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Sekeris A, Algahtani T, Aldabergenov D, Rock KL, Auwal F, Aldewaissan F, Williams BD, Kalk NJ, Copeland CS. Trends in deaths following drug use in England before, during, and after the COVID-19 lockdowns. Front Public Health 2023; 11:1232593. [PMID: 37841731 PMCID: PMC10570433 DOI: 10.3389/fpubh.2023.1232593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
Aim This research aimed to describe how the characteristics of deaths following drug use changed during the COVID-19 pandemic in England, and how this can inform future strategy to support the health and social care of people who use drugs in future emergency scenarios. Method All deaths reported to the National Programme on Substance Abuse Deaths which occurred between January 2018 and December 2021 inclusive were extracted for analysis. Exponential smoothing models were constructed to determine any differences between forecasted vs. actual trends. Key results Following the first lockdown period in England there were significant increases in the proportion of people who died at home beyond the 95% confidence bounds of the exponential smoothing model and concurrent decreases in the proportion of people who died in hospital. Whilst the overall proportion of deaths attributable to opioids did not significantly deviate from the forecasted trend, there were significant increases in methadone-related deaths and decreases in heroin/morphine-related death beyond the 95% confidence bounds. The proportion of deaths concluded as suicide increased, as did those implicating antidepressant use. There were no changes in the proportion of deaths following use of other drug classes, alcohol use in combination with psychoactive drugs, or on decedent demographics (gender, age, and drug user status). A small number of deaths due to drug use had COVID-19 infection itself listed as a cause of death (n = 23). Conclusion For people who use drugs, the impact of the restrictions due to the COVID-19 pandemic was greater than that of infection from the virus itself. The health and social care strategy for these people needs to be pre-emptively adapted to mitigate against the specific risk factors for fatal drug overdose associated with future emergency scenarios.
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Affiliation(s)
- Athanasios Sekeris
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Thikra Algahtani
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Daniyar Aldabergenov
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Kirsten L. Rock
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Fatima Auwal
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Farah Aldewaissan
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Bryn D. Williams
- Department of Anaesthetics, Royal Free Hospital NHS Foundation Trust, London, United Kingdom
| | - Nicola J. Kalk
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Caroline S. Copeland
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
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Are periodontitis, dental caries and xerostomia more frequently present in recreational ecstasy users? Br Dent J 2022; 232:389-395. [PMID: 35338292 DOI: 10.1038/s41415-022-4040-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/19/2021] [Indexed: 11/08/2022]
Abstract
Objectives The aim of this retrospective study was to determine whether there is a difference in oral health between recreational ecstasy users and non-recreational drug users.Study design In a cross-sectional study, dental records of 149 individuals visiting an academic dental clinic in Amsterdam who reported recreational ecstasy use, defined as no more than twice a week, were systematically analysed and compared to a group of age- and sex-matched non-drug users randomly selected from this institute. The parameters retrieved from the dental records were decayed, missed and filled teeth index (DMFT), number of endodontically treated teeth, presence of active caries lesions, periodontitis, tooth wear, xerostomia and self-reported use of oral hygiene devices.Results Periodontitis, active caries lesions and xerostomia were statistically significantly more present in ecstasy users. Ecstasy users brush their teeth significant less frequently per day than non-recreational drug users. There were no significant differences in DMFT and in the devices used for brushing/interdental cleaning and frequency of use of these interdental devices between both groups.Conclusion Periodontitis, active caries lesions and xerostomia are more frequently present in recreational ecstasy users compared to age- and sex-matched non-users.
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Liu Y, Bleasdale J, Przybyla S, Higgins MC, Zhang C. Racial Variations in Psychosocial Vulnerabilities Linked to Differential Poppers Use and Associated HIV-Related Outcomes among Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas. Subst Use Misuse 2022; 57:560-568. [PMID: 35067175 DOI: 10.1080/10826084.2021.2023185] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background: Poppers use has become increasingly prevalent and is associated with elevated HIV risk among young men who have sex with men (YMSM) in urban settings. However, knowledge regarding racial variations of poppers use and their psychosocial determinants to inform culturally-targeted interventions remain limited. Methods: We conducted a cross-sectional study among YMSM recruited from two US metropolitan areas (Nashville, TN and Buffalo, NY) to investigate the differences of socio-environmental and mental health factors associated with poppers use and important HIV-related outcomes [e.g., HIV testing, pre-exposure prophylaxis (PrEP, substance use, and risky sexual behaviors] among White and Black YMSM (i.e., YWMSM and YBMSM). Results: Among 347 YMSM aged 18-35 years, 32.3% reported poppers use. Notably, poppers-using YWMSM were more likely (p < 0.05) to report mental health burdens (e.g., depression, anxiety, loneliness), while poppers-using YBMSM were more likely (p < 0.05) to experience adverse social-environmental events (e.g., unstable housing, food insecurity, no health insurance, perceived HIV stigma, internalized homonegativity). Poppers-using YMSM showed a higher prevalence of sexual risk behaviors (e.g., event-level alcohol/drug use, condomless insertive/receptive anal sex, group sex) compared to their non-user counterparts, with YWMSM showing the highest likelihood to engage in these risk behaviors. Compared to poppers-using YBMSM, poppers-using YWMSM were associated with a higher likelihood of ever testing for HIV, ever using PrEP and willingness to use PrEP in the next 12 months. Conclusion: Given the distinctive patterns of psychosocial determinants of poppers use between YWMSM and YBMSM, culturally-tailored poppers reduction programs should be designed to tackle the associated HIV risks among YMSM with effectivenes.
