# Dying from ecstacy? **URL:** \ **Category:** Factual Questions\ **Created:** [April 10, 2004, 7:18am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298 "2004-04-10T07:18:51Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![pool](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pool/32/4152_2.png) [@pool](https://boards.straightdope.com/u/pool)\ **Post date:** [April 10, 2004, 7:18am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/1 "2004-04-10T07:18:51Z")
I have seen a bunch of anti-drug commercials lately focusing on the dangers of ecstasy or MDMA and in some of the commercials people who have allegedly died from ecstasy are shown. My question is if indeed this is the case…how exactly are they dying? I mean is is respiratory failure, heart failure, etc. what? In a lot of cases there are other substances in ecstasy that have been used to replace MDMA is it possible that these people could of had some sort of allergic reaction, in the cases that are shown it is usually the only second or third time the person has done it, although I wonder if that information would be completely accurate. ---
**Author:** ![pool](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pool/32/4152_2.png) [@pool](https://boards.straightdope.com/u/pool)\ **Post date:** [April 10, 2004, 7:20am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/2 "2004-04-10T07:20:12Z")
Damnit the thread title should be spelled ecstasy, not ecstacy ☹ ---
**Author:** ![ruadh](https://avatars.discourse-cdn.com/v4/letter/r/d2c977/32.png) [@ruadh](https://boards.straightdope.com/u/ruadh)\ **Post date:** [April 10, 2004, 7:45am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/3 "2004-04-10T07:45:36Z")
There’ve been a couple high-profile cases on this side of the pond where someone died from kidney failure, brought on by drinking excessive amounts of water because of feeling dehydrated. ---
**Author:** ![jnglmassiv](https://avatars.discourse-cdn.com/v4/letter/j/f07891/32.png) [@jnglmassiv](https://boards.straightdope.com/u/jnglmassiv)\ **Post date:** [April 10, 2004, 7:53am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/4 "2004-04-10T07:53:02Z")
I’ve always heard dehydration and elevated body temperature were the killers. Just the word on the streets, though. ---
**Author:** ![LolaBaby](https://avatars.discourse-cdn.com/v4/letter/l/d2c977/32.png) [@LolaBaby](https://boards.straightdope.com/u/LolaBaby)\ **Post date:** [April 10, 2004, 7:58am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/5 "2004-04-10T07:58:47Z")
I’ve seen those commercials too. > [@](#): > > A few hours after taking at least one Ecstasy pill, Marissa went into convulsions. After more than a day in a coma, she died at Harborview Medical Center. The official cause of death: anoxic encephalopathy, or lack of oxygen to the brain, specifically due to “MDMA intoxication.” from [http://seattlepi.nwsource.com/lifestyle/69811\_ecstasy10.shtml](http://seattlepi.nwsource.com/lifestyle/69811_ecstasy10.shtml) [This site doesn’t think it’s the prime reason](http://drugs.greenparty.org.uk/secret/secret_ecstasy.htm) > [@](#): > > There were two autopsies performed on Morgan, one by the Marin County Coroner, and one by a private pathologist. The Marin County Coroner attributed Morgan’s death to “cardiac dysrhythmia due to idiosyncratic drug reaction.” from [http://leda.lycaeum.org/?ID=10657](http://leda.lycaeum.org/?ID=10657) All seem anecdotal; I found them just by Googling. ---
**Author:** ![hlanelee](https://avatars.discourse-cdn.com/v4/letter/h/3bc359/32.png) [@hlanelee](https://boards.straightdope.com/u/hlanelee)\ **Post date:** [April 10, 2004, 11:10am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/6 "2004-04-10T11:10:58Z")
I haven’t seen it yet, but I’m sure I will witness some guys, drinking a beer or a cocktail and talking about what a horrible drug ecstasy it, that it kills people. I saw people, drinking and talking about what a horrible thing crack was, people get addicted to it and die. Ditto, cocaine and acid. People like to drink and talk about how bad the **drug** problem is, referring to the drug _de jour_ and ignoring that ethyl alcohol has ruined more live throughout history than all other narcotics combined. This rant has been brought to you courtesy of a reformed whore. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [April 10, 2004, 11:44am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/7 "2004-04-10T11:44:45Z")
