Ecstasy: high MDMA levels
In 2013, 1,833 tablets sold as ecstasy were analysed in the laboratory. Table 10.3.1 shows the percentage of analysed tablets divided in 5 categories of substance(s). Figure 10.3.1 shows the average MDMA concentration of tablets sold as ecstasy.
In 2013, 86% of the tablets sold as ecstasy contained an MDMA-like substance as the only scheduled drugs; mostly MDMA and sporadicaly (also) MDEA and MDA. This percentage had been higher (approximately 92%) in previous years, and was comparable to the percentage in 2004, after a drop to 71% in 2008 and 2009. The dose of MDMA in tablets sold as ecstasy is historically high. In 2013, the highest
measured dose was 366 mg MDMA. Tablets containing at least 1 mg MDMA that were analysed in the laboratory in 2013 contained 111 mg on average and 114 mg in the first half of 2014 (see figure 10.3.1). This suggests that the presumed shortage of MDMA precursors in 2009, when the average MDMA concentration was only 66 mg, has reversed.
The concentration of MDMA in tablets has always shown a wide variation. Excluding ecstasy tablets without any trace of MDMA, in 2013 5% of the ecstasy tablets contained between 1 and 35 mg MDMA, 11% contained between 36 and 70 mg and, 33% between
117 71 and 105 mg, 26% between 106 and 140 mg and 26% contained a high dose of over 140 mg. Since 2009 a steady increase is seen in the proportion of tablets in the two highest categories. The first half of 2014 shows even a larger proportion in the highest potency category (>140 mg, 27%).
In general, users subjectively rate doses between 81 and 100 mg as most positive or desirable, while for higher doses the likelihood of desirable effects decrease and the risk of adverse effects increase (Brunt et al. 2012). Thus in 2013, half of the tested tablets contained more MDMA than the previously reported desired dose. Moreover, the increased MDMA content in ecstasy tablets has been associated with an increase in (severity of) health related emergencies at dance parties, although there is no proof of causality (see chapter 6).
DIMS detected the harmful substance PMMA in an increasing number of ecstasy tablets: from approximately 30 yearly between 2010-2012 to a worrying upward trend of 48 tablets in 2013, and 27 tablets in the first half of 2014.
Whereas usually PMMA is detected in tablets also containing MDMA, the number of tablets containing a substantial concentration of only PMMA increased: from 6 tablets of 20 mg or more in 2012, to 13 in 2013 and 9 tablets in the first half of 2014. The use of PMMA was associated with several fatal emergencies in 2010 and 2011 (4 with use of PMMA verified, one non-verified), and one in 2013, although other substances might also have contributed to death. The number of nonfatal emergencies is not known. As for the past two years, mCPP was again detected less frequently (3.1% in all tablets).
Mephedrone was not detected in the laboratory analysed tablets in 2013.
Table 10.3.1: Content of tablets sold as ‘ecstasy’ based on laboratory analyses
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 Number of tablets analysed 1,985 2,140 2,523 2,319 2,183 2,181 2,357 2,183 1,848 1,833 Only MDMA-like substancesI 91.9% 88.6% 83.2% 84.6% 70.5% 70.8% 81.9% 90.5% 92.0% 86.1% (Meth) amphetamine 0.8% 4.0% 1.8% 0.7% 1.1% 4.9% 2.9% 2.3% 1.0% 3.0% MDMA-like substances and (meth)am- phetamine 0.3% 1.4% 2.2% 1.3% 1.4% 1.3% 2.2% 3.0% 2.0% 3.0% OthersII 4.5% 0.3% 4.5% 3.8% 7.4% 1.40% 1.8% 1.0% 1.0% 3.9% MiscellaneousIII 2.5% 5.7% 8.3% 9.6% 17.7% 21.7% 11.2% 3.2% 4.0% 4.0%
I. Also includes caffeine. II. Category 'others' may include samples with MDMA and pharmacologically active non- scheduled substances. III. In 2009: The category miscellaneous consisted mainly of mCPP (11.60%) and mephedrone (7.4%). In 2010, 2011 and 2012 this category consisted mainly of mCPP and caffeine. In 2013, there were many samples seen with PMMA, with or without MDMA (‘others’ and ‘miscellaneous’). Source: DIMS, Trimbos Institute.
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Figure 10.3.1: Average concentration of MDMA in tablets sold as ecstasyI
I. Tablets analysed in the laboratory containing at least 1 mg MDMA. * First half of 2014. Source: DIMS, Trimbos Institute.
Amphetamine
Purity of amphetamine powders shows strong fluctuations, which may be associated with (temporary) shortages in precursors. Whenever the content of amphetamine drops in the powders, this is compensated by an increase in caffeine, the most preferred adulterant. In 2013, DIMS received 1,237 powders sold as speed.
The majority of speed powders (97%) contained amphetamine, with an average concentration of 47% in 2013 and 49% in 469 powders containing at least a trace of amphetamine in the first half of 2014. This is a substantial increase compared with 27% in 2012.
Methamphetamine was rarely detected in speed samples in the Netherlands.
Figure 10.3.2 suggests an inverse relation between the concentration of amphetamine and caffeine in the samples sold as amphetamine. In 2012, the concentration caffeine was 55%, which was 39% in 2013 and 35% in the first half of 2014.
