​NSW Health is warning the public of multiple high-dose MDMA (ecstasy) tablets in circulation in NSW, found to contain a higher dose than is usually expected.

The tablets were detected by the NSW Government's Drug Checking Service at Knockout Outdoor music festival in Sydney on Saturday 3 October.

NSW Health has previously warned the community about the circulation of high-dose MDMA tablets however the ongoing detection of these tablets and the upcoming summer festival season has prompted further warning.

Images and information available at 2026 - Public drug warnings ​.

Dr Hester Wilson, Chief Addiction Medicine Specialist at NSW Health said the tablets could be in circulation anywhere across the state.

“We are concerned about the prolonged detection of these high-dose MDMA tablets and are urging the community to be aware and vigilant, particularly for those people attending major festivals over the next few weeks," Dr Wilson said.

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

“The risk of serious harm is increased when MDMA is taken with other stimulants including synthetic cathinones, amphetamines and if high amounts (including multiple doses) are consumed over a short period.

“The amount of MDMA in a tablet or capsule can vary significantly, even within the same batch.

“Hot environments, such as at music festivals, also 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's also 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 (000)."

Drug checking services, experienced onsite medical providers and teams of well- trained peer volunteers from programs such as DanceWize NSW​ and ACON Rovers​ are available to provide support 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 more information about drug checking at festivals in NSW, see NSW drug checking services 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.

NUAA also provides a range of harm minimisation resources and advice and can be reached on 1800 644 413.

NSW public drug warnings are available at Public drug warnings.