PMID- 32677861 OWN - NLM STAT- MEDLINE DCOM- 20210730 LR - 20210730 IS - 1556-9519 (Electronic) IS - 1556-3650 (Linking) VI - 59 IP - 2 DP - 2021 Feb TI - MDMA-related presentations to the emergency departments of the European Drug Emergencies Network plus (Euro-DEN Plus) over the four-year period 2014-2017. PG - 131-137 LID - 10.1080/15563650.2020.1784914 [doi] AB - CONTEXT: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. FAU - Noseda, Roberta AU - Noseda R AUID- ORCID: 0000-0002-4946-7926 AD - Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland. FAU - Schmid, Yasmin AU - Schmid Y AD - Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland. FAU - Scholz, Irene AU - Scholz I AD - Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. AD - Institute of Pharmacology, University of Bern, Bern, Switzerland. FAU - Liakoni, Evangelia AU - Liakoni E AD - Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. AD - Institute of Pharmacology, University of Bern, Bern, Switzerland. FAU - Liechti, Matthias E AU - Liechti ME AD - Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland. FAU - Dargan, Paul I AU - Dargan PI AD - Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK. AD - Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK. FAU - Wood, David M AU - Wood DM AD - Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK. AD - Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK. FAU - Dines, Alison M AU - Dines AM AD - Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK. FAU - Yates, Christopher AU - Yates C AD - Emergency Department and Clinical Toxicology Unit, Hospital Universitari Son Espases, Mallorca, Spain. FAU - Heyerdahl, Fridtjof AU - Heyerdahl F AD - Prehospital Division, Oslo University Hospital, Oslo, Norway. AD - The Norwegian Air Ambulance Foundation, Bodo, Norway. FAU - Hovda, Knut E AU - Hovda KE AD - The Norwegian CBRNE Centre of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway. FAU - Giraudon, Isabelle AU - Giraudon I AD - European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal. FAU - Ceschi, Alessandro AU - Ceschi A AD - Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland. AD - Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland. AD - Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano, Switzerland. CN - Euro-DEN Research Group LA - eng PT - Journal Article PT - Multicenter Study PT - Observational Study DEP - 20200717 PL - England TA - Clin Toxicol (Phila) JT - Clinical toxicology (Philadelphia, Pa.) JID - 101241654 RN - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine) SB - IM MH - Adult MH - *Emergency Service, Hospital MH - Europe MH - Female MH - Humans MH - Male MH - N-Methyl-3,4-methylenedioxyamphetamine/*poisoning MH - Retrospective Studies MH - Time Factors OTO - NOTNLM OT - 3,4-Methylenedioxymethamphetamine (MDMA) OT - Emergency Department OT - Euro-DEN Plus OT - acute toxicity OT - recreational use FIR - Anand, Lukasz IR - Anand L IRAD- Department of Clinical Toxicology, Medical University of Gdansk, Poland FIR - Anseeuw, Kurt IR - Anseeuw K IRAD- Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium FIR - Badaras, Robertas IR - Badaras R IRAD- Republic Vilnius University Hospital, Vilnius, Lithuania FIR - Bonnici, Jeffrey IR - Bonnici J IRAD- Mater Dei Hospital, Msida, MSD 2090, Malta FIR - Brvar, Miran IR - Brvar M IRAD- Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Ljubljana, Slovenia FIR - Burke, Rachel IR - Burke R IRAD- Emergency Department, Mater Misericordiae University Hospital, Dublin 7, Republic of Ireland FIR - Caganova, Blazena IR - Caganova B IRAD- National Toxicological Information Centre, University Hospital, Bratislava, Slovakia FIR - Eyer, Florian IR - Eyer F IRAD- Department of Clinical Toxicology, Klinikum Rechts der Isar, Technical University of Munich, Germany FIR - Galicia, Miguel IR - Galicia M IRAD- Emergency Department, Hospital Clinic Barcelona, Spain FIR - Geith, Stefanie IR - Geith S IRAD- Department of Clinical Toxicology, Klinikum Rechts der Isar, Technical University of Munich, Germany FIR - Gillebeert, Johan IR - Gillebeert J IRAD- Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium FIR - Grenc, Damjan IR - Grenc D IRAD- Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Ljubljana, Slovenia