How many deaths are due to Ecstasy?

Surprisingly, this is not easy to answer. The official British Home Office figures are so out of date as to be useless, although officials guess that the present total figure is somewhere between 10 and 20.(80, 81)

The National Poisons Unit put the present figure of known confirmed Ecstasy-related deaths at 14 for the period January 1988 to July 1992.(52) These are fatal cases where MDMA was found in the victim's blood or urine, but it is not necessarily implied that MDMA was the cause of death. Their list is not comprehensive.

Newspaper reports up to March 1993 blame Ecstasy for the death of 17 to 22 people(82), but these figures cannot be trusted. The main reason is that 'Ecstasy-related death' is often mistakenly taken as meaning that MDMA was the cause of death, rather than that the victim was known to have taken MDMA but the cause had not been established. Even the 'quality' newspapers and medical journals cannot be trusted (see chapter 7).

In the USA, an examination of the deaths of five people who had taken Ecstasy showed that other potentially lethal medical factors played a major part. Although MDMA was found in the victims' blood when they died and may have contributed to their death in some unknown or indirect way, in four cases there was an explanation for their death which was not related to taking MDMA.(53) The fifth death may also have been due to other causes.(26)

An organisation called DAWN (Drug Abuse Warning Network, part of the National Institute of Drug Abuse) collects reports of illicit drug use from hospital casualty departments all over the United States.(22) Whenever someone turns up at an emergency room and a drug is involved, either found on the person or in their blood or urine, or even if a patient comes in with a problem and mentions that it is drug-related, a report is sent to DAWN besides reports from postmortem examinations when drugs have been detected. These reports are analysed and figures are published for all drugs that are reported over 200 times in the past year. Although 138 drugs are listed, Ecstasy has never been included. DAWN publishes a separate list of drugs that have caused more than 10 deaths, but again Ecstasy is not included. The figures imply that there is no general medical cause for concern over MDMA use: though there are mishaps, these are rare. Indeed, there are well over a hundred other drugs that cause more problems. Even if the number of problems due to MDMA were increased in proportion to usage in Britain, there would still not be a significant number.

In conclusion, it seems likely that, apart from very rare incidents, the deaths in Britain as a consequence of taking MDMA is limited to those who died of heat stroke, of which 14 cases are known to date. The worst annual figure was that for 1991 with seven confirmed Ecstasy-related deaths known to The National Poisons Unit.(52)

The number of people in the UK who take Ecstasy has been discussed in Chapter 5. An educated guess is that the number lies between one and five million. How often users take the drug is also open to guesswork. A London survey showed that a third of users took Ecstasy at least once a week, while a minority binged on 10-20 over a weekend. This would imply that average usage among this sample was somewhere in the region of 25 a year, although this may not be typical.

Taking the worst figure of seven deaths in 1991 and assuming there were only 1 million users, the risk of dying from using Ecstasy would have been 7 in a million or 1 in 143,000 per year. If users take an average of 25 Es a year, then the risk of death on each occasion is 7 in 25 million or 1 in 3.6 million.

To put this into perspective, if you take five rides at a fun fair you run a risk of 1 in 3.2 million of being killed through an accident.(83) Some sports are obviously dangerous, such as parachuting which kills 3 in 1000 participants per year. Even skiing in Switzerland is risky - 1 in 500,000 are killed.(84) If you play soccer, every year you run a risk of 1 in 25,000 of being killed. But if you stay at home instead of going out you still aren't safe, since the risk of being killed through an accident at home is 1 in 26,000 a year!(16)

Many prescription drugs carry a high risk, including some you can buy over the counter without prescription. For example, over 200 people die from taking Paracetamol in Britain each year, more than ten times as many as die from MDMA.(30, 162)

Many people will argue that these figures are meaningless as they are based on guessed statistics. Suppose the figures distort the results ten times over, the risk of dying through taking Ecstasy is still smaller than taking part in a wide range of acceptable activities. It has been said that more people would die if alcoholic drinks replaced Ecstasy at raves.(55) Moreover, if ravers and organisers took the appropriate steps to avoid overheating the risk would be negligible.