Trends in MDMA‐related mortality across four countries
Aims To determine trends in 3,4 methylenedioxymethamphetamine (MDMA)‐related death rates across Australia, Finland, Portugal and Turkey and to analyse the toxicology and causes of death across countries. Design Analysis of MDMA‐related deaths extracted from a national coronial database in Australia...
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| Veröffentlicht in: | Addiction (Abingdon, England) England), 2021-11, Vol.116 (11), p.3094-3103 |
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| creator | Roxburgh, Amanda Sam, Bulent Kriikku, Pirkko Mounteney, Jane Castanera, Antonio Dias, Mario Giraudon, Isabelle |
| description | Aims
To determine trends in 3,4 methylenedioxymethamphetamine (MDMA)‐related death rates across Australia, Finland, Portugal and Turkey and to analyse the toxicology and causes of death across countries.
Design
Analysis of MDMA‐related deaths extracted from a national coronial database in Australia (2001–19) and national forensic toxicology databases in Finland (2001–17), Portugal (2008–19) and Turkey (2007–17). Presentation of MDMA use and seizure data (market indicators).
Setting
Australia, Finland, Portugal and Turkey.
Cases
All deaths in which MDMA was considered by the forensic pathologist to be contributory to death.
Measurements
Information collected on cause and circumstances of death, demographics and toxicology.
Findings
A total of 1400 MDMA‐related deaths were identified in Turkey, 507 in Australia, 100 in Finland and 45 in Portugal. The median age ranged from 24 to 27.5 years, and males represented between 81 and 94% of the deaths across countries. Standardized mortality rates significantly increased across all four countries from 2011 to 2017 during a period of increased purity and availability of MDMA. The underlying cause of death was predominantly due to drug toxicity in Australia (n = 309, 61%), Finland (n = 70, 70%) and Turkey (n = 840, 60%) and other causes in Portugal (n = 25, 56%). Minorities of all deaths across the countries were due to MDMA toxicity alone (13–25%). These deaths had a significantly higher blood MDMA concentration than multiple drug toxicity deaths in Australia, Finland and Turkey. Drugs other than MDMA commonly detected were stimulants (including cocaine, amphetamine and methamphetamine) (Australia 52% and Finland 61%) and alcohol (Australia 46% and Portugal 49%). In addition to MDMA toxicity, benzodiazepines (81%) and opioids (64%) were commonly identified in these deaths in Finland. In comparison, synthetic cannabinoids (15%) and cannabis (33%) were present in a minority of deaths in Turkey.
Conclusions
Deaths related to 3,4 methylenedioxymethamphetamine (MDMA) increased in Australia, Finland, Portugal and Turkey between 2011 and 2017. Findings show MDMA toxicity alone can be fatal, but multiple drug toxicity remains more prevalent. |
| doi_str_mv | 10.1111/add.15493 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2578911575</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2578911575</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3883-3d0743c8cef0a15e3e7deccb2e51875bb36aadca6b985366ac7bd2cfb84d53093</originalsourceid><addsrcrecordid>eNp1kLtOwzAUhi0EoqUw8AIoEhNDWjsnjp2xarhJrVjKbPkWKVWaFDsR6sYj8Iw8CaYpbJzlLJ--858foWuCpyTMTBozJTTN4QSNCWQ4xmkKp2iM84zGCUnxCF14v8EYM56n52gEwCCnWTJGfO1sY3xUNdGqWM2_Pj6drWVnTbRtXSfrqttHUrvW-6hsexfptm86V1l_ic5KWXt7ddwT9Ppwv148xcuXx-fFfBlr4BxiMJiloLm2JZaEWrDMWK1VYinhjCoFmZRGy0zlnEKWSc2USXSpeGoo4Bwm6Hbw7lz71lvfiU3I0YSTIqHhHUIoo4G6G6hDVGdLsXPVVrq9IFj8dCRCR-LQUWBvjsZeba35I39LCcBsAN6r2u7_N4l5UQzKb3DBcJ8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2578911575</pqid></control><display><type>article</type><title>Trends in MDMA‐related mortality across four countries</title><source>Wiley Blackwell Single Titles</source><creator>Roxburgh, Amanda ; Sam, Bulent ; Kriikku, Pirkko ; Mounteney, Jane ; Castanera, Antonio ; Dias, Mario ; Giraudon, Isabelle</creator><creatorcontrib>Roxburgh, Amanda ; Sam, Bulent ; Kriikku, Pirkko ; Mounteney, Jane ; Castanera, Antonio ; Dias, Mario ; Giraudon, Isabelle</creatorcontrib><description>Aims
To determine trends in 3,4 methylenedioxymethamphetamine (MDMA)‐related death rates across Australia, Finland, Portugal and Turkey and to analyse the toxicology and causes of death across countries.
