MDMA – the current situation in Europe (European Drug Report 2024)

MDMA is a synthetic drug chemically related to the amphetamines, but with somewhat different effects. In Europe, MDMA use has generally been associated with episodic patterns of consumption in the context of nightlife and entertainment settings. On this page, you can find the latest analysis of the drug situation for MDMA in Europe, including prevalence of use, seizures, price and purity and more. 

This page is part of the European Drug Report 2024, the EMCDDA's annual overview of the drug situation in Europe.

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Last update: 11 June 2024

Signs of increasing MDMA production in Europe; strong products still creating health risks

MDMA is a synthetic drug chemically related to the amphetamines, but with somewhat different effects. In Europe, MDMA use has generally been associated with episodic patterns of consumption in the context of nightlife and entertainment settings. Survey data indicate that MDMA is the second most commonly used illicit stimulant in Europe, after cocaine. The use of the drug appeared to decline temporarily during the early phases of the COVID-19 pandemic but bounced back when social distancing measures were lifted. The most recently available data would suggest that the current situation is relatively stable in terms of annual consumption, although the national situation is relatively heterogeneous and there are some possible signs of a slight increase in use in some countries. Almost two thirds of the European cities reporting wastewater analysis found an increase in MDMA residues between 2022 and 2023.

European production for a global MDMA market

MDMA production is known to take place within Europe, both for domestic consumption and for export to non-EU markets. Europe is recognised as an important global supply source for this substance, with most MDMA production thought to be concentrated in or around the Netherlands. Monitoring trends in illicit drug production is always challenging but there are now some possible indications to suggest increasing levels of MDMA production within Europe, following a recent period in which production volumes are thought to have declined. The number of MDMA laboratories dismantled in the European Union rose to 48 in 2022 (25 in 2021), while seizures of the internationally controlled precursor chemical PMK (piperonyl methyl ketone) and its glycidic derivatives for manufacturing MDMA increased markedly in 2022, to 19.9 tonnes (2.6 tonnes in 2021). Alternative chemicals were also seized in notable quantities in 2022. These reports of increased seizures of MDMA precursors and alternative chemicals, combined with information about MDMA exports, may reflect an increase in the production of the drug for global markets and a general rebound following a decline related to the COVID-19 pandemic. However, not all recent data suggest this. In 2022, the quantity of MDMA tablets seized in the European Union declined by nearly a third, while the quantity of MDMA powder seized declined slightly. The MDMA content of tablets and the purity of powders continued to decline in 2022 from a pre-pandemic peak in 2019, with declines in the MDMA content of ecstasy tablets observed in recent years in some important source countries, most notably the Netherlands.

MDMA product strength remains a concern

Despite indications that the MDMA content of ecstasy tablets is decreasing, with a typical MDMA content of 140 to 157 milligrams, the overall strength of tablets available on the retail market remains high by historical standards. The availability of higher-strength products potentially increases the risk of adverse health outcomes associated with the consumption of this substance.

MDMA tablets are typically available in many designs, often colourful replications of brand logos. Alongside powders and tablets, more-novel MDMA products, such as edibles (candies, gelatines and lollipops), have been reported to have become available in recent years in some countries, for example, Belgium and Czechia. As with cannabis edibles, these products pose difficulties in regulating intended dosage and increase the risk of inadvertent consumption, especially a concern if they are consumed by minors.

The use of MDMA is rarely cited as a reason for entering drug treatment in Europe, but acute poisonings and deaths are sometimes associated with the consumption of this substance. Some countries, including Germany, reported small numbers of drug-induced deaths involving MDMA in 2022, while Türkiye remains the only country reporting larger numbers. The reasons for this are not clear. The use of MDMA therefore continues to represent an important issue for prevention and harm reduction messaging and interventions. Measures typically undertaken in this area include risk communications about high-strength products and safer use guidelines, as well as providing drop-in services and, in some countries, pill testing services, where consumers can have the composition of their substances analysed.

While it is difficult to generalise due to limitations in national and European coverage, the available information from drug checking services suggests that MDMA products are generally less subject to adulteration than other illicit drugs they screened in 2022. This does occur, however, as illustrated by the occasional detection of synthetic cathinones in MDMA tablets. Such drug mixtures, which have been reported to the EU Early Warning System as being mis-sold as MDMA to consumers, may also increase the risk to consumers of experiencing unexpected adverse effects and potential harm.

Additional detailed information about MDMA can be found in the joint EMCDDA-Europol EU Drug Markets: In-depth analysis and the EMCDDA's Stimulants: health and social responses.

