People have fatal overdoses on MDMA and hart attacks etc.
Amphetamines use is linked with cardiovascular issues and brain damage.
For each cause of death, the researchers compared trends in deaths in states with legal markets with those in states that had comprehensive medical cannabis programs and similar trends in death rates prior to implementing markets…
The study did not link cannabis use with traffic fatalities.
The study linked trends.
Cannabis use was not a factor in those deaths. Not listed as a cause. Not listed as intoxicated at time of accident.
There is a significant difference between the narrative being schlepped versus what data was actually accumulated.
Findings show that meta-analyses and culpability studies consistently indicate a slightly but significantly increased risk of crashes after acute cannabis use. These risks vary across included study type, crash severity, and method of substance application and measurement. Some studies show a significant correlation between high THC blood concentrations and car crash risk. Most studies do not support this relationship at lower THC concentrations. However, no scientifically supported clear cut-off concentration can be derived from these results. Further research is needed to determine dose-response effects on driving skills combined with measures of neuropsychological functioning related to driving skills and crash risk.
Suppose you have a study of 10k people split 5k:5k between smokers and non smokers. In the non smokers group you get say 10 cases of lung cancer and the smokers group you get 200. It’s really tempting to say the individual smokers got long cancer from smoking, but the base rate isn’t 0 so you don’t know who was screwed either way. Perhaps if nobody smoked in that total population there would have been 19 cases of lung cancer or perhaps 22.
Thus only thing you can say is smoking increases RISK of lung cancer not link it to specific cases.
People OD and die from drinking water, that doesn’t make it as dangerous as heroin.
From one rave “Twelve patients with 3,4-methylenedioxymethamphetamine (MDMA) toxicity from a single rave event presented to multiple San Francisco Bay area hospitals with various life-threatening complications including seizures and hyperthermia. Eight required emergent endotracheal intubation and six had hypotension. Hyperkalemia, acute kidney injury, and rhabdomyolysis were present in most of the patients. In all, 2 patients died, 4 survived with permanent neurologic, musculoskeletal, and/or renal sequelae, and 6 survived without any apparent lasting deficits. Hyperthermia was present in 10 patients and was severe (40.9-43° C) in 7. Using multiple cooling methods, the average time to achieve cooling was 2.7 hours. Serum drug analysis was performed on 3 patients, demonstrating toxic MDMA concentrations without the presence of other xenobiotics. Two capsules confiscated by police at the event contained 82% and 98% MDMA, respectively, without other pharmacologically active compounds. Capsule #2 contained 270 mg MDMA, which is more than twice the amount of MDMA usually contained in 1 dose. The MDMA-induced hyperthermia significantly contributed to the morbidity and mortality in this case series. Factors contributing to the severity of the hyperthermia include ingestion of large doses of MDMA, a warm ambient environment, and physical exertion.”
To be clear drug testing would have discovered fentanyl or other common drugs in their bloodstream, so it’s not just based on the pills recovered. Granted legalization would likely result in more consistent doses which would help, but the drug itself would still be risky if people just kept consuming more.
MDMA screws up the body's ability to regulate temperature. But without the warm environment and physical activity leading to hyperthermia, I can't imagine any of those people would have even needed medical attention.
That said, personally I would never call MDMA "the poster child for safe illegal drugs". Just because it won't kill you, doesn't mean it is safe or risk-free.
More broadly, I’m including traffic fatalities as a risk from alcohol and falls under LSD, so having deadly issues regulating body temperature definitely qualifies in an apples to apples comparison here.
Again, no, that San Francisco situation is strictly not describing an overdose. From the comfort of your living room, you can consume a massively higher amount of MDMA than what was described in that paper, and won't suffer significant medical issues.
> I’m including traffic fatalities as a risk from alcohol
OK, but that doesn't mean a drunk-driving fatality is an overdose on alcohol.
If they had taken that much at home it may not have resulted in an overdose, but in this situation it did.
I suppose you're free to say that, and everyone else is free to ignore this as ridiculous nonsense which is completely out-of-step with the widely-used definition of "overdose".
You're completely ignoring the context of the event. Have you ever been to a rave? Some promoters are good and understand the importance of providing free/inexpensive water, proper ventilation, and security who are able to spot attendees requiring medical intervention. Other promoters are shady AF and do none of those things. In the latter case, if someone consumes MDMA and also dances for hours without hydration and the venue is way too hot / oversold, yes that person is at risk of hyperthermia.
That can also happen even to sober people, I've literally seen it.
Try asking your GP about what it an insulin OD entails and they will refer to the results not the specific dose. Though obviously there’s a dose large enough it’s never appropriate.
And indeed some countries legally require it.
It appears thar heat stroke caused the problems not "toxic MDMA concentrations". The LD50 of MDMA is estimated to be 180mg/kg - Were those ravers taking tens of capsules? I presume there are toxicology reports from the deaths that estimated the dosages. But alcohol is poisonous if you have too much - we don't usually call it "toxic".
Weirdly they mention "a warm ambient environment" but what were the humidity levels? I presume there is good information on the underlying causes of death elsewhere? That summary is terribly uninformative.
"mortality from classic heat stroke approaches 80% and, for exertional heatstroke, 33% in the absence of prompt treatment" : https://www.nejm.org/doi/full/10.1056/NEJMcp2210623
Disclaimer: personally I'm not a MDMA user. I'm a concerned citizen that thinks raves are generally healthier than bars. "sensible" MDMA usage anecdotally within those events seems safe to me (sample of thousands of people, zero deaths). Number of people I know dead from MDMA: zero. Number of people I personally know dead from alcohol: many (I am a middle aged guy so some were long term effects, one was in a house fire).
Drunk driving is a more indirect risk, but I am also including that as one of the risks of Alcohol consumption elsewhere in the thread. If you’re objecting to the name fine, but the risk still exists as MDMA consumption regularly kills people due to this and other risks.
PS: Water toxicity is a similar situation. It’s not just the amount of water alone that’s a problem instead the amount they’ve been sweating is often a contributing factor. Oddly, they also mention MDMA as a risk: https://en.wikipedia.org/wiki/Water_intoxication