Design
Analysis of MDMA‐related deaths extracted from a national coronial database in Australia (2001–19) and national forensic toxicology databases in Finland (2001–17), Portugal (2008–19) and Turkey (2007–17). Presentation of MDMA use and seizure data (market indicators).
Setting
Australia, Finland, Portugal and Turkey.
Cases
All deaths in which MDMA was considered by the forensic pathologist to be contributory to death.
Measurements
Information collected on cause and circumstances of death, demographics and toxicology.
Findings
A total of 1400 MDMA‐related deaths were identified in Turkey, 507 in Australia, 100 in Finland and 45 in Portugal. The median age ranged from 24 to 27.5 years, and males represented between 81 and 94% of the deaths across countries. Standardized mortality rates significantly increased across all four countries from 2011 to 2017 during a period of increased purity and availability of MDMA. The underlying cause of death was predominantly due to drug toxicity in Australia (n = 309, 61%), Finland (n = 70, 70%) and Turkey (n = 840, 60%) and other causes in Portugal (n = 25, 56%). Minorities of all deaths across the countries were due to MDMA toxicity alone (13–25%). These deaths had a significantly higher blood MDMA concentration than multiple drug toxicity deaths in Australia, Finland and Turkey. Drugs other than MDMA commonly detected were stimulants (including cocaine, amphetamine and methamphetamine) (Australia 52% and Finland 61%) and alcohol (Australia 46% and Portugal 49%). In addition to MDMA toxicity, benzodiazepines (81%) and opioids (64%) were commonly identified in these deaths in Finland. In comparison, synthetic cannabinoids (15%) and cannabis (33%) were present in a minority of deaths in Turkey.
Conclusions
Deaths related to 3,4 methylenedioxymethamphetamine (MDMA) increased in Australia, Finland, Portugal and Turkey between 2011 and 2017. Findings show MDMA toxicity alone can be fatal, but multiple drug toxicity remains more prevalent.</description><identifier>ISSN: 0965-2140</identifier><identifier>EISSN: 1360-0443</identifier><identifier>DOI: 10.1111/add.15493</identifier><identifier>PMID: 33739562</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Amphetamines ; Benzodiazepines ; Blood levels ; Cannabinoids ; Cannabis ; Cocaine ; Death ; Death & dying ; Demography ; Drug abuse ; Drug‐related deaths ; Ecstasy ; Ecstasy drug ; Forensic science ; Males ; Marijuana ; MDMA ; Men ; Methamphetamine ; Minority groups ; Mortality ; Mortality rates ; Opioids ; Purity ; Stimulants ; Toxicity ; Toxicology ; Trends</subject><ispartof>Addiction (Abingdon, England), 2021-11, Vol.116 (11), p.3094-3103</ispartof><rights>2021 Society for the Study of Addiction</rights><rights>2021 Society for the Study of Addiction.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3883-3d0743c8cef0a15e3e7deccb2e51875bb36aadca6b985366ac7bd2cfb84d53093</citedby><cites>FETCH-LOGICAL-c3883-3d0743c8cef0a15e3e7deccb2e51875bb36aadca6b985366ac7bd2cfb84d53093</cites><orcidid>0000-0001-8609-0075 ; 0000-0002-9612-5179</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fadd.15493$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fadd.15493$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33739562$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roxburgh, Amanda</creatorcontrib><creatorcontrib>Sam, Bulent</creatorcontrib><creatorcontrib>Kriikku, Pirkko</creatorcontrib><creatorcontrib>Mounteney, Jane</creatorcontrib><creatorcontrib>Castanera, Antonio</creatorcontrib><creatorcontrib>Dias, Mario</creatorcontrib><creatorcontrib>Giraudon, Isabelle</creatorcontrib><title>Trends in MDMA‐related mortality across four countries</title><title>Addiction (Abingdon, England)</title><addtitle>Addiction</addtitle><description>Aims
To determine trends in 3,4 methylenedioxymethamphetamine (MDMA)‐related death rates across Australia, Finland, Portugal and Turkey and to analyse the toxicology and causes of death across countries.
Design
Analysis of MDMA‐related deaths extracted from a national coronial database in Australia (2001–19) and national forensic toxicology databases in Finland (2001–17), Portugal (2008–19) and Turkey (2007–17). Presentation of MDMA use and seizure data (market indicators).
