What to Do If You Can’t Sleep on MDMA

When Ciara Robertson had her first taste of MDMA at 20 years old, she expected to have the time of her life. She and a co-worker met up at a Brooklyn apartment and popped a pill sometime around 9 p.m. “My co-worker was saying that it would make me feel really happy and really good and really warm,” she told VICE. But after a couple of hours, Robertson said, “I didn’t feel any of that. All I felt was awake.”

Later that night, Robertson tried desperately to fall asleep. What she was experiencing was not excited or giddy wakefulness but what she described as a “cracked out” state: Her body was exhausted, and she wasn’t up by choice. By the time she finally fell asleep, she had been up for 36 hours straight. That’s the thing with MDMA: It’s all fun and games until it’s time for bed.

The science behind MDMA and sleep

Assuming that you’re not getting 100 percent pure MDMA straight from a research lab, you’re probably getting it on the street in the form of molly or ecstasy. Molly and ecstasy are essentially the same unregulated varieties of MDMA—molly comes as brown or white crystal powder that is sometimes stuffed into see-through capsules, while ecstasy comes as pressed tablets. 

According to the National Institute on Drug Abuse, ecstasy is often cut with substances other than MDMA, including amphetamines, heroin, and caffeine. Molly, which is often erroneously thought of as a purer form of ecstasy, is often cut with other stimulants, including methylone, a psychoactive drug found in bath salts. The amalgamation of mystery chemicals found in street drugs likely contributes to why you can’t fall asleep, so try to test your MDMA to ensure you’re not staying awake for the wrong reasons. 

But make no mistake: It’s also the MDMA keeping you up. The drug promotes the release of a few neurotransmitters of the brain: dopamine, which is responsible for motivation and attention; norepinephrine, which increases alertness and influences the sleep/wake cycle; and serotonin, which plays a key role in mood regulation and sex drive. But MDMA is not just helping to release these chemicals—it’s also blocking their reuptake, which means they’re not being reabsorbed or broken down as they should be, causing a gnarly bottleneck in the synaptic cleft that makes you feel all those euphoric effects all at once, per the NIH

“Your body has secreted so much serotonin and dopamine that it gets tired of making it.”

Norepinephrine, the neurotransmitter responsible for increased heart rate and elevated breathing, is the main reason you can’t fall asleep long after feelings of deep joy have passed. “Your body has secreted so much serotonin and dopamine that it gets tired of making it,” explained Khary Rigg, an Associate Professor at the Department of Mental Health Law & Policy at the University of South Florida. “Its reserves are depleted, and the brain is like, OK, we don’t need to be secreting these chemicals at the level that we were.” 

Although recovery depends on how much MDMA you took, there is no data that definitively says when, exactly, your brain gets back to normal. Studies done on primates and mice have found that it can take weeks, months, or even years. According to Rigg, 30 days is a good benchmark for the brain to get back to where it was before the drug was taken. During this lengthy recomposition period, your brain tries to re-balance its serotonin system and restock on serotonin transporters, a protein essential for regulating and recycling the neurotransmitter.  

It’s imperative to remember that it’s not your fault if you can’t sleep—the chemicals in your brain are pretty screwed up right now. So… where do we go from here?

Possible ways to make it better 

A few years ago, when she was a sophomore in college, Abigail Eastman went to a FISHER concert and took “just a little bit” of ecstasy, she said. When she got home from the concert at 2 a.m., she lay on her couch, wide awake. She stared at a wall for eight hours straight, trying to fall asleep. “It was really miserable. All I wanted to do was go to bed, and my body was exhausted, and nothing was going through my brain, but I physically couldn’t sleep,” she said. She got up and had another full day before finally crashing 26 hours after taking the pill. Eastman said that to eventually fall asleep, she smoked weed and took a 5-HTP supplement, which is available in pharmacies like Walgreens and helps increase serotonin levels. Eastman says that both helped her feel more restful. 

What about benzos? “Benzodiazepines are one of the drug classes known not to interact well with MDMA and are associated with a higher risk of death,” Rigg said. “Other drugs people should avoid when coming down from MDMA are opioids of any kind, muscle relaxants, and alcohol.” James Giordano, a professor of neurology and biochemistry at Georgetown University Medical Center who has studied MDMA extensively, agreed that there’s a higher risk of misusing benzodiazepine during an MDMA trip, but he did say it’s probably safe to take one after the acute effects of MDMA have worn off. 

“Don’t sweat it—you’re gonna fall asleep. It may not be today, but you are gonna fall asleep.”

Melatonin, commonly known as the sleep hormone, is probably safe to take, according to Giordano. “Taking a melatonin supplement carries very little risk, although some individuals will have a blunted response to melatonin during the MDMA crash,” he said. 

Benadryl, which is an antihistamine, might not be the worst idea either, Giordano added. That’s because after taking MDMA, “Individuals have an increase in the brain levels of histamine, which is an excitatory chemical in the brain,” he said. But he clarified that, even after taking an antihistamine, it’s unlikely anyone coming down from a trip will be able to fall asleep immediately. The goal shouldn’t be to catch some Z’s but more to relax so that you don’t panic about your inability to sleep: “Let your body [replenish] the levels of serotonin, and as those levels of serotonin come back to their normal functional range, your sleep cycle will readjust.”

In your quest to fall asleep, one of your goals should be making your MDMA-induced wakefulness as pleasant as possible so that your anxiety doesn’t keep you up longer than necessary. Chelsea Rose Pires, a licensed therapist and Executive Director of the Zendo Project, an organization specializing in harm reduction around psychedelics, recommends making sure you’re in a good headspace before taking MDMA. People are more likely to get desperate about their inability to sleep when they are having negative thoughts, so it’s also good to have an emergency plan that includes a sober person you can call if you’re freaked out. When I asked her about “bad trips,” Pires said she prefers to call them “difficult trips” instead. “Difficult is not necessarily bad,” she said. “Those experiences can be opportunities for learning and growth when we embrace them and move through them.”

Acceptance

So now you’re here, still up and resigned to the fact that it’s going to be a while before you get some restful sleep. Create a chill environment around yourself. Put on your favorite cartoons, or listen to your favorite album. Journal, if that’s your thing. Chances are that if you’re coming down from ecstasy, you’re also starting to feel a little lonely, which Giordano called the “MDMA crash hole.” This is happening because your oxytocin and dopamine systems, which aid in feelings of closeness and belonging, are also out of whack. If anyone you trust is still awake, call them. 

Don’t beat yourself up for not being able to fall asleep—it’s only going to foster cycles of negative thinking. “Some people respond to insomnia with a lot of anxiety, and it gets to be a feedback loop: Insomnia causes anxiety, anxiety worsens insomnia,” said Rick Strassman, an adjunct associate professor of psychiatry at the University of New Mexico School of Medicine.

I can certainly relate. Recently, I went through a trip that took weeks to recover from, including an entire weeknight spent trying to convince myself that I was asleep when I wasn’t. Sleep came a day later when I accepted that I would be up for however long the drug wanted me to be. “The important thing to understand here is don’t sweat it—you’re gonna fall asleep. It may not be today, but you are gonna fall asleep,” said Giordano.

The bottom line is if you’re wide awake on MDMA and want desperately to sleep, buckle down and try to relax your body. Think about other things besides sleep. Maybe take a Benadryl but definitely avoid doing more drugs, no matter how miserable you might feel now. Remember that sleep is not only possible—it’s inevitable.

VICE US