Analysis of illicit ecstasy tablets: implications for clinical management in the accident and emergency department.

Abstract

Objective-To examine the composition of illicitly manufactured "ecstasy" tablets sold on the UK drugs market. Methods-Analysis by gas chromatography of 25 jl) were analysed by gas chromatography with flame ionisation detection. Samples were injected onto a silated glass (1.5 m x 4 mm internal diameter) column packed with 2% potassium hydroxide and 10% Apiezon L on Chromosorb-w-(AW) 100-120 mesh. Nitrogen at a flow rate of 60 ml/min was the carrier gas; hydrogen flow was at 1.0 kg/cm2 and air flow 1.2 kg/cm2. Analysis for the presence of amphetamine, methylamphetamine, methyldioxyamphetamine (MDA), MDMA, methyldioxyethamphetamine (MDEA), and a range of other drugs took place over a temperature gradient held at 1 55°C for 10 min followed by an increase of 8°C/min to a final temperature of 195°C. Temperatures of the injection and detector ports were 200°C and 190°C respec-tively. Extracts of tablets and quality control samples were measured against known concentrations of standards (10 gg/ml) and the detector recalibrated after every 10th sample. Paracetamol and caffeine were assayed by enzyme colorimetric assay and ketamine by using an in-house gas chromatography-mass spectrometry procedure. ResultsEach of the ecstasy samples in the present study was in tablet form, except for one, rhubarb and custard, which was a red and yellow capsule containing powder. Weights and dimensions of the tablets varied (see table 1). Of the 25 tablets handed in, doves (small white tablets embossed with a dove shape on one side) were the most common (n=7) and all contained MDMA (range 19-140 mg). One of these dove tablets also contained traces of caffeine. A further five tablets (love heart, MDMA tablet, New Yorker, purple heart, and the rhubarb and custard capsule) also contained doses of MDMA (range 2-105 mg). One of these five tablets (purple heart) contained traces of caffeine and another (MDMA tablet) contained 39 mg of caffeine. The only capsule, 194 on 7 June 2019 by guest. Protected by copyright.

Is ecstasy MDMA? A review of the proportion of ecstasy tablets containing MDMA, their dosage levels, and the changing perceptions of purity

“…Nevertheless, it should be emphasized that no study has employed a randomized sampling procedure. Most have used samples brought in by recreational drug users, or obtained from amnesty bins (Renfroe 1986;Sherlock et al 1999;Ramsey et al 2001;Spruit 2001). Others have been of police seizures, but when these involve large batches of uniform tablets it may lead to an overestimated level of purity (Cole et al 2002).…”

“…Thus in a survey from 1994, the contents other than MDMA, MDA or MDEA comprised caffeine, amphetamine or ephedrine mixed with caffeine, caffeine Survey of 100 recreational ecstasy/MDMA users High level of purity described Henry et al (1992) UK 1990-1991 Toxicological analyses of 7 deaths attributed to MDMA or ecstasy MDMA confirmed in every case, with one also containing MDA and amphetamine Davison and Parrott (1997) UK 1993 Survey of 20 recreational ecstasy/MDMA users No subjective reports of purity problems Hammersley et al (1999) UK 1993-1995 Survey of 209 recreational ecstasy/MDMA users No subjective reports of purity problems Baggott et al (2000), USA 1999 Private ($100 per test) biochemical analysis of 107 pills** Majority (63%) MDMA, MDA, MDEA. Various others, including dextromethorphan *Sample size too small to generate a useful population estimate **Paid sample probably generating an overrepresentation of atypical drugs and paracetamol, or ketamine/ephedrine/caffeine mixtures (Sherlock et al 1999). In a later USA survey, many samples contained the antitussive dextromethorphan, while others contained caffeine, ephedrine, pseudoephedrine, salicylates, or no identifiable drug (Baggott et al 2000).…”

The risky cocktail: what combination effects can we expect between ecstasy and other amphetamines?

“…Several previous publications highlighted the fact that many of the MDMA pills available in illicit markets contain a number of other substances, sometimes cheaper and easily obtained, like METH (Camilleri and Caldicott 2005), d-AMP (Sherlock et al 1999;Teng et al 2006), 4-MTA (Tanner-Smith 2006Teng et al 2006) and other related derivatives. In order to assess whether the prognostic value of CA expectations fitted to more realistic scenarios, we studied mixture C, where the influence of varying concentrations of a threecomponent mixture (4-MTA, METH and d-AMP) was combined with a constant concentration of MDMA.…”

Behavioral and Neurochemical Consequences of Long-Term Intravenous Self-Administration of MDMA and Its Enantiomers by Rhesus Monkeys

“…For example, ecstasy pills in the UK have been shown to vary up to 70-fold in terms of their MDMA content (Sherlock et al, 1999). Another source of variation seems to be temporal in nature, with older estimates of MDMA content per pill typically ranging between 75 and 150 mg (Kirsch, 1996;Wolf et al, 1995), while more recent studies have found average levels between 60 and 80 mg (Cole et al, 2002).…”