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

Surrey Young People’s Substance Use Service City-level market size estimates were developed for Brussels, in Belgium, and five cities in Sweden (see Table 6.1. Estimated value of MDMA consumed in selected European cities, 2020). The price data used was the average retail price for MDMA in the country concerned, drawn from the EUDA’s annual data collection (see Section Price and purity). 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 royalmedspharma.com 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.

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.

The majority of drug-induced deaths in Türkiye are among younger people, predominantly males, and are more likely to involve stimulant drugs rather than opioids, compared with the European Union and Norway. For example, in Germany, MDMA was mentioned in 1 in 25 fatal overdoses in 2022, with most of the cases involving multiple drugs. A review of MDMA-related mortality in royalmedspharma.com 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). However, studies have suggested that an increase has been observed in some countries. Furthermore, when factoring in the higher price of MDMA in Sweden, the market value in Stockholm is about 3.5 times that of Brussels. Ecstasy adulteration is responsive to market pressures

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

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.

This finding is interesting because it challenges the convention that cryptomarkets facilitate the globalization of drug retail markets. The most common routes for drugs were those within North America, Europe, and Oceania. We find that cryptomarkets still tend to be dominated by vendors from the US, the UK, Australia, and a few other countries (see figure below). Since Silk Road (the first cryptomarket) was put under the spotlight in 2011, the role these online market places play in global illegal trade has become hotly debated. In the worst cases, a fake pill may contain drugs or chemicals that could harm you. Medicines sold online and by places that do not have a physical address can be fak