This report describes annual data and 20-year trends in the use of ecstasy and related drugs, harms associated with use, and drug markets in Queensland.\ua0 It forms part of a nationwide, annual series of reports prepared for the Commonwealth Government and distributed widely to state government health and law enforcement agencies, and is used to inform policy and treatment responses.\ua0In the 2019 sample, cannabis and ecstasy were the drugs of choice nominated\ua0(28% and 23%), while cannabis and alcohol were the drugs used most often\ua0(54% and 21%). A quarter of recent users consumed ecstasy weekly or more often; most perceived it easy or very easy to obtain. One in 4 participants had recently used methamphetamine, 67% cocaine, 53% LSD, 56% nitrous oxide and 27% ketamine