From the National Drug and Alcohol Research Centre

Many of you may have read the story this morning regarding ecstasy deaths, reported in the Daily Telegraph and the Herald Sun.

The opening paragraph claims the following: The party drug ecstasy is killing more than one person every fortnight nationwide, with almost a third of deaths occurring in car crashes.

As is often the case the story is not entirely accurate, so I would like to give you a little more information.

Unfortunately the Australian Bureau of Statistics (ABS) mortality register does not distinguish between ecstasy and other amphetamine type substances (ATS) related deaths. However, the National Coronial Information System (NCIS) does make this distinction, however these data are quite limited in the information they provide.

The NCIS defines a primary contribution as “producing the actual physical harm, most closely linked to the cause of death”, secondary contribution as “involved at the start of the injury event”, tertiary contribution as “other mechanisms involved in the injury event”.

If it is thought that drug use contributed to the risk of road traffic crashes, for example, it would be a secondary contribution; if the cause of death was drug toxicity or drug overdose and a drug was one of those detected, it would be implicated as one of the primary contributions to death (note that since ecstasy was usually one of a range of drugs detected, other drugs would also be classed as a primary contribution).

So what does the data tell us? Over the four year period 2001-2004, NCIS identified 112 ecstasy-related deaths. Although ecstasy was deemed to be a primary contributor in 51 (46%) of these, MDMA was the sole drug present in only six (5%) of these deaths. It is important to note that the majority of deaths were due to either a road traffic crash (RTC, 28%) or drug toxicity (40%).

Importantly, MDMA was rarely the only drug identified in drug toxicity deaths (3 of 45 deaths), and never the only drug in the overdose deaths. Some of the causes of the ecstasy-related deaths are particularly interesting and quite bizarre – three deaths were due to drowning, six were hangings and 8 were falls from a height!

Two implications of this data are firstly that death as a direct result of ecstasy consumption seems to be very rare in Australia compared to the extent of use, and ecstasy is usually only one of a range of drugs detected at death (a point that the newspapers chose to ignore!). Secondly, a substantial proportion of ecstasy-related deaths involve a motor vehicle accident. If you wish to read more about this, you will find the full PDI Bulletin (Kinner, Fowler, Fischer, et al (2005)) at the following location:


http://ndarc.med.unsw.edu.au/NDARCWeb.nsf/resources/BulletinsPDI_2005/$file/PDI+APRIL+2005.pdf

Paul Dillon
Manager
National Drug and Alcohol Research Centre
UNSW SYDNEY NSW 2052