E for Ecstasy by Nicholas Saunders
Appendix 1: Reference Section

85 Rave- and Ecstasy-related admissions in West Lothian 1991-1992; a review by Dr. P. Freeland submitted for publication to The Annals of Emergency Admission

Dr. Freeland's review examines the frequency and nature of presentations to West Lothian hospitals in 1991 and 1992 following the ingestion of drugs in the context of rave parties, by means of retrospective analysis of case notes.

He found a total of seven cases; six having said they took Ecstasy and at least two having taken other drugs in combination with Ecstasy. Six were aged between 18 and 21 and the seventh was 27. Five were male. The invariable clinical finding was tachycardia - a racing heart. Complaints on admission included "buzzing sensations", anxiety and collapse. One patient admitted taking Ecstasy, Temazepam, cannabis and a cocaine-related drug in combination on the evening of admission to hospital. He had a high temperature (39.5 degrees C) and developed acute renal failure and coagulopathy - kidney failure and blood clotting. He recovered and was discharged after 18 days.

Another had taken Ecstasy, amphetamine and cannabis and complained of palpitations and a "buzzing sensation". He was discharged the next day. In addition, one patient had severe muscle spasms: this patient did not admit to taking any drug, but amphetamine was found in his blood (MDMA was not looked for).

The other patients, including all those who admitted to taking Ecstasy, discharged themselves. There were no fatalities.

The minimum hospitalisation rate is calculated to be 23 per 100,000 rave attendances, based on venue capacities.

"Although the study aimed to look particularly at MDMA, the high prevalence of multiple drug use and the absence of specific toxicological results on these cases make it impossible to pass any judgement on MDMA per se," Dr. Freeland concludes.