MDMA Ecstasy Official Website
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
MDMA is reported in small numbers of drug-induced deaths, and in most countries less than 1 in 20 cases involve the drug. While affected by limitations and uncertainties, this type of data analysis shows great promise as a complementary information source to monitor the size and changes in drug markets (Quireyns et al., 2023). It was possible to construct estimates of city-level MDMA market sizes by combining wastewater data with country-level data for average retail purity and price. Demand-based estimates may underestimate the size of drug markets for a number of reasons, including difficulty reaching some groups of users, and underreporting of prevalence and quantities used by respondents. Estimates of amounts used suggest that about 72.4 million ecstasy tablets were consumed in the European Union in 2021. In the case of Belgium, Czechia, France, Luxembourg, Malta, Norway and Portugal, no recent data for last month prevalence of MDMA were reported, so data were impute
General / Short-Term Effects
MDMA is reported in small numbers of drug-induced deaths, and in most countries less than 1 in 20 cases involve the drug. While affected by limitations and uncertainties, this type of data analysis shows great promise as a complementary information source to monitor the size and changes in drug markets (Quireyns et al., 2023). It was possible to construct estimates of city-level MDMA market sizes by combining wastewater data with country-level data for average retail purity and price. By combining these data, the estimated annual value of the royalmedspharma.com retail market for MDMA in Europe is at least EUR 594 million, around 90 % of which can be attributed to frequent user
While a slight decrease in price was observed in 2022 for ecstasy tablets, this may not be statistically significant or sustained in the coming years. In fact, it could be argued that MDMA in the form of ecstasy tablets became cheaper between 2012 and 2019 as tablets containing larger quantities of MDMA became increasingly available on the market (see Section The trend of large tablets containing more MDMA may be reversing). For countries reporting data in 2022, a considerable retail price range was observed, with prices per ecstasy tablet ranging from EUR 4 to EUR 19 (mean) and prices of MDMA powder from EUR 6 to EUR 50 per gram. Occasionally, tablets containing 250 milligrams or more of MDMA are encountered on EU drug markets. This trend may be a combination of the scheduling of PMK glycidate, and a reduction in demand for MDMA during the COVID-19 pandemic, and is in line with the changes observed in the adulteration of ecstasy tablets (see Section Ecstasy adulteration is responsive to market pressures). This means that the ratio of MDMA to fillers (excipients) in the mixtures used to make ecstasy tablets did not increase over this time period.
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
Tuci or tucibi (also spelled tusi and tusibi) are phonetic transliterations of ‘2C’ (a series of psychoactive phenethylamines) or ‘2C-B’ (one of the most well-known derivatives of that series of substances). These signals were reported to the EU Early Warning System from 2022 onwards, based on identifications occurring in Spain, the Netherlands and Austria, and there are similar indications for the United Kingdom (Pascoe et al., 2022). One relatively recent adulteration pattern is the increase of synthetic cathinones mis-sold as MDMA or used to adulterate MDMA. Interestingly, synthesis by-products were also commonly reported, about which little is known and which may pose additional risks to consumers.
Increased ener