Ireland is being impacted by a surge in high-potency drugs entering the European market, with the HSE warning that MDMA tablets now in circulation contain up to three times the usual dosage.

Speaking on The Anton Savage Show, Professor Eamon Keenan, HSE National Clinical Lead for Addiction Services, said the strength of MDMA pills currently being identified poses serious risks to both users and healthcare professionals.

“One pill doesn't equal one dose,” he said, explaining that tablets containing “over 300 milligrams” of MDMA have been detected this year, which he described as “the highest dose we've ever seen in Ireland."

He warned that stronger pills significantly increase the risk of harm.

“With the higher dose comes a significantly increased risk of serious harms and adverse consequences,” he said, particularly at a time of year when large social events are taking place.

Professor Keenan said users may not realise the strength of a tablet before taking too much.

“Everybody has a different reaction to the tablets,” he said, noting that drug testing carried out at festivals over the past four years has found tablets ranging from zero milligrams up to 312 milligrams of MDMA.

Because of this uncertainty, he urged people to take precautions.

“So start low, go slow. Don't take the full tablet because, as we say, one dose doesn't equal one pill.”

He also advised against mixing drugs with alcohol or prescription medication, warning that interactions are often overlooked.

Man with Tesla ecstasy pills baggie; pills shaped like a shield with the Tesla logo; 240 milligrams of recreational MDMA, Molly, drugs.

While the HSE does not encourage drug use, Professor Keenan acknowledged the reality of the situation.

“Obviously, we'd much prefer it if people didn't take drugs at all, but the reality is that if people do decide to take drugs, they do have to take steps to look after themselves and their friends.”

He said the rise in drug potency reflects wider European trends, driven by increasingly organised criminal networks.

“What we're seeing in Europe and right across Europe now is a modern drug phenomenon where criminal networks have grown stronger, they've grown richer, they've grown more interconnected.”

MDMA, which declined in popularity after the 1990s rave era, has returned, particularly at dance and techno events.

Wastewater analysis carried out in 2024 at Dublin’s Ringsend plant found MDMA and ketamine use in the capital to be in line with other European cities.

“It’s naive for us to suggest or to think that these drugs are not being used at a reasonably high level,” he said.

Professor Keenan added that drug use is not confined to cities.

“Drugs like cocaine are available right across the country in every small village and town across the country,” he said, calling for increased investment in health services, law enforcement and community supports to address the issue.

Written by Annemarie Roberts