When 3,4-methylenedioxymetamfetamine (MDMA) is taken with alcohol, emergency department visits show higher odds of agitation, drowsiness, and vomiting compared to MDMA alone. Co-intoxication with other substances increases odds of bradycardia, psychosis, and coma. Mortality rates remain low across all groups. Female patients report less chest pain but more vomiting, headache, and hypotension than males. These variations suggest that physicians should consider both the type of co-intoxication and patient sex to optimize treatment.
Methoxetamine (MXE) and two methoxy-substituted analogs of phencyclidine (3-MeO-PCP and 4-MeO-PCP) are sold as legal alternatives to banned dissociative drugs like ketamine and PCP. This study tested whether these new psychoactive substances cross-react with five commercial urine immunoassays designed to detect PCP. 3-MeO-PCP and 4-MeO-PCP showed cross-reactivity ranging from 1% to 143% across all assays, and urine samples from two overdose cases were positive for PCP. MXE showed very weak cross-reactivity (0.04% to 0.25%), and ketamine was not detected in any assay. The assays can rapidly screen for 3-MeO-PCP and 4-MeO-PCP but not for ketamine, and MXE's low reactivity limits its detection.