This article was first published June 10, 2021.
MDMA is known for its brutal comedowns. But when it’s used in research, participants don’t report any comedowns at all. So what if it’s not the drug that gives comedowns, but instead the way people take it?
Jack* wakes up alone in the passenger seat of his shitty white Honda. His jeans are completely soaked through, enough for him to actually lower his head and slowly bend his knee towards his nose to smell them.
It’s not piss. But they don’t smell good.
“I woke up and it literally felt like I was melting,” he says. “I was sitting in my car dripping and shivering. Rocking back and forth, practically vibrating with the worst heart palpitations and depression I have ever felt. I didn’t know what to do with myself.”
This day is seared into Jack’s brain as “the worst fucking comedown I’ve ever had”. A mixture of MDMA pills, Ritalin, and alcohol left him looking and feeling like a damp smooshed shell of his past self.
Anyone who has taken some version of a “party drug” has probably experienced a comedown.
A comedown is a self-inflicted and temporary punishment for messing with your brain chemistry. For some, it’s no worse than a sluggish hangover, but for others, it can be a pretty traumatic state of anxiety, depression, insomnia, depersonalization, or the whole lot all at once.
It’s become universally accepted that in order to feel on top of the world one night you have to feel like absolute garbage for the next day or two…or week.
Jack remembers one of the first things someone ever told him about MDMA was that it was like “borrowing tomorrow’s happiness”.
“But the kind of ‘borrow’ where you never see it again,” he says.
Even international research into MDMA usage colloquially refers to comedowns as ‘Suicide Tuesdays’, which when you think about it, is pretty fucked up.
But the feeling is real.
“For days my head was twisted,” says Jack. “I actually started to feel really uncomfortable and unsafe about the way I was thinking.”
“Like I rationally knew why I was feeling so dark, but I just got stuck in this circling thought pattern where I didn’t like myself, and really doubted myself. It actually scared me how real it felt. I thought it could have lasted longer.”
What’s interesting about the drug MDMA is that in its purest form it can actually be used to help treat severe mental health conditions like chronic depression and post-traumatic stress disorder (PTSD). But the way it is taken recreationally can cause completely the opposite effect.
Using MDMA in research
A recent study in the U.S. found MDMA-assisted therapy significantly reduced symptoms of severe PTSD.
In the study, 90 people with PTSD were randomly assigned to have therapy sessions either while on MDMA or a placebo. Researchers found the group that was given MDMA had a greater and more "robust" reduction in symptoms over 18 weeks, even among people with associated conditions like childhood trauma, dissociation, and depression which make PTSD harder to treat.
Interestingly, none of the patients who took MDMA reported any negative comedown effects. And other research using MDMA has found the same.
So why does recreational use result in a comedown?
Re: asked a drug expert and three drug takers what they’ve learnt about comedowns (including how to take the “down” out of comedown). Here’s what they said.
- Drug users should know what they are taking, and how much.
“The biggest thing is most of us have no idea what we are taking,” says Madeleine*. “As soon as I learned how to figure this out, my comedowns are nothing like they used to be.”
Madeleine is a 24-year-old student who used to take “pressies” regularly. Pressies are a pressed party pill that is usually sold as MDMA, but more often than not is a cocktail of all kinds of things, commonly eutylone, a cathinone also known as bath salts.
In fact, 40 percent of MDMA in New Zealand last summer was actually bath salts.
Pressies can also vary hugely in strength. Often the pill could have anywhere between 50mg to 350mg of MDMA, but a person would have no idea until they tested it, or until it kicked in.
A common dose of MDMA is often between 80 to 120 milligrams, but KnowYourStuffNZ, an organisation that tests drugs, has found pills which contain three times as much.
“Hands down the worst comedown I’ve ever had, which still haunts me a little bit, was when I once did 300mg in a night in one dose,” says Madeleine. “I felt completely out of it the next day and two whole weeks later I was the most depressed I’ve ever been in my life. And I’ve been diagnosed with depression since I was 18.”
“I was so depressed my body felt like lead and I couldn’t think straight. I could barely move or anything. I spent entire days without touching the floor of my bedroom and it triggered reliving trauma I thought I had worked through.”
“The biggest reason anyone would experience such severe comedown side effects is that they're likely not taking MDMA,” says Paul Glue, a professor of psychopharmacology at Otago University. His research focuses on the pharmacology of drug treatments in psychiatry.
“When you buy MDMA the chances it is relatively pure MDMA is incredibly low, especially in pressed pills,” says Paul. “Often it is ethylone, so one of the components of bath salts.”
“While you may get that feeling of euphoria, it can have some very different effects a couple of days afterwards.”
So why did none of the patients in the PTSD study report any negative comedown effects after taking MDMA?
Paul says it’s because the subjects were probably well-rested, hydrated, and had been given a very precise and controlled dose. They were also given essentially the purest MDMA that can be manufactured.
“For a drug to be FDA-approved you have to show that you adhere to certain manufacturing principles,” says Paul. “The levels of impurities in your drug substance is either tiny or zero. Sadly drug dealers don’t need to bother with this meticulous attention to detail.”
In New Zealand, it’s now legal for users to test their drugs with services like KnowYourStuff, which can help determine what the contents really are and the potential dosage. KnowYourStuff publishes an online Pill Library which tracks pills that were sold as MDMA but contained other substances.
- Re-dosing makes a comedown worse
Another difference with how people take MDMA on a night out compared to how it's used in research is how often doses are taken.
