Dr John Henry, of the National Poisons Unit at Guy's Hospital, London, said: "We're ahead of other countries because it is now part of the national culture. Many people do it. But, as far as I know, the numbers of deaths are small elsewhere."
There have been very few in the United States. The incidence is lower because the drug is generally taken in more leisurely circumstances than the hot and frenzied surroundings of a night-club.
However, Dr Henry is now receiving reports from Germany, Sweden and Italy. "I have heard from colleagues in Germany two or three times recently with cases of liver damage and people needing liver transplants."
The reports are coming from cities well-known for their night life, like Hamburg and Berlin.
He believes that more may emerge when the risks become more widely known and ecstasy is identified as a possible factor in young people's deaths.
In Britain, Dr Henry believes as many as 50 young people a year are dying as a consequence of taking the drug. There are certainly more than the commonly quoted figure of a total of 50. More accurate figures will eventually become available through the national mortality data but those statistics are currently running with a three-year time lag.
He does not understand why "this fad, this craze" of taking ecstasy has taken hold but he fears for its implications. "We are [effectively] conducting a massive experiment," he said. The long-term effects are unknown.
His biggest worry is the possibility of higher suicide and depression rates among the young people who regard "dropping an E" as barely breaking the law.
Dr Henry said those who have used ecstasy have lower levels of a hormone called seratonin in their spinal fluid. So do depressives.Reuse content