Kaye Sharlene, Darke Shane, Duflou Johan
National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia.
Drug Alcohol Depend. 2009 Oct 1;104(3):254-61. doi: 10.1016/j.drugalcdep.2009.05.016. Epub 2009 Jul 14.
To examine the demographic characteristics, circumstances, toxicology and major organ pathology of MDMA-related deaths in Australia.
Retrospective review of cases in which MDMA was a cause of death, as identified from the National Coronial Information System.
82 cases over a 5-year period were identified. The majority of decedents were male (83%), with a median age of 26 years. Deaths were predominantly due to drug toxicity (82%), with MDMA the sole drug causing death in 23% of cases, and combined drug toxicity in 59% of cases. The remaining deaths (18%) were primarily due to pathological events/disease or injury, with MDMA a significant contributing condition. Cardiovascular pathology, typically atherosclerosis, was detected in 58% of decedents, with moderate-severe atherosclerosis in 23% of cases. The prevalence of such pathology is higher than that expected among similarly aged members of the general population. Cerebrovascular pathology, primarily cerebral haemorrhage and hypoxic damage, was present in 12% of cases.
MDMA has contributed to a clinically significant number of deaths in Australia. The prevalence of cardiovascular pathology was similar to that among methamphetamine and cocaine fatalities. Whilst cardiovascular pathology may reflect the use of other stimulants, the cardiotoxic properties of MDMA have been well-documented. Future studies examining MDMA-related morbidity and mortality in the context of other risk factors are recommended. Overall, the current study highlights the need to educate users about the potential harms of MDMA use, particularly that in conjunction with other stimulants, opioids and alcohol, which are known to increase overall toxicity.
研究澳大利亚摇头丸相关死亡案例的人口统计学特征、情况、毒理学及主要器官病理学情况。
对国家死因信息系统中确定摇头丸为死因的案例进行回顾性研究。
在5年期间共确定了82例案例。大多数死者为男性（83%），中位年龄为26岁。死亡主要归因于药物毒性（82%），其中23%的案例中摇头丸是唯一导致死亡的药物，59%的案例是联合药物毒性。其余死亡案例（18%）主要归因于病理事件/疾病或损伤，摇头丸是一个重要的促成因素。58%的死者检测到心血管病理学情况，通常为动脉粥样硬化，23%的案例存在中度至重度动脉粥样硬化。这种病理学情况的患病率高于一般人群中同龄人的预期患病率。12%的案例存在脑血管病理学情况，主要为脑出血和缺氧性损伤。
在澳大利亚，摇头丸导致了数量可观的临床死亡案例。心血管病理学情况的患病率与甲基苯丙胺和可卡因致死案例中的患病率相似。虽然心血管病理学情况可能反映了其他兴奋剂的使用，但摇头丸的心脏毒性特性已有充分记录。建议未来在其他风险因素背景下研究摇头丸相关的发病率和死亡率。总体而言，当前研究强调有必要对使用者进行教育，使其了解使用摇头丸的潜在危害，特别是与其他已知会增加总体毒性的兴奋剂、阿片类药物和酒精同时使用时的危害。
