Forensic Science, Medicine, and Pathology

, Volume 7, Issue 3, pp 248–252 | Cite as

“Ecstasy” associated deaths: what is a fatal concentration ? Analysis of a case series

  • C. M. MilroyEmail author
Original Article


Amphetamine derivative drugs, particularly 3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy, are popular recreational drugs. MDMA is associated with causing death by a number of mechanisms, including hyperpyrexia, cardiac arrhythmia water intoxication and liver failure. Seventy-seven deaths where MDMA was detected in body fluids/organs were reviewed. Of these cases 59 deaths had MDMA present in blood. In 13 cases death was attributable to the toxic effects of MDMA alone with a range of 0.478–53.9 mg/l, mean 8.43 mg/l, median 3.49 mg/l. In 22 cases death was due to polydrug use, with an MDMA range of 0.04–41.5 mg/l, mean 2.90 mg/l, median 0.76 mg/l. In 24 cases death was due to trauma with an MDMA range of 0.035–4.81 mg/l, mean 0.862 mg/l, median 0. 483 mg/l. There is considerable overlap between the concentration of MDMA seen in deaths from direct MDMA toxicity and deaths associated with trauma. These findings show, that like other stimulant drugs, no specific concentration can be used to determine death without consideration of the history and full autopsy findings.


3,4-methylenedioxymethamphetamine MDMA Ecstasy Toxicology Death Autopsy 



I would like to acknowledge the help of Ms L Jenkins, Department of Clinical Chemistry of the Royal Hallamshire Hospital, Sheffield for information on analytical techniques.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Eastern Ontario Forensic Pathology, Unit of the Ontario Forensic Pathology Service, Division of Anatomical PathologyThe Ottawa HospitalOttawaCanada
  2. 2.Department of Pathology and Laboratory MedicineUniversity of OttawaOttawaCanada

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