More commonly known as ecstasy or Molly, MDMA has remained controversial since its popularity exploded in 1990s nightclubs and underground raves. As some researchers supported the drug’s potential use in psychotherapy, a broad range of people were using it recreationally. And by the mid-2000s, it wasn’t only ravers using MDMA; high school kids, college students, and young adults of many different backgrounds were indulging in the drug, and its popularity peaked. Though MDMA use began to decline after that, it's now back on the rise, according to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

In its 2016 European Drug Report, the agency warns that not only is MDMA returning to popularity, but that the tablets, capsules, and powders containing the drug are much more powerful than in previous years. MDMA has been a “common stimulant of choice for young people,” according to the report, which is based on survey data collected by the EMCDDA. According to the research, at least 2.1 million people aged 15 to 34 had used ecstasy in the past year — 300,000 higher than the 2015 estimate.

The study authors point to innovative and aggressive marketing techniques for the uptick in popularity, including gimmicky tablet designs like glow in the dark pills and superman logos. It’s a campaign that the agency says “may be a deliberate strategy by producers to improve perception of the drug after a lengthy period in which poor drug quality and adulteration had resulted in a decline in use.”

According to The Guardian, experts say today’s MDMA has the potential to be much more dangerous than its ancestors: in the 1990s and 2000s, the average MDMA content of a tablet was around 50 to 80 milligrams. Today, this amount is closer to 125 milligrams, with some “super-pills” containing a reported range of 270 to 340 milligrams available.

Alexis Goosdeel, the EU drug agency’s director, explained the dangers of ecstasy’s resurgence among a new, vulnerable population.

“The revival of MDMA brings with it the need to rethink existing prevention and harm-reduction responses to target and support a new population of users who may be using high-dose products, without fully understanding the risks involved,” she told The Guardian. “Intoxications and even deaths associated with this drug are highlighted in our new report. This is particularly worrying since MDMA is moving into more mainstream social settings and is increasingly available via online markets.”

The report examined illicit drug use across the EU, and touched on the costs — both economical and social — of drugs including opioids, amphetamines, and hallucinogens. Its summarization of overdoses highlights the rise of deaths from overdoses in some countries, as well as from certain drugs. Heroin and other opioids in particular have caused more deaths than in previous years, along with cocaine in countries including the UK, Ireland, Lithuania, and Sweden.

“The reasons behind these rises in fatal overdoses are unclear, but a number of factors may be involved, including: increased heroin availability, higher purity, aging users and changing consumption patterns, including use of synthetic opioids and medicines,” the report states.

Ecstasy may have exhibited the biggest jump in popularity, but cannabis remained the king of illicit drugs in the EU. It accounts for the highest share in value of the EU’s illicit drug market, with an estimated annual value of 9.3 billion euros for the last year when figures were available (2013). Heroin sales were second highest, at 6.8 billion euros. MDMA sales, meanwhile, are approximated at 700 million euros.

Experts concluded that the EU faces a growing problem with drugs, which has been exacerbated by new avenues of production, marketing, and distribution.

Source: European Monitoring Centre for Drugs and Drug Addiction. European Drug Report Trends and Developments 2016. 2016.