Review of deaths related to taking ecstasy, England and Wales, 1997-2000

Original article can be found at: http://www.bmj.com/archive/--Copyright BMJ Publishing Group Ltd DOI : 10.1136/bmj.326.7380.80Peer reviewe

Trends in UK deaths associated with abuse of volatile substances, 1971-2008. Report 23.

This is the twenty-third annual report of the Volatile Substance Abuse (VSA) Mortality Project, and has been produced by the International Centre for Drug Policy (ICDP) based at St. George’s, University of London. This report outlines the current trends, examines the nature of the problems, and identifies the factors associated with deaths from abuse of volatile substances occurring inthe United Kingdom in 2008

Overview of amphetamine-type stimulant mortality data – UK, 1997–2007

Original article is available at: http://content.karger.com/ Copyright Karger.Background/Aims: Despite being amphetamine derivatives, MDMA and its analogues show a number of clinical pharmacological differences with respect to both amphetamine (AMP) and methylamphetamine (METH). We aimed here at reporting and analysing information relating to the socio-demographics and clinical circumstances of the AMP-type stimulant-related deaths for the whole of the UK. Methods: Data (1997–2007) were taken from the National Programme on Substance Abuse Deaths (np-SAD) database, collecting information from UK coroners/procurators fiscal. To calculate rates of fatalities per 100,000 users, appropriate AMP/METH and ecstasy users’ numbers were taken from the 2001–2007 British Crime Survey. Results: Overall, 832 AMP/METH- and 605 ecstasy (mostly MDMA and methylenedioxyamphetamine/MDA)-related deaths were respectively identified. In comparison with AMP/METH victims, the ecstasy ones were more likely to be younger (28.3 vs. 32.7 years; p < 0.0001) and less likely to be known as drug users (PR = 1.9; CI 1.5–2.6). Ecstasy was more likely to be identified on its own than AMP/METH (p = 0.0192). Contributory factors were more frequently mentioned by coroners in the ‘AMP/METH-only’ (106 cases) group than in the ‘ecstasy-only’ (104 cases) one (p = 0.0043). Both poly- and monodrug AMP/METH fatalities per 100,000 16- to 59-year-old users were significantly more represented than ecstasy fatalities (respectively 17.87 ± 4.77 deaths vs. 10.89 ± 1.27; p = 0.000; 2.09 ± 0.88 vs. 1.75 ± 0.56; p = 0.0096). However, mono-intoxication ecstasy fatalities per 100,000 16- to 24-year-old users were significantly more represented than AMP/METH fatalities (1.67 ± 0.52 vs. 0.8 ± 0.65; p = 0.0007). Conclusion: With respect to AMP/METH, ecstasy was here more typically identified in victims who were young, healthy, and less likely to be known as drug users. AMP/METH high mortality rates may be explained by users’ high levels of physical co-morbidity; excess ecstasy-related fatality rates in young users may be a reason for concern. Although the coroners’ response rate was of 90–95%, study limitations include both reporting inconsistency over time and lack of routine information on drug intake levels prior to death.Peer reviewe

Trapped in the "K-hole" : overview of deaths associated with ketamine misuse in the UK (1993-2006)

Peer reviewedFinal Accepted Versio

Mephedrone (4-methylmethcathinone; 'meow meow') : chemical, pharmacological and clinical issues

“The original publication is available at www.springerlink.com”. Copyright SpringerRecently, those substances deriving from the active ingredient of the Khat plant, cathinone, have been rising in popularity. Indeed, 4-methylmethcathinone (mephedrone; 'meow meow' and others) has been seen by some as a cheaper alternative to other classified recreational drugs.We aimed here at providing a state-of-the-art review on mephedrone history and prevalence of misuse, chemistry, pharmacology, legal status, product market appearance, clinical/management and related fatalities.Because of the limited evidence, some of the information here presented has been obtained from user reports/drug user-orientated web sites. The most common routes for mephedrone recreational use include insufflation and oral ingestion. It elicits stimulant and empathogenic effects similar to amphetamine, methylamphetamine, cocaine and MDMA. Due to its sympathomimetic actions, mephedrone may be associated with a number of both physical and psychopathological side effects. Recent preliminary analysis of recent UK data carried out in 48 related cases have provided positive results for the presence of mephedrone at postmortem.Within the UK, diffusion of mephedrone may have been associated with an unprecedented combination of a particularly aggressive online marketing policy and a decreasing availability/purity of both ecstasy and cocaine. Mephedrone has been recently classified in both the UK and in a number of other countries as a measure to control its availability. Following this, a few other research psychoactives have recently entered the online market as yet unregulated substances that may substitute for mephedrone. Only international collaborative efforts may be able to tackle the phenomenon of the regular offer of novel psychoactive drugsPeer reviewedFinal Accepted Versio

Ecstasy (MDMA, MDA, MDEA, MBDB) consumption, seizures, related offences, prices, dosage levels and deaths in the UK (1994-2003)

The final, definitive version of this article has been published in the Journal, Journal of Psychopharmacology, 2006 20 (3) pp.456-463, Copyright British Association for Psychopharmacology on SAGE Journals Online: http://online.sagepub.com/ DOI : 10.1177/0269881106060147Peer reviewe