Recent changes in lung cancer incidence for south Asians: a population based register study.

took several different (prescribed and non-prescribed) drugs with ecstasy; the large number of people who also took opiates seems surprising but confirms previous findings and may explain why a high proportion of the victims were known to services. People may have taken ecstasy with other drugs to modulate the effects—ecstasy had, at least, a facilitating role in causing death. A small proportion of people (6/81; 7%) died after taking only ecstasy—a previously doubted possibility. Toxicological tests could detect all drugs that had been taken in the 2-3 days before death and gave only limited information about which drugs had been taken on the last occasion. Deaths related to ecstasy occurred in two clusters (urban industrial areas in southeast and northern England); people died mostly at party times (weekends, summer, and at New Year). Information about the incidence of taking ecstasy and other drugs and amounts taken is unfortunately lacking; the database of the National Programme on Substance Abuse Deaths (which is being extended to Northern Ireland and Scotland) will collect more information in future—for example, the concentration of individual drugs in tissues—to obtain a better understanding of the role of other drugs in deaths related to taking ecstasy.