Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, the Netherlands.
The Maastricht Forensic Institute, Maastricht, the Netherlands.
J Psychopharmacol. 2020 Jun;34(6):591-599. doi: 10.1177/0269881119897559. Epub 2020 Jan 7.
The recreational drug ecstasy (3,4-methylenedioxymethamphetamine) is currently used world-wide. Severe (including fatal) health incidents related to ecstasy have been reported but a risk assessment of acute non-fatal and fatal ecstasy-related health incidents has never been performed.
In the current risk assessment review, national data of non-fatal health incidents collected in the Netherlands were combined with the nationwide exposure to ecstasy, that is, last-year prevalence of ecstasy use. In addition, the annual number of ecstasy-related deaths in Great Britain (Scotland, Wales and England) was used to assess the risk of fatal ecstasy-related cases.
In the Netherlands, the estimated risk of a moderate to severe acute health incident following the use of ecstasy is one in 900 pills (0.11%), whereas for cocaine it is one in 1600 doses (0.06%) and for gamma-hydroxybutyrate one in 95 doses (1.05%). With respect to ecstasy-related deaths in Great Britain, the estimated risk of ecstasy alone per user is 0.01-0.06%, which is close to the range of the fatality risk in chronic alcohol users (0.01-0.02%), amphetamine users (0.005%) and cocaine users (0.05%), but much lower than that of opiate use (heroin and morphine: 0.35%).
The current review shows that almost no data are available on the health risks of ecstasy use. The few data that are available show that ecstasy is not a safe substance. However, compared to opiates (heroin, morphine), the risk of acute ecstasy-related adverse health incidents per ecstasy user and per ecstasy use session is relatively low.
娱乐性毒品摇头丸（3,4-亚甲二氧基甲基苯丙胺）目前在全球范围内使用。已报告与摇头丸相关的严重（包括致命）健康事件，但从未对急性非致命和致命摇头丸相关健康事件进行风险评估。
在当前的风险评估综述中，将荷兰收集的非致命性健康事件的国家数据与全国范围内的摇头丸暴露情况（即去年摇头丸使用的流行率）相结合。此外，还使用了英国（苏格兰、威尔士和英格兰）每年与摇头丸相关的死亡人数来评估致命性摇头丸相关病例的风险。
在荷兰，使用摇头丸后发生中度至重度急性健康事件的估计风险为每 900 片（0.11%）一片，而可卡因为每 1600 剂（0.06%），γ-羟基丁酸为每 95 剂（1.05%）。就英国的摇头丸相关死亡而言，估计每个使用者单独使用摇头丸的风险为 0.01-0.06%，接近慢性酒精使用者（0.01-0.02%）、安非他命使用者（0.005%）和可卡因使用者（0.05%）的死亡率范围，但远低于阿片类药物使用者（海洛因和吗啡：0.35%）。
目前的综述表明，几乎没有关于摇头丸使用的健康风险的数据。现有的少量数据表明，摇头丸不是一种安全的物质。然而，与阿片类药物（海洛因、吗啡）相比，每个摇头丸使用者和每个摇头丸使用过程中与急性摇头丸相关的不良健康事件的风险相对较低。
