In the worst cases, a fake pill may contain drugs or chemicals that could harm you. This organization verifies Internet drugstores throughout the United States and most Canadian provinces. This may not reflect use patterns, but rather differences in the offer, legal requirement and access to drug treatment between countries. Almost two thirds (503) of all new treatment entrants were reported from three countries, Germany (213); France (169) and Hungary (121). Demographic insights obtained from drug-related emergencies are in general agreement with other data sources (see Section Prevalence and patterns of use). The median percentage of drug-related presentations involving MDMA was 4.7 % across the reporting hospitals in 2022, and 2.8 % for presentations involving MDMA as the sole drug reported.
THC Drug Test – Marijuana Urine Dip Test 50 ng/ml

When using wastewater data to estimate MDMA markets, the use of MDMA is based on the excreted parent drug, rather than on an excreted metabolite (which is the case for some other drugs, such as cocaine and heroin


Alcohol was co-consumed across 67 % of all MDMA-related hospital emergencies, and the other drugs commonly consumed alongside MDMA included cocaine, amphetamine, methamphetamine, ketamine, heroin, GHB and cannabis. The median percentage of drug-related presentations involving MDMA was 4.7 % across the reporting hospitals in 2022, and 2.8 % for presentations involving MDMA as the sole drug reported. For example, in Germany, MDMA was mentioned in 1 in 25 fatal overdoses in 2022, with most of the cases involving multiple drugs. This increase coincided with a period of increased purity and availability of MDMA in these markets, suggesting that changes in MDMA supply may result in serious public health risks. Furthermore, when factoring in the higher price of MDMA in Sweden, the market value in Stockholm is about 3.5 times that of Brussel


However, royalmedspharma.com from 2019 onwards, the quantity of MDMA found in tablets appears to have slightly decreased. However, larger seizures of these mixtures have also been reported in the European Union. These detections have generally been small in quantity with the powders containing a range of different substances – always ketamine and MDMA, and typically additional substances including cocaine, caffeine or cathinones. The majority of these identifications were reported by Spain, although pink powders have also been reported in Czechia, Germany, Estonia, Hungary, the Netherlands, Austria, Poland, Romania, Sweden and Norway. Throughout 2021, and continuing into 2022 and 2023, a number of detections of pink powders consistent with tucibi were reported to the EU Early Warning System. Tuci or tucibi products can also be sold under the name ‘pink cocaine’ despite rarely containing 2C-type phenethylamines or cocaine.
Wastewater-based methods
For the six countries that reported data for 2022, prices for tablets varied from EUR 733 to EUR 7 228. Tablets containing more than 150 milligrams of MDMA are considered high-strength ecstasy tablets, given the dose of MDMA required to elicit subjective effects in adults (a). On occasion, exceptionally high-strength ecstasy tablets were reported, reaching upwards of 250 milligrams of MDMA per tablet, which made up 1 % of all tablets tested in 2023 (3 % in the same period in 2022). In 2023, 39 % of the MDMA tablets tested by drug checking organisations submitting data to the TEDI network contained between 100 and 149.0 milligrams of MDMA (35 % in the same period in 2022), and 26 % contained between 150 and 199.9 milligrams (29 % in 2022).
Increased ener


Some of the price disparity may be attributed to local factors, including distance to the producing centres (Netherlands and Belgium), but statistical artefacts (e.g. small sample sizes) may also be a factor. Individual factors and sex affect this dose, with women considered to be more susceptible to the 5-HT-releasing effects of MDMA (Liechti et al., 2001). Harm reduction responses, including the provision of drug-checking services and appropriate risk-communication strategies, are crucial to minimise these risks. This is consistent with law enforcement information that suggests the MDMA market in Europe is supplied by the same pool of producers, mostly based in the Netherlands and Belgium. It should be noted that this trend was observed across several countries in Europ

You can access data by country by clicking on the map or selecting a country from the dropdown menu. Looking at longer-term trends in wastewater analysis, in most cases the levels increased between 2011 and 2016, and have since fluctuated. The data show that large quantities of MDMA are used in cities in Belgium, Czechia, the Netherlands, Spain and Portugal. The latest available data suggest royalmedspharma.com an overall relatively stable level of consumption of MDMA in the European Union, although there are variations at national level. 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). Profits generated by the sale of MDMA tablets are expected to be significant given the volume of the trade.