Blog - Beach House Rehab Center
January 16, 2019

Ecstasy Detox Guide


Ecstasy (officially known as “MDMA”) is a synthetic, psychoactive drug chemically resembling stimulants and hallucinogens. Ecstasy is popular among adolescents and enjoys a glamorized reputation as a night-life favorite. Although it is available as a tablet, powder, capsule, or in liquid form, it also snorted in order to achieve a quicker high. Deemed a Schedule 1 Substance and subject to the highest level of legal scrutiny and penalties, ecstasy is often mixed with other synthetic drugs or cheap household substances and sold on the street under the moniker Molly.  Ecstasy produces intense euphoria while distorting sensory perceptions, and is considered extremely unpredictable and dangerous.

According to the 2014 Global Drugs Survey (GDS), ecstasy was listed in the top five drugs among recreational drug users. Of the 80,000 surveyed, over 20 percent of US respondents reported using ecstasy within the past year. Approximately 50 percent of them also reported “clubbing” at least four times annually.


Like other mind-altering substances, ecstasy artificially manipulates brain chemistry in order to produce euphoria users are willing to pay high prices to experience. This legendary high—the result of elevated neurotransmitter levels—overrides the central nervous system (CNS) with pleasurable sensations, but wears off quickly. Especially after long-term use, the brain is left in a less efficient state due to the depletion of neurotransmitters that occurs as a backlash effect. Until the delicate balance of brain chemicals is eventually restored, users may experience the following withdrawal symptoms:

  • Anxiety
  • Mood swings
  • Irritability
  • Fatigue
  • Disorientation
  • Difficulty concentrating
  • Impaired memory / cognition
  • Loss of appetite
  • Hallucinations
  • Insomnia
  • Paranoia / delusions
  • Panic attacks
  • Depression
  • Intense cravings


Ecstasy withdrawal is usually broken down into four separate stages, with the intensity and longevity of each phase varying depending upon multiple factors including the length of addiction, usual dosage, gender, age, weight, height, and overall physical and psychological condition. During the first stage, initial symptoms peak with maximum intensity, usually beginning within six hours following dosage (after which time ecstasy stops working in the brain). This phase, which lasts for approximately 72 hours, includes primarily psychological symptoms including paranoia, delusions, panic attacks, depression, and intense cravings. The remaining stages are as follows:

  • Stage 2 – After 72 hours, ecstasy is no longer present in the body in any significant quantity. During this phase—which lasts for approximately one week—continuing physical and psychological symptoms, such as anxiety, mood swings, mental fatigue, difficulty concentrating, memory impairment, and loss of appetite, set in.
  • Stage 3 – Within 10 days, ecstasy is no longer present in the system, and the previous symptoms have already peaked with maximum intensity. In addition to cravings and continued mood shifts, clients may experience muscle rigidity and hallucinations— both of which tend to pass quickly.
  • Stage 4 – This final ecstasy withdrawal stage is characterized by a diminishing regularity and severity of symptoms. Although this stage generally lasts for up to three months, lingering symptoms may persist for months or years—a phenomenon known as post-acute withdrawal syndrome (PAWS). The milder effects of PAWS can lead some clients to abandon their vigilance and feel that they have prematurely overcome their addiction. However, this is not the case. Extra precautions must be taken during PAWS to help ensure optimal recovery outcomes and prevent relapse— the same as during any other stage.


Inpatient treatment is an empirically proven treatment protocol in which clients live at a designated residential facility for a period of one month to three months. During their stay, clients receive ongoing medical management and intensive clinical supervision. In addition to the heightened security and 24/7 staff monitoring, clients also enjoy a strong sober support network and optimal recovery environment. Beyond these evidence-based benefits, many state-of-the-art facilities offer amenities such as yoga, meditation, regular group outings and recreational activities, alumni networking, and aftercare services. 

Medication-Assisted Treatment

Medication-assisted treatment (MAT) describes a detox and treatment protocol that combines behavioral and psychotherapy in tandem with Food and Drug Administration (FDA)-approved pharmacological interventions for maximum benefit. The following therapeutic modalities are frequently included:

  • Dialectical behavior therapy (DBT)
  • Motivational interviewing (MI)
  • Trauma-informed therapy
  • Family therapy
  • Cognitive behavioral therapy (CBT)

Ecstasy is a relatively new drug for which no clearly defined medication regimen exists. Depending upon client needs, various prescription medications ranging from antidepressants (SSRIs) to antipsychotics may be administered during detox and subsequent treatment. Ultimately, a licensed physician and supporting clinicians will decide what is best for each client on a case-by-case basis, following careful evaluation and assessment.