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Affiliation(s)
- Yu Liu
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Jacob Bleasdale
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Sarahmona Przybyla
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | | | - Chen Zhang
- School of Nursing, University of Rochester, Rochester, New York, USA
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4
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Affiliation(s)
- Raymen R Assaf
- Pediatric Emergency Medicine, Department of Emergency Medicine, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 21, Torrance, CA 90502, USA; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Kelly D Young
- Pediatric Emergency Medicine, Department of Emergency Medicine, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 21, Torrance, CA 90502, USA; David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Noseda R, Schmid Y, Scholz I, Liakoni E, Liechti ME, Dargan PI, Wood DM, Dines AM, Yates C, Heyerdahl F, Hovda KE, Giraudon I, Ceschi A, Anand L, Anseeuw K, Badaras R, Bonnici J, Brvar M, Burke R, Caganova B, Eyer F, Galicia M, Geith S, Gillebeert J, Grenc D, Gorozia K, Jaffal K, Jürgens G, Konstari J, Kutubidze S, Laubner G, Liguts V, Lyphout C, Mégarbane B, Miró Ò, Moughty A, O'Connor N, Paasma R, Perez JO, Perminas M, Persett PS, Põld K, Puiguriguer J, Radenkova-Saeva J, Rulisek J, Sopirala R, Stašinskis R, Surkus J, Toth I, Vallersnes OM, Vigorita F, Waldman W, Waring WS, Zacharov S. MDMA-related presentations to the emergency departments of the European Drug Emergencies Network plus (Euro-DEN Plus) over the four-year period 2014–2017. Clin Toxicol (Phila) 2020; 59:131-137. [DOI: 10.1080/15563650.2020.1784914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Roberta Noseda
- Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Yasmin Schmid
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Irene Scholz
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Evangelia Liakoni
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Matthias E. Liechti
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Paul I. Dargan
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, UK
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - David M. Wood
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, UK
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Alison M. Dines
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, UK
| | - Christopher Yates
- Emergency Department and Clinical Toxicology Unit, Hospital Universitari Son Espases, Mallorca, Spain
| | - Fridtjof Heyerdahl
- Prehospital Division, Oslo University Hospital, Oslo, Norway
- The Norwegian Air Ambulance Foundation, Bodo, Norway
| | - Knut E. Hovda
- The Norwegian CBRNE Centre of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Isabelle Giraudon
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Alessandro Ceschi
- Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano, Switzerland
| | - Lukasz Anand
- Department of Clinical Toxicology, Medical University of Gdansk, Poland
| | - Kurt Anseeuw
- Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium
| | | | | | - Miran Brvar
- Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Rachel Burke
- Emergency Department, Mater Misericordiae University Hospital, Dublin 7, Republic of Ireland
| | - Blazena Caganova
- National Toxicological Information Centre, University Hospital, Bratislava, Slovakia
| | - Florian Eyer
- Department of Clinical Toxicology, Klinikum Rechts der Isar, Technical University of Munich, Germany
| | | | - Stefanie Geith
- Department of Clinical Toxicology, Klinikum Rechts der Isar, Technical University of Munich, Germany
| | - Johan Gillebeert
- Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium
| | - Damjan Grenc
- Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ketevan Gorozia
- Archangel St. Michael Multiprofile Clinical Hospital, Tbilisi, Georgia
| | - Karim Jaffal
- Department of Medical and Toxicological Critical Care, Lariboisiere Hospital, INSERM UMRS-1144, Paris-Diderot University, Paris, France
| | - Gesche Jürgens
- Zealand University Hospital Roskilde, Clinical Pharmacology Unit, Roskilde, Denmark
| | | | - Soso Kutubidze
- Archangel St. Michael Multiprofile Clinical Hospital, Tbilisi, Georgia
| | - Gabija Laubner
- Republic Vilnius University Hospital, Vilnius, Lithuania
| | | | | | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Lariboisiere Hospital, INSERM UMRS-1144, Paris-Diderot University, Paris, France
| | - Òscar Miró
- Emergency Department, Hospital Clınic, University of Barcelona, Catalonia, Spain
| | - Adrian Moughty
- Emergency Department, Mater Misericordiae University Hospital, Dublin 7, Republic of Ireland
| | - Niall O'Connor
- Department of Emergency Medicine, Our Lady of Lourdes Hospital, Drogheda, County Louth, Republic of Ireland
| | | | - Juan Ortega Perez
- Clinical Toxicology Unit, Emergency Department, Hospital Son Espases, Palma de Mallorca, Balearic Island, Spain
