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Aftercare & RecoveryMDMA (Ecstasy/Molly) Withdrawal & Detox
Written by Megan Hull
& Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS, CACP
Medically Reviewed
Up to Date
Updated 03/10/2022
Key Takeaways
- Other street names for MDMA are Molly, Ecstasy, X, and Adam.
- MDMA is both a stimulant and hallucinogen (psychedelic).
- MDMA has a high potential for abuse and addiction because its withdrawal symptoms can cause people to crave the drug.
- MDMA withdrawal can last between 1-4 weeks.
- MDMA withdrawal can be unpredictable because of the unpredictability of what each pill contains.
- People can detox from home, but it is generally safer to undergo medical detox, whether inpatient or outpatient.
Ecstasy, or Molly, can cause unpredictable withdrawal symptoms because it is often mixed with other addictive drugs.
MDMA is the chemical shorthand for the drug 3,4-methylenedioxymethamphetamine. Other names that MDMA goes by include: Molly, Ecstasy, E, X, and Adam.
MDMA is famous for being a drug used at raves and in club settings. It is both a stimulant and a psychedelic (or hallucinogen), so it both gives people energy and changes how what their senses perceive.
Someone on MDMA may see colors and hear music differently, often making the experience more pleasurable. Changes to sensory perception are by raves focus so much on vivid colors and music as part of the experience.
MDMA also increases feelings of empathy and closeness towards others.
MDMA is a Schedule I medication according to the Drug Enforcement Agency (DEA), meaning it has a high potential for abuse and addiction and no recognized medical usage.
People who become addicted to MDMA will experience withdrawal symptoms if they stop using the drug. An inability to stop a drug is called dependence and may require MDMA detox.
What is Ecstasy Withdrawal?
Addiction to a drug like MDMA develops when someone becomes stuck in the cycle of euphoria, crash, and craving. MDMA causes intense euphoria followed by a crash for several days because it depletes neurotransmitters like serotonin, dopamine, and norepinephrine. Uncomfortable symptoms of a crash then fuel craving because a person wants to stop the negative symptoms.
Once addicted to MDMA, brain cells become used to heightened levels of serotonin, dopamine, and norepinephrine. In response, brain cells adjust to the drug and produce less of these neurotransmitters. This adjustment is called dependence.
Once dependent, stopping MDMA causes MDMA withdrawal symptoms because the brain cells are producing fewer neurotransmitters than they need.
Ecstasy Withdrawal Symptoms
Since Ecstasy affects so many systems in the brain, it causes a wide range of withdrawal symptoms. Some of the most common Molly withdrawal symptoms include:
- Aggression
- Depression
- Fatigue
- Hallucinations
- Heart damage
- Irregular heartbeat
- Irritability
- Loss of impulse control
- Panic Attacks
- Problems with memory and attention
- Suicidal thoughts
- Trouble sleeping (insomnia)
How Long Does Molly Withdrawal Last?
The half-life of MDMA is about 6-9 hours, meaning half of a dose is broken down by the body in that amount of time. To completely remove MDMA, most need about 30-45 hours or just under two days.
Depending on the level of addiction, withdrawal symptoms may begin immediately after stopping MDMA or a few days later. People with very severe addictions need to keep using the drug just to prevent withdrawal.
Molly Withdrawal Timeline
0-2 days
This is the initial detox period and when MDMA is being metabolized from the body. Most people will not begin withdrawal symptoms at this time, but some might.
3-7 days
For most people, symptoms will peak at this time. Most commonly, people will experience fever or temperature irregularities, trouble sleeping, memory problems, anxiety or panic attacks, irritability, and irregular heartbeat. Symptoms can be very uncomfortable but are generally not dangerous.
1-4 weeks
The severity of withdrawal symptoms will begin to subside. Sleep and eating patterns should be returning to normal. Mood symptoms like anxiety and depression will stabilize as long as the person does not have underlying mental health diagnoses. Past four weeks most people should no longer experience symptoms of withdrawal.
