While individual tablet weight cannot be a direct predictor of how much MDMA is present in each tablet, at population level this trend is consistent when comparing larger ecstasy tablets (almost always containing more MDMA) with smaller tablets (almost always containing less MDMA). This means that consumers buying ecstasy tablets in Europe in 2019 would obtain a product containing up to almost double the highest amount of MDMA recorded in ecstasy tablets in 2011. In Australia, in January 2024, potent opioids of the nitazene family were found in brightly coloured tablets with logos reminiscent of ecstasy tablets. In tablets, adulterants typically include stimulants and MDMA-type substances – other phenethylamines with comparable subjective effects, such as MDA (3). Caffeine is the adulterant most commonly found in ecstasy tablets as well as in MDMA powders and crystals. Adulteration appears to be more frequent in ecstasy tablets than in MDMA crystals.
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Estimates of amounts used suggest that about 72.4 million ecstasy tablets were consumed in the European Union in 2021. The total quantity of MDMA consumed in Europe is reached by multiplying the number of users by the amount used, combining prevalence data from general population surveys and the amount used from the EWSD. Information gathered in the 2021 EWSD suggests that, on average, those who reported having used MDMA in the last 12 months, consumed one ecstasy tablet or 0.4 grams of MDMA in crystal or powders form each time they used the dru


Adaptations in the behaviours of people who use MDMA shows that they are able, willing and indeed eager to minimise their risk exposure where possible. The demand for stimulants in social environments appears to be resilient more broadly, even in the face of such market shocks. Options for future regulated online sales exist but need to account for problems such as the lack of face-to-face interaction with a vendor (and the potential loss of key tailored harm reduction which can be given in person), and meaningful enforcement of age controls. The pull factors of the darknet in the current illegal market highlight important challenges for a regulated market. This is up from 48.7% in 2015, when the percentage was also higher than for any other dru


According to survey data, the two largest MDMA consumer markets per capita in the European Union are the Netherlands and Ireland, with 6 % or more people aged 15 to 34 reporting to have consumed MDMA in the last year. Some of the high-strength ecstasy tablets are scored to allow consumers to divide them into smaller portions. These identifications of high-strength ecstasy tablets prompted harm reduction organisations to issue alerts. In December 2023, beige-golden ecstasy pills with an Audi-logo containing over 300 milligrams of MDMA (between 316 and 324 milligrams) were submitted to drug testing in the Netherlands (DIMS, 2023). However, this trend appears to be changing, as ecstasy tablets have tended to contain less MDMA since 201


From 2004 to 2009, the proportion of seized European ecstasy tablets that contained MDMA as the only scheduled substance dropped substantially. When availability of MDMA is high, ecstasy tablets tend to contain MDMA as the main or only psychoactive ingredient, with the opposite occurring when there are shortages. An equal percentage of respondents reported delivery through regular mail or post, and picking the drugs up from a location without any personal contact (7 %). More than three quarters of EWSD respondents (77 %) reported meeting their dealer outside as the usual method for receiving drugs, followed by home delivery (17 %). Web-based surveys, such as the EWSD, can provide a helpful insight, although the results cannot be generalised to the population as a whole, or indeed to all people who use drugs.
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Given the option, it is clear that people who use MDMA and other drugs will embrace harm reduction approaches, and support their development. Harm reduction is not a principle that policy makers will need to force upon people who use MDMA or other drugs in nightlife and party settings. Significant numbers of people not only like MDMA’s effects and are willing to take known risks (health and legal) to enjoy them, but they seem to prefer it to most available substitutes. Perhaps most obviously it demonstrates, yet again, the futility of putting enforcement, targeting either people who use or supply, at the forefront of the policy response to drugs. The EMCDDA also reported in 2019 that ‘transactions involving quantities of MDMA tablets mdma for sale online indicative of the middle level of the market account for more than double the revenue of sales of retail-level quantities’.
MDMA rarely cited as a reason for entering drug treatment in Europe
Consumers in the Netherlands will typically pay EUR 4.50 per tablet but, as stated above, prices may reach as high as EUR 19 mdma for sale online per tablet in some European countries, and more in other regions of the world. According to Dutch Police, these tablets are sold to distributors at EUR 0.59 per unit (2022 values), who in turn re-sell them at EUR 1.78 each (for quantities above 99 tablets). The subsequent drop in MDMA content in tablets since 2019 does not appear to have been accompanied by a significant drop in price. In 2021, adult respondents to the EWSD reported paying a median of EUR 7.20 per ecstasy tablet and a median of EUR 37.40 per gram for MDMA powder. (a) In clinical trials, doses of MDMA capable of producing subjective effects vary from 1.5 to 1.7 mg/kg of body weight, or approximately 105 to 119 milligrams for a 70-kilogram individua