The cost of responding to MDMA overdoses has risen by more than $1500 since before the pandemic to an average of almost $8000 per patient in Victoria.
The jump has been attributed to the rising cost of services, with the figure including the price of ambulances, emergency presentations and hospital treatment.
There were 246 MDMA overdoses in 2021-22 which cost taxpayers $1.9 million, according to analysis from the Parliamentary Budget Office released on Wednesday.
That's compared to $3.6m spent on 572 overdoses in 2018-19, the most recent financial year unaffected by the pandemic and lockdowns.
In 2020-21 and 2021-22 the average cost per overdose was $7936 and $7870 respectively.
It cost $6304 per patient in 2018-19.
MDMA, commonly known as ecstasy, is considered a party drug, with the report noting the drop in cases is likely due to fewer festivals, social and music events due to the health response to COVID-19.
While the number of government service responses dropped 58 per cent during that time, the report showed overall costs only decreased by 46 per cent.
That's been attributed to the rising cost of providing services, particularly in hospitals.
The report considered that each overdose may require more than one government service response, for example both an ambulance and hospital presentation, so the number of responses in the analysis is higher than the number of overdoses.
MDMA use is in the spotlight after nine people were admitted to hospital after overdoses at a festival in Flemington earlier in January, sparking renewed political debate about pill testing.
The ACT is the only Australian jurisdiction that does pill testing, but it is legalised in Queensland.
Victoria's acting Health Minister Ingrid Stitt said the government would look at the Parliamentary Budget Office report but has no plans to change its policy on drug checking.
"We have seen some unfortunate incidents across the summer and of course festival season is continuing so these are issues that I'll be talking with the premier (about) in coming days and weeks," Ms Still told reporters in Melbourne on Thursday.
There were 50 fatal incidents out of 1875 MDMA-related overdoses in Victoria in the four years from July 1, 2018 to June 30, 2022.
The 1875 overdoses cost taxpayers $12.7 million in total.
The analysis was requested by upper house Libertarian party MP David Limbrick in June 2023, who supports pill testing.
He said the state government appears less "hard line" against it compared to previous years and believes if it gets the green light then festivals and health organisations could pick up the tab rather than taxpayers.
"I don't see it as a silver bullet solution, it's more band-aid but it's certainly that has the potential to reduce harm for people who take drugs," Mr Limbrick said.
The report noted the true number of government responses and cost of MDMA overdoses could be higher than reported due to hospital coding practices and does not include the price of law enforcement, harm reduction and drug-related prevention.
Data on hospital costs in 2021-22 had not been collected by the time the analysis was prepared and was instead based on historical data.
