Aims To determine trends in 3,4 methylenedioxymethamphetamine (MDMA)-related death rates across Australia, Finland, Portugal and Turkey to analyse the toxicology causes of countries. Design Analysis MDMA-related deaths extracted from a national coronial database Australia (2001–19) forensic databases Finland (2001–17), (2008–19) (2007–17). Presentation MDMA use seizure data (market indicators)....