Among other potential problems, Ectasy/MDMA can cause elevated body temperatures. Once your temperature hits 105 or higher your brain could wind up cooked. “Malignant hyperthermia”, as it’s called, can also cause kidney damage, or destroy muscle tissue (and massive destructrion of muscle tissue can also mess up your kidneys) These lethal cases of overheating are most likely to happen when people are highly active in heated areas, or areas with limited ventilation - like raves, for instance. It can also raise heart rate and blood pressure, which case trigger a heart attack or other cardiovascular tragedy in those who have a pre-existing problem. So it doesn’t require non-MDMA substances in a dose of E to potentially hurt or kill the taker. The fact that there often _are_ adulterants does not help the situation. ---
**Author:** ![alterego](https://avatars.discourse-cdn.com/v4/letter/a/6bbea6/32.png) [@alterego](https://boards.straightdope.com/u/alterego)\ **Post date:** [April 10, 2004, 12:06pm UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/8 "2004-04-10T12:06:27Z")
The Master [Speaks](http://www.straightdope.com/columns/031010.html) ---
**Author:** ![Roches](https://avatars.discourse-cdn.com/v4/letter/r/bc8723/32.png) [@Roches](https://boards.straightdope.com/u/Roches)\ **Post date:** [April 10, 2004, 3:23pm UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/9 "2004-04-10T15:23:12Z")
The condition Broomstick described – muscle damage leading to kidney failure – is called _rhabdomyolysis_ and was first discovered during the Second World War when people rescued from collapsed buildings in London were dying several days afterwards. In these cases, physical trauma was causing destroyed muscle tissue to break down and enter the bloodstream, overloading the kidneys and causing them to fail. Rhabdomyolysis can be also caused by prolonged extreme fever, especially if intense physical activity is also involved, as with MDMA overdoses. The malignant-hyperthermia-leading-to-rhabdomyolysis mechanism is one of several associated with MDMA-related deaths. I suppose extreme hyperthermia might be enough in itself to cause death. Some people have also died from acute liver failure, though these are probably predisposed to it, and tends to happen to people using MDMA for the first time or those who have not used it heavily. Dehydration, aside from being an effect of hyperthermia, may have caused some deaths by itself. But some MDMA users have died from drinking too much water. Drinking massive amounts of water can lead to the concentration of sodium in the brain becoming too low to conduct electric signals, simply because the usual mixture of water and electrolytes becomes diluted by massive amounts of water. This is called _dilutive hyponatremia_, and it caused the death of Leah Betts, probably one of the most well-known MDMA victims who was featured in an extensive advertising campaign in the UK. (All these conditions, plus a few others, are mentioned in Cecil’s article.) None of these conditions requires adulterants in an ecstacy tablet – they can all be caused by pure MDMA. Most of them are related to the fact that MDMA is a methamphetamine analog, and I suppose they appear in methamphetamine users as well. Some other amphetamine analogs are more effective than MDMA at causing death, so an ecstacy tablet that doesn’t contain MDMA can be more dangerous than one that does. All this being said, there have been relatively few deaths from MDMA compared to the number of users. Some ‘harder’ recreational drugs such as cocaine, heroin and methamphetamine have killed far more people than MDMA. So has acetaminophen/paracetamol. This is why I find it disturbing that anti-MDMA information tends to focus on the rather remote possibility of death and not on the far greater (but less clear) risk of neurotoxicity. MDMA has a specific mechanism for causing brain damage that is probably irreversible and almost certainly does occur in humans during recreational use. While there is evidence that neurotoxicity does occur even with low-level recreational use, I expect that cases of ‘Ricaurte’s disease’ (my term – G.A. Ricaurte has conducted extensive research into MDMA neurotoxicity) will begin to appear within 10 or 20 years. It is also possible that heavy MDMA users have already begun to suffer ill effects from this neurotoxicity but that it has gone undiagnosed or been misdiagnosed as depression or a neurodegenerative disorder with a surprisingly early onset. ---
