The risk factors for ecstasy and related drug overdose: A case-crossover study

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Our ability to respond to the emergent harms of Ecstasy and Related Drug (ERD) use is hampered by our lack of understanding of the practices users engage in that place them at risk of harm. This study will examine the risk factors for non-fatal ERD Emergency Department (ED) admission in a sample of non-fatal ERD overdose victims recruited through two hospital EDs in Melbourne. The research involves a case-crossover study of the risk factors for ERD-related ED admission, as well as a detailed case series of ERD-related ED admissions. The case-crossover investigation will involve a comparison between behaviours occurring prior to the critical drug use episode with typical drug use behaviours and more specifically those occurring prior to a control use episode (another occasion on which ERDs were used). Data will be collected by Researchers positioned in the ED, with information collected on the specifics of the critical and control use episodes through interviews with participants following stabilisation and a return to consciousness. The case series will be established from all ERD-related ED admissions flagged as such by triage nurses. Potential risk factors under study will include the environmental conditions in which the drug was used (eg time of day, physical location), other drug taking behaviour, personal factors (eg asthma, depression) and other dose-related issues (eg amount purchased, source of purchase). Statistical analysis will establish the major differences between the critical, typical and control use episodes. The proposed research will examine risk factors for ERD-related harms within the context of an understanding of the usual practices and behaviour of users of these drugs. Identifying transient change in risk behaviours will provide a foundation for developing contextually-sensitive strategies for harm minimisation. The development of a detailed case series will impact upon the treatment and management of acute ERD-related harms.