American Journal of Forensic Medicine & Pathology
September 1, 2000
Johan Duflou, Adam M. Mark
51 citations
A 29-year-old man died from aortic dissection and cardiac tamponade after taking ecstasy (MDMA) at a rave. He had no history of hypertension or other known risk factors for aortic dissection, though a minor degree of cystic medial necrosis was found in the aorta. Autopsy toxicology showed low residual MDMA levels in the blood about 48 hours after ingestion. The report suggests a probable link between MDMA use and aortic dissection in a previously healthy young adult, discusses possible mechanisms, and notes challenges in diagnosing this complication.
Addiction
May 21, 2024
Shane Darke, Johan Duflou, Amy Peacock et al.
14 citations
From 2000 to 2023 in Australia, 43 deaths involving LSD (33 cases) or psilocybin (10 cases) were identified. Most deaths were from traumatic accidents (36.4% for LSD, 40.0% for psilocybin) or self-harm by physical means (12 cases, all involving LSD). Multiple drug toxicity accounted for about a fifth of deaths. Only one death was attributed solely to LSD toxicity, and two followed a cardiovascular event after LSD use. In four psilocybin cases the cause was undetermined. Severe agitation was the most common clinical presentation. Median blood concentrations were 0.8 μg/l for LSD and 20 μg/l for psilocin. Pre-existing organ pathology was uncommon.
Drug and Alcohol Dependence Reports
March 22, 2026
Shane Darke, Johan Duflou, Michael Farrell et al.
From 2000 to 2025, 70 fatal poisonings involving new psychoactive stimulants and hallucinogens (NPSH) were identified in Australia, the first occurring in 2007. In nearly a quarter of cases, the person appeared unaware they were consuming an NPSH, and about a third involved injection. Common signs of acute poisoning included intense agitation, sudden collapse, and hyperthermia. Cathinones were the most frequently detected NPSH, followed by phenethylamines and tryptamines. Over a quarter of cases had multiple NPSH in the blood. In the 2020s, tryptamines became more common while phenethylamines became less common, and a wider range of NPSH were detected. Psychoactive drugs besides NPSH were present in most cases, especially psychostimulants and hypnosedatives.