MDMA-related presentations to the emergency departments of the European Drug Emergencies Network plus (Euro-DEN Plus) over the four-year period 2014–2017

Noseda, Roberta; Schmid, Yasmin; Scholz, Irene; Liakoni, Evangelia; Liechti, Matthias E.; Dargan, Paul I.; Wood, David M.; Dines, Alison M.; Yates, Christopher; Heyerdahl, Fridtjof; Hovda, Knut E.; Giraudon, Isabelle; Ceschi, Alessandro; Anand, Lukasz; Anseeuw, Kurt; Badaras, Robertas; Bonnici, Jeffrey; Brvar, Miran; Burke, Rachel; Caganova, Blazena; Eyer, Florian; Galicia, Miguel; Geith, Stefanie; Gillebeert, Johan; Grenc, Damjan; Gorozia, Ketevan; Jaffal, Karim; Jürgens, Gesche; Konstari, Jutta; Kutubidze, Soso; Laubner, Gabija; Liguts, Viesturs; Lyphout, Cathelijne; Mégarbane, Bruno; Miró, Òscar; Moughty, Adrian; O'Connor, Niall; Paasma, Raido; Perez, Juan Ortega; Perminas, Marius; Persett, Per Sverre; Põld, Kristiina; Puiguriguer, Jordi; Radenkova-Saeva, Julia; Rulisek, Jan; Sopirala, Radhika; Stašinskis, Roberts; Surkus, Jonas; Toth, Ibolya; Vallersnes, Odd Martin; Vigorita, Federico; Waldman, Wojciech; Waring, W. Stephen; Zacharov, Sergej

doi:10.6084/m9.figshare.12850133.v2

ictx_a_1784914_sm9167.docx (50.81 kB)

MDMA-related presentations to the emergency departments of the European Drug Emergencies Network plus (Euro-DEN Plus) over the four-year period 2014–2017

Version 2 2021-02-25, 09:50

Version 1 2020-08-24, 08:46

journal contribution

posted on 2021-02-25, 09:50 authored by Roberta Noseda, Yasmin Schmid, Irene Scholz, Evangelia Liakoni, Matthias E. Liechti, Paul I. Dargan, David M. Wood, Alison M. Dines, Christopher Yates, Fridtjof Heyerdahl, Knut E. Hovda, Isabelle Giraudon, Alessandro Ceschi, Lukasz Anand, Kurt Anseeuw, Robertas Badaras, Jeffrey Bonnici, Miran Brvar, Rachel Burke, Blazena Caganova, Florian Eyer, Miguel Galicia, Stefanie Geith, Johan Gillebeert, Damjan Grenc, Ketevan Gorozia, Karim Jaffal, Gesche Jürgens, Jutta Konstari, Soso Kutubidze, Gabija Laubner, Viesturs Liguts, Cathelijne Lyphout, Bruno Mégarbane, Òscar Miró, Adrian Moughty, Niall O'Connor, Raido Paasma, Juan Ortega Perez, Marius Perminas, Per Sverre Persett, Kristiina Põld, Jordi Puiguriguer, Julia Radenkova-Saeva, Jan Rulisek, Radhika Sopirala, Roberts Stašinskis, Jonas Surkus, Ibolya Toth, Odd Martin Vallersnes, Federico Vigorita, Wojciech Waldman, W. Stephen Waring, Sergej Zacharov

3,4-Methylenedioxymethamphetamine (MDMA) remains one of the most commonly used recreational drugs in Europe. Monitoring of Emergency Department (ED) presentations with acute toxicity associated with MDMA is important to determine trends in MDMA use and harms.

Data were extracted from the European Drug Emergencies Network (Euro-DEN) Plus database for all ED presentations with acute toxicity involving MDMA use, alone or in combination with other substances, between 1 January 2014 and 31 December 2017. Geographical distribution, time trends, patient demographics, clinical features, management and outcome were analysed.

Out of 23,947 presentations, 2013 (8.4%) involved MDMA, used alone (88, 4.4%) or with other substances (1925, 95.6%). The proportion of MDMA presentations varied by country, from over 15% in France to less than 5% in Norway. For the 15 sentinel centres where data were available for all four years, MDMA-related presentations peaked in 2016 (10.4% versus 8.1% in 2015, p < 0.0001), thereafter decreasing in 2017 (8.2%, p = 0.0002). 1436 (71.3%) presentations involved males. Females were significantly younger than males (median 23 years, interquartile range, IQR, 20–27 years, versus median 25 years, IQR 21–30 years, p < 0.0001). Compared to presentations of acute toxicity with lone-use cocaine, presentations with lone-use MDMA occurred more frequently during the weekend (58.0% versus 43.9%, p = 0.02), were more frequently medically discharged directly from the ED (74.7% versus 62.4%, p = 0.03), and less frequently received sedation (43.5% versus 66.5%, p = 0.003).

This large multicentre series of MDMA presentations to EDs showed geographical variation and changes in time trends and in patient demographics. Triangulation with data from complementary sources including seizures, prevalence of use and wastewater analysis, will enable a greater understanding of the public health implications of MDMA use in Europe.