Dual Diagnosis Treatment

Anxiety, depression and post-traumatic stress disorder (PTSD) are often precipitating factors involved in ecstasy addiction. Treating these co-occurring disorders with proper medication is a critical component of successful detox for many clients— especially those suffering from polysubstance abuse. Supplemental medications such as gabapentin, pregabalin, buspirone, and sleep aids may be prescribed in addition to the primary medication routine used to treat the official substance use disorder (SUD).    


Outpatient treatment offers a more flexible option for those with demanding personal and/or professional schedules. Unlike residential treatment, outpatient treatment is offered on a non-residential basis and typically revolves around a predetermined schedule of group and individual therapy sessions. For many clients, outpatient treatment represents a natural progression in continuing care upon successful completion of detox and a residential program.  Although outpatient treatment is generally cheaper than inpatient services, it does not boast the round-the-clock clinical supervision and may be inappropriate for those suffering from full-blown ecstasy addiction.


Ecstasy detox requires professional, medically managed supervision and should never be performed at home under self-guided care. Those who defy official medical advice in an attempt to save time or money are saving neither, while incurring unnecessary risks and increasing their likelihood of future relapse. Overdoses, unanticipated complications, and even death can all result from choosing self-administered treatment above professional medical care.


Tapering is a controversial but effective detox method that involves administering diminishing doses of ecstasy within a predetermined timeframe. This provides a gradual acclimation process that is generally well-tolerated by the majority of clients and allows sufficient time to adapt to life without the drug. Quitting ecstasy cold turkey is dangerous and may result in precipitated withdrawal— a sudden acceleration and intensification of withdrawal symptoms that can be debilitating and, in some cases, deadly.   


There is no one-size-fits-all treatment option or approach that works for everyone. Each client must decide what is optimal based upon their individual needs and long-term treatment objectives. Facility location, affordability, reputation, and insurance coverage are all major factors to be considered before arriving at an informed decision. Spirituality and faith also play a significant role in determining treatment for certain clients— especially since holistic and faith-based options now exist.

Although affordability is the single greatest concern for the majority of clients, it should never be the only reason to arrive at a final decision regarding treatment. For those with insurance-related questions, reputable facilities will be able to verify coverage and benefits prior to enrollment. In the rare event that coverage is denied, admissions staff will discuss a range of additional financial options including federal grants, private scholarships and/or other forms of aid.  The following considerations should also be factored into a final decision:

  • Program reputation (locally and nationally)
  • Addition of amenities, aftercare services and on-site benefits
  • Use of state-of-the-art technology and treatment options
  • Availability of alternative healing modalities
  • Proximity to major recreational attractions (ocean, mountains, etc.)
  • Accessibility from major airports


Optimal post-treatment outcomes are best achieved by following a multi-pronged approach.  Although unforeseen circumstances help determine the likelihood of long-term sobriety, many factors can be controlled through a disciplined, highly committed approach. A comprehensive aftercare plan should include ongoing medication management, random drug testing, one-on-one and group therapy, life and job skills coaching (if necessary), a healthy diet, regular physical activity, and abstinence from social and environmental triggers. Additionally, participation in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), commitment to a spiritual program or faith-based community, and a working relationship with a sponsor must be included in order to maximize the probability of success.


Although genetic tendencies and environmental factors make certain people more prone to addiction, anyone, at any time, regardless of race, socioeconomic status, age, gender, or religion can end up in need of ecstasy detox. If you or someone you love is addicted to ecstasy and in need of medical help, call a substance abuse professional today.

Most importantly, remember that ecstasy abuse may result in overdose— and potentially death. Overdose is considered a life-threatening emergency requiring immediate medical attention in a hospital emergency room (ER) or intensive care unit (ICU).

For more about ecstasy addiction and recovery, check out these related articles:


CMAJ. The pharmacology of “ecstasy” (MDNA) and other related drugs. October, 2001.

Social Cognitive and Affective Neuroscience. ‘Ecstasy’ as a social drug: MDMA preferentially affects responses to emotional stimuli with social content. August, 2014.

Journal of Psychoactive Drugs. The Role of MDMA (Ecstasy) in Coping with Negative Life Situations Among Urban Young Adults. July, 2011.

International Journal of Drug Policy. From ecstasy to MDMA: Recreational drug use, symbolic boundaries, and drug trends. Dec, 2017.