Shifting Patterns in Ecstasy Use: Increasing Detection of MDA in Forensic Seizures and Toxicological Cases in Southern Brazil.

Ecstasy-type drugs are the most frequently seized synthetic drugs in Brazil, usually containing a mixture of MDMA and its analog MDA. In recent years, an increasing number of samples have been found to contain only MDA, possibly reflecting shifts in the synthetic routes of ecstasy-type substances during the COVID-19 pandemic. However, the exclusive use of MDA remains poorly characterized, and its toxicological profile is still not fully understood. Data from chemical analyses of drug seizures in Rio Grande do Sul, Southern Brazil, were reviewed. In addition, blood and urine samples collected from clinical and forensic cases involving ecstasy use were analyzed by LC-MS/MS. MDA was detected in 31.1% of seized drug samples, surpassing MDMA, which accounted for 25.6%. A marked rise in MDA detections was observed after 2020, peaking at 52.6% of seizures in 2023. In addition, sixteen clinical and four postmortem cases involving MDMA and/or MDA were documented, with MDA predominating from 2021 onwards. The study identified a higher prevalence of MDA compared to MDMA, indicating a shift in ecstasy use patterns in Brazil. This finding underscores the need for robust analytical approaches and sustained toxicological monitoring to support drug surveillance and public health policies.