Setting
Australia, Finland, Portugal and Turkey.
Cases
All deaths in which MDMA was considered by the forensic pathologist to be contributory to death.
Measurements
Information collected on cause and circumstances of death, demographics and toxicology.
Findings
A total of 1400 MDMA‐related deaths were identified in Turkey, 507 in Australia, 100 in Finland and 45 in Portugal. The median age ranged from 24 to 27.5 years, and males represented between 81 and 94% of the deaths across countries. Standardized mortality rates significantly increased across all four countries from 2011 to 2017 during a period of increased purity and availability of MDMA. The underlying cause of death was predominantly due to drug toxicity in Australia (n = 309, 61%), Finland (n = 70, 70%) and Turkey (n = 840, 60%) and other causes in Portugal (n = 25, 56%). Minorities of all deaths across the countries were due to MDMA toxicity alone (13–25%). These deaths had a significantly higher blood MDMA concentration than multiple drug toxicity deaths in Australia, Finland and Turkey. Drugs other than MDMA commonly detected were stimulants (including cocaine, amphetamine and methamphetamine) (Australia 52% and Finland 61%) and alcohol (Australia 46% and Portugal 49%). In addition to MDMA toxicity, benzodiazepines (81%) and opioids (64%) were commonly identified in these deaths in Finland. In comparison, synthetic cannabinoids (15%) and cannabis (33%) were present in a minority of deaths in Turkey.
Conclusions
Deaths related to 3,4 methylenedioxymethamphetamine (MDMA) increased in Australia, Finland, Portugal and Turkey between 2011 and 2017. Findings show MDMA toxicity alone can be fatal, but multiple drug toxicity remains more prevalent.</description><subject>Amphetamines</subject><subject>Benzodiazepines</subject><subject>Blood levels</subject><subject>Cannabinoids</subject><subject>Cannabis</subject><subject>Cocaine</subject><subject>Death</subject><subject>Death & dying</subject><subject>Demography</subject><subject>Drug abuse</subject><subject>Drug‐related deaths</subject><subject>Ecstasy</subject><subject>Ecstasy drug</subject><subject>Forensic science</subject><subject>Males</subject><subject>Marijuana</subject><subject>MDMA</subject><subject>Men</subject><subject>Methamphetamine</subject><subject>Minority groups</subject><subject>Mortality</subject><subject>Mortality rates</subject><subject>Opioids</subject><subject>Purity</subject><subject>Stimulants</subject><subject>Toxicity</subject><subject>Toxicology</subject><subject>Trends</subject><issn>0965-2140</issn><issn>1360-0443</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kLtOwzAUhi0EoqUw8AIoEhNDWjsnjp2xarhJrVjKbPkWKVWaFDsR6sYj8Iw8CaYpbJzlLJ--858foWuCpyTMTBozJTTN4QSNCWQ4xmkKp2iM84zGCUnxCF14v8EYM56n52gEwCCnWTJGfO1sY3xUNdGqWM2_Pj6drWVnTbRtXSfrqttHUrvW-6hsexfptm86V1l_ic5KWXt7ddwT9Ppwv148xcuXx-fFfBlr4BxiMJiloLm2JZaEWrDMWK1VYinhjCoFmZRGy0zlnEKWSc2USXSpeGoo4Bwm6Hbw7lz71lvfiU3I0YSTIqHhHUIoo4G6G6hDVGdLsXPVVrq9IFj8dCRCR-LQUWBvjsZeba35I39LCcBsAN6r2u7_N4l5UQzKb3DBcJ8</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Roxburgh, Amanda</creator><creator>Sam, Bulent</creator><creator>Kriikku, Pirkko</creator><creator>Mounteney, Jane</creator><creator>Castanera, Antonio</creator><creator>Dias, Mario</creator><creator>Giraudon, Isabelle</creator><general>Blackwell Publishing Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7TK</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>NAPCQ</scope><orcidid>https://orcid.org/0000-0001-8609-0075</orcidid><orcidid>https://orcid.org/0000-0002-9612-5179</orcidid></search><sort><creationdate>202111</creationdate><title>Trends in MDMA‐related mortality across four countries</title><author>Roxburgh, Amanda ; Sam, Bulent ; Kriikku, Pirkko ; Mounteney, Jane ; Castanera, Antonio ; Dias, Mario ; Giraudon, Isabelle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3883-3d0743c8cef0a15e3e7deccb2e51875bb36aadca6b985366ac7bd2cfb84d53093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Amphetamines</topic><topic>Benzodiazepines</topic><topic>Blood levels</topic><topic>Cannabinoids</topic><topic>Cannabis</topic><topic>Cocaine</topic><topic>Death</topic><topic>Death & dying</topic><topic>Demography</topic><topic>Drug abuse</topic><topic>Drug‐related deaths</topic><topic>Ecstasy</topic><topic>Ecstasy