ECSTASY VICTIMS SHOWED EXTREME SYMPTOMS

CALGARY - Emergency doctors and nurses call it "crack dancing," the
involuntary spasms and jerks of a delirious patient, suspected of
having overdosed on cocaine, methamphetamine or ecstasy.

It's an all-too-familiar signal for emergency room doctor Mark Yarema
that a patient has been abusing drugs.

But last month, the 15-year ER veteran encountered a sudden rash of
patients admitted to hospital with symptoms well beyond the typical.

"They presented with extreme manifestations," Yarema recalled in an
interview with the Herald. "Instead of just being agitated, they were
comatose. Instead of an irregular or fast heart rate, they may have
already been in cardiac arrest, and they often didn't present with the
odd movements and crack dancing because their bodies were extremely
rigid."

"It was an extreme form of total-body muscle contraction, and in some
cases, they seized as well."

Now health officials have confirmed that five recent drug overdose
deaths are linked to a batch of the street drug ecstasy laced with a
lethal chemical never before seen in Calgary by police.

Toxicology tests revealed that, in each case, victims who believed
they were ingesting ecstasy, or MDMA, were actually consuming a
dangerous compound laced with paramethoxymethamphetamine (PMMA), a
substance five times more toxic than ordinary ecstasy.

All those who died were hospitalized with temperatures soaring above
40 degrees, said Yarema, who treated one of the deceased and
supervised the treatment of two others.

He said the recent spate of deaths has disturbed him.

"There's no question in my mind that these deaths are the most
concerning, the most unfortunate, the most saddening of my career,"
said Yarema, who is also medical director of the city's Poison and
Drug Information Service.

He noted a disturbing increase in the number of hospitalizations -
individuals who ingested the drug and survived.

"Even though it only seems like five deaths, a good 10 to 15
individuals who (were admitted to hospital) survived," Yarema said.
"So there's really three times as many people that we've seen in the
past couple of months who are likely being exposed to the same drug."

And health officials are partly attributing the increase in cases to
the chemical's deceptively delayed onset.

"The danger with PMMA in particular is that within seconds to minutes
you may not notice any effect and it can lead people into taking more
pills," Yarema said. "And when the desired effect occurs, you've
essentially overshot your target . . . and that may be why we're
seeing people with such severe symptoms."

Daniel Dahl, 18, who overdosed on the drug last month, is believed to
have ingested up to seven tablets. In late November, Alex Kristof, 16,
died after taking eight tablets at a house party in the northwest.

"Having been in the emergency medicine community for 15 years in
Calgary, we see the occasional MDMA case in the ER department," Yarema
said, "but they are not nearly as sick as the ones that have been
coming through."