Low Hospital Admission Rates Following MDMA (Ecstasy) Intake in Essen (Germany) Norbert Scherbaum, MD, 1 Udo Bonnet, MD, 1 Fabrizio Schifano, MD, MRCPsych, 2 Werner Birkemeyer, MD, 3 Andreas Hufnagel, MD, 4 Daniel Schmitz, MD, 5 Stefan-Chan Sipal, MA, 6 Petra Wiemer, MD, 7 Cornelius Wurthmann, MD 8 1 Department of Addictive Behaviour and Addiction Medicine, Rhine State Hospital, University Hospital Essen, Germany 2 Pharmacy and Postgraduate Medical Schools, University of Hertfordshire, Hatfield, United Kingdom 3 Department of Internal Medicine and Cardiology, Alfried Krupp Hospital, Essen, Germany 4 Department of Neurology, University Hospital Essen, Germany 5 Department of Trauma Surgery, University Hospital Essen, Germany 6 Department of Child and Adolescent Psychiatry, Hospital Essen South, Essen, Germany 7 Department of Child and Adolescent Psychiatry, Rhine State Hospital, University Hospital, Essen, Germany 8 Department of Psychiatry and Psychotherapy, Philippusstift Hospital Essen, Germany BACKGROUND MDMA (ecstasy) is a popular recreational drug. Similar to other EU countries, 1,2 recorded lifetime preva- lence of MDMA intake in Germany in the 15–24 age range group is about 4–6%. 1,3 Although perceived as a safe drug by users, 4 after acute ecstasy administration several serious physical and psychiatric complications have been reported, sometimes leading to hospitalization and even death. 2 Typically, ecstasy clinical consequences are described as case reports; therefore, it is not yet clear how often they occur over time in a discrete catchment area. The present study aimed at longitudinally investi- gating rates and characteristics of hospital admissions following acute complications associated with recent MDMA intake. METHODS The study was carried out in Essen, Germany, between September 2001 and August 2003. All heads of Essen hos- pital departments were first informed about the study and asked for their participation; seven departments accepted. An acute complication was here defined as a health- adverse event that occurred in the context of previous 24-hour MDMA intake. Participating centers recorded a number of clinical and sociodemographic issues, includ- ing amount of MDMA consumed within the 24 hours previous to admission and rates of drug intake in the previous 30 days, according to the Germany-validated European version of the Addiction Severity Index (Europ-ASI). 5 Each department committed itself to a prospective, longitudinal, observation period of at least 6–12 months. Study protocol was approved by the Essen University Hospital Ethics Committee. RESULTS Total length of observational period for all participat- ing departments was 127 months. During this period, a total of five cases of recent MDMA-related hospitaliza- tions, either on its own or in combination, were reported. DISCUSSION To our knowledge, this investigation was the first to be carried out within a European context to assess rates and characteristics of MDMA acute complications requiring hospital admission. Out of 127 months of observation, four out of the five recorded admissions involved psycho- pathological complications. Low admission rates found here are in line with those observed during previous large-scale techno=rave events, where ecstasy is frequently consumed. 2 Five MDMA-associated hospitalizations out of a 600,000 population equals to 0.57 cases per 100,000 general population per year, which is similar to what Received January 8, 2007; revised January 11, 2007; accepted January 22, 2007. Address correspondence to Professor F. Schifano, University of Hertfordshire, School of Pharmacy, Hatfield, Herts, AL10 9AB, United Kingdom. E-mail: F.Schifano@herts.ac.uk. The American Journal on Addictions, 16:428–429, 2007 Copyright # American Academy of Addiction Psychiatry ISSN: 1055-0496 print / 1521-0391 online DOI: 10.1080/10550490701525699 428