“My friends used to literally dunk our fingers in a bag and keep dipping throughout the night,” says Emma*, a 19-year-old musician. “That’s how you learn the hard way that re-dosing makes your comedown so much worse.”
There’s science behind why re-dosing makes a comedown worse. MDMA is broken down in your body by enzymes in your liver. But one of the elements in MDMA actually stops one of these major enzymes from working. This means your body can find it harder to break down MDMA after more and more doses, which puts more stress on your body.
Which, unsurprisingly, can lead to loss of sleep, exhaustion, dehydration, and other physical effects that contribute to a punishing comedown.
Re-dosing also generally means taking a larger quantity of MDMA in total, and large doses can have a direct impact on the severity of the comedown. Just like how drinking more means you’ll probably have a worse hangover.
- Don’t come down alone
By far the most wholesome lesson we can learn from MDMA research is the value of a comedown buddy.
In the MDMA-assisted therapy study, each participant was given eight hours of “supportive therapy” which spans across the period they were high, and when they were easing out of that high. The researchers said MDMA paired with talk therapy allowed the participant to stay “emotionally engaged while revisiting traumatic experiences without becoming overwhelmed by anxiety or other painful emotions”.
While the average party-goer might not be too keen on getting high with their therapist next to them (and most people probably wouldn’t be able to foot the eight-hour session bill anyway) Paul says there is something to be said about having someone around during a comedown who is knowledgeable, comfortable to be with and who you can trust.
“Having something akin to psychotherapy to manage your reaction to some of the memories and thoughts that may come up, I think is a really important part of this,” he says. “It’s about having knowledgeable people who will support you, whatever happens through the experience.”
Paul says a big part of this is being able to ease out of a feeling of euphoria and back into reality without really even noticing. “It is no wonder people can feel depressive symptoms if they have suddenly gone from being surrounded by people they love and releasing all of this serotonin, to then suddenly being alone in their room with this feeling of being ‘back to reality’ and the ‘good times are over’.”
“Some people might also be taking it to escape pre-existing feelings of depression, so when they return to their normal state the contrast of feeling euphoric and then feeling heavy so quickly can be overwhelming.”
Jack says it makes sense some people want to come down alone because they’re exhausted, feeling irritable, and probably smell and look like shit. “But having a day or two where you are around the same people, but not on drugs can help you ease out of the comedown. You don’t get the same ruthless shock to the system.”
He says people definitely should make their comedown buddy or buddies the same people who they have been high with. “In this vulnerable state, the last thing you want to deal with is people judging your pathetic state of existence or interrogating you about what happened. You want this feeling of riding it out together.”
So maybe next time there’s a festival or have a big night out, book the extra night at an Airbnb and spend it together. Or stay the night at a mate's house and make a ridiculous amount of food together that's easy on the jaw. If the company is good enough, you might not even notice the low at all.
- Prioritise self care
Sometimes things don’t happen the way they probably “should”. Like Jack, people might not bother testing their drugs, or re-dose a bunch. Now they’re in bed or in a car, alone, feeling sorry for themselves. Shit happens.
But the good thing is, some self care can go a long way.
When you google ‘how to cure a comedown’ you get the same classic (and valid) answers: drink water, eat decent food, sleep, crack open a window and listen to some music or a shitty TV show.
Those do work. But here is a list of things that are a little more obscure, but valid in their own right.
“I’ve found that being submerged in water really helps me,” Emma laughs. “No science behind it at all. But it just works. A beach is most ideal, but even just a gym pool is sometimes enough to get that weightless feeling.”
“A good jerk often helps me,” says Jack. “It’ll either tire you out a bit so you can get some shut-eye or some dirty porn will really give you some perspective on life. You know...it could be worse.”
“Blow your nose, take a shower, then take some 5-HTP and Benadryl and you’ll make it through,” says Madeleine.
5-Hydroxytryptophan-, or as it’s often called, 5-HTP is one of the crucial things the body needs to make serotonin. But when the body is low on it, it can be bought in a bottle over the counter at a pharmacy. Ah, the joys of modern medicine. That same naturally-occurring amino acid can also be found in marmite and orange juice.
“I only ever take 5-HTP 24 hours afterwards and for about a week after using MDMA,” says Madeleine. “It just helps take an edge off the low.”
“This might sound useless,” says Jack. “But simply being aware of why you're feeling that way and knowing that it’s a chemical imbalance in your brain because you took drugs and it’s not real, really helps. Just reminding yourself of that doesn’t make it go away but for me, it makes it more bearable.”
“It just helps give you that perspective when you feel like your life is doomed. It’s actually not, it might just feel like it for a little while. But you’ll move out of it soon.”
* names have been changed
Check out the New Zealand Drug Foundation for more information on drug harm reduction.
This story is part of Re:’s Drug Week. We’re talking nangs, comedowns, decriminalisation and more.
Where to get help:
- The Ministry of Health has a list of different addiction help services here
-
Free 24-hour drug and alcohol helpline: 0800 787 0797
- 1737: The nationwide, 24/7 mental health support line. Call or text 1737 to speak to a trained counsellor.
- Suicide Crisis Line: Free call 0508 TAUTOKO or 0508 828 865. Nationwide 24/7 support line operated by experienced counsellors with advanced suicide prevention training.
- Youthline: Free call 0800 376 633, free text 234. Nationwide service focused on supporting young people.
- OUTLine NZ: Freephone 0800 OUTLINE (0800 688 5463). National service that helps LGBTIQ+ New Zealanders access support, information and a sense of community.
More stories: