Misrepresentation of MDMA in the United States, 1999-2023.
Eric L Sevigny, Sylvia Thyssen, Earth Erowid, Russell Lea
Drug and Alcohol Dependence November 1, 2024 DOI: 10.1016/j.drugalcdep.2024.112467 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Sample size | 4,719 |
| Population | Alleged MDMA samples submitted to a drug checking service |
| Duration | 1999-2023 |
| Topics | MDMA |
| Keywords | Safe supply Drug checking services MDMA Adulteration Harm reduction Substance testing Ecstasy purity |
| Citations | 5 |
| Key findings | Only 48% of alleged MDMA samples contained MDMA alone, but MDMA-only prevalence recovered from a low of 15.2% in 2009 to 74.1% in 2023. |
Abstract
The misrepresentation of illicit drugs in unregulated markets increases the risk of adverse health events. This study analyzed drug checking data to compare represented, expected, and actual content of alleged MDMA samples, estimate trends in the quality of the MDMA supply, document the presence of adulterants, compare patterns of adulteration, and validate drug checking against law enforcement data. The study analyzed 4719 alleged MDMA samples submitted to the DrugsData drug checking service between 1999-2023. Measures captured characteristics and quality of the MDMA supply, including represented content, expected and actual content, sample form, and specific adulterants. Tests of association were conducted using Pearson's chi-square or Spearman's rho, and tests for trends were performed using joinpoint regression. Most samples (75 %) were expected to contain MDMA, but this varied significantly by represented content (p<0.001). About half the samples (48 %) contained MDMA-only, which also varied significantly by represented content (p<0.001). MDMA-only prevalence declined from 1999-2009 (57.4-15.2 %, p<0.05), recovered from 2009-2017 (15.2-56.0 %, p<0.05), and increased more moderately from 2017-2023 (56.0-74.1 %, p<0.05). Overall, 199 unique adulterants were detected in the MDMA supply across 25 years. We confirmed robust correlations in adulterant prevalence trends between drug checking and law enforcement seizure data. While users typically expected alleged MDMA samples to contain only MDMA, more than half of the submitted MDMA samples were misrepresented in some manner. Despite high levels of misrepresentation, MDMA quality has stabilized at relatively high levels in recent years.
Comparable studies
Other observational and cohort studies on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Subjective Reports of the Effects of MDMA in a Clinical Setting Individuals who took MDMA in a clinical setting | 1986 | Observational study | |
| Memory impairment in abstinent MDMA ("Ecstasy") users Abstinent MDMA users | 1998 | Observational cohort | |
| Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people | 2000 | Observational | |
| The Psychological and Physiological Effects of MDMA on Normal Volunteers Older, more educated, drug-experienced individuals | 1986 | Observational cohort | |
| Cognitive performance in recreational users of MDMA or 'ecstasy': evidence for memory deficits Young people who were regular or novice MDMA users, or non-users | 1998 | Observational cohort | n = 30 |
Citations in the library
Cited by 3
- Risk communication about high-dose MDMA: Impact of a hypothetical drug alert on future MDMA use. Drug and Alcohol Review May 1, 2025
- Monday mood decline after weekend ecstasy use: A retrospective analysis of daily diary reports. Drug and Alcohol Dependence Reports June 1, 2026
- Sociodemographic and clinical correlates of drug testing use among psychedelic users Journal of Psychedelic Studies May 28, 2026
Cites 19
- Instability of the ecstasy market and a new kid on the block: mephedrone Journal of Psychopharmacology September 8, 2010
- The early use of MDMA (‘Ecstasy’) in psychotherapy (1977–1985) Drug Science, Policy and Law 2018
- Agony and ecstasy: a review of MDMA effects and toxicity European Psychiatry August 1, 2000
- Who is ‘Molly’? MDMA adulterants by product name and the impact of harm-reduction services at raves Journal of Psychopharmacology July 10, 2017
- An Exploration of the History and Controversies Surrounding MDMA and MDA Journal of Psychoactive Drugs September 1, 2001
and 14 more in the library