Overview of amphetamine-type stimulant Deaths

[gomaos]

i found this pretty interesting:
http://www.maps.org/sys/nq.pl?id=2227&fmt=page

Overview of amphetamine-type stimulant Deaths in the UK - Critical Review and Commentary

Ilsa Jerome
February, 2010

Recently the news media have picked up on a report published in the journal Neuropsychobiology comparing deaths associated with amphetamine with ecstasy-related deaths, spawning news reports with headlines such as "Ecstasy Especially Deadly for Young Users", wherein the study's first author, Fabrizio Schifano, is quoted as saying, "that ecstasy seemed to have a higher "intrinsic toxicity," particularly among users ages 16-24."

However, upon examination of the report itself, including the abstract and the paper, this conclusion is not warranted. In fact, the paper does not provide sufficient evidence to make declarations about toxicity in general, and the evidence it does supply does not suggest that ecstasy is especially toxic to younger people. Instead, it restricts itself to discussing deaths due to ecstasy and amphetamines, and the comparisons find that overall, amphetamines were associated with a greater number of deaths.

Schifano F, Corkery J, Naidoo V, Oyefeso A, Ghodse H (2010) Overview of Amphetamine-Type Stimulant Mortality Data - UK, 1997-2007. Neuropsychobiology 61: 122-130

ABSTRACT: Background/Aims: Despite being amphetamine derivatives, MDMA and its analogues show a number of clinical pharmacological differences with respect to both amphetamine (AMP) and methylamphetamine (METH). We aimed here at reporting and analysing information relating to the socio-demographics and clinical circumstances of the AMP-type stimulant-related deaths for the whole of the UK. Methods: Data (1997-2007) were taken from the National Programme on Substance Abuse Deaths (np-SAD) database, collecting information from UK coroners/procurators fiscal. To calculate rates of fatalities per 100,000 users, appropriate AMP/METH and ecstasy users' numbers were taken from the 2001-2007 British Crime Survey. Results: Overall, 832 AMP/METH- and 605 ecstasy (mostly MDMA and methylenedioxyamphetamine/MDA)-related deaths were respectively identified. In comparison with AMP/METH victims, the ecstasy ones were more likely to be younger (28.3 vs. 32.7 years; p < 0.0001) and less likely to be known as drug users (PR = 1.9; CI 1.5-2.6). Ecstasy was more likely to be identified on its own than AMP/METH (p = 0.0192). Contributory factors were more frequently mentioned by coroners in the 'AMP/METH-only' (106 cases) group than in the 'ecstasy-only' (104 cases) one (p = 0.0043). Both poly- and monodrug AMP/METH fatalities per 100,000 16- to 59-year-old users were significantly more represented than ecstasy fatalities (respectively 17.87 +/- 4.77 deaths vs. 10.89 +/- 1.27; p = 0.000; 2.09 +/- 0.88 vs. 1.75 +/- 0.56; p = 0.0096). However, mono-intoxication ecstasy fatalities per 100,000 16- to 24-year-old users were significantly more represented than AMP/METH fatalities (1.67 +/- 0.52 vs. 0.8 +/- 0.65; p = 0.0007). Conclusion: With respect to AMP/METH, ecstasy was here more typically identified in victims who were young, healthy, and less likely to be known as drug users. AMP/METH high mortality rates may be explained by users' high levels of physical co-morbidity; excess ecstasy-related fatality rates in young users may be a reason for concern. Although the coroners' response rate was of 90-95%, study limitations include both reporting inconsistency over time and lack of routine information on drug intake levels prior to death.

===

This report details data drawn from a national database recording substance-abuse deaths in the UK (the National Programme on Substance Abuse Deaths, or n-SAD). It is notable that the report provides no indication as to how the database determines a death to be "drug related." It appears that in some cases, detection of a substance in or on the person is used, but it is not apparently necessary. This is especially evident when considering that nearly a fourth of the "ecstasy related" deaths are associated with MDA, and not MDMA (117 of 605 deaths over a ten year period) and one death due to PMA. This paper does not compare ecstasy-related fatalities to fatalities from any other substance save amphetamine, and hence dose not permit blanket statements about the risks of ecstasy, only in relation to amphetamine. It is likely that deaths due to other substances, as opiates, are going to be higher than deaths associated with either ecstasy or amphetamines.

