Data was gathered from 15 selected "sentinel" emergency departments in the metropolitan Sydney area across a five-week observation period beginning 3 weeks before commencement of the 2000 Olympic Games and ending 3 days after closing ceremonies. (Due to debate over definition of alcohol-related adverse events, emergency room visits relating to alcohol were not tabulated or analyzed). The rate of drug-related emergencies increased from rates seen before the Olympics, and drug-related emergencies were highest at the time of the closing ceremonies. Most drug-related adverse events occurred at two of fifteen emergency departments in inner-city areas said to be "hot spots" for illicit drug use. 424 (3%) of 55,272 visits were related to illicit drug use. Of those 424 visits, 85 Ecstasy-related visits occurred in these 15 "sentinel" emergency departments (20% of all drug-related cases). Ecstasy-related presentations were second highest to all drug cases recorded, with heroin producing the highest number of visits (158 of 424, or 37.3%. Use of more than one drug (in overall sample) was reported in 112 of 424 cases (26%) of this sample. 73% (311 of 424) were discharged after the visit, and 23% (93) were admitted to the hospital. Of these 93 cases, 41 (44%) were heroin-related; no information is provided on the number of hospitalized ecstasy-related cases. The overall sample of drug-related adverse events found them more likely to be reported in young men, and nearly all individuals experiencing drug-related adverse events were residents of the Sydney area (83%), while another 8% were from the rest of Australia. One of two deaths was related to complications of Ecstasy use in a 35-year old man (the other death was heroin-related). 3 cases of grand-mal seizures reported at the same location within a 3-hour period suggested a case of an adulterated or fake Ecstasy pill being sold in this area. The authors note that Ecstasy-related adverse events are not coded in the ICD coding scheme and are not routinely reported, and they suggest that such a code be added. A limitation of this study is that drug type is categorized on the basis of self-report, and results of laboratory tests were not offered here. As already indicated, some of the "Ecstasy-related" adverse events might be associated with fake or adulterated pills.