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PMA deaths in Ontario"G. Cimbura,f m.sc.phm., TorontoSummary: A new street-drug,para-methoxyamphetamine (PMA),recently made its appearance inOntario. Between March andAugust1973 there were nine deaths of youngpeople in this province that wereattributed to the drug. PMAappearsto have a powerful haHucinogenic effectas well as a markedtoxicity to thecentral nervoussystem. The clinicalpicture resembles that observedin cases of acutepoisoning byamphetamine and methylenedioxy-amphetamine (MOA).Resume: Les dScdspar lapara-me'thoxyamphe'tamineenOntarioUne nouvelledrogue populaire,lapara-methoxyamph6tamine (PMA),vient de faire sonapparition enOntario. De mars a aout 197% on aenregistre dans cette province neufdeces de jeunes gens qui etaientattribues a cette drogue. La PMAsemble avoir unpuissant effethallucinogene et une forte toxicite surle systeme nerveux central. Le tableauclinique se rapproche de celui qu'onobserve dans les cas d'intoxicationaigue par I'amphetamine et lamethylenedioxyamphetamine (MOA).Para-methoxyamphetamine (PMA)isone of thesynthetic amphetamine de-rivatives with central stimulant andhaHucinogenic propertieswhich haveno official use inpracticalmedicine.Since May 1973 PMA has been on thelist of "restricted"drugs and thereforeissubjectto the strictest of controlsplacedondrugs bythe Food andDrugsAct. Other substances in thiscategory include lysergic acid diethyla-mide (LSD);3,4-methylenedioxyamphe-tamine (MDA); and2,5-dimethoxy-4-methylamphetamine (STP).Possessionor use of thesedrugsisillegal, exceptbyauthorizedinvestigators.Thestoryof the PMA fatalities be¬gan in March 1973. Although relativelylittle is known about thedrugevennow,the situation was much worsethen; the drug was so "new" that ourlaboratorydid not even have asample?Presented at the Continuing EducationalCourse for Coroners, October 1973, TorontotHead of the Toxicology Section, The Centreof Forensic Sciences, Ministry of the SolicitorGeneral, TorontoReprint requests to: Mr. G. Cimbura, TheCentre of Forensic Sciences, 8 JarvisSt.,Toronto, Ont. M5E 1M8of it for thenecessary analyticalcom¬parisons. Between March and August1973 there were nine deaths ofyoungpeoplein Ontario attributed to PMA.PharmacologyAlmost all of the data available havetheir source in studies of thetheory ofthe biochemical basis forschizophre¬nia, viz, the hypothesis that an aberra-tion in the metabolism of catechola¬mines can produceendogenous psycho-togens resemblingthe well-knownhallucinogenmescaline.1"3'5 PMA re¬sembles mescalinestructurally (Fig. 1)as wellas,to someextent, pharma-cologically.In the late 1960s aninvestigationwas carried out on thebehaviouraleffects in rats of variousmethoxylatedamphetamines.1 PMA was found to bethe mostpotent hallucinogen with theexception of LSD. This work also sug¬gestedthat substitution of amethoxygroupin thepara position of the am¬phetamine moleculeisimportantforhaHucinogenic properties.The animal studies were followedbyhumanpharmacological investiga¬tions by Shulgin,Sargent and Naranjo,2whose results indicate that PMA hasahaHucinogenic potencyfive timesthat of mescaline and three times thatof MDA.Also,it wouldappearthatthe "effective" human dose of PMAis about 0.75 mg/kg body weight (about52mgfor a 70 kgperson).CHg.CH2.NH2Mescaline¦¦ ¦¦PeyoteO-AmphetamineCH~?H NH2 "Benzedrine""Dexedrine"L&jj.CHg.CH.N^MethamphetamineMethedrine"Speed"t^SK0-<>-CH2.CH -NH2MDACH3 methylenedioxyamphetamine"Love Pill"H2. CH. NH2PMACH3 p-methoxyamphetamineFIG. 1.Chemical structure of severalpsychotogens.CMA JOURNAL/JUNE8, 1974/VOL. 110 1263