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Tijdschrift voor Psychiatrie 62 (2020) 8, 693 - 701

Review article

Recreative ecstasy use in the Netherlands: use characteristics, health risks and criminality

J. van Amsterdam, W. van den Brink

background Ecstasy (mdma) is used by approximately 370,000 Dutch people yearly, mainly young adults with a good education.
aim To describe ecstasy-related negative health effects, health risks, use profiles and crime based on data from scientific literature and other publicly available sources.
results Ecstasy appears to cause little health damage during recreational use. Adverse health incidents, particularly hyperthermia, are observed, but are probably partly due to the use of ecstasy under (a combination of) unfavourable circumstances, such as: a warm environment, too little drinking, and considerable physical exertion (dancing). The estimated risk of serious ecstasy-related non-fatal accidents was 1 in 3,400 pills and 1 per 700 users. The number of fatal ecstasy-related incidents is estimated to be a maximum of 35 per year. Crime associated with the production and trade of ecstasy is worrying and, according to some authors, disruptive to society.
conclusion On the basis of these results, we conclude that the use of ecstasy does involve health risks, but given the widespread use of ecstasy, the number of (fatal) incidents is relatively low. Better information about the conditions under which ecstasy can be used more safely will contribute to fewer incidents.

keywords adverse health effects, criminality, ecstasy, hyperthermia, incidents, mdma