A Dutch drug addiction and mental health institute has issued a red alert over ecstasy pills shaped like Donald Trump’s head after tests found they contained very high levels of PMMA, a potentially lethal substance. The warning matters because PMMA can take longer to have an effect than MDMA, increasing the risk that users take more and overdose.

The Utrecht-based Trimbos Institute said pills submitted to testing centres in August could cause overheating, nausea, a raised heart rate and convulsions, with potentially fatal consequences. No deaths or serious illnesses linked to the pills had been reported, but the institute urged people not to use them; ecstasy remains illegal in the Netherlands, where a 2024 government report said 550,000 people used it at least once in 2022.