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 individual. Harm reduction responses, including the provision of drug-checking services and appropriate risk-communication strategies, are crucial to minimise these risks. Some tablets even contain stamping that indicate the quantity of MDMA present, although this is not always accurate and may also constitute a health risk. For example, in August 2023, tablets containing 350 milligrams of MDMA were seized in Spain.


It’s important to be careful when taking any type of drug. This makes it hard to know what reactions to expect after taking MDMA or if negative side effects will be experienced. RAND is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. In essence, cryptomarkets have grown at a fairly decent rate since 2013, but their global impact could be overstated — for now. The specialization also reflects the interconnection of physical and virtual drug distribution channel


A study conducted by 10 drug-checking organisations from the TEDI network found that the increase in MDMA content in tablets in this time period was directly related to an increase in the average weight of ecstasy tablets (Vrolijk et al., 2022). The average content of MDMA in ecstasy tablets appears to be on a slight downward trend from 2019, after close to a decade of increasingly stronger (and larger) tablets becoming available on the market. On occasion, neurotoxic compounds such as PMMA (5) are detected mixed with, or as a replacement for, MDMA in ecstasy tablets. From 2019 onwards a new cycle appears to have begun, whereby the number of ecstasy tablets containing other substances alongside, or instead of, MDMA has increased (as expressed by a drop in percentage in the indexed trends shown above from 96 % in 2019 to 73 % in 2022). Crystal MDMA was marketed as a purer product compared to ecstasy tablets, an assertion that was and remains largely true (see Section The trend of large tablets containing more MDMA may be reversing). One way to observe these cycles is to monitor rates of adulteration, as expressed by the percentage of tested samples of seized ecstasy tablets that contain MDMA and no other royalmedspharma.com scheduled substances.
Wastewater-based methods
Although often used interchangeably, ecstasy and MDMA are not necessarily synonyms. Additionally, particularly with instant messaging applications, transactions may be organised online, but completed using in-person pick-up or ‘dead-drop’ delivery. This appears to be supported by existing studies that indicate that MDMA is bought online mostly by retail distributors for the purpose of re-sale rather than purchased directly by retail clients (Aldridge and Décary-Hétu, 2016; Gremeaux, 2022). Data collected from individuals submitting MDMA samples to drug-checking services between 2019 and 2022 appear to support these findings from the EWSD.
Increased ener

Again, these data should be interpreted with caution and not necessarily be seen as statistically representative of the market as a whole. Crystal MDMA appeared on the European market at that time, as a response to a fall in consumer confidence due to concerns about the low quality of ecstasy. However, adulteration is commonplace, and therefore these tablets may contain a variety of substances in addition to, or instead of, MDMA. Based on reporting from drug-checking clients, the majority of samples were reported as being obtained from a supplier (either a trusted supplier or a random street supplier) and a smaller proportion (close to 5 %) as bought on the internet (surface web or darknet).


For some countries (Belgium, Croatia, Denmark, France, Malta, Netherlands, Norway and Türkiye) no data were available from the EWSD. The annual amounts used, in tablets, could be estimated for each survey participant based on their responses to questions on the number of tablets used on a typical day, multiplied by the number of days they said they used the drug in a year. As such, only last year prevalence and last month prevalence data are required to distinguish these two groups. Prevalence rates of the number of MDMA users, obtained from general population surveys, are multiplied by 2021 Eurostat population data of the age group. Wastewater data also reflect the predominant use of ecstasy in recreational settings, with more than three quarters of cities reporting that higher loads of MDMA were present in wastewater during the weekend than during weekdays in 2022. While the number of tablets used per session has not changed substantially from literature findings dating from several decades ago, today’s MDMA users generally ingest higher quantities of the psychoactive substance than before (Gremeaux, 2022