One of the classic works regarding the drug ecstasy is the book Ecstasy: The Clinical, Pharmacological and Neurotoxicological Effects of the Drug MDMA.1 It reports that ecstasy (chemical name 3,4-methylenedioxymethamphetamine or, as it is often abbreviated, MDMA) is a drug with properties of both stimulant drugs like amphetamines and psychedelic and hallucinogenic drugs like mescaline.
While MDMA was once used as a pharmacotherapeutic agent for the management of psychiatric disorders, and while there are current clinical trials investigating its use for the treatment of conditions such as Post-Traumatic Stress Disorder (PTSD),1,2 the United States Drug Enforcement Administration (DEA) classifies ecstasy as a Schedule I drug.3 This designation indicates that it has no currently accepted medicinal uses, yet it does carry a serious potential for abuse and the development of physical dependence.3
One of the more appealing side effects of MDMA is the feelings of euphoria it produces, as well as its ability to make people very sociable, open, and even empathetic to others. These effects have led to MDMA becoming popular with young adults and even adolescents who frequent nightclubs, social gatherings, and parties, or who may be somewhat awkward socially or feel inhibited in social situations.
The National Institute on Drug Abuse (NIDA) reports that MDMA use can lead to physical dependence and the development of a substance use disorder—the diagnostic term for substance addiction.4 However, other sources suggest that the addictive properties of MDMA may be mostly psychological.1
Some important considerations about treating a potential addiction to MDMA include:1,4
- One of the first and most important considerations is that pills that are reported to contain MDMA often contain other potentially dangerous and addictive drugs, such as PCP or cocaine. Even though the addictive potential for MDMA itself continues to be debated, many of the other substances found in the pills labeled as ecstasy have demonstrable abuse liability and an undeniable track record for addiction development.
- People who stop using MDMA experience a powerful crash as a result of the depletion of many neurotransmitters in the brain. If you’ve abused MDMA for some length of time, you may be taking extremely high doses of the drug, so when you stop using, the potential for adverse side effects significantly increases. To counter the comedown, some ecstasy users may start abusing other drugs to counteract these feelings.
- You can develop a tolerance to ecstasy/MDMA very quickly. Tolerance occurs when you need more of the drug to achieve the effects that you once achieved at much lower amounts or doses.
If you or someone you love struggle with problematic use of ecstasy or MDMA, call our helpline at 1-888-287-0471 for more information about your treatment options.
Inpatient and Outpatient Treatment Options
Any recovery program for substance abuse, whether inpatient or outpatient, should begin with a thorough assessment of your presenting problems, physical health, mental health, and social support system. A thorough mental health evaluation, physical examination, and the initial history that you provide serve to:5
- Identify the important personal aspects of your presenting complaint (in this case, ecstasy or MDMA abuse or addiction).
- Identify any co-occurring substance use disorders and any co-occurring psychological or psychiatric disorders such as depression, anxiety disorders, bipolar disorder, or personality disorders.
- Ascertain your physical health and identify any significant medical situations that need to be addressed.
- Determine your personal understanding of your situation, including how you feel about your drug use or abuse, whether you are motivated to get into recovery, what types of beliefs you have regarding addiction, and how many of your friends use drugs.
- Determine your social support network and attempt to use it as a strength in the recovery process.
- Understand as much as possible about your abilities, strengths, weaknesses, and attitudes toward other issues regarding your substance use.
In some cases, additional evaluation of your problem-solving, memory, intellectual ability, and academic abilities may be necessary. Combined, these intake assessments pave the way for personalizing your treatment program. No two people are alike, so everyone will require different combinations of treatment.
Many people who abuse ecstasy will benefit from an initial inpatient treatment program designed to:5
- Assist you through the early stages of recovery. Vigilant supervision and administration of any needed medications or therapy during detoxification can help you safely and comfortably navigate the withdrawal period. Inpatient withdrawal management allows treatment staff to closely monitor for and, if needed, manage any complications that arise.
