title: Variability in the 3,4-methylenedioxymethamphetamine content of 'ecstasy' tablets in the UK.
abstract: BACKGROUND
  Toxicity, such as hyperpyrexia, associated with the use of 3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy') appears to be related to serum MDMA concentrations. However, there does not appear to be a similar association with the number of tablets ingested, suggesting variation in the tablet content of MDMA. Although work has shown this variation in other areas of the world, no studies have reported on the variation of MDMA content in UK ecstasy tablets.
  
  
  METHODS
  Ecstasy tablets seized from individuals attending nightclubs were analysed qualitatively to determine if they contained MDMA and quantitatively to determine the MDMA content per tablet.
  
  
  RESULTS
  The mean amount of MDMA hydrochloride in 101 seized ecstasy tablets was 58.7±22.9 mg per tablet, with a range of 20 mg to 131 mg per tablet. The majority (96.0%) of tablets contained less than 100 mg MDMA per tablet. There appeared to be a bimodal distribution of MDMA content at approximately 20-40 mg per tablet and 60-80 mg per tablet.
  
  
  CONCLUSIONS
  There is variability in the MDMA content of ecstasy tablets in the UK. This variability could potentially put users at increased risk of acute harm due to inadvertent excess ingestion of MDMA, as they are unaware of the differences in the MDMA content. Repeat sampling and quantification of MDMA content of ecstasy tablets in the UK will allow better education of users about the potential harms associated with the variability in the MDMA content. In addition, it will provide information to allow the monitoring of changes in not only the MDMA content, but also other adulterants, in ecstasy tablets.
authors: Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, and King's Health Partners, London, UK. david.wood@gstt.nhs.uk
authors: David Michael
authors: DM
authors: Wood
authors: Vasoulla
authors: V
authors: Stribley
authors: Paul Ivor
authors: PI
authors: Dargan
authors: Susannah
authors: S
authors: Davies
authors: David W
authors: DW
authors: Holt
authors: John
authors: J
authors: Ramsey
mesh_terms: D006213:Hallucinogens / Q000737:chemistry*; D013287:Illicit Drugs / Q000737:chemistry*; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000737:chemistry*; D013607:Tablets / Q000737:chemistry; D006113:United Kingdom
chemical_list: D006213:Hallucinogens; D013287:Illicit Drugs; D013607:Tablets; D018817:N-Methyl-3,4-methylenedioxyamphetamine