Death, related ecstasy

As recreational use of ecstasy has dramatically increased in recent years, deaths related to its use have been reported. In a retrospective review of all violent deaths from 1992 to 1997 in South Australia, six deaths were associated with ecstasy abuse aU occurred after September 1995. Three victims had documented hyperthermia and there was evidence of hyperthermia in another. The authors suggested that individual susceptibility to MDMA may be caused by impaired metabolism by CYP2D6 or through genetically poor metabolism (seen in 5-9% of Caucasians). One woman, who died with a cerebral hemorrhage, had fluoxetine (a CYP2D6 inhibitor) present in her blood. Furthermore, toxicology identified paramethoxyamfetamine (PMA) in all the cases, amfetamine/metamfetamine in four cases, and... 

Ecstasy (MDMA, E) Stimulant effects No clear Deaths related... 

There have been nearly 80 deaths in the UK related to Ecstasy use. Why this particular group of people died when so many others have also taken the drug is... 

More people are overdosing on GHB than ecstasy. In 2000, 2,482 GHB users visited the emergency room for an overdose, compared with 1,742 ecstasy users. There also are more deaths from GHB. According to the DEA, 73 people have died from taking GHB since 1995, compared to 27 ecstasy-related deaths from 1994 to 1998. 

Despite earlier concern over earlier ecstasy deaths, there is no evidence to suggest that any of these deaths are due to a "contaminant" or "adulterant". Toxicity and death appears to be directly related to the amoimt of MDMA contained in the tablets or capsules that were ingested. The interpretation of post-mortem blood concentrations is a complex issue, with differences in concentrations of MDMA and MDA observed between different anatomical sites. MDMA has been shown to undergo post-mortem redistribution and concentrations measured in post-mortem blood may be much higher than concentrations close to the time of death. This can lead to "error" in the estimation of the quantity of drug ingested from post-mortem concentrations in blood. 

Although relatively rare, ecstasy is known to cause liver damage, leading to rapidly developing (fulminant) liver failure and death in a few individuals. This appears to be associated with a rare idos)mcratic reaction to the drug, and not related to dose or frequency of use. The precise mechanism remains unknown, but could be the production of a "toxic" metabolite in certain individuals. In some patients, liver transplantation offers the only chance of recovery. 

Death In a review of deaths in individuals taking various amphetamines during 1997-2007, 832 deaths were related to amfe-tamine or metamfetamine and 605 to ecstasy [10 ]. The latter were younger (28 versus 33 years) and less likely to be known as drug users (RR=1.9 CI = 1.5, 2.6). Contributory factors, such as physical co-morbidity, were more frequently mentioned by coroners in the former. Ecstasy was more often associated with mono-intoxication. 

Death Ecstasy-related deaths in Australia between 1 July 2000 and 30 June 2005 have been reviewed [27. The cases were identified using the National Coroners Information System (NCIS). There were 82 deaths. The median age was 26 (range 17-58) years, 83% were men, and almost three-quarters were employed. Of the 67 cases in which MDMA was the direct or antecedent cause of death, it was due to drug toxicity in 91%. Ecstasy alone was implicated in 25% of these cases and combined drugs in 66%. The most common drugs combined with MDMA were opioids (54%), metamfetamine (42%), benzodiazepines (23%), and alcohol (21%). In 10%, cardiovascular complications or diseases arising from, or complicated by, use of MDMA was a direct cause of death. Injury was a direct cause in 9% of the cases. In 7% of cases cerebrovascular complications were... 

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