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Ramsey JD, Johnston A, Holt DW. 
“Death rate from use of ecstasy or heroin”. 
Lancet. 1999 Dec 18-25;354(9196):2166.
Sir-Sheila Gore (Oct 9, p 1265)1 raises some fascinating points that highlight the difficulties of estimating death rates in young people who use ecstasy or heroin. We suggest that the situation is even more complex. First, what constitutes an ecstasy-related or heroin-related death, may be difficult to define from current statistics. A parallel may be drawn with the monitoring of mortality related to volatile-substances abuse carried out at our medical school, for which a criterion for inclusion is: 'Would the deceased still be alive if (s)he had not abused the volatile substance?' By this criterion, deaths from causes such as road traffic accidents are included if the death was secondary to intoxication witha volatile compound.
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