Seized MDMA in the U.S. is primarily manufactured in clandestine laboratories in the Netherlands and Belgium. MDMA destined to the U.S. from the Netherlands is transferred through Germany and Poland and smuggled into the U.S. via body carriers, by air/sea cargo, luggage, and by express mail. Another significant source country is Canada. Operation Candy Box identified an international drug trafficking organization through which up to one million MDMA tablets per month were smuggled into the U.S. A small number of MDMA clandestine laboratories have also been identified operating in the U.S.

DMA is available in every region of the country, principally in large metropolitan areas. Miami, New York, and Los Angeles the primary market areas for MDMA smuggled into the U.S. from Western European. Florida leads the nation in MDMA seizures. International traffickers use south Florida as a base of operations for the importation and distribution of MDMA.