Since 2009, the non-controlled substance 4-fluoramphetamine (4-FA) has been detected in samples sold as speed. In 2013, there were only 8 4-FA samples sold as speed, compared with 46 in 2012. However, 14 samples were sold as 4-FA in 2013 (and it was detected in 58 ‘miscellaneous’ samples not sold as speed, cocaine or ecstacy/MDMA), suggestive of a specifc market for 4-FA (see next paragraph).
Since 2010, 4-methylamphetamine (4-MA) was increasingly found in speed samples with its peak of 191 (12%) in 2012. It has been suggested that 4-MA is less potent than amphetamine (Wee et al., 2005). Nonetheless, 4-MA has been associated with fatal intoxications and after a quick scan on the risks of 4-MA (CAM, June 2012), it was placed on Schedule I of the Opium Act (immediate placement on June 13 2012 and by way of a governmental decree (algemene maatregel van bestuur) on May 31 2013 (Stb. 2013-207) (see National Report 2013 § 2.1). In 2013, 4-MA was detected in 84 of the samples sold as speed.
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Figure 10.3.2: Average concentration of amphetamine and caffeine in speed samplesI
I. Data based on a selection of samples containing at least a trace of amphetamine and caffeine. Source: DIMS, Trimbos Institute.
Cocaine
In 2013, 1,286 powders sold as cocaine were analysed.
Most samples (95%) contained cocaine (among other substances). In recent years, the average cocaine concentration increased from 49% in 2011 to 61% in 2013, and 59% in the first half of 2014. In the nineties however, the average was higher; 65-71% (Brunt et al., 2010).
Since 2002, the percentage of cocaine samples containing pharmacologically active adulterants or diluents has strongly increased until 2009 ( Brunt et al., 2009), and was thereafter stable at approximately 80%.
Figure 10.3.3 shows that the proportion of powders sold as cocaine containing
levamisole is still very high (63% in 2013 and 66% the first half of 2014). Levamisole is an antihelminticum used mainly for veterinary purposes. It is also used as an anti-cancer drug, but is not officially registered for human use in the Netherlands. The average dose of levamisole was 10.0% in 2013 and 10.5% in the first half of 2014 compared with 7.5% in 2012. In North-America, the use of cocaine adulterated with levamisole has been associated with serious blood diseases. In the Netherlands a few cases have been reported (Vos N, Ned Tijdschr Geneeskunde 2014; CAM 2014).
The proportion of powders sold as cocaine with phenacetin is lower than in previous years (14% in 2013, 16% in the first half of 2014).
Hydroxyzine is an antihistamine with anxiolytic properties also used for skin disease that was hardly seen in samples sold as cocaine before 2010. The percentage was in 2013 (8%) similar to 2012 (9%), both much lower than the proportion in 2010-2011.
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Figure 10.3.3: Percentage of powders sold as cocaine also containing medicines
Source: DIMS, Trimbos Institute.
Other substances
Several “new psychoactive substances” (or research chemicals) were found in 2013 samples (in total) analysed in the laboratory. Most common were 4-fluoramphetamine (see also § 2.4), followed by, methylone, methoxetamine and 6-AP. The number of samples containing 4-methylamphetamine, which was brought under control of the Opium Act in June 2012, dropped from 199 in 2012 to 84 in 2013.
Cannabis
Since 2000, the DIMS also monitors the THC content and prices of cannabis. In 2014, 200 samples of different cannabis products (about 1 gram each) were procured from a random sample of coffee shops and chemically analyzed (Rigter and Niesink 2014). Figure 10.3.4 shows the average concentration of THC in Dutch-grown weed (‘nederwiet’), imported weed and imported hashish (see also Standard Table 14). Two types of samples of Dutch
marihuana were bought: the most “favorite” variety (normally reported here, unless
mentioned otherwise) and the most “potent” variety, according to the perception of owners of coffee shops. In 2010, there was a change in the laboratory assessing the THC
concentration, which may have had some impact on the trend data.
Between 2000 and 2004, the percentage of THC in Dutch-grown weed (most favorite type) doubled from 9% to 20%. Between 2010 and 2013, the average concentration decreased from 17.8% to 13.5% and remained at a similar level (14.6%) in 2014. Similar to 2012, there was no significant difference in the percentage of THC in Dutch
weed sold as ‘most potent type’ (15.3%) and the most favorite type (14.6%). In 2013 however, Dutch weed sold as ‘most potent type’ was indeed stronger than the ‘most favorite’ type (15.6% against 13.5%).
The THC concentration in imported weed increased between 2007 and 2009 and dropped again afterwards.
121 The percentage of THC in imported hashish dropped from 18.7% in 2006 to 13.3% in
2007, and fluctuated in the consecutive years. These changes are hard to explain. Dutch weed contains approximately 3 times more THC than imported weed. This
relatively high THC content in Dutch weed is probably due to highly professional cultivation methods, which have been refined more and more during the past years. A bill has been prepared to reschedule cannabis containing 15% THC or more from
Schedule II to Schedule I of the Opium Act (see chapter 1).
In 2014, a THC concentration of 15% or more was found in 50% of the (most favorite) Dutch weed samples, and 58% of the imported hashish.
Figure 10.3.4: Average THC percentage in cannabis products
Source: THC-monitor, DIMS, Trimbos Institute (Rigter and Niesink, 2014). Dutch weed: sold as ‘most favorite’ type.