Exclusion of MDMA Hallucinogenic Substances and Inhalents

Estimating the contribution that MDMA (ecstasy), hallucinogenic substances and inhalants make to premature mortality presents problems¹. Although there are case reports of deaths associated with MDMA intoxication^2-4, these appear to be rare by comparison with overdose deaths due to opioids and cocaine in developed societies with a moderate prevalence of illicit drug use and good mortality data, such as Australia⁵. There is also continuing controversy about the existence and significance of any MDMA dependence syndrome, and there is no specific MDMA dependence syndrome currently classified in the American Psychiatric Association or the ICD.

References

1. Boot BP, McGregor LS, Hall W. MDMA (Ecstasy) neurotoxicity: assessing and communicating the risks. Lancet 2000;355(9217):1818-1821.
2. Parr MJA, Heather ML, Botterill P. Hyponatraemia and death after "ecstacy" ingestion. Medical Journal of Australia 1997;166:136-141.
3. Dowling GP, McDonough E, Bost RO. Eve and ecstasy. A report of five deaths associated with the use of MDEA and MDMA. Journal of the American Medical Association 1987;257:1615-1617.
4. Henry JA, Jeffreys KJ, Dawling S. Toxicity and deaths from 3,4 methylenedioxymethamphetamine ("ecstasy"). The Lancet 1992;340:284-287.
5. Ridolfo B, Stevenson C. The quantification of drug-caused mortality and morbidity in Australia, 1998. Canberra: Australian Institute of Health and Welfare, 2001.