MDMA misinformation: what dealers claim versus the actual MDMA content in ecstasy pills in the netherlands

Background:

In December 2023, a batch of ecstasy pills containing over 300 mg MDMA base emerged on the Dutch drug market. Concerned by this development, the Drug Information and Monitoring System (DIMS) issued a nationwide “Red Alert” warning. Curiously, during this Red Alert, anecdotal information surfaced, suggesting that individuals perceived a tablet with such a high MDMA content as common practice in the Netherlands. It is unclear why these people think that ecstasy pills with such high MDMA doses are common. Perhaps dealers overestimate the content of the ecstasy pills they sell. Consequently, the current research compares dealer claims with the actual MDMA content in ecstasy pills. 

Methods:

To investigate this, a study was conducted in which contents of ecstasy pills were compared with the dose claimed by dealers, according to the person submitting the pill. Ecstasy pills that were sent to the laboratory for chemical analysis in 2022 and for which the expected MDMA dose was available, were eligible for this study – 1380 pills were selected. The laboratory results were given in MDMA base. It was unclear if the claims made by dealers referred to MDMA HCl or base.

Results:

Laboratory results for these pills ranged between 2 and 323 mg MDMA base, with half of the pills containing between 131 and 196 mg MDMA base. The average content was 137 mg MDMA base. Dealers indicated that contents for these pills would range between 60 and 400 mg MDMA. Half of the pills were sold with claims between 200 and 250 mg of MDMA. The average content indicated by dealers was 223 mg MDMA.

Conclusions

Dealers consistently overestimated the amount of MDMA in ecstasy pills they sold to consumers. The precise magnitude of the overestimation remains uncertain and it remains unknown whether it was intentional. Nonetheless, the discrepancy adds to the uncertainty regarding contents of ecstasy pills and therefore poses an extra public health risk. The overestimation potentially influences risk perception of people who use drugs. These findings emphasize the need for pill testing for providing reliable data for harm reduction strategies and to refute misinformation spread by dealers. Furthermore it needs to be considered how to best share this information with a broader audience.