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

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 Norwa

The drug can be used to reduce inhibitions and eliminate anxiety and produces feelings of empathy for others. In Napa County MDMA or ecstasy is sold in pill form. Persistent deficits in serotonin are likely responsible buy mdma for many of the persistent behavioral effects that the user experiences. MDMA in its true form works in the brain by increasing the activity levels of at least three neuro-transmitters, serotonin, dopamine, and norepinephrine. Ecstasy adulteration is responsive to market pressures

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

According to survey data, the two largest MDMA consumer markets per capita in the European Union are the Netherlands and Ireland, with 6 % or more people aged 15 to 34 reporting to have consumed MDMA in the last year. While a slight decrease in price was observed in 2022 for ecstasy tablets, this buy mdma 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. Da

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

Rates of adulteration of ecstasy tablets, their MDMA content and their price tend to reflect broader changes in the factors that affect the MDMA market. MDMA is most commonly found on the European market in the form of ecstasy tablets, relatively pure crystals or powders (finely ground crystals of MDMA that are typically mixed with other substances). For example, many people who use drugs recreationally access internet-based resources to obtain and exchange advice and information about their drugs of choice, with experienced ‘recreational’ drug users frequently offering experiential ‘knowledge’ to young people new to dance club scenes. (1) The European Web Survey on Drugs (EWSD) is a voluntary, anonymous survey run by the EUDA and its partners targeting directly people who use drugs who are 18 years old or older, and are living in one of the participating countries. 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). 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 respondent

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