MDMA – the current situation in Europe (European Drug Report 2025)
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 2025, the EUDA’s annual overview of the drug situation in Europe.
Last update: 5 June 2025
Strong MDMA products still posing health risks, as European production increases
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. More than half of the European cities reporting wastewater analysis found an increase in MDMA residues between 2023 and 2024.
Europe remains a globally significant source of MDMA
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. Most of this production takes place in the Netherlands and Belgium, where police detect illicit laboratories ranging in size from small-scale to larger facilities each year (Figure 5.1). Recently, MDMA production sites have also been dismantled in Spain and, to a lesser extent, in France, Poland and Sweden. This likely reflects a diversification of production locations. Although monitoring trends in illicit drug production is always challenging, there are signals to suggest that production within Europe may now be increasing, following a decline during the COVID-19 pandemic. In 2023, at least 36 MDMA laboratories were dismantled in the European Union (48 in 2022), while seizures of the internationally controlled precursor chemical PMK (piperonyl methyl ketone) and its glycidic derivatives for manufacturing MDMA increased markedly for a second year in a row in 2023, to 63.1 tonnes (19.9 tonnes in 2022). Alternative chemicals for the manufacture of MDMA, such as MAMDPA and IMDPAM, continued to be seized in 2023, reflecting how organised crime groups involved in the drug’s production switch between precursors to avoid legal controls. 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 the COVID-19 pandemic. Recent increases in the quantities of MDMA tablets and powders seized in Europe also suggest a likely increase in MDMA production in the European Union.
Source: Belgian Police, 2023.
MDMA produced in Europe is trafficked to regions such as Oceania, Asia and Latin America. A development of concern is the possible use of the reverse cocaine trafficking route from Europe to Latin America, with indications of MDMA being exchanged for cocaine. The trafficking of MDMA to Latin America presents an opportunity for MDMA producers in Europe, given the price of synthetic drugs in the region and the large potential market. The possibility of using established cocaine trafficking routes, previously thought to be ‘one-way’ routes, may further motivate MDMA producers in Europe to traffic the drug to Latin America and collaborate closer with cocaine trafficking networks.
The environmental impact of MDMA production in Europe is significant, with each kilogram of MDMA generating approximately 58 kilograms of toxic waste. Overall, MDMA production in the European Union potentially generates between 1000 and 3000 tonnes of chemical waste each year. Production sites are prone to accidents, explosions and fires due to the volatile chemicals involved – posing significant risks to surrounding communities.
Lack of consumer awareness of MDMA product strength remains a concern
The MDMA content of ecstasy tablets available on the retail market remains high by historical standards. While ecstasy tablets containing up to 350 milligrams of MDMA are still reported as being sold in Europe, on average, the MDMA content of ecstasy tablets appears to have stabilised in recent years, at a relatively high level of between 138 and 158 milligrams per tablet. This is a decline from the pre-pandemic peak average of 170 milligrams of MDMA per tablet in 2019. Nonetheless, the relatively high strength of current MDMA tablets can be seen from a comparison with 2011, when the average MDMA content in tablets was around 84 milligrams. The continued availability of higher-strength products potentially increases the risk of adverse health outcomes associated with the consumption of this substance. Health risks from consuming MDMA can also be exacerbated by polysubstance use, which remains common.
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 occasionally been detected 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, of particular 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 its use. Some countries, including Germany, reported relatively small but increasing numbers of drug-induced deaths involving MDMA in 2023. Türkiye remains the only country reporting a high proportion of drug-induced deaths in which MDMA is mentioned in the toxicological analysis. However, the reasons for this are not clear. The identification of MDMA in post-mortem analysis, particularly alongside other substances, does not necessarily mean that the drug either caused or contributed to the fatal overdose. There are, however, some reports of fatalities where only MDMA was involved, suggesting that the drug was the probable cause of death in those cases.
The use of MDMA remains 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, drug checking services, where consumers can have the composition of their substances analysed. As the MDMA content and purity of batches of pills and powders in circulation at the retail level can vary, consumers are exposed to potentially shifting and unpredictable levels of risk. For example, in Ireland, the Health Service Executive Safer Nightlife Programme, operating at a large music festival in August 2024, found that over half of the surrendered or confiscated tablets analysed contained 200 milligrams of MDMA. A rapid risk alert was used to inform harm reduction efforts and was shared on social media, festival screens and on the festival application (see Figure 5.2). The communication advised potential consumers of the risks to health, as various medical emergencies, including fits, were reported as linked to the use of the pills at the event.
Note: Issued by the Health Service Executive Safer Nightlife Programme, to warn about high-strength MDMA products.
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 2024. This does occur, however, as illustrated by the occasional detection of synthetic cathinones in MDMA tablets, Nonetheless, the proportion of MDMA samples analysed by European drug checking services that were adulterated with cathinones declined from 6 % to less than 2 % between 2023 and 2024. 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 EUDA-Europol EU Drug Markets: In-depth analysis and the EUDA’s Stimulants: health and social responses.
Key data and trends
Prevalence and patterns of MDMA use
- Surveys conducted by 26 EU countries between 2015 and 2024 suggest that 2.6 million young adults (aged 15 to 34) used MDMA in the last year (2.6 % of this age group), with 2.7 % (1.3 million) of those aged 15 to 24 years estimated to have used MDMA in the last year (for survey data, see Figure 5.3).
- Of the 15 European countries that undertook surveys since 2022 and provided confidence intervals, 1 reported lower estimates than their previous comparable survey, 6 reported higher estimates and 8 reported stable estimates.
- In the 2024 ESPAD school survey, MDMA/ecstasy was rated as easily obtainable by around 10 % of the 15- to 16-year-old ESPAD students in the European Union. On average, 1.8 % of the students reported having used the drug at least once in their lifetime, and less than 1 % reported having used MDMA for the first time at age 13 or younger.
- Of the 76 cities that have data on MDMA residues in municipal wastewater for 2023 and 2024, 41 reported an increase, 11 a stable situation and 24 a decrease (Figure 5.4). All of the 9 cities with data for both 2024 and 2011 had higher MDMA mass loads in 2024.
- The 2024 European Web Survey on Drugs, a non-representative survey of people who use drugs, indicated that MDMA/ecstasy was the second most commonly used drug among respondents, with a third of respondents using it in the last 12 months. For nearly 80 % of respondents, music festivals or parties were the preferred settings for using the drug. Only 10 % of participants indicated using it with no other substance on the last occasion: 70 % used it with alcohol, 55 % with tobacco and 27 % with herbal cannabis. In terms of the products used, around 28 % reported using powders/crystals, 37 % consumed tablets/pills and 36 % had used both types. On average, respondents reported typically consuming 1 tablet on a day of use.
Deaths and hospital presentations related to MDMA
- MDMA is reported in relatively small numbers of drug-induced deaths, and in most countries fewer than 1 in 20 cases involve the drug. Türkiye is an outlier, with MDMA identified in almost 1 in 3 drug-induced deaths (89 out of 300 in 2023). 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.
- In Germany, toxicology information is confirmed in around 4 out of 10 cases, and autopsies are conducted for just over half of the cases. Information for the other cases comes from the reporting police officers. However, bearing in mind possible underestimation, drug-induced deaths with MDMA mentioned accounted for 6 % of the cases reported in 2023, representing an increase from 4 % in 2021 and 2022. The number of these deaths has increased from 59 cases in 2021 and 65 in 2022 to 105 in 2023. This compares with an increase from a total of 1460 cases of drug-induced deaths in Germany in 2021 and 1631 in 2022 to 1838 cases in 2023. In fewer than 1 in 5 cases where MDMA was mentioned, it was the only drug identified.
- In some countries where full toxicology analysis data were available, a significant proportion of the MDMA-related deaths involved only MDMA. For example, almost a third (28/89, 31 %) of the MDMA-related deaths in Türkiye and around half (6/11) in Finland involved only MDMA.
- MDMA was the eighth most frequently reported drug by Euro-DEN Plus hospitals in 2023. The drug was reported by 20 sentinel hospitals in 2023 and was involved in a median of 5 % of presentations across the 22 hospitals in the European Union and Norway that reported data for that year.
- Only in the sentinel hospitals in Ghent in Belgium and Parnu in Estonia was MDMA involved in more than 1 in 10 presentations.
- In half of the Euro-DEN hospitals in 2023, at least 2 out of 3 presentations with MDMA were among males, over 4.5 in 10 were among young people aged less than 25 years.
- Most MDMA cases were associated with polysubstance use. MDMA was the sole drug reported for around a third of the MDMA-related presentations (2 % of all presentations). However, alcohol was reported in almost half of these.
- Almost half of the cases with MDMA involved (46 %) presented on either Saturdays or Sundays.
- Alcohol was co-ingested with MDMA in more than half (55 %) of the cases for which we have information on alcohol ingestion. Cocaine, cannabis and amphetamine were the drugs most commonly reported in presentations with MDMA involved.
MDMA market data
- In 2023, EU Member States reported 17 000 seizures of MDMA (14 500 in 2022), amounting to 3.6 tonnes of MDMA powder (1.2 tonnes in 2022) and 7.2 million MDMA tablets (2.5 million in 2022). Türkiye seized 5.2 million MDMA tablets in 2023 (5 million in 2022) (Figure 5.5).
- In 2023, 2 EU Member States reported dismantling 36 MDMA laboratories. Belgium reported 4 MDMA laboratories, with the Netherlands reporting 32.
- Seizures of MDMA precursors increased to 64.1 tonnes in 2023 (20.5 tonnes in 2022), mainly in the form of the MDMA precursor PMK and its glycidic derivatives, of which 63.1 tonnes was seized in 2023 (19.9 tonnes in 2022). Seizures of alternative chemicals for the production of MDMA were also reported in 2023: 565.4 kilograms of MAMDPA (37 kilograms in 2022) and, for the first time, seizures of IMDPAM (450 kilograms).
- In 2023, MDMA tablets seized in Europe contained on average between 138 and 158 milligrams of MDMA (140-157 milligrams in 2022), and the average purity of seized MDMA powders ranged from 24 % to 100 % (46-100 % in 2022), with half the countries reporting values in the range 67-88 % (66-87 % in 2022) (Figure 5.5). The Netherlands, a key source country for the supply of MDMA to Europe, reported an average MDMA content of ecstasy tablets of 133 milligrams and 75 % purity for MDMA powders.
- In the first half of 2024, a total of 2747 samples sold as MDMA were tested for psychoactive adulterants by 13 drug checking services in 10 EU Member States. MDMA was the sole psychoactive substance in 2589 samples, while the remaining 158 samples contained at least one other psychoactive substance. Synthetic cathinones were the most frequently detected of these, representing less than 2 % of samples sold as MDMA (Figure 5.6, Figure 5.7 and Figure 5.8), down from 6 % in 2023.
Source data
The complete set of source data for the European Drug Report 2025, including metadata and methodological notes, is available in our data catalogue.
A subset of this data, used to generate infographics, charts and other elements on this page, may be found below.
Prevalence of drug use data tables including general population surveys and wastewater analysis (all substances)
Data tables specific to MDMA