> and these days it's often laced with other substituted amphetamines such as mephedrone or PMA
"Often"? Often where? I'd say no since we'd hear about accidents with ecstasy "often" as well. This happens rarely, still.
EDIT: Found some data [1]:
"Although more recent ED data are not publicly available, the number of reported poisonings involving “hallucinogenic amphetamines” (which are most commonly MDMA and MDMA-like drugs) rose from 2057 (including 3 deaths) in 2009 to 2514 (including 14 deaths) in 2013"
"Ecstasy purity was low in the US in the mid-1990s3 and purity plummeted in Europe around 2009,11 but increased in 2010,8,11 while purity of powder and crystal ecstasy reportedly remained high in Europe (at 75–97%) in 2008–2013.11 However, the presence of synthetic cathinones (“bath salts”) and other novel psychoactive substances (NPS) increased within both pills and powders from 2008–2013.11 Spain in particular had a high prevalence of synthetic cathinones such as mephedrone and methylone detected in powder ecstasy.9 Despite extensive research in Europe, purity of ecstasy in the US over the last decade has not been formally researched."
See PMA wikipedia page* for some documented examples of this sort of thing. The MDMA precursor safrole is aggressively controlled so a strong incentive exists to substitute other substances/analogs. I would regard black market MDMA with some skepticism these days.
13 people in New Zealand were put in hospital this summer [1] by MDMA laced with N-Ethylpentylone. It was also discovered after pill testing at a festival in Australia. In January several people in Melbourne were hospitalised one weekend after taking laced MDMA.
I couldn't say how often MDMA is laced, and in what quantities, but it's definitely out there.
"Often"? Often where? I'd say no since we'd hear about accidents with ecstasy "often" as well. This happens rarely, still.
EDIT: Found some data [1]:
"Although more recent ED data are not publicly available, the number of reported poisonings involving “hallucinogenic amphetamines” (which are most commonly MDMA and MDMA-like drugs) rose from 2057 (including 3 deaths) in 2009 to 2514 (including 14 deaths) in 2013"
"Ecstasy purity was low in the US in the mid-1990s3 and purity plummeted in Europe around 2009,11 but increased in 2010,8,11 while purity of powder and crystal ecstasy reportedly remained high in Europe (at 75–97%) in 2008–2013.11 However, the presence of synthetic cathinones (“bath salts”) and other novel psychoactive substances (NPS) increased within both pills and powders from 2008–2013.11 Spain in particular had a high prevalence of synthetic cathinones such as mephedrone and methylone detected in powder ecstasy.9 Despite extensive research in Europe, purity of ecstasy in the US over the last decade has not been formally researched."
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578728/