Patel Manish M, Wright David W, Ratcliff Jonathan J, Miller Michael A
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA 30333, USA.
Acad Emerg Med. 2004 Feb;11(2):208-10.
To report the pathology, toxicology, cause, and manner of death in 3,4-methylenedioxymethamphetamine (MDMA)-associated fatalities in the United States. Although use trends are increasing, data regarding the hazards of MDMA are limited.
The authors obtained fatality reports from participating medical examiners in the United States. Cases were identified as "drug-unrelated" when MDMA did not directly cause death (e.g., motor vehicle collision); deaths from drug toxicity were judged "drug-related."
Thirty-eight (8%) of the surveyed medical examiners reported 102 deaths associated with MDMA use from 1999 to 2001. Ten percent of fatalities occurred in 1999 and 90% thereafter, representing a 400% relative increase. Victims tended to be young (mean age = 25), white (n = 87 [85%]), male (n = 70 [69%]), and otherwise healthy. Seventy-one (70%) deaths were drug-related (DR) and 31 (30%) were drug-unrelated (DU). Twenty-four (35%) DR deaths had a mean delay of 6.7 hours (95% CI = 5.1 to 8.2) in activating emergency medical services. Fifty-five DR cases (81%) were found in asystole and pronounced dead at the scene.
The MDMA-associated fatal events typically occur in young, otherwise healthy individuals. MDMA's impact on the public health and safety of young adults and teenagers needs further assessment.
报告美国与3,4－亚甲基二氧甲基苯丙胺（摇头丸）相关死亡案例的病理学、毒理学、死因及死亡方式。尽管摇头丸的使用呈上升趋势，但有关其危害的数据有限。
作者从美国参与调查的法医处获取死亡报告。若摇头丸未直接导致死亡（如机动车碰撞），则此类案例被认定为“与毒品无关”；因药物毒性导致的死亡被判定为“与毒品相关”。
在接受调查的法医中，有38位（8%）报告了1999年至2001年间102例与使用摇头丸相关的死亡案例。10%的死亡案例发生在1999年，此后为90%，相对增长了400%。受害者多为年轻人（平均年龄 = 25岁），白人（n = 87 [85%]），男性（n = 70 [69%]），且其他方面健康。71例（70%）死亡与毒品相关（DR），31例（30%）与毒品无关（DU）。24例（35%）与毒品相关的死亡案例中，呼叫急救服务的平均延迟时间为6.7小时（95%置信区间 = 5.1至8.2）。55例（81%）与毒品相关的案例被发现心脏停搏，并在现场被宣布死亡。
与摇头丸相关的致命事件通常发生在原本健康的年轻人身上。摇头丸对年轻人及青少年公共健康和安全的影响需要进一步评估。
