Shedding New Light on the "Safe" Club Drug: Methylenedioxymethamphetamine (Ecstasy)-related Fatalities
Patel MM, Wright DW, Ratcliff JJ, Miller MA.
Department of Emergency Medicine,
Emory University School of Medicine
(MMP, DWW, JJR), Atlanta, GA.
Acad Emerg Med. 2004 Feb;11(2):208-10.


OBJECTIVES: To report the pathology, toxicology, cause, and manner of death in 3,4-methylenedioxymethamphetamine (MDMA)-associated fatalities in the United States. Although use trends are increasing, data regarding the hazards of MDMA are limited. METHODS: The authors obtained fatality reports from participating medical examiners in the United States. Cases were identified as "drug-unrelated" when MDMA did not directly cause death (e.g., motor vehicle collision); deaths from drug toxicity were judged "drug-related." RESULTS: Thirty-eight (8%) of the surveyed medical examiners reported 102 deaths associated with MDMA use from 1999 to 2001. Ten percent of fatalities occurred in 1999 and 90% thereafter, representing a 400% relative increase. Victims tended to be young (mean age = 25), white (n = 87 [85%]), male (n = 70 [69%]), and otherwise healthy. Seventy-one (70%) deaths were drug-related (DR) and 31 (30%) were drug-unrelated (DU). Twenty-four (35%) DR deaths had a mean delay of 6.7 hours (95% CI = 5.1 to 8.2) in activating emergency medical services. Fifty-five DR cases (81%) were found in asystole and pronounced dead at the scene. CONCLUSIONS: The MDMA-associated fatal events typically occur in young, otherwise healthy individuals. MDMA's impact on the public health and safety of young adults and teenagers needs further assessment.

Club drugs
Liver failure
Brain damage?
Kidney damage
Deaths in New York
Long-term brain damage?
Toxic metabolites of MDMA?
MDMA and sympathetic activity
A toxic intraneuronal metabolite of serotonin?
Electrophysiological evidence of 5-HT damage
Non-neurotoxic and neurotoxic serotonin-releasers
Ecstasy-induced toxicity and the dopamine transporter
MDMA (Ecstasy) : neuropharmacology and neurotoxicity
5-HT, 5-HIAA, norepinephrine, epinephrine and dopamine
Lack of serotonin neurotoxicity after intracerebral Ecstasy microinjection

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