| | - Marius Perminas
- Hospital of Lithuanian University of Health Sciences (LSMU), Kauno klinikos, Kaunus, Lithuania
| | - Per Sverre Persett
- Department of Acute Medicine, Medical Division, Oslo University Hospital, Norway
| | - Kristiina Põld
- Emergency Medicine Department, North-Estonia Medical Centre, Tallinn, Estonia
| | - Jordi Puiguriguer
- Clinical Toxicology Unit, Emergency Department, Hospital Son Espases, Palma de Mallorca, Balearic Island, Spain
| | | | - Jan Rulisek
- 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
| | - Radhika Sopirala
- Department of Emergency Medicine, Our Lady of Lourdes Hospital, Drogheda, County Louth, Republic of Ireland
| | | | - Jonas Surkus
- Hospital of Lithuanian University of Health Sciences (LSMU), Kauno klinikos, Kaunus, Lithuania
| | | | - Odd Martin Vallersnes
- Department of General Practice, University of Oslo, Oslo, Norway
- Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway
| | | | - Wojciech Waldman
- Department of Clinical Toxicology, Medical University of Gdansk, Poland
- Pomeranian Centre of Toxicology, Gdansk, Poland
| | - W. Stephen Waring
- Acute Medical Unit, York Teaching Hospitals NHS Foundation Trust, York, UK
| | - Sergej Zacharov
- 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
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Case Study: Naltrexone for the Treatment of Nitrous Oxide Use. J Addict Med 2020; 14:e277-e279. [PMID: 32142053 DOI: 10.1097/adm.0000000000000642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Using a clinical case example, we describe and discuss the use of oral naltrexone as a novel treatment strategy for nitrous oxide use. Nitrous oxide is an inhalant drug that is readily available and legally obtained. Though frequency of reported cases of substance use disorder for nitrous oxide is low, previous case reports have described severe neurological and psychiatric harms associated with chronic use. Despite this, evidence for pharmacotherapy is currently lacking. Clinical studies have shown variable efficacy for naltrexone across a number of substances including alcohol, nicotine, and stimulants. CASE We present here a case of a 41-year-old man with a substance use disorder for nitrous oxide who was reportedly using of up to four hundred 8 g canisters of nitrous oxide per day. Oral naltrexone was initiated at 50 mg daily in an attempt to decrease cravings. The dose was subsequently titrated to 100 mg daily, resulting in a decrease in nitrous oxide use to less than sixty 8 g canisters per week over a 1-month timeframe. DISCUSSION Previous literature surrounding naltrexone provides both a plausible mechanism of action for craving reduction as well as a precedent for its use across a number of substances. To our knowledge, use of naltrexone for nitrous oxide use has not been previously described. While clinical studies are currently lacking, this case highlights naltrexone as a possible treatment strategy for nitrous oxide use, with potential to reduce significant harms associated with chronic use.
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Veen C, Jacobs G, Philippens I, Vermetten E. Subanesthetic Dose Ketamine in Posttraumatic Stress Disorder: A Role for Reconsolidation During Trauma-Focused Psychotherapy? Curr Top Behav Neurosci 2019; 38:137-162. [PMID: 29637527 DOI: 10.1007/7854_2017_34] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Despite efforts to develop more effective therapies, PTSD remains a difficult disorder to treat. Insight into the dynamic nature of memory formation and its required molecular machinery can provide an opportunity to target pathological memories for emotionally arousing events. As memories become labile upon retrieval, novel information can update the strength and course of these consolidated memories. Targeting the process of reconsolidation may offer a relevant approach to attenuate fearful and traumatic memories. Specific molecular mechanisms that are required for reconsolidation of arousing information include an intact functioning of the glutamatergic signaling pathways and, more specifically, the integrity of NMDA receptors. Ketamine, a noncompetitive NMDA-receptor antagonist, is receiving increasing interest for a variety of psychiatric indications. This compound can also be an interesting candidate for targeting emotional memories. We explore whether single intravenous infusion of a subanesthetic dose of ketamine can be considered as a viable augmentation strategy for trauma-focused psychotherapy in patients with PTSD. As a consequence, a systematic approach is needed to assess the pharmacodynamic effects of ketamine in relation to both psychotherapy and its pharmacokinetics prior to its application in patient populations. By using a "question-based drug development plan," we can explore such aspects for novel drugs, and we formulated five additional topics that need to be addressed concerning the psychotherapeutic approach and phase orientation of pharmacological assisted psychotherapy.
