Glad to hear that you decided to kick the painkillers, OP. :D
As for myself...I definitely had a lot of new and exciting feelings about things that just haven't panned out in the two years since I took my first pill. Not everything can be solved by just talking it out, as I first believed. I think MDMA has a tendency to trivialize problems, because it inspires you with unnatural confidence that is difficult to summon in daily life. That said, I truly believe the realizations you come to are real; it's just that they're not as simple to apply as they seem at the time you form them.
The ideas that have stayed with me from my first roll, namely an increased belief in people's inherent goodness and a feeling that I'm not so different from everyone else, have remained because I've made an active effort to integrate them into my daily life. The same goes for every revelation, I think: no matter how blindingly brilliant it may seem, its real proof is its ability to withstand the daily grind.
The biggest danger in my mind is losing faith in your ability to hope and dream, because so many of these realizations don't pan out. You start to feel like they're just "drug ideas" and cut yourself off from a really potent source of inspiration. Everything good in life takes work, so keep working at what you learn and don't give up.
(Sorry if this sounds like a lecture; your post just made me think, heh.)