Visits to the emergency department due to ecstasy (MDMA) and amphetamine derivative consumption Epidemiological, clinical and evolutional profile.
To describe clinical and epidemiologic characteristics of emergency department visits related with ecstasy usage, determine the rate of re-visits of the patients and their related factors. The clinical histories of the patients coming to the Emergency Department for ecstasy-related problems were reviewed during 89 consecutive months in order to define the epidemiological and clinical profile. The computerized system of admission was used to study re-visits to the emergency department, reviewing the clinical history of the re-visits to see if they were related with drug consumption. The study included 498 cases (71% male, mean age 26.5 years). The majority of the patients were attended on the weekend (66.6%) and at night (57%). Main complaints were anxiety or altered thoughts (32.8%), agitation (17.2%), impaired awareness level (7.2%) and convulsions or abnormal movements (5.6%). A total of 81% of the patients had consumed other substances besides ecstasy, mainly ethanol (53%), cocaine (36%) and gammahydroxibutirate (liquid ecstasy, 25%). Twenty six patients (5%) required admission to hospital (6 in the intensive care unit) and 4 died (0.8%). Fifteen percent of the patients were re-attended in the same ED for drug-related problems after a mean follow-up of 3 years, the new visit being more frequent during the first months. The need for an urgent psychiatric visit (OR 6.3 95% CI 2.9-12.8) and hospital admission (OR 3.5 95% CI 1.5-8.4) during their first ED attendance were independently associated with a greater risk of re-attendance. Ecstasy consumption frequently leads to an ED visit, sometimes due to severe medical complications, and at least 15% of patients will need urgent care again for drug-related problems within the next 3 years. This likelihood increases along with increased severity of the index episode (need of psychiatric consultation or hospital admission).