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Affiliation(s)
- Cato Veen
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
| | - Gabriel Jacobs
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Centre for Human Drug Research, Leiden, The Netherlands
| | | | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Arq Psychotrauma Research Group, Diemen, The Netherlands
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El-Khoury J, Bilani N, Abu-Mohammad A, Ghazzaoui R, Kassir G, Rachid E, El Hayek S. Drugs and Alcohol Themes in Recent Feature Films: A Content Analysis. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2019. [DOI: 10.1080/1067828x.2018.1561575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | | | | | | | | | - Elza Rachid
- American University of Beirut, Beirut, Lebanon
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Palamar JJ, Griffin-Tomas M, Acosta P, Ompad DC, Cleland CM. A comparison of self-reported sexual effects of alcohol, marijuana, and ecstasy in a sample of young adult nightlife attendees. PSYCHOLOGY & SEXUALITY 2018; 9:54-68. [PMID: 29430277 DOI: 10.1080/19419899.2018.1425220] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Alcohol, marijuana, and ecstasy (3,4-methylenedioxymethamphetamine [MDMA], 'Molly') are among the most prevalent substances used by young adults; however, few studies have focused on the specific sexual effects associated with use. Examining subjective sexual effects (e.g. increased libido) associated with use can inform prevention efforts. Data were analysed from 679 nightclub and dance festival attendees in New York City (ages 18-25) to examine and compare self-reported sexual effects associated with use of alcohol, marijuana, and ecstasy. Results suggest that compared to marijuana, alcohol and ecstasy were more strongly associated with heightened perceived sexual effects (i.e. perceived sexual attractiveness of self and others, sexual desire, length of intercourse, and sexual outgoingness). Increased body and sex organ sensitivity and increased sexual intensity were most commonly associated with ecstasy use. Sexual dysfunction was most common while using alcohol or ecstasy, especially among males, and females were more likely to report sexual dysfunction after using marijuana. Post-sex regret was most common with alcohol use. Alcohol, marijuana, and ecstasy each have different sexual effects; therefore, each is associated with different risks and benefits for users. Findings can inform prevention and harm reduction as young adults are prone to use these substances.
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA.,Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Marybec Griffin-Tomas
- Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA.,College of Global Public Health, New York University, New York, NY, USA
| | - Patricia Acosta
- Department of Population Health, New York University Langone Medical Center, New York, NY, USA
| | - Danielle C Ompad
- Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, New York, NY, USA.,Center for Health, Identity, Behavior, and Prevention Studies, New York University, New York, NY, USA.,College of Global Public Health, New York University, New York, NY, USA
| | - Charles M Cleland
- Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, New York, NY, USA.,Rory Meyers College of Nursing, New York University, New York, NY, USA
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10
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Beloate LN, Coolen LM. Influences of social reward experience on behavioral responses to drugs of abuse: Review of shared and divergent neural plasticity mechanisms for sexual reward and drugs of abuse. Neurosci Biobehav Rev 2017; 83:356-372. [DOI: 10.1016/j.neubiorev.2017.10.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 10/13/2017] [Accepted: 10/17/2017] [Indexed: 10/25/2022]
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Abstract
MDMA is often taken recreationally with alcohol as combined-use. The objective was to determine MDMA postmortem redistribution (PMR) and corresponding effects in combined-style under different storage conditions. Steps were 20%-mixture of alcohol-water for initial 4 weeks to Group-A&B and intragastric infusions of MDMA (150 mg/kg) to Group-A later; in the same time, drinking pure water to Group-C&D first and then MDMA-fed to Group-C. The sacrificed rats were kept under different conditions for 10-d, during which the body fluids and tissues were collected on 15 continuous time-points and then detected. The MDMA concentrations were quite different along with postmortem interval (PMI) went by; the area under concentration-PMI curve significantly increased with combined-alcohol in comparison to MDMA alone, while that significantly decreased by lowering preservation temperature, allied with corresponding humidity. Combined-alcohol could exacerbate PMR of MDMA, as concentrations of combined-use rats’ samples were quite higher than mono-MDMA ones under any conditions, while different for body fluids and tissues; meanwhile lowering storage temperature could alleviate effects of alcohol. The study implies that in case of combined-use, the changes of concentrations are probably effected by some combined component, especially when come to identification of toxic level or even death.
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