Ecstasy (MDMA) is not a common drug for primary addiction. There is no specific treatment; rather, general methods of treating addictive behavior are the rule.
The first step (along with abstinence) is to identify the reasons for taking the drug and see how those problems can be addressed in other, more healthy ways. Because ecstasy is taken to overcome social anxiety and shyness, this is good place to start.
Addiction is more than just using the drug to enjoy an occasional party. To rise to the level of an addiction, users have to feel dependent on the drug. Treatment will focus on overcoming this need.
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Complete physical recovery from chronic ecstasy use is likely to take weeks to months. This is because the drug alters neurological pathways in the brain, and these need time to return to normal. Although there are no specific medications to help this, it is thought that SSRIs might be useful in the treatment of ecstasy addiction.
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Acute withdrawal is usually fairly short and the major symptoms are fatigue, depression and anxiety. These might be treated pharmacologically if a physician determines they are clinically significant. Patients should be evaluated for liver function and damage to the teeth (from teeth grinding during sleep) as part of their treatment.
Long term abstinence is difficult to maintain, not because ecstasy is necessarily so addictive, but because it has a reputation for being a safe drug and because users may feel strong peer pressure to use again. Ecstasy is not safe and patients should be taught how the drug causes changes in the brain as well as known dangers from MDMA. Education is part of Cognitive Behavioral Therapy (CBT). The goal of CBT is to change the user’s response to cravings and pressure to abuse.
Support groups are also a recommended treatment, and Narcotics Anonymous will allow ecstasy addicts to attend meetings. This style of group therapy is valuable because it not only connects users with others who are combating addiction, but also as a replacement peer group. Avoiding situations where ecstasy is available and ‘normal’ is very important and one of the best ways to avoid awkward situations is the simple statement, “I’d like to, but I have to go to a meeting.”
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