MDMA dosage in XTC tablets: size matters
Background: Since the last worldwide crisis on the market of 3,4-methylenedioxymethamphetamine (MDMA) in 2009, dosages in ecstasy tablets have risen exponentially according to both media and centers of drug monitoring. This study evaluates the dosage of MDMA in ecstasy tablets in the Netherlands over the past 10 years, and aims to validate and specify the growing concern for high dosed tablets.
Methods: The data of the Drug Information and Monitoring System (DIMS) was used to evaluate all tablets that were sold as ecstasy and analyzed by DIMS in their laboratory from January 2008 through December 2017. The concentration of MDMA in 19,691 tablets was determined with GC-MS and LC-DAD. Additional characteristics of the tablets like logo’s, breaklines, size, and weight were recorded.
Results: 2009 marked the lowest average dosage of ecstasy samples with 65.8 mg MDMA base per tablet. In 2017 this number had more than doubled to 149.4 mg MDMA base per tablet. The study also shows that 41.9% of ecstasy tablets in 2017 contained such a high dose of MDMA base (>160mg) that the probability of adverse effects generally exceeded that of positive effects, compared to just 1.1% of tablets in this range in 2009. Interestingly, the actual purity of MDMA in ecstasy tablets (mg of MDMA base per mg weight of tablet) has not changed significantly since 2012, while the weight of tablets has risen. Also, the amount of ecstasy tablets containing breaklines (making them easier to split) showed only a small increase following the rise in MDMA dosage.
Conclusions: MDMA dosage in ecstasy tablets has shown a strong increase throughout ten years of monitoring MDMA content. Interestingly, the actual purity of MDMA in ecstasy tablets (mg of MDMA base per mg weight of tablet) has not changed significantly since 2012, while the weight of tablets has risen. The increasing MDMA dose of the last 5 years is therefore exclusively explained by an increased weight/size of the tablets. This means that while the message "XTC is getting stronger" is well communicated by both harm-reduction initiatives and media, "XTC tablets are getting bigger" is actually equally appropriate. The study furthermore finds that the purity of MDMA in tablets is stabilizing (most tablets contain roughly the same % of MDMA), and that the growing inclusion of breaklines on tablets fails to correct for the rise in the size and MDMA dosage of ecstasy tablets.