FIR - Gorozia, Ketevan IR - Gorozia K IRAD- Archangel St. Michael Multiprofile Clinical Hospital, Tbilisi, Georgia FIR - Jaffal, Karim IR - Jaffal K IRAD- Department of Medical and Toxicological Critical Care, Lariboisiere Hospital, INSERM UMRS-1144, Paris-Diderot University, Paris, France FIR - Jurgens, Gesche IR - Jurgens G IRAD- Zealand University Hospital Roskilde, Clinical Pharmacology Unit, Roskilde, Denmark FIR - Konstari, Jutta IR - Konstari J IRAD- Malmi Hospital, Helsinki, Finland FIR - Kutubidze, Soso IR - Kutubidze S IRAD- Archangel St. Michael Multiprofile Clinical Hospital, Tbilisi, Georgia FIR - Laubner, Gabija IR - Laubner G IRAD- Republic Vilnius University Hospital, Vilnius, Lithuania FIR - Liguts, Viesturs IR - Liguts V IRAD- Riga East Clinical University Hospital, Riga FIR - Lyphout, Cathelijne IR - Lyphout C IRAD- Ghent University Hospital, Belgium FIR - Megarbane, Bruno IR - Megarbane B IRAD- Department of Medical and Toxicological Critical Care, Lariboisiere Hospital, INSERM UMRS-1144, Paris-Diderot University, Paris, France FIR - Miro, Oscar IR - Miro O IRAD- Emergency Department, Hospital Clinic, University of Barcelona, Catalonia, Spain FIR - Moughty, Adrian IR - Moughty A IRAD- Emergency Department, Mater Misericordiae University Hospital, Dublin 7, Republic of Ireland FIR - O'Connor, Niall IR - O'Connor N IRAD- Department of Emergency Medicine, Our Lady of Lourdes Hospital, Drogheda, County Louth, Republic of Ireland FIR - Paasma, Raido IR - Paasma R IRAD- Foundation Parnu Hospital, Parnu Estonia FIR - Ortega Perez, Juan IR - Ortega Perez J IRAD- Clinical Toxicology Unit, Emergency Department, Hospital Son Espases, Palma de Mallorca, Balearic Island, Spain FIR - Perminas, Marius IR - Perminas M IRAD- Hospital of Lithuanian University of Health Sciences (LSMU), Kauno klinikos, Kaunus, Lithuania FIR - Sverre Persett, Per IR - Sverre Persett P IRAD- Department of Acute Medicine, Medical Division, Oslo University Hospital, Norway FIR - Pold, Kristiina IR - Pold K IRAD- Emergency Medicine Department, North-Estonia Medical Centre, Tallinn, Estonia FIR - Puiguriguer, Jordi IR - Puiguriguer J IRAD- Clinical Toxicology Unit, Emergency Department, Hospital Son Espases, Palma de Mallorca, Balearic Island, Spain FIR - Radenkova-Saeva, Julia IR - Radenkova-Saeva J IRAD- University Hospital for Emergency Medicine "N.I.Pirogov", Sofia, Bulgaria FIR - Rulisek, Jan IR - Rulisek J IRAD- Department of Anesthesia and Intensive Care, 1st Faculty of Medicine, Charles University and General University Hospital, U Nemocnice 2, 120 00 Prague 2, Czech Republic FIR - Sopirala, Radhika IR - Sopirala R IRAD- Department of Emergency Medicine, Our Lady of Lourdes Hospital, Drogheda, County Louth, Republic of Ireland FIR - Stasinskis, Roberts IR - Stasinskis R IRAD- Riga East Clinical University Hospital, Riga FIR - Surkus, Jonas IR - Surkus J IRAD- Hospital of Lithuanian University of Health Sciences (LSMU), Kauno klinikos, Kaunus, Lithuania FIR - Toth, Ibolya IR - Toth I IRAD- Ghent University Hospital, Belgium FIR - Vallersnes, Odd Martin IR - Vallersnes OM IRAD- Department of General Practice, University of Oslo, Oslo, Norway IRAD- Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway FIR - Vigorita, Federico IR - Vigorita F IRAD- San Gerardo Hospital [U.O.S. Pronto Soccorso], ASST-Monza, Italy FIR - Waldman, Wojciech IR - Waldman W IRAD- Department of Clinical Toxicology, Medical University of Gdansk, Poland IRAD- Pomeranian Centre of Toxicology, Gdansk, Poland FIR - Waring, W Stephen IR - Waring WS IRAD- Acute Medical Unit, York Teaching Hospitals NHS Foundation Trust, York, UK FIR - Zacharov, Sergej IR - Zacharov S IRAD- Toxicological Information Centre, Department of Occupational Medicine, 1st Faculty of Medicine, Charles University and General University Hospital, Na Bojisti 1, 120 00 Prague 2, Czech Republic EDAT- 2020/07/18 06:00 MHDA- 2021/07/31 06:00 CRDT- 2020/07/18 06:00 PHST- 2020/07/18 06:00 [pubmed] PHST- 2021/07/31 06:00 [medline] PHST- 2020/07/18 06:00 [entrez] AID - 10.1080/15563650.2020.1784914 [doi] PST - ppublish SO - Clin Toxicol (Phila). 2021 Feb;59(2):131-137. doi: 10.1080/15563650.2020.1784914. Epub 2020 Jul 17.