Death rates from ecstasy (MDMA, MDA) and polydrug use in England and Wales 1996–2002

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Abstract
The present study reports on all deaths related to taking ecstasy (alone, or in a polydrug combination) occurring in England and Wales in the time frame August 1996–April 2002. Data presented here are based on all information recorded in the National Programme on Substance Abuse Deaths (np‐SAD) database. The np‐SAD regularly receives all information on drug related deaths in addicts and non addicts from coroners. A total of 202 ecstasy‐related fatalities occurred in the chosen time‐frame, showing a steady increase in the number of deaths each year. The ratio male:female was 4:1 and 3 of 4 victims were younger than 29. In 17% of cases ecstasy was the sole drug implicated in death and in the remaining cases a number of other drugs (mostly alcohol, cocaine, amphetamines and opiates) have been found. According to toxicology results, MDMA accounted for 86% of cases and MDA for 13% of cases; single deaths were associated with MDEA and PMA. This is the largest sample of ecstasy related deaths so far; possible explanations are given for the observed steady increase in ecstasy‐related deaths and a tentative ‘rationale’ for this polypharmacy combination is then proposed. Copyright © 2003 John Wiley & Sons, Ltd.