The Trimbos Institute, a leading drug treatment and mental health organisation in the Netherlands, has issued a "red alert" warning against ecstasy pills shaped like Donald Trump's head, saying they can be fatal. Testing found the pills contain a high concentration of PMMA (para-methoxymethamfetamine), a substance chemically similar to ecstasy's active ingredient MDMA but slower to take effect, which can lead users to take additional doses and risk a fatal overdose.

The pills, pictured in green, yellow, red and blue variants, bear Trump's likeness on the front and the word "Trump" alongside the letters "NL" on the back; they were recently handed in at Dutch centres that test drugs before use. Trump-shaped ecstasy pills have appeared before, including seizures by Indiana police in 2018 and German police in 2017, the latter worth an estimated $46,000. The institute says no overdoses or deaths linked to PMMA have yet been recorded, though ecstasy use remains widespread in the Netherlands despite being illegal, with hundreds of thousands of users annually.