drug</topic><topic>Forensic science</topic><topic>Males</topic><topic>Marijuana</topic><topic>MDMA</topic><topic>Men</topic><topic>Methamphetamine</topic><topic>Minority groups</topic><topic>Mortality</topic><topic>Mortality rates</topic><topic>Opioids</topic><topic>Purity</topic><topic>Stimulants</topic><topic>Toxicity</topic><topic>Toxicology</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roxburgh, Amanda</creatorcontrib><creatorcontrib>Sam, Bulent</creatorcontrib><creatorcontrib>Kriikku, Pirkko</creatorcontrib><creatorcontrib>Mounteney, Jane</creatorcontrib><creatorcontrib>Castanera, Antonio</creatorcontrib><creatorcontrib>Dias, Mario</creatorcontrib><creatorcontrib>Giraudon, Isabelle</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Addiction (Abingdon, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roxburgh, Amanda</au><au>Sam, Bulent</au><au>Kriikku, Pirkko</au><au>Mounteney, Jane</au><au>Castanera, Antonio</au><au>Dias, Mario</au><au>Giraudon, Isabelle</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in MDMA‐related mortality across four countries</atitle><jtitle>Addiction (Abingdon, England)</jtitle><addtitle>Addiction</addtitle><date>2021-11</date><risdate>2021</risdate><volume>116</volume><issue>11</issue><spage>3094</spage><epage>3103</epage><pages>3094-3103</pages><issn>0965-2140</issn><eissn>1360-0443</eissn><abstract>Aims
To determine trends in 3,4 methylenedioxymethamphetamine (MDMA)‐related death rates across Australia, Finland, Portugal and Turkey and to analyse the toxicology and causes of death across countries.
Design
Analysis of MDMA‐related deaths extracted from a national coronial database in Australia (2001–19) and national forensic toxicology databases in Finland (2001–17), Portugal (2008–19) and Turkey (2007–17). Presentation of MDMA use and seizure data (market indicators).
Setting
Australia, Finland, Portugal and Turkey.
Cases
All deaths in which MDMA was considered by the forensic pathologist to be contributory to death.
Measurements
Information collected on cause and circumstances of death, demographics and toxicology.
Findings
A total of 1400 MDMA‐related deaths were identified in Turkey, 507 in Australia, 100 in Finland and 45 in Portugal. The median age ranged from 24 to 27.5 years, and males represented between 81 and 94% of the deaths across countries. Standardized mortality rates significantly increased across all four countries from 2011 to 2017 during a period of increased purity and availability of MDMA. The underlying cause of death was predominantly due to drug toxicity in Australia (n = 309, 61%), Finland (n = 70, 70%) and Turkey (n = 840, 60%) and other causes in Portugal (n = 25, 56%). Minorities of all deaths across the countries were due to MDMA toxicity alone (13–25%). These deaths had a significantly higher blood MDMA concentration than multiple drug toxicity deaths in Australia, Finland and Turkey. Drugs other than MDMA commonly detected were stimulants (including cocaine, amphetamine and methamphetamine) (Australia 52% and Finland 61%) and alcohol (Australia 46% and Portugal 49%). In addition to MDMA toxicity, benzodiazepines (81%) and opioids (64%) were commonly identified in these deaths in Finland. In comparison, synthetic cannabinoids (15%) and cannabis (33%) were present in a minority of deaths in Turkey.
Conclusions
Deaths related to 3,4 methylenedioxymethamphetamine (MDMA) increased in Australia, Finland, Portugal and Turkey between 2011 and 2017. Findings show MDMA toxicity alone can be fatal, but multiple drug toxicity remains more prevalent.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>33739562</pmid><doi>10.1111/add.15493</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8609-0075</orcidid><orcidid>https://orcid.org/0000-0002-9612-5179</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Blackwell Single Titles |
| subjects | Amphetamines Benzodiazepines Blood levels Cannabinoids Cannabis Cocaine Death Death & dying Demography Drug abuse Drug‐related deaths Ecstasy Ecstasy drug Forensic science Males Marijuana MDMA Men Methamphetamine Minority groups Mortality Mortality rates Opioids Purity Stimulants Toxicity Toxicology Trends |
| title | Trends in MDMA‐related mortality across four countries |
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