Factors Affecting Ecstasy Withdrawal
The single biggest complicating factor of Ecstasy withdrawal is that it is usually not pure MDMA, but a mixture of multiple drugs. Law enforcement has found that when someone buys Ecstasy, they are only getting a tablet or capsule with MDMA about 60% of the time.
When MDMA is actually in the mixture, there are often other drugs mixed in as well. Ecstasy tablets have been found to contain ketamine, MDA (a designer drug similar to MDMA), cocaine, methamphetamine and synthetic cathinones (“bath salts“).
A few other factors affect Ecstasy withdrawal as well, including:
Additives
Drugs like methamphetamine and cocaine may be mixed into Ecstasy and have a higher potential for addiction and harm than MDMA alone. Mixtures of multiple stimulants will cause more damage to the heart, kidneys, liver and other organs than the stimulants by themselves. Someone addicted to multiple drugs will also experience longer and more severe withdrawal symptoms, depending on the combination.
Dosage
Dosage plays a small roll in the severity of withdrawal symptoms because in general if someone is addicted to MDMA, they are not taking small doses.
Frequency of Use
More frequent usage will prolong withdrawal symptoms, sometimes from just a few days to up to a week.
How to Detox from Molly
The safest way to detox from Molly is to get in touch with addiction medicine professionals and enter a medical detox program. While withdrawal from MDMA is generally not life-threatening, it can affect many organ systems and cause potential harm. Entering medical detox will ensure that a team of clinicians can monitor for and prevent permanent damage to the kidneys, heart, and liver.
The “crash” and mood symptoms of MDMA can be very severe, and people withdrawing are at an increased risk of depression and anxiety symptoms, which may lead to suicidal thoughts or actions. Medical detox will also monitor for these symptoms.
Also, If any other drugs were present in the Ecstasy pills, these could be identified with drug testing techniques.’
Treatment centers provide a safe environment to detox from the harmful effects of MDMA withdrawal.
When someone enters a facility for medical detox, they are encouraged, but not required, to continue on with substance use disorder (SUD) treatment after detox. However, if someone is not ready to treat addiction, most facilities will still provide detox services.
Related Topic: Hallucinogen detox
Treatment centers provide medically assisted detox with trained addiction professionals. Detox from the ingredients in Ecstasy can be not only uncomfortable but medically dangerous as well. Medical teams can ensure that detox and withdrawal happen as safely as possible.
An inpatient facility is where a person stays at a treatment center through the duration of the detox process. Inpatient is more appropriate for people with severe substance use disorder (SUD), co-occurring mental health diagnoses or mild medical complications needing continued monitoring.
Outpatient treatment usually happens with the supervision of a physician, but the person stays living at their home at the same time. Outpatient detox is appropriate for people with mild withdrawal symptoms and no medical complications.
Finding a Detox Center
For those living in Florida, The Recovery Village Palm Beach at Baptist Health has inpatient and outpatient services for people with SUD, whether with MDMA, alcohol or another drug.
The Recovery Village Palm Beach at Baptist Health also has treatment facilities located across the country, and resources are available in many states.
Each person has different needs in a detox center and should consider locations, cost, available programs, and long-term support services in their decision.
View Sources
Drug Enforcement Administration. “3,4-Methylenedioxymethamphetamine.” 2013. Accessed Aug 12, 2019.
National Institute on Drug Abuse. “MDMA (Ecstasy/Molly).” 2019. Accessed Aug 12, 2019.
National Institute on Drug Abuse. “What Are the Effects of MDMA?” 2019. Accessed Aug 12, 2019.
Toxnet. “3,4-Methylenedioxymethamphetamine.” 2019. Accessed Aug 12, 2019.
Saleemi, Sarah, et. al. “Who Is ‘Molly’? MDMA Adulterants by Product Name and the Impact of Harm-Reduction Services at Raves.” Journal of Psychopharmacology, 2017. Accessed Aug 12, 2019.
Authorship
Editor - Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read More
Medical Reviewer - Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read More