**Author:** ![Silver\_Serpentine](https://avatars.discourse-cdn.com/v4/letter/s/3be4f8/32.png) [@Silver\_Serpentine](https://boards.straightdope.com/u/Silver_Serpentine)\ **Post date:** [April 10, 2004, 3:26pm UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/10 "2004-04-10T15:26:10Z")
This is just what I learned about X (I don’t feel like typing out the entire word, since I misspell it about 75% of the time) when I was in high school, so I don’t know how accurate it all is. But it sounds good. X elevates the body temperature. Which can fry zee brain. Also, since it’s mostly used at raves or rave-like events, you’re in a hot, crowded room, and may not have water handy, so dehydration is a possibility. There’s also a chance of a heart attack. Then you get to another little point. Not all X is MDMA. Some folks will cut it with lord knows what else, with unknown side-effects. So, while you may remain cool and well-hydrated (being all safe from MDMA side-effects), you could dye from injesting, say, rat poison. A few years back, this was apparently enough of a problem for raves to have an X testing table, where folks could get their X tested to make sure it was what it was supposed to be. Then there’s the possibility of being too drugged out of your mind to know what you’re doing, but I don’t know how much X it would take to be that inebreated. ---
**Author:** ![Kalt](https://avatars.discourse-cdn.com/v4/letter/k/b9e5f3/32.png) [@Kalt](https://boards.straightdope.com/u/Kalt)\ **Post date:** [April 10, 2004, 5:23pm UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/11 "2004-04-10T17:23:30Z")
The main study relied upon (which of course made front page news when it came out) by those who claim MDMA (ecstasy) is extremely deadly was recently retracted, because the scientist (funded by the DEA of course) who did the study did not use ecstasy at all, but rather methamphetamine. The entire study was retracted in toto (which of course made 18th page news, if it was reported at all). see [http://www.wired.com/news/business/0,1367,60328,00.html?tw=wn\_story\_related](http://www.wired.com/news/business/0,1367,60328,00.html?tw=wn_story_related) see also (more detail) [http://stopthedrugwar.org/chronicle/302/oops.shtml](http://stopthedrugwar.org/chronicle/302/oops.shtml) Yes, MDMA does increase body temperature which can cause hyperthermia, but it’s quite rare that people die from that. And when they do, it’s because they are severely dehydrated from not drinking water and from dancing around for hours and hours in a hot, crowded club. ---
**Author:** ![II\_Gyan\_II](https://avatars.discourse-cdn.com/v4/letter/i/bbe5ce/32.png) [@II\_Gyan\_II](https://boards.straightdope.com/u/II_Gyan_II)\ **Post date:** [April 10, 2004, 7:16pm UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/12 "2004-04-10T19:16:24Z")
> [@Roches](#): > > The malignant-hyperthermia-leading-to-rhabdomyolysis mechanism is one of several associated with MDMA-related deaths. It should be noted that MDMA by itself does NOT trigger significant elevated body temperature. In her [book](http://www.amazon.com/exec/obidos/tg/detail/-/0892818573), Holland mentions that when MDMA sessions were legal practice in psychiatry, core body temp. would rise by an average of 1 Fahrenheit. It’s the strenuous physical activity while on E, that’s instrumental. > [@](#): > > MDMA has a specific mechanism for causing brain damage that is probably irreversible and almost certainly does occur in humans during recreational use. Well, the fact that MDMA causes brain ‘damage’ is itself under question in this [url-[http://boards.straightdope.com/sdmb/showthread.php?p=4740911#post4740911](http://boards.straightdope.com/sdmb/showthread.php?p=4740911#post4740911)]post. ---
**Author:** ![II\_Gyan\_II](https://avatars.discourse-cdn.com/v4/letter/i/bbe5ce/32.png) [@II\_Gyan\_II](https://boards.straightdope.com/u/II_Gyan_II)\ **Post date:** [April 10, 2004, 7:18pm UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/13 "2004-04-10T19:18:59Z")
Proper link to that [post](http://boards.straightdope.com/sdmb/showthread.php?p=4740911#post4740911). ---
**Author:** ![Zoe](https://avatars.discourse-cdn.com/v4/letter/z/a4c791/32.png) [@Zoe](https://boards.straightdope.com/u/Zoe)\ **Post date:** [April 11, 2004, 3:50am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/14 "2004-04-11T03:50:47Z")
Peter Jennings recently narrated a one hour special on MDMA. I was surprised to learn that there didn’t seem to be a lot of adverse effects until the government banned it. Then the illegal forms were blended with other not-so-good drugs and the impure nature of the drug now causes problems. Someone did a study in New York of 19,000 deaths there. Only two were related to MDMA use. There were more deaths related to prescription medications. From what was said on the program, however, MDMA lowers seratonin levels. I would think that anyone who has had problems with depression would especialy want to be very careful about using it. ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [April 11, 2004, 4:43am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/15 "2004-04-11T04:43:24Z")
