Pharmacological content of tablets sold as "ecstasy": results from an online testing service.

PURPOSE This study examined the pharmacological content of tablets sold as ecstasy, the variation of tablet content by geographic region, and change in tablet content between 1999 and 2005. METHODS The sample was comprised of tablets anonymously submitted for laboratory testing between 1999 and 2005 (n=1214). Tablet height, width, geographic region, and year of submission were all used to predict the pharmacological content of the tablets. RESULTS Overall, 39% of the tablets were comprised of MDMA only, 46% only contained substances other than MDMA and 15% were mixtures of MDMA and other substances. Tablet height and width were inversely related to tablet purity. Ecstasy tablets from California and Florida had decreased likelihoods of containing non-MDMA substances. The purity of tablets decreased over time, which was largely a result of an increasing number of tablets comprised of MDMA along with other substances. CONCLUSIONS Ecstasy users may be putting themselves at increased risk of substance-induced anxiety, mood, and psychotic disorders by unknowingly ingesting substances other than MDMA. To decrease detrimental health effects, prevention programs should emphasize the impurity of ecstasy tablets and focus on the health impacts of these substances, particularly for populations at high-risk of substance-induced disorders.