Ecstasy deaths

Earlier this year ecstasy hit the headlines yet again when a 20-year-old Sydney woman died after taking the drug. It was later discovered that the capsule she took contained PMA (paramethamphetamine), a particularly toxic form of amphetamine. Once again, this has led some to believe that ecstasy or MDMA cannot cause significant harm. What is the reality?

If you look at the statistics in the UK (where they have much better records on ecstasy-related deaths), there have been over 200 reported deaths since 1988 linked to ecstasy. It would appear that nobody has died directly from the toxic effects of the drug, i.e. been poisoned or suffered an allergic reaction. Instead, deaths have fallen into three categories.

Most of the deaths are due to overheating. Use of ecstasy by itself in a hot environment such as a club increases body temperature. Combined with dancing in a crowded venue, ecstasy use can cause body temperature to rise over the danger limit of 40oC with symptoms that include convulsions, dilated pupils, very low blood pressure, and accelerated heart rate. Death is caused by respiratory collapse resulting from disseminated intravascular coagulation (DIC). What seems to happen is that MDMA somehow reacts with the chemicals that control blood coagulation. This causes the blood to coagulate where it shouldn’t, such as in the lungs; air cannot get through and the person dies. Also, if all the blood clotting agent has been used up in the wrong places, then the blood might not coagulate where it should and this can cause haemorrhaging from all the internal lesions that the human body normally sustains without problems.

There have also been recorded deaths caused by drinking too much fluid. The condition is known as dilutional hyponatremia. Ecstasy appears to affect the workings of the kidneys by inappropriately secreting an anti-diuretic hormone which prevents the excretion of fluids. Water is retained in the body, especially in the highly water-absorbent brain cells, and eventually the pressure shuts down primary bodily functions such as breathing and heartbeat. Symptoms include dizziness and disorientation leading to collapse into coma. Not all of those affected die; there are a number of ecstasy users who have been admitted to hospital in this condition, but who survived.

The final cause of death is heart failure. Ecstasy causes significant rises in blood pressure and heart rate which a fit young person can normally sustain. However, a few young people have succumbed to these stimulant effects, sometimes as a result of an undiagnosed heart condition.

We still need to find out much more about ecstasy. It does not seem to be as simple as high levels of MDMA causing poisoning. There are documented cases of users with high levels of MDMA in their blood who have survived overdoses, and others where a typical dose of around 100-150mg has caused death.

Remember: if you do not want any negative consequences, do not use the drug and, no matter how many times you have used a substance, never be blas?/p>