A cluster of recent fatalities among ecstasy (MDMA) users in western Canada has been linked to tainted drugs. At least five people in Alberta and three in British Columbia have died in the past few weeks. In six of those cases so far, paramethoxymethamphetamine (PMMA) has been found in toxicology reports.

The outbreak of deaths began last month in Calgary, and by December 29, Alberta Health Services sent out an alert warning that "Ecstasy or a combination of toxic substances sold on the street as Ecstasy is the likely cause of three recent Calgary-area deaths."

Then, in a new joint warning on January 11, the city of Calgary and Alberta Health Services announced that the province's chief medical examiner had confirmed that "paramethoxymethamphetamine (PMMA) and methamphetamine -- not previously associated with street drugs sold in Calgary as 'ecstasy' -- was present in toxicology results for each of five recent Calgary-area street-drug deaths."

On Thursday, British Columbia Provincial Health Officer Dr. Perry Kendall confirmed that PMMA had shown up in one of the BC deaths, while toxicology reports were still outstanding in the two other cases.

PMMA is thought to be a less expensive compound to produce than ecstasy, similar in appearance, and produces similar, though stronger, psychoactive and physical effects. Its use as an adulterant has been linked to earlier clusters of deaths in Norway and the Netherlands.

"There are some important differences in the toxicity of PMMA compared to MDMA" said Dr. Mark Yarema, Medical Director of the Poison and Drug Information Service (PADIS). "Although all have toxic effects, PMMA is considered more toxic than MDMA, with a higher incidence of seizures and elevated body temperature. Also, the onset of action of PMMA is delayed and its initial effect may be milder. This is dangerous as it may result in users ingesting several tablets to achieve a desired effect, with potentially fatal consequences."

If Canada is going to continue to subject recreational drug users to the Russian roulette of buying drugs without quality controls or ingredients labeling in the black market, it behooves drug users to do what they can to protect themselves. They could start by checking in with organizations such as DanceSafe or checking into ecstasy testing kits.