"Ecstasy" associated deaths: what is a fatal concentration ? Analysis of a case series.
Forensic science, medicine, and pathology September 2011 DOI: 10.1007/s12024-010-9220-7 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 77 |
| Population | Deaths where MDMA was detected in body fluids or organs |
| Topics | MDMA |
| Key findings | MDMA blood concentrations overlap considerably between deaths from direct MDMA toxicity and those from trauma, so no specific concentration can determine the cause of death without considering the history and full autopsy findings. |
Abstract
Amphetamine derivative drugs, particularly 3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, are popular recreational drugs. MDMA is associated with causing death by a number of mechanisms, including hyperpyrexia, cardiac arrhythmia water intoxication and liver failure. Seventy-seven deaths where MDMA was detected in body fluids/organs were reviewed. Of these cases 59 deaths had MDMA present in blood. In 13 cases death was attributable to the toxic effects of MDMA alone with a range of 0.478-53.9 mg/l, mean 8.43 mg/l, median 3.49 mg/l. In 22 cases death was due to polydrug use, with an MDMA range of 0.04-41.5 mg/l, mean 2.90 mg/l, median 0.76 mg/l. In 24 cases death was due to trauma with an MDMA range of 0.035-4.81 mg/l, mean 0.862 mg/l, median 0. 483 mg/l. There is considerable overlap between the concentration of MDMA seen in deaths from direct MDMA toxicity and deaths associated with trauma. These findings show, that like other stimulant drugs, no specific concentration can be used to determine death without consideration of the history and full autopsy findings.
Comparable studies
Other case reports and case series on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA Individuals whose deaths were associated with MDMA or MDEA use | 1987 | Case series | n = 5 |
| Pathology of deaths associated with "ecstasy" and "eve" misuse. Young white men aged 20 to 25 who died after using ring-substituted amphetamines (MDMA... | 1996 | Case series | n = 7 |
| 'Eve' and 'Ecstasy' Individuals who died after using MDMA or MDEA | 1987 | Case series | n = 5 |
| A Method of Conducting Therapeutic Sessions with MDMA Clients with clear therapeutic purpose, excluding those with serious functional... | 1998 | Case study | n = 2 |
| Diversity of Psychopathology Associated with use of 3,4-Methylenedioxymethamphetamine (‘Ecstasy’) Psychiatric patients presenting between 1990 and 1992 whose symptoms developed in the... | 1994 | Case series | n = 13 |
Citations in the library
Cited by 7
- MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults. Progress in Neuro-Psychopharmacology and Biological Psychiatry January 4, 2016
- 3,4-methylenedioxymethamphetamine (MDMA): current perspectives Substance Abuse and Rehabilitation November 1, 2013
- Critical Role of Peripheral Vasoconstriction in Fatal Brain Hyperthermia Induced by MDMA (Ecstasy) under Conditions That Mimic Human Drug Use Journal of Neuroscience June 4, 2014
- Key interindividual determinants in MDMA pharmacodynamics Expert Opinion on Drug Metabolism & Toxicology January 5, 2018
- Interest and limits of using pharmacogenetics in MDMA-related fatalities: A case report. Forensic science international. Genetics March 1, 2025
and 2 more in the library
Cites 11
- 'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA JAMA March 27, 1987
- Pathology of deaths associated with "ecstasy" and "eve" misuse. Journal of Clinical Pathology February 1, 1996
- Ecstasy induced hepatitis mimicking viral hepatitis. Gut June 1, 1995
- Ecstasy (MDMA) Deaths in New York City: A Case Series and Review of the Literature Journal of Forensic Sciences 2002
- A Fatal Trip with Ecstasy: A Case of 3,4-Methylene-Dioxymethamphetamine/ 3,4-Methylenedioxy-Amphetamine Toxicity Journal of the Royal Society of Medicine 1996
and 6 more in the library