MDMA-related presentations to the emergency departments of the European Drug Emergencies Network plus (Euro-DEN Plus) over the four-year period 2014–2017
Creators: name: Noseda, Roberta
name: Schmid, Yasmin
name: Scholz, Irene
name: Liakoni, Evangelia
name: Liechti, Matthias E.
name: Dargan, Paul I.
name: Wood, David M.
name: Dines, Alison M.
name: Yates, Christopher
name: Heyerdahl, Fridtjof
name: Hovda, Knut E.
name: Giraudon, Isabelle
name: Ceschi, Alessandro
name: Lukasz Anand
name: Anseeuw, Kurt
name: Badaras, Robertas
name: Bonnici, Jeffrey
name: Brvar, Miran
name: Burke, Rachel
name: Blazena Caganova
name: Eyer, Florian
name: Galicia, Miguel
name: Geith, Stefanie
name: Gillebeert, Johan
name: Grenc, Damjan
name: Gorozia, Ketevan
name: Jaffal, Karim
name: Jürgens, Gesche
name: Konstari, Jutta
name: Kutubidze, Soso
name: Gabija Laubner
name: Liguts, Viesturs
name: Lyphout, Cathelijne
name: Mégarbane, Bruno
name: Òscar Miró
name: Moughty, Adrian
name: O'Connor, Niall
name: Paasma, Raido
name: Perez, Juan Ortega
name: Perminas, Marius
name: Persett, Per Sverre
name: Põld, Kristiina
name: Puiguriguer, Jordi
name: Radenkova-Saeva, Julia
name: Rulisek, Jan
name: Sopirala, Radhika
name: Stašinskis, Roberts
name: Surkus, Jonas
name: Toth, Ibolya
name: Vallersnes, Odd Martin
name: Vigorita, Federico
name: Waldman, Wojciech
name: W. Stephen Waring
name: Zacharov, Sergej
Publisher: name: Taylor & Francis
Year: 2021
Subjects: subject: Medicine
subject: Neuroscience
subject: Pharmacology
subject: Ecology
subject: FOS: Biological sciences
subject: FOS: Biological sciences
subject: Cancer
subject: 111714 Mental Health
subject: FOS: Health sciences
subject: FOS: Health sciences
subject: 110309 Infectious Diseases
subject: Computational Biology

description: 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% <i>versus</i> 8.1% in 2015, <i>p</i> p = 0.0002). 1436 (71.3%) presentations involved males. Females were significantly younger than males (median 23 years, interquartile range, IQR, 20–27 years, <i>versus</i> median 25 years, IQR 21–30 years, <i>p</i> versus 43.9%, <i>p</i> = 0.02), were more frequently medically discharged directly from the ED (74.7% <i>versus</i> 62.4%, <i>p</i> = 0.03), and less frequently received sedation (43.5% <i>versus</i> 66.5%, <i>p</i> = 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.