NSW Health is warning the public of high-dose MDMA tablets (ecstasy) in circulation across NSW, found to contain around twice the average dose of other MDMA tablets.

The purple-grey tablets have a 'Punisher' skull design on the front.

For images and more information on the high dose MDMA tablets, see: 2024 - Public drug warnings

Medical Director of the NSW Poisons Information Centre, Dr Darren Roberts, said consuming high doses of MDMA has been linked to cases of serious illness and death in NSW.

“MDMA can cause severe agitation, raised body temperature, seizures or fits, irregular heart rhythm and death," Dr Roberts said.

“Other risks include taking MDMA in combination with other stimulants, such as amphetamines or cocaine.

“The amount of MDMA in a tablet or capsule can vary a lot, even within the same batch. The health risks from MDMA are greatly increased if high amounts (including multiple doses) are consumed over a short period.

“Hot environments, such as at music festivals, increase the risk of harm from MDMA. Taking a break from dancing, seeking shade, and drinking water are important measures to reduce the risk of overheating.

“It is very important to remember, if you or a friend has taken drugs and feel unwell, you won't get into trouble for seeking medical care. If you or a friend feels unwell, please seek help immediately by calling Triple Zero.

“There are experienced onsite medical providers and teams of well-trained peer volunteers from programs such as DanceWize NSW who are ready to support you at many major festivals. Other event staff are also trained to help patrons."

For more information about staying safe, including the warning signs to seek help, see Stay OK at Music Festivals.

For information about the potential adverse effects of MDMA, please contact the NSW Poisons Information Centre on 13 11 26.

For support and information with alcohol, MDMA and other drugs, please contact the Alcohol and Drug Information Service on 1800 250 015. This is a 24/7 service offering confidential and anonymous telephone counselling and information. NSW Users and AIDS Association (NUAA) also provides a range of harm minimisation resources and advice and can be reached on 1800 644 413.