- Isolate you from potential negative influences that can increase your risk of relapse. Quitting drugs on your own can be difficult. The risk of early relapse may be at an all-time high should you be struggling with intense physical and psychological effects of withdrawal. When you are in an inpatient recovery program, you have the advantage of stronger supports and treatments to assist you in negotiating this difficult phase.
- Lay the groundwork for long-term recovery and relapse prevention by getting you involved in individual therapy, group therapy, and other activities to assist in developing habits that proactively foster recovery.
- Treat any co-occurring conditions (or dual diagnosis issues) to benefit overall treatment outcomes.
Even if you begin your recovery from ecstasy in an inpatient program, you may eventually transition to an outpatient treatment program. Inpatient treatment programs are time-limited and the length of stay will often be influenced by your insurance coverage. Nearly any treatment protocol provided in an inpatient unit can also be given in an outpatient environment as well, including:5
- Outpatient detox and withdrawal management.
- Outpatient medical management for dually diagnosed mental health issues or medical conditions.
- Therapy and counseling for substance abuse, including individual therapy, group therapy, or attending both individual and group sessions.
- Family therapy for you and your family if they wish to get involved in the recovery process and address issues within your family system.
- Social support groups such as 12-step groups: These are not formally defined as therapy groups because they are typically not run by licensed professional therapists, but they can be very important in recovery because you’re able to develop a social support network through meeting others in recovery. This allows you to share and learn from each other, and support each other.
- Other types of supports and interventions as needed, given your case: These may include tutoring services for school, vocational rehabilitation to assist with employment issues, occupational therapy, and physical therapy.
If you or someone you know is abusing ecstasy and MDMA, call 1-888-287-0471 to learn more about the different types of treatment options available.
Long-Term Recovery Strategies
Your recovery is the most important thing in your life and that it makes everything else work for you. The key to maintaining long-term recovery for addiction to any drug, including ecstasy, is to stay involved in your recovery program. This includes maintaining an ongoing program of recovery that uses the principles of stress reduction, relapse prevention, and positive living learned in counseling, therapy sessions, and social support groups. One of the most common long-term recovery strategies is frequent, active participation at 12-step meetings because they’re ongoing and they allow you to maintain contacts with others in recovery. Peer support groups also help you stay focused on your own recovery, and give you the opportunity to give back to others as you become more experienced.
Other important strategies over the long-term include:
- Making a commitment to always remember that your recovery is the most important thing in your life and that it makes everything else work for you.
- Avoiding people, places, and things that are associated with your past substance abuse. Many people in recovery find they have to let go of some old friends, old hangouts, and old habits to remain drug-free. And those who make positive social contacts and develop social support in recovery often have the most success with this aspect of long-term recovery.
- In recovery, you learn to identify the triggers or predisposing conditions that can lead to using your drug of choice. A solid recovery program helps you identify these triggers and develop a strategy to address them when they are unavoidable, or to avoid them when this is a viable option. Continuing to remain vigilant to these predisposing conditions and addressing them is extremely important.
- Practicing stress-management techniques that you learn in counseling sessions; recognize the signs of stress and be proactive in addressing them.
- Keeping relatively busy: Many people relapse when they get bored or when their routine becomes stale. Staying busy can include taking up a hobby, developing a new interest, going back to school, getting into physical fitness, or getting in the meditation.
- Peroutka, S. J. (Ed.). (1989). Ecstasy: The Clinical, Pharmacological and Neurotoxicological Effects of the Drug MDMA (Vol. 9). New York: Springer Science & Business Media.
- Oehen, P., Traber, R., Widmer, V. & Schnyder, U. (2013). A randomized, controlled pilot study of MDMA (±3, 4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD). Journal of Psychopharmacology, 27(1), 40–52.
- United States Drug Enforcement Administration. (N. D.). Drug scheduling.
- National Institute on Drug Abuse. (2016). DrugFacts: (MDMA: Ecstasy).
- Ries, R. K., Fiellin, D. A., Miller, S. C. & Saitz, R. (2014). The ASAM Principles of Addiction Medicine. New York: Lippincott Williams & Wilkins.