Setting the issue of definition aside, the authors state in the abstract that the total number of deaths related to amphetamines is greater than the deaths related to ecstasy when examining the entire population of people aged 16-59. Examining data from Table 1 of the paper, it is clear that a greater number of deaths involved more than one drug, with approximately 5/6 of the ecstasy-realted deaths involving at least one other substance, including alcohol. It appears that only by selecting a very specific slice of data (deaths apparently related to a single drug in people aged 16-24) that they can make statements about ecstasy-related deaths being higher than amphetamine-related deaths. This is hardly the same as saying that ecstasy is more dangerous to young people than amphetamine.

Perhaps unsurprisingly, a large percentage of drug-related fatalities occurred in known drug addicts. Though it is unclear how the n-SAD database established this information, the UK also has a database recording information on people receiving treatment for substance abuse, the National Drug Treatment Monitoring System. Coroners or others may have had access to this information that would flag these individuals because they were already known to the criminal justice or drug abuse treatment systems. Ninety-one (91%) of the 832 amphetamine-related deaths and 86% of the 605 ecstasy-related deaths occurred in "known drug addicts." It may well be true that ecstasy-related deaths are less likely to have occurred in known drug addicts, but how significant can this be when over 80% of both types of fatality did, in fact, take place in known drug addicts?

The authors also present percentages of drug related deaths per 100,000 users in Tables 5 and 6, devided by age group. Here we learn that an estimated 6.85 deaths occurred per 100,000 users aged 16 to 24 over the ten year period, and 6.62 deaths per 100,000 ecstasy users, and when a death is solely attributed to a single substance, 0.8 deaths per 100,000 are attributed to amphetamines and 1.67 are solely attributed to ecstasy. While this may be a statistically significant difference, in all cases these estimated death rates are low and not at all suggestive that ecstasy is "intrinsically toxic." What's more, by subtracting sole use deaths from total estimated deaths, it is still the case that polysubstance use accounts for a greater number of deaths in either population (6.05 for amphetamine-related deaths, 4.95 for ecstasy-related deaths).

It is notable that in the US, the death rate for people aged 16-24 is about 1 in 1000, and so an activity that produces a death rate of less than 1 per 100,000 engaged in the activity every year does not seem especially alarming.

By relying on fatalities only, it is hard to assess the circumstances that led to these deaths. If present, this information might shed more light on these statistics. Specifically, it seems likely that younger ecstasy users might behave differently from older ecstasy users or younger amphetamine users. Knowing this information might also help in assessing the significance of ecstasy users being more likely to be "healthy." After all, if patterns of drug use make it more likely that amphetamine users will be unhealthy, this could not lead one to conclude that ecstasy is more lethal to "healthy people," but that amphetamine use is associated with being less healthy.

As an additional note, fatalities are a poor indicator of drug toxicity, since substances can produce toxic effects without producing death, and death can results from an interplay between substance, setting and individual characteristics. It is dramatic and easily read, but that doesn't make fatality the best indicator of toxicity, only the one that requires the least effort to explain or the most attention-grabbing one. This is true whether one is considering substances or any other agent. Nonetheless, this should be kept in mind when viewing the data.

In conclusion, it appears that the authors are determined to wring some bad news about ecstasy from this data, but that they can only do so by selectively attending to specific sub-samples contained within the overall sample of deaths. It does not support the claim that ecstasy use is especially dangerous for younger people nor that ecstasy is intrinsically toxic.

===
This review would not have been as well-written or informative without the insights of two anonymous colleagues who took the time to comb through the report.

[the germinator]

I saw a show a few months back called "Countdown to Delirium", it was a top 20 countdown of the most harmful drugs in the UK compiled by by people with letters preceding their names (PhD etc...) who conducted some big study to find the worst 20.
Anyways, this scientist who admitted she was way against drugs, especially MDA, said that she was shocked to find that MDA isn't bad for you and also, if you are unlucky enough to experience side effects from it, these are totally reversible within 1 year.
Alcohol & Tobacco flogged MDA, Speed too. Smack was #1 and Coke was #2, & then I think it was Booze then tobacco.
I don't understand how they can still say this stuff, christian propaganda...
What do we believe?
Lyin' Bastards

[brugman]

[gomaos]

Alcohol & Tobacco flogged MDA, Speed too. Smack was #1 and Coke was #2, & then I think it was Booze then tobacco
more deaths from heroin and cocaine then from booze and tobacco?
I find that hard to believe.
Or is it the "how many per 100000" ratio?
in which case it would sound right

[the germinator]

more deaths from heroin and cocaine then from booze and tobacco?
I find that hard to believe.

Yeah I thought the same when I saw it but someone told me they're counting behind the scenes murders etc as well, casualties of the war on drugs too I spose If gear & coke were legal the statistics would be much different, if ya' hadta' run around scoring home made booze I'll bet it'd be different...