It’s always hard to write about this sort of thing, since the people who use it pooh-pooh the risks and the people who are strongly against drugs will say anything. Ecstasy has caused deaths from the complications listed above – certainly in combination with hyperthermia and dancing it can cause kidney failure, red muscle breakdown, etc. I don’t see why people couldn’t have allergic reactions to MDMA. Like most drugs, ecstasy has a more potent effect when combined with alcohol or other drugs. It is also difficult to ascertain the purity of drugs and impure ecstasy probably causes much of the morbidity. Special K (ketamine) can be pretty dangerous. As an emergency room doctor, this is among my least favoured overdoses to see. ---
**Author:** ![paperbackwriter](https://avatars.discourse-cdn.com/v4/letter/p/53a042/32.png) [@paperbackwriter](https://boards.straightdope.com/u/paperbackwriter)\ **Post date:** [April 11, 2004, 5:06am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/16 "2004-04-11T05:06:52Z")
> [@Kalt](#): > > The main study relied upon (which of course made front page news when it came out) by those who claim MDMA (ecstasy) is extremely deadly was recently retracted, because the scientist (funded by the DEA of course) who did the study did not use ecstasy at all, but rather methamphetamine. The entire study was retracted in toto (which of course made 18th page news, if it was reported at all). > > see [http://www.wired.com/news/business/0,1367,60328,00.html?tw=wn\_story\_related](http://www.wired.com/news/business/0,1367,60328,00.html?tw=wn_story_related) > > see also (more detail) [Oops! -- "Killer Ecstasy" Study Retracted, NIDA Credibility on the Line, RAVE Act Still Law](http://stopthedrugwar.org/chronicle/302/oops.shtml) Gross misinterpretations of the study. The study that was retracted was _not_ about MDMA causing sudden death, it was about MDMA causing long-term brain damage. Two separate (if related) issues. You can read [an abstract of the original article](http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12351788), and [a link to the retraction](http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12970544), through PubMed. The original claim is definitively concerned with long-term brain damage: > [@](#): > > These results … suggest that recreational MDMA {ecstasy} users may unwittingly be putting themselves at risk, either as young adults or later in life, for developing neuropsychiatric disorders related to brain dopamine and/or serotonin deficiency {Parkinsonian or Alzheimer’s-type syndromes}. Ecstasy has been identified as the cause of death in several cases. For instance, [Allan Ho](http://www.canoe.ca/Health0005/05_ecstasy.html) in Canada, [Brandy French](http://www.canoe.ca/Health0005/05_ecstasy.html) in Pittsburgh, and [a number of young adults in England](http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12351788). ---
**Author:** ![Jack\_Sarang](https://avatars.discourse-cdn.com/v4/letter/j/e8c25b/32.png) [@Jack\_Sarang](https://boards.straightdope.com/u/Jack_Sarang)\ **Post date:** [April 11, 2004, 10:09am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/17 "2004-04-11T10:09:42Z")
There is a severe problem of the media misreporting MDMA overdoses. They rely upon someone saying something to the effect of “The victim took ecstasy”, before any autospy positively identifies the chemical. The majority of MDMA deaths in my view, do not come from MDMA but pills being advertised as such. Pills that actually contain PMA or any number of other adulterants. Drug producers sell PMA as MDMA because it has similar effects but is much easier and cheaper to synthesize than MDMA. The problem with PMA is that it is lethal in doses that MDMA is not (2-3 pills). PMA raises body temperature uncontrollably and the victim literally cooks from the inside out. Info about PMA here: [PMA](http://www.erowid.org/chemicals/pma/pma.shtml) ---
**Author:** ![LuckySevens](https://avatars.discourse-cdn.com/v4/letter/l/ad7895/32.png) [@LuckySevens](https://boards.straightdope.com/u/LuckySevens)\ **Post date:** [April 11, 2004, 1:45pm UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/18 "2004-04-11T13:45:24Z")
a lot of deaths would probably come from bad pills too. Its a big problem, theres a few ecstacy kits you can buy off the net that test your pills. But 15 year olds out in some dodgy night club dont usually check out there merchandise, die from misuse, then the media jump all over it. ---
