Dancing without hydrating increases the risk of overheating, which is why many MDMA-related deaths seem to occur at festivals. The maintenance of cool body temperature is imperative to harm reduction for “Molly” users.
First responders typically work to reduce the effects of overheating by applying ice packs. But a new drug might work to control hyperthermia in MDMA and methamphetamine users. Ryanodex, an Eagles Pharmaceuticals drug, will begin clinical trials in summer 2016.
On Monday, Eagle Pharmaceuticals announced a partnership with the the National Institute of Health/National Institute on Drug Abuse to examine the efficacy of the drug’s treatment of MDMA/methamphetamine-induced hyperthermia.
“We are very pleased to be working alongside the NIH to explore the potential of Ryanodex to reduce elevated body and brain temperature resulting from the use of Ecstasy and Methamphetamine,” Scott Tarriff, president and CEO of Eagle Pharmaceuticals, said in a press release. “Results of our recently completed clinical study of Ryanodex for Exertional Heat Stroke indicated that patients receiving Ryanodex in addition to standard of care (SOC)—which is currently limited to body cooling and supportive measures—experienced an incremental therapeutic benefit over patients receiving SOC only.”
Managing hyperthermia in stimulant-users who have fallen ill is arguably an ideal method of reducing the harms associated with drug toxicity. According to a 2001 study of the pharmacology and toxicity of “ecstasy” and related drugs, the pattern of MDMA-related toxicity that “closely resembles” heatstroke is “perhaps the most dangerous form of toxicity induced by ‘ecstasy,’” as well as among the most commonly linked to fatality. The authors write that this “hyperpyrexic pattern” of toxicity has “become increasingly frequent since the adoption of MDMA by participants in raves,” adding that “the drug action, intense physical activity and a hot environment contribute to this increase.” Similarly, methamphetamine toxicity is “tightly related to both the degree of hyperthermia and the intensity of structural brain damage.”
“Brain hyperthermia is one of the leading causes of severe morbidity and death in MDMA (“Ecstasy”) and Methamphetamine intoxication,” the press release said, adding statistics about hospitalizations related to the drugs:
“In 2011, the last year for which data is available, 125,000 emergency room visits were related to Ecstasy and Methamphetamine use. Methamphetamines are the fourth most reported illicit drug in emergency room visits following cocaine, marijuana, and heroin. And, according to the Drug Abuse Warning Network (“DAWN”), the number of emergency room visits involving Ecstasy among patients younger than 21 increased 128 percent between 2005 and 2011.”
Hydrating, taking breaks from dancing, and cooling down are suggested means of reducing the risk posed by stimulants and MDMA in particular, but a drug that counteracts overheating after symptoms have surfaced could add another layer of defense.
“The development of Ryanodex for body and brain hyperthermia associated with intoxication from illicit psychostimulant drugs in a preclinical model in collaboration with NIDA experts, will be an important step forward in addressing the serious consequences of this condition,” Adrian Hepner, executive vice president and chief medical officer of Eagle Pharmaceuticals said in the release.
Research into Ryanodex will begin with animal studies, and Eagle Pharmaceuticals says initial results may appear in late 2016 or early 2017. If it is effective and affordable for first responders to carry, it could reduce the severity of drug-induced heatstroke on the body’s organs. If it works really well, it holds the potential to reduce MDMA/methamphetamine-related deaths.