[the germinator]

Anyone know any fair dinkum info about safe administration of Butylone and Methylone and the physical side effects of these compounds.
I heard of someone who's been shooting a cock-tail of the 2, he says it feels pretty fuckin incredible but he noticed that his target arm has numbness throughout the fingers and his other arm and both legs have some superficial numbness, these symptoms didn't pop up 'til he'd put away 2g of B-1 and 3g of M-1, in 50 -100mg doses so I spose he had a lot of goes, that might explain why the arm which he uses is sore and numb, but wtf is the go with the other limbs.
He reckons that the Methylone he got tasted (and produced a feeling) like it was spiced up with a little heroin, his GF get's spewy from Opiates and, this stuff did the same thing to her.
Does anyone know if M-1 or B-1 tweak opioid receptors?
Thanx.

[Jonny Deformed]

Think i read somewhere that M1 is an maoi?
I have definitely read about the vasoconstrictive effects which often lead to blue/purple limbs.
Usually after 2-3g over a weekend.
Heart pains, shortness of breath are usually there too.

Not good, hope it's not permanent.

[the germinator]

It might be me but still I think I'll steer clear of that Methylone shit.

[Jonny Deformed]

Read accounts of people sweating a viscus sweet smelling oil of sorts.
Body tremors, coming in waves or constant ranging from barely noticeable to almost epileptic proportions.
Rigidity, bradykinesia, postural instability.
Very Parkinson's diseasesque.

Wasn't it first used for PD treatment?

[Jonny Deformed]

I read one report of a fella developing delusions of eugenics after noticing these side effects on the tail end of the inevitable binge.
Referring to eugenics in the abuse sense of the word, eg improving human genetic qualities by extermination of "undesired" population groups.

1.Create an mdma shortage.
2.Provide a legal alternative that is unbelievably morish and degenerative.
3.Result, fat wallet, dead or dying drug users, more fuel for the war on consciousness i mean drugs campaign.


craziness.

[sketchykid]

I heard of someone who's been shooting a cock-tail of the 2, he says it feels pretty fuckin incredible but he noticed that his target arm has numbness throughout the fingers and his other arm and both legs have some superficial numbness, these symptoms didn't pop up 'til he'd put away 2g of B-1 and 3g of M-1, in 50 -100mg doses so I spose he had a lot of goes, that might explain why the arm which he uses is sore and numb, but wtf is the go with the other limbs.

Not familiar with B-1 & M-1, but the above symptoms have been noticed
shooting large amounts of Meth/Amps over an extended period. The lack of sleep
appeared to contribute to the numbness in the extremities, not sure why,
but I would recommend ceasing all chems and allowing the body time to sleep,
reinstate a good diet, take a good multi-vitamin and try and normalize - then see if these
symptoms are still present.

Take care of that target arm, losing veins or the arm itself is not impossible.
If it gets itchiness under the skin anywhere, I would see a GP. Could be bad.

Apart from all that........

Most likely is the compound itself causing the problems,
but I would be trying to 'health-up' (sleep,food etc) to at least rule
those factors out.

[the germinator]

He was surprized to wake up this morning, and he is sure that some damage has been done to his neural pathways.
He's a bit paranoid, reckons all sorts of stupid shit that is just not happening.

[sketchykid]

If the binge has been over many days, he may still require more sleep
and nutrients. It would not be uncommon to suffer some paranoia and
possible psychosis after being awake for many days without compounds
let alone with them.

How is his capillary refill?
(press down on a finger nail and see how long it takes for blood to flow back)

Still any numbness in limbs? Pins and needles?

[the germinator]

yeah still a bit numb, painful to push the nail down too hard apparently. But it's only in the fingers now, last night his arms, legs, back and face were all numb and his chest was very painful.
Poor idiot, should be more careful.

[thc_acetate]

I think what we need to take into account with a lot of these newer RCs that are hitting the market its not llike they've been in use for 50 or so years and in doing research of late I find some of the things happening to be quite concerning there is apparently a new cathonine analouge known as fephadrone ( now say that in a daffy duck style voice 10 times quickly ) which there seems to be sweet FA research or records of human consumption at least withe PEAs we have Shulgin's work to go off some of these substances hitting the markjet i can't find a thing on another thing which concerns are these products known as bubblez which are a mix of Methylone , Butylone , Flephadrone and methadrone in varying degrees I mean i love reaserching newer more unheard of stuff myself but i also like there to be some established dosage range and if i'm combiuning things the quanities of what i combine with what these presold combos IMO are drastically increasing the risk of issues occuring in users anid it would seem the market is set up to pray on the young and niave party goers