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Schifano F, Corkery J, Naidoo V, Oyefeso A, Ghodse H. 
“Overview of Amphetamine-Type Stimulant Mortality Data - UK, 1997-2007”. 
Neuropsychobiology. 2010 Jan 29;61(3):122-130.
Background/Aims: Despite being amphetamine derivatives, MDMA and its analogues show a number of clinical pharmacological differences with respect to both amphetamine (AMP) and methylamphetamine (METH). We aimed here at reporting and analysing information relating to the socio-demographics and clinical circumstances of the AMP-type stimulant-related deaths for the whole of the UK.

METHODS: Data (1997-2007) were taken from the National Programme on Substance Abuse Deaths (np-SAD) database, collecting information from UK coroners/procurators fiscal. To calculate rates of fatalities per 100,000 users, appropriate AMP/METH and ecstasy users' numbers were taken from the 2001-2007 British Crime Survey.

RESULTS: Overall, 832 AMP/METH- and 605 ecstasy (mostly MDMA and methylenedioxyamphetamine/MDA)-related deaths were respectively identified. In comparison with AMP/METH victims, the ecstasy ones were more likely to be younger (28.3 vs. 32.7 years; p < 0.0001) and less likely to be known as drug users (PR = 1.9; CI 1.5-2.6). Ecstasy was more likely to be identified on its own than AMP/METH (p = 0.0192). Contributory factors were more frequently mentioned by coroners in the 'AMP/METH-only' (106 cases) group than in the 'ecstasy-only' (104 cases) one (p = 0.0043). Both poly- and monodrug AMP/METH fatalities per 100,000 16- to 59-year-old users were significantly more represented than ecstasy fatalities (respectively 17.87 +/- 4.77 deaths vs. 10.89 +/- 1.27; p = 0.000; 2.09 +/- 0.88 vs. 1.75 +/- 0.56; p = 0.0096). However, mono-intoxication ecstasy fatalities per 100,000 16- to 24-year-old users were significantly more represented than AMP/METH fatalities (1.67 +/- 0.52 vs. 0.8 +/- 0.65; p = 0.0007). Conclusion: With respect to AMP/METH, ecstasy was here more typically identified in victims who were young, healthy, and less likely to be known as drug users. AMP/METH high mortality rates may be explained by users' high levels of physical co-morbidity; excess ecstasy-related fatality rates in young users may be a reason for concern. Although the coroners' response rate was of 90-95%, study limitations include both reporting inconsistency over time and lack of routine information on drug intake levels prior to death.
Comments and Responses to this Article
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earth - mark
Apr 17, 2011 1:59
Misleading stress on risk of death #

The actual finding reported in this paper is that the ratio of 'ecstasy' deaths to the population was slightly lower than the comparable rate for amphetamines. Only by separating out 'single-drug' fatalities and younger people, 'ecstasy' deaths were more common than amphetamine deaths.

Another point is that 82% of the 605 reported 'ecstasy' deaths over the 11 years they studied involved 'known drug addiction'. That leaves only 11 deaths per year among non addicts. For single-drug deaths (106 in the 11 year period), 65% were 'known addicts', leaving 3.2 deaths per year in the United Kingdom who had only taken 'ecstasy' and were not also 'addicts'.

The British Home Office estimates around 500,000 ecstasy users per year during that period, meaning somewhat less than 1 death per hundred thousand users and substantially less than that per use-session.
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