Urine specimens from 34 active-duty U.S. Army personnel who tested positive for amphetamines were reanalyzed. All samples contained both MDMA (ecstasy) and its metabolite MDA. MDMA concentrations ranged from 0.38 to 96.2 mg/L (mean 13.4 mg/L), and MDA concentrations ranged from 0.15 to 8.6 mg/L (mean 1.6 mg/L). The average ratio of MDA to MDMA was 0.15, similar to the ratio of amphetamine to methamphetamine (0.10). The presence of MDA at about 10–15% of the MDMA concentration is consistent with MDMA metabolism alone, suggesting use of only MDMA rather than combined use of both drugs.
Five teenage males in three states died after intentionally ingesting large, recreational doses of dextromethorphan, a common over-the-counter cough suppressant that can cause intoxication, hallucinations, and dissociation at high doses. All obtained the drug from the same internet supplier. Postmortem blood concentrations ranged from 950 to 3230 ng/mL, far above therapeutic levels. Three also had diphenhydramine, one a trace of alprazolam, and two tested positive for cannabinoids. Each death was attributed to dextromethorphan toxicity or combined drug toxicity. The article describes the drug's metabolism, pharmacology, and interaction risks, and notes that the deaths led to prosecution of three individuals involved in selling or distributing the drug.