Key data and trends

Prevalence of MDMA use

• Surveys conducted by 26 EU countries between 2015 and 2023 suggest that 2.2 million young adults (aged 15 to 34) used MDMA in the last year (2.2 % of this age group), with 2.3 % (1.1 million) of those aged 15 to 24 years estimated to have used MDMA in the last year (for survey data, see Figure 5.1).
• Of the 13 European countries that undertook surveys since 2021 and provided confidence intervals, 4 reported higher estimates than their previous comparable survey and 9 reported stable estimates.

• Of the 69 cities that have data on MDMA residues in municipal wastewater for 2022 and 2023, 42 reported an increase, 11 a stable situation and 16 a decrease (Figure 5.2). All of the 10 cities with data for both years had higher MDMA mass loads in 2023 than in 2011.

Deaths and hospital presentations related to MDMA

• MDMA is reported in small numbers of drug-induced deaths, and in most countries less than 1 in 20 cases involve the drug. For example, in Germany, MDMA was mentioned in 1 in 25 fatal overdoses in 2022, with most of the cases involving multiple drugs. Türkiye is an outlier, with MDMA identified in almost 1 in 5 drug-induced deaths (46 out of 246 in 2022). 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.
• MDMA was the sixth most frequently reported drug by Euro-DEN Plus hospitals in 2022. The drug was reported by 19 sentinel centres in 2022 and was involved in an estimated 4.7 % of presentations (median) across the 23 centres that reported data for that year. Alcohol was co-used in most reported cases. The drugs most commonly found in association with MDMA were cocaine and cannabis, and in some centres also GHB/GBL, amphetamine and synthetic cathinones.
• In 2022, the share of acute drug-toxicity presentations involving MDMA increased as compared to other substances and the previous year (or MDMA was reported for the first time) in 10 of the Euro-DEN hospitals. In 5 hospitals, this share decreased and in 4 it remained stable.
• Only in the sentinel hospitals in Belgium, France and the Netherlands, was MDMA involved in more than 1 in 10 presentations.
• In half of the Euro-DEN hospitals in 2022, at least 3 out of 4 presentations with MDMA were among males, at least 4 in 10 were among young people aged less than 25 years, and MDMA was the sole drug reported for less than 3 % of the MDMA-related presentations. Alcohol was co-ingested in at least 2 out of 3 cases, and cocaine and amphetamine were the drugs most commonly reported in presentations with MDMA involved.

MDMA market data

• In 2022, EU Member States reported 14 500 seizures of MDMA (10 000 in 2021), amounting to 1.2 tonnes of MDMA powder (1.6 tonnes in 2021) and 2.5 million MDMA tablets (3.5 million in 2021). Türkiye seized 5 million MDMA tablets in 2022 (7.6 million in 2021) (Figure 5.3).
• In 2022, 6 EU Member States reported dismantling 48 MDMA laboratories (25 in 2021). Belgium reported 27 MDMA laboratories in 2022 (8 in 2021), with the Netherlands reporting 13, Spain reporting 5 and France, Poland and Sweden reporting 1 each.
• Seizures of MDMA precursors increased to 20.5 tonnes in 2022 (7.1 tonnes in 2021). Seizures of the MDMA precursor PMK and its glycidic derivatives of 19.9 tonnes were reported in 2022 (2.6 tonnes in 2021). Seizures of alternative chemicals for the production of MDMA were also reported: MAMDPA was seized in smaller amounts in 2022 (37 kilograms, compared with 4.5 tonnes in 2021).
• While high by historical standards, the average MDMA content in tablets continued to decline in 2022 from a peak in 2019; the purity of powders was stable compared with 2021. MDMA tablets seized in Europe contained on average between 140 and 157 milligrams of MDMA (161-173 milligrams in 2021), and the average purity of seized MDMA powders ranged from 46 % to 100 % (42-100 % in 2021), with half the countries reporting values in the range 66-87 % (69-85 % in 2021). The Netherlands, however, reported a lower average MDMA content of ecstasy tablets (130 milligrams per tablet).

• In the first half of 2023, the average MDMA tablet tested by drug checking services in 18 cities in 10 EU Member States contained 134 milligrams of the drug (139 milligrams in the same period of 2022). The average purity of MDMA powder reported was 80 % (78 % in first half of 2022) (Figure 5.4).
• In 2023, a total of 1 541 samples sold as MDMA were tested for psychoactive adulterants by 12 drug checking services in 9 EU Member States. MDMA was the sole psychoactive substance in 1 325 samples, while the remaining 216 samples contained at least one other psychoactive substance. Synthetic cathinones were the most frequently detected of these, representing 44 % of all detected psychoactive adulterants in samples sold as MDMA (Figure 5.5). Synthetic cathinones were reported by services in 9 Member States (compared with 4 in 2022), with all 12 services reporting the detection of these substances in at least one MDMA sample. The synthetic cathinones most frequently detected in MDMA products in 2023 were 3-CMC, 4-CMC, 3-FEA, 3-MMC and dipentylone.

Source data

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