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Variability in the 3,4-methylenedioxymethamphetamine content of ‘ecstasy’ tablets in the UK
  1. David Michael Wood1,
  2. Vasoulla Stribley2,
  3. Paul Ivor Dargan1,
  4. Susannah Davies3,
  5. David W Holt4,
  6. John Ramsey5
  1. 1Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, and King's Health Partners, London, UK
  2. 2Cardiovascular Genetics and Lab Forensic Genetics Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
  3. 3Forensic Toxicology Service, Analytical Unit, St George's, University of London, London, UK
  4. 4Bioanalytics, Analytical Unit, St George's University of London, London, UK
  5. 5TICTAC Communications Ltd, St George's, University of London, London, UK
  1. Correspondence to Dr David M Wood, Medical Toxicology Office, 2nd Floor, Bermondsey Wing, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK; david.wood{at}


Background Toxicity, such as hyperpyrexia, associated with the use of 3,4-methylenedioxymethamphetamine (MDMA; ‘ecstasy’) appears to be related to serum MDMA concentrations. However, there does not appear to be a similar association with the number of tablets ingested, suggesting variation in the tablet content of MDMA. Although work has shown this variation in other areas of the world, no studies have reported on the variation of MDMA content in UK ecstasy tablets.

Methods Ecstasy tablets seized from individuals attending nightclubs were analysed qualitatively to determine if they contained MDMA and quantitatively to determine the MDMA content per tablet.

Results The mean amount of MDMA hydrochloride in 101 seized ecstasy tablets was 58.7±22.9 mg per tablet, with a range of 20 mg to 131 mg per tablet. The majority (96.0%) of tablets contained less than 100 mg MDMA per tablet. There appeared to be a bimodal distribution of MDMA content at approximately 20–40 mg per tablet and 60–80 mg per tablet.

Conclusion There is variability in the MDMA content of ecstasy tablets in the UK. This variability could potentially put users at increased risk of acute harm due to inadvertent excess ingestion of MDMA, as they are unaware of the differences in the MDMA content. Repeat sampling and quantification of MDMA content of ecstasy tablets in the UK will allow better education of users about the potential harms associated with the variability in the MDMA content. In addition, it will provide information to allow the monitoring of changes in not only the MDMA content, but also other adulterants, in ecstasy tablets.

  • acute toxicity
  • drug abuse
  • ecstasy
  • MDMA
  • mental health
  • recreational drugs
  • tablet analysis
  • toxicology

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  • Competing interests DMW and PID have acted as scientific advisors to the UK Advisory Council on the Misuse of Drugs (ACMD) and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

  • Provenance and peer review Not commissioned; externally peer reviewed.