{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T02:55:42Z","timestamp":1790564142909,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007281","name":"National Drug and Alcohol Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To determine: (1) Population rates of fatal methylenedioxymethamphetamine (MDMA)\u2010related poisoning over the period 2016\u20132023, years with high closure rates in the National Coronial Information System (NDIS); (2) the case characteristics of known cases of fatal MDMA\u2010related poisoning, 2016\u20132025; and (3) whether there have been changes in case characteristics of known fatal cases in the period pre\u2010COVID (2016\u20132019), COVID (2020\u20132022) and post\u2010COVID (2023\u20132025).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective study of fatal MDMA\u2010related poisonings in Australia retrieved from the NCIS, 2016\u20132025 [Correction added on 28 September 2026, after first online publication: In the previous sentence, \u201cNDIS\u201d has been changed to \u201cNCIS\u201d.].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Australia\u2010wide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Cases<\/jats:title>\n                    <jats:p>217 cases of fatal MDMA\u2010related poisoning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Population rates, case characteristics, circumstances of death, toxicology, major autopsy findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was a statistically significant increasing trend in the population rate over 2016\u20132019 [annual percentage change\u2009(APC) =\u200961.52], and a statistically significant decreasing trend over 2019\u20132023 (APC\u2009=\u2009\u221226.72). The mean age was 33.5\u00a0years, and males comprised 170 cases (78.3%). In 179 cases (82.5%) the cause of death was attributed to multiple drug toxicity. The fatal incident occurred in a private setting in 171 cases (78.8%), with 16 (7.4%) occurring at a music festival. The median MDMA blood concentration was 0.41\u2009mg\/l (range 0.00\u201325.0\u00a0mg\/l). Cases in which death was attributed solely to MDMA toxicity had a higher median MDMA concentration than multiple drug toxicity deaths (1.7 vs. 0.30\u2009mg\/l). Psychoactive drugs other than MDMA were detected in 199 cases (91.7%), most commonly other psychostimulants (147, 67.7%) and opioids (98, 45.2%). Cardiomegaly was diagnosed in 33 cases (16.6%) in which the heart was examined, and severe coronary artery disease in 27 (13.6%). There were no statistically significant differences across time periods in age, sex, substance use issues, injecting drug use, intentionality, MDMA concentrations or diagnoses of cardiomegaly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>While death rates in Australia from methylenedioxymethamphetamine\u2010related poisoning have declined from 2019, case characteristics have remained relatively stable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/add.70613","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:54:39Z","timestamp":1790031279000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Methylenedioxymethamphetamine (MDMA)\u2010related fatal poisoning in Australia, 2016 to 2025: Trends, characteristics and toxicology"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-7055","authenticated-orcid":false,"given":"Shane","family":"Darke","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5863-635X","authenticated-orcid":false,"given":"Johan","family":"Duflou","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"},{"name":"Sydney Medical School University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agata","family":"Chrzanowska","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7008-8130","authenticated-orcid":false,"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5946-2144","authenticated-orcid":false,"given":"Julia","family":"Lappin","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"},{"name":"Discipline of Psychiatry and Mental Health University of New South Wales  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5705-2026","authenticated-orcid":false,"given":"Amy","family":"Peacock","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney Australia"},{"name":"School of Psychological Sciences University of Tasmania  TAS Australia"},{"name":"National Drug Research Institute Curtin University  Perth Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Disposition of toxic drugs and Chemicals in Man","author":"Baselt RC","year":"2020"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13412"},{"key":"e_1_2_9_4_1","volume-title":"Australian Drug Trends 2025: Key findings from the National Ecstasy and related drugs reporting System (EDRS) interviews","author":"Sutherland R","year":"2025"},{"key":"e_1_2_9_5_1","first-page":"1","article-title":"Poisoned streets: A study on high\u2010purity synthesis and toxicological profiling of methamphetamine, MDMA, and aminorex","volume":"15","author":"Raef NA","year":"2025","journal-title":"Int J Med Toxicol Forensic Med"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14659891.2018.1436607"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/npr2.12485"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/00048674251315642"},{"key":"e_1_2_9_9_1","volume-title":"European drug report 2025: Trends and developments","author":"European Union Drugs Agency","year":"2025"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2023.103976"},{"key":"e_1_2_9_11_1","unstructured":"United Nations Office on Drugs and Crime.World drug report 2025. 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