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Updated: Coroners tie more deaths to tainted ecstasy

Toxic ingredient PMMA found in five B.C. victims and five more in Calgary who took party drug
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Typical appearance of ecstasy pills.

Tests now show five ecstasy-related deaths in B.C. over the past six months occurred because the party drug was tainted by a much more lethal component.

The B.C. Coroners Service reviewed 16 deaths of B.C. ecstasy users in 2011 and early 2012 and found three victims in the Lower Mainland and two more on Vancouver Island tested positive for paramethoxy-methamphetamine (PMMA), which police believe is being used as a cheaper ingredient.

"It's considerably more neurotoxic," provincial health officer Dr. Perry Kendall said Thursday.

The investigation was launched after five ecstasy users who died in Calgary and an initial one in the Lower Mainland tested positive for PMMA. Test results have not yet come back for at least one more recent B.C. death believed linked to ecstasy.

The B.C. victims in recent months included a 14-year-old boy and a 17-year-old girl.

Health officials say PMMA is a rare drug that had not previously been tested for in coroners' investigations.

Kendall said PMMA takes effect much more slowly than expected by ecstasy users, who may be used to feeling the effects within 45 minutes.

He said users may think the pills aren't working or they're weak and take a second or a third one and then overdose.

"They're thinking they have lower dose pills," Kendall said. "In fact, they have higher dose pills that are a lot more toxic."

The result can be elevated body temperature and potential brain and organ damage.

Asked why only one person in a group of friends that take the same drug might have a negative reaction and die, Kendall pointed to different body weights, different medicine or other drug and alcohol interactions, or even different genetic predispositions for breaking down toxins.

"These pills are made in the bathtub," he added. "So there's no guarantee that Pill A has exactly the same composition as Pill B."

Kendall said he's not able to directly link the Calgary PMMA deaths with the B.C. cases, but police believe most of the ecstasy sold in Calgary comes from B.C.

Two young people died within the past month after ingesting ecstasy in Abbotsford and a third is recovering in intensive care. Two women from Vancouver, both 22, have also died in recent weeks.

Deaths due to ecstasy use are not a new phenomenon in this province.

B.C. recorded 20 deaths linked to ecstasy in 2010, 21 in 2009 and 23 in 2008.

Kendall said the pills are typically contaminated with other drugs, including methamphetamine, ephedrine, caffeine, ketamine (an anaesthetic) and PCP, a horse tranquilizer.

"Don't take ilicit pills," he advised. "You don't know what's in them. They're almost certainly going to be contaminated."

Anyone who does take ecstasy despite that warning, he said, should never take more than one and should have a sober person with them to seek immediate help at the first sign of medical distress.

Of the 85 B.C. ecstasy-related deaths from 2006 to 2011, 41 were classified as mixed drug overdoses, 16 as motor vehicle incidents, 13 as MDMA (ecstasy) overdoses, eight were due to falls and seven were due to either drowning or other causes. An additional 14 cases are still under investigation.

The Vancouver Coastal health region accounted for 31 ecstasy-related deaths over that period, while 26 were recorded in the Fraser region.

The largest number of ecstasy deaths happened in Vancouver (22), followed by Surrey (8), which recorded five in 2010.