During the Ecstasy Withdrawal Process
People do crave for the drug, mostly wishing to end their (temporary) suffering. Outside a supportive and controlled environment, such as an inpatient clinic, they are at a relatively high risk of getting back to the drug.
During this phase, the body is already in the middle of readjusting and particularly vulnerable. And desensitized by a prolonged period without MDMA, the brain is more receptive to it. In this stage of physical vulnerability, previous doses might lead to overdose. That is dangerous for the heart, liver and could even be lethal.
Having a support network is crucial. Depression can stay for several months or years. If it is untreated, one risks the relapse to Ecstasy or another form of addiction. A supportive surrounding (family, friends, community) and therapy are very effective in overcoming depression and gaining knowledge on how to transition into a functional life. The ex-Ecstasy user will have much less ground or reasons for relapse.
A German longitudinal study showed that 93% of 2446 studied Ecstasy-users were no longer addicted to MDMA after three years. Among them, 50% quit using the drug altogether. 43% still used it, but without meeting the criteria for a substance abuse disorder. The authors even suggested calling Ecstasy a transient phenomenon, which sounds encouraging.
Making Withdrawal Easier
There are different ways to enhance withdrawal process considerably.
- Being around understanding and supportive people (family, friends, community)
- Don’t hesitate to ask for help. Support groups, treatment centers, and inpatient clinics are there to help to get a life in hand.
- Eat healthy food and drink enough water
- Exercise daily, even if it is 5 minutes
- Kalant H. The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ. 2001; 165(7): 917–928. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81503/.
- McKetin R. et al. The effect of the ecstasy ‘come-down’ on the diagnosis of ecstasy dependence. Drug and Alcohol Dependence. 2014; 139: 26-32. doi: 10.1016/j.drugalcdep.2014.02.697. https://www.ncbi.nlm.nih.gov/pubmed/24703083.
- Leung K. S., Ben Abdallah A., Copeland J., Cottler L. B. Modifiable risk factors of ecstasy use: risk perception, current dependence, perceived control, and depression. Addictive Behaviors. 2010; 35(3): 201–208. doi:10.1016/j.addbeh.2009.10.003. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2815072/.
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