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A review of MDMA-related mortality in Australia and three European countries (Portugal, Finland and Türkiye) showed an increase in the number of fatalities between 2011 and 2017 (Roxburgh et al., 2021).
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
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
Surrey Young People’s Substance Use Service
Smaller numbers of respondents buy ecstasy also reported using the darknet (13 %) and social media (7 %). The products had a net weight of approximately 20 grams each and contained between 130 and 176 milligrams of MDMA, evenly distributed inside the lollipops. In recent years, the appearance of alternative (non-tablet) edible consumer products containing MDMA has also been reported, including candies, jellies, gummies and lollipops (see Box 6.1. Lollipops containing MDMA seized in Belgium). More rarely, almost pure MDMA base in liquid form has been sold to consumers, which represents a serious health risk (Drugs Information Monitoring System [DIMS], 2022). Additional data were shared with the EUDA by the Drug information and Monitoring System (DIMS) in the Netherlands.
Studying the drug purchasing behaviours of users is useful for understanding market dynamics, but challenging given the clandestine nature of these transactions. The increasing use of the darknet to buy MDMA (and other drugs), and the embrace of harm reduction services such as drug safety checking, are clear indicators of this. It is clear that MDMA has a considerably more resilient popularity than any other amphetamine-type stimulant buy ecstasy or synthetic drug that has entered the market in recent history. As so often, enforcement interventions have failed to prevent rising use, or prevent supply in the longer term, instead only serving to temporarily displace using behaviours and mutate the market in ways that increased health harms. Of those who reported obtaining MDMA in the 2019 Global Drug Survey, 67% reported having obtained it through the darknet — higher than for any other dru
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. A number of substances can also be sold as MDMA, in what is sometimes called mis-selling or adulteration by substitution – whereby another substance is passed off as MDMA to the consumer. Adulteration of MDMA occurs by adding other psychoactive substances, typically stimulants, to MDMA in tablet, powder or crystal form.
Adulteration of MDMA occurs by adding other psychoactive substances, typically stimulants, to MDMA in tablet, powder or crystal form. PMK glycidate, first reported in Europe in 2013, had a particular role in this resurgence (see Section Production - designer precursors substitute scheduled MDMA starting materials). In 2009 and the following years, it was therefore unlikely that consumers who purchased ecstasy in Europe would obtain unadulterated MDMA. In 2009, on average, only 31 % of the tablets analysed contained MDMA alone, compared with almost 100 % in 2004. This includes law enforcement pressure, a variety of factors affecting MDMA production, such as the availability of MDMA precursors, and, more generally, globalisation of the illicit drug supply chain
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. Meanwhile, data from drug-checking services suggest that approximately 85 % of the powders tested in 2023 contained between 80 and 100 % MDMA (81 % in 2022). Data reported to drug-checking services are generally in agreement with these trends. The detection of mixtures of MDMA and ketamine combined with other substances including cocaine have also increased in some regions of Europe, and are sold as ‘pink cocaine’, ‘tuci’ or ‘tucibi’ (see Box 6.3. What is tucibi?
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
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
Surrey Young People’s Substance Use Service
Smaller numbers of respondents buy ecstasy also reported using the darknet (13 %) and social media (7 %). The products had a net weight of approximately 20 grams each and contained between 130 and 176 milligrams of MDMA, evenly distributed inside the lollipops. In recent years, the appearance of alternative (non-tablet) edible consumer products containing MDMA has also been reported, including candies, jellies, gummies and lollipops (see Box 6.1. Lollipops containing MDMA seized in Belgium). More rarely, almost pure MDMA base in liquid form has been sold to consumers, which represents a serious health risk (Drugs Information Monitoring System [DIMS], 2022). Additional data were shared with the EUDA by the Drug information and Monitoring System (DIMS) in the Netherlands.
Studying the drug purchasing behaviours of users is useful for understanding market dynamics, but challenging given the clandestine nature of these transactions. The increasing use of the darknet to buy MDMA (and other drugs), and the embrace of harm reduction services such as drug safety checking, are clear indicators of this. It is clear that MDMA has a considerably more resilient popularity than any other amphetamine-type stimulant buy ecstasy or synthetic drug that has entered the market in recent history. As so often, enforcement interventions have failed to prevent rising use, or prevent supply in the longer term, instead only serving to temporarily displace using behaviours and mutate the market in ways that increased health harms. Of those who reported obtaining MDMA in the 2019 Global Drug Survey, 67% reported having obtained it through the darknet — higher than for any other dru
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. A number of substances can also be sold as MDMA, in what is sometimes called mis-selling or adulteration by substitution – whereby another substance is passed off as MDMA to the consumer. Adulteration of MDMA occurs by adding other psychoactive substances, typically stimulants, to MDMA in tablet, powder or crystal form.
Adulteration of MDMA occurs by adding other psychoactive substances, typically stimulants, to MDMA in tablet, powder or crystal form. PMK glycidate, first reported in Europe in 2013, had a particular role in this resurgence (see Section Production - designer precursors substitute scheduled MDMA starting materials). In 2009 and the following years, it was therefore unlikely that consumers who purchased ecstasy in Europe would obtain unadulterated MDMA. In 2009, on average, only 31 % of the tablets analysed contained MDMA alone, compared with almost 100 % in 2004. This includes law enforcement pressure, a variety of factors affecting MDMA production, such as the availability of MDMA precursors, and, more generally, globalisation of the illicit drug supply chain
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. Meanwhile, data from drug-checking services suggest that approximately 85 % of the powders tested in 2023 contained between 80 and 100 % MDMA (81 % in 2022). Data reported to drug-checking services are generally in agreement with these trends. The detection of mixtures of MDMA and ketamine combined with other substances including cocaine have also increased in some regions of Europe, and are sold as ‘pink cocaine’, ‘tuci’ or ‘tucibi’ (see Box 6.3. What is tucibi?
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