Man, say, is left with ecstasy (4)
I believe the answer is:
isle
'man say' is the definition.
(Isle of Man)
'is left with ecstasy' is the wordplay.
'left' becomes 'l' (common abbreviation).
'with' is a charade indicator (letters next to each other).
'ecstasy' becomes 'e' (informal term for the drug).
'is'+'l'+'e'='ISLE'
(Other definitions for isle that I've seen before include "Land amid water" , "Land cut off by water" , "Rum, for example" , "eg Man, Ely" , "Such as Man or Bute" .)