Ecstasy addiction symptoms and signs of use

12Physical signs during ecstasy use

• Clearly dilated pupils, sometimes with sensitivity to light.
• Jaw clenching, teeth grinding and repeated chewing movements.
• Heavy sweating and a hot body, or chills.
• Racing heartbeat and a slight tremor.
• Nausea or poor appetite.
• Blurred vision or rapid involuntary eye movements.

13Behavioral and psychological signs

Ecstasy changes behavior in a way that may seem "nice" at first, which is why families sometimes do not notice it:

14What do you notice in the days after use?

One of the clearest signs is a repeating pattern: a holiday or a party, then two or three days of obvious change in mood and energy. The family may notice:

• Sadness, listlessness or unexplained crying in the middle of the week.
• Irritability and a short temper, and difficulty concentrating and studying.
• Long sleep or insomnia, and poor appetite.
• Jaw pain or small sores inside the mouth from grinding.

These signs alone do not prove use, but their repeating after parties and nights out is worth a calm conversation. What happens when the drug is stopped completely is described on the page about ecstasy withdrawal symptoms.

15Indirect signs at home

• Colored pills with logos on them, or small bags containing powder or crystals.
• Excessive attachment to nightclubs and festivals, and coming home late, worn out.
• Repeated requests for money with no clear reason.
• New friends he avoids talking about.
• Constant use of gum or lollipops, or devices to protect the teeth, with no medical reason.

16Signs that the situation is dangerous right now

Some of what you may notice during use is a warning of a complication that needs immediate emergency care, as well as being a sign of use:

• Very hot skin with confusion, or sweating that has stopped.
• Severe headache and repeated vomiting after drinking a lot of water.
• Muscle stiffness, severe tremor or seizures.
• Chest pain or a very fast heartbeat.
• Severe agitation, frightening hallucinations or loss of consciousness.

In any of these cases call an ambulance (123) immediately, and do not wait for them to "come around" on their own.

17Why is ecstasy use hard to detect?

Ecstasy differs from many substances in that it is usually taken on occasions spread far apart, outside the home, leaves no smell like hashish or alcohol, and its effect is over within hours. The behavior of the person during the effect also looks friendly and cheerful, so it does not raise alarm. That is why families usually notice the pattern, not the moment: the repeated comedown after parties, and the gradual change in friends, interests and money.

18When does use become addiction? Diagnostic criteria

Doctors rely on the DSM-5 diagnostic criteria for substance use disorder. In brief they include the following, and the disorder is usually diagnosed when two or more are present within a year:

1. Using more, or for longer, than the person intended.
2. A wish to stop, or failed attempts to cut down.
3. Spending a lot of time obtaining the substance, using it or recovering from its effects.
4. A strong, urgent craving to use.
5. Failing to meet obligations at school, work or home.
6. Continuing despite relationship problems caused by use.
7. Giving up important activities in favor of use.
8. Using in physically dangerous situations.
9. Continuing despite knowing that it causes or worsens a physical or psychological problem such as depression.
10. Tolerance: needing more to get the same effect.
11. Psychological and physical symptoms on stopping.

19How do you tell ecstasy from other substances?

Because pills are often adulterated with methamphetamine or other substances, signs may be mixed; only the doctor can identify the substance through assessment and testing.

20Symptoms of ecstasy use in teenagers

It is sometimes hard to tell teenage mood swings from drug use, but these signals deserve attention: a sudden drop in school performance, staying out late at parties the family knows nothing about, a change of friends, extreme secrecy about the phone, and sharp mood swings that repeat on particular days of the week.

21After you notice the signs: what is the next step?

1. Calmly note what you see: the changes, their timing, and how they relate to going out and parties.
2. Talk with your partner or another trusted family member so you agree on one approach.
3. If you are hesitant, ask for a specialist family consultation before confronting.
4. Choose a calm time for the conversation, away from the day of the party and the day after.
5. Offer help and a specialist assessment rather than punishment alone.

Do not busy yourself with proving the use; aim for a specialist assessment that establishes the size of the problem and the way to treat it.

22How do you talk to someone you suspect is using ecstasy?

What the first conversation needs to do is open a door that stays open, not end in a confession; if the young person feels safe, he will come back to you when he needs help.