**Author:** ![II\_Gyan\_II](https://avatars.discourse-cdn.com/v4/letter/i/bbe5ce/32.png) [@II\_Gyan\_II](https://boards.straightdope.com/u/II_Gyan_II)\ **Post date:** [April 12, 2004, 12:10am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/19 "2004-04-12T00:10:16Z")
An interesting [update](http://www.maps.org/sys/w3pb.pl?mode=show&type=review&r_id=1): > [@](#): > > Rhesus monkeys that regularly pressed levers to receive i.v. injections of MDMA for eighteen months had little to no signs of harm to brain serotonin or dopamine neurons. However, they did work less hard for MDMA over the course of the study, even while they continued to work for cocaine injections. The researchers measured harm to the brain in several ways, including measuring levels of a protein associated with neurons and measuring brain levels of serotonin and dopamine, and none of these methods detected signs of obvious neurotoxicity. These findings also suggest that apparent tolerance to the effects of MDMA (seen here as reduced interest in taking more of it) does not occur as a result of damage to serotonin or dopamine neurons. > … > Another major difference between this study and studies that have found signs of harm to brain serotonin neurons is that MDMA was self-administered in this study, and not given to subjects by the researchers. This is referred to as “contingent” administration, in contrast to “noncontigent” administration, and the authors note that studies with other substances suggest that drug effects, even effects on brain chemistry, can depend on whether non-human animal subjects self-administer the substance, or are given it independent of their actions. To date, no research has studied differences in effects of contingent and noncontingent administration of MDMA, but this study raises the possibility that such differences exist. It may be the case that MDMA is only harmful to serotonin cells when it is given noncontingently, but that such effects are greatly reduced when doses are self-administered. > > If the findings uncovered by Fantegrossi and colleagues can be generalized to humans, then it appears that anecdotal reports of tolerance to MDMA, or its “loss of magic” over time cannot be treated as indicators of harm to the brain. It is not clear what lies behind reduced rates of MDMA self-administration. It is possible that MDMA changes the number or level of activity of specific serotonin receptors, perhaps as a result of repeated stimulation of affected receptors. If the “loss of magic” in humans is analogous to reduced self-administration in rhesus monkeys, then the cause or causes of long-term tolerance to MDMA effects cannot be harm to serotonin or dopamine neurons. Findings reported in this study also suggest that regular ingestion of MDMA may not harm serotonin axons. If this is the case, then taking a few doses of 125 mg (approximately 1.8 mg/kg) MDMA at three to five-week intervals seems especially unlikely to pose any risks of harm to these neurons. Full [paper](http://www.maps.org/w3pb/new/2004/2004_fantegrossi_20541_1.pdf) (PDF). ---
**Author:** ![paperbackwriter](https://avatars.discourse-cdn.com/v4/letter/p/53a042/32.png) [@paperbackwriter](https://boards.straightdope.com/u/paperbackwriter)\ **Post date:** [April 12, 2004, 12:22am UTC](https://boards.straightdope.com/t/dying-from-ecstacy/239298/20 "2004-04-12T00:22:24Z")
> [@Jack Sarang](#): > > There is a severe problem of the media misreporting MDMA overdoses. They rely upon someone saying something to the effect of “The victim took ecstasy”, before any autospy positively identifies the chemical. Well, I screwed up some of my links in the previous post, but in the cases I listed, MDMA was identified as the cause of death by coroner’s inquests. The Daniel Ho link is correct, but here are better ones for [Brandy French](http://www.thepittsburghchannel.com/station/855845/detail.html) and [Lorna Spinks](http://society.guardian.co.uk/drugsandalcohol/story/0,8150,515625,00.html). From the second article: > [@](#): > > In May two female teenage students died after taking so-called ‘super-strength’ ecstasy pills. The pictures of the bloated body of Lorna Spinks, 19, shocked the nation. Subsequent analysis by police showed that both women had taken pills from a batch that was coloured lime-green and stamped with a euro symbol. They contained 129mg of MDMA, the active ecstasy ingredient So unadulterated MDMA can also lead to death by overdose or negative reaction. [Next page](https://boards.straightdope.com/t/dying-from-ecstacy/239298.md?page=2)