Nationwide registration of clinical "XTC"-incidents
Landelijke registratie klinische "XTC"-incidenten
Spaans E, Beltman W, Joore JCA, Mensinga TjT, de Vries I, Mostert LJ, Meulenbelt J
RIVM Report 660010001
The present study is a registration during one year, of the extent, the severity and the circumstances of acute "XTC" intoxications for which admission was considered necessary in a hospital in the Netherlands. The clinical phenomena as well as serum and urine samples of patients suspected of having used "XTC" were analysed. This drug screening made it possible to relate the symptoms to the substances that were found present in the urine or serum samples of each patient.36 men and 14 women were included in the study and most of them were 18 - 28 years of age. Only five patients (10%) had used "XTC" at a mega-dance-party and 60% of the patients had used the "XTC" at home, or in a bar or disco. The other 30 % of the patients took the tablets accidently or in a suicidal attempt. Nearly all the patients had used one or more substances besides "XTC", mostly alcohol. Of the patients 80% were mildly intoxicated, with symptoms as restlessness, tachycardia, mydriasis, nausea and perspiration. In addition to these, 20 % of the patients were severely intoxicated, with symptoms such as hypo- or hypertension, convulsions or coma. One patient died.The analysis confirmed that most patients had used several drugs (such as alcohol, cocaine, amphetamin, cannabis and Gamma-hydroxy-butyric-acid (GHB)) besides "XTC". Moreover, by comparing the serum and urine results with the reported intake, it became clear that the exposure varied widely. In this study 17 different substances (such as MDA, MDMA, amphetamin, 2-CB, MDDM, 2-CT-2 and ephedrin) were found. There was no difference in clinical severity between the mono MDMA and MDEA intoxications and the rest of the study population, with the exception of GHB. In this study the reported number of hospital admissions due to the "XTC" use was relatively low and of these patients 20% were severely intoxicated. This study confirms that the content of "XTC" tablets is heterogeneous and that concomitant drug abuse is a risk factor. When one wants to study the effects of XTC, i.e. MDMA, it is necessary that one knows the composition of the "XTC" tablets and to evaluate concomitant drug abuse. Otherwise it is not possible to confidently attribute observed "XTC"-effects to XTC, i.e. MDMA, itself.