Ecstasy Use Research Articles

The drug purity discounting task: Ecstasy use likelihood is reduced by probabilistic impurity according to harmfulness of adulterants

BackgroundEcstasy typically contains adulterants in addition to, or in lieu of, MDMA which may pose a greater risk to users than MDMA itself. The current study aimed to evaluate the effectiveness of adulterant-related informational prompts in reducing Ecstasy use using a novel probability discounting task. MethodsAn online sample of past-month Ecstasy users (N = 278) were randomized to one of four different framing prompt conditions: no prompt; a prompt describing MDMA’s effects; a prompt describing adulterants as inert “filler”; or a prompt describing adulterants as pharmacologically-active, potentially-harmful compounds. Each prompt contained general, potential public-health information that was not specifically related to subsequent behavioral tasks. All participants then completed an identical Drug Purity Discounting Task, in which they indicated the likelihood of using a sample of Ecstasy across different probabilities of the sample being impure, and then completed a hypothetical Ecstasy purchasing task. ResultsLikelihood of Ecstasy use decreased as impurity probability increased across conditions. Ecstasy use likelihood was highest in the “inert” prompt condition, whereas pharmacologically-active adulterant or adulterant-nonspecific prompts resulted in comparably low likelihood of use. Ecstasy-use likelihood did not differ among conditions when the likelihood of sample impurity was 0. Ecstasy purchasing did not differ among groups. Inelastic purchasing was associated with greater likelihood of using potentially-impure Ecstasy. ConclusionsAltogether, these data highlight the necessity of education regarding pharmacologically-active, rather than inert, adulterants in Ecstasy, and suggest that increased access to drug checking kits and services may mitigate some of the harms associated with Ecstasy use.

Fatal and non-fatal health incidents related to recreational ecstasy use.

Background:The recreational drug ecstasy (3,4-methylenedioxymethamphetamine) is currently used world-wide. Severe (including fatal) health incidents related to ecstasy have been reported but a risk assessment of acute non-fatal and fatal ecstasy-related health incidents has never been performed.Methods:In the current risk assessment review, national data of non-fatal health incidents collected in the Netherlands were combined with the nationwide exposure to ecstasy, that is, last-year prevalence of ecstasy use. In addition, the annual number of ecstasy-related deaths in Great Britain (Scotland, Wales and England) was used to assess the risk of fatal ecstasy-related cases.Results:In the Netherlands, the estimated risk of a moderate to severe acute health incident following the use of ecstasy is one in 900 pills (0.11%), whereas for cocaine it is one in 1600 doses (0.06%) and for gamma-hydroxybutyrate one in 95 doses (1.05%). With respect to ecstasy-related deaths in Great Britain, the estimated risk of ecstasy alone per user is 0.01–0.06%, which is close to the range of the fatality risk in chronic alcohol users (0.01–0.02%), amphetamine users (0.005%) and cocaine users (0.05%), but much lower than that of opiate use (heroin and morphine: 0.35%).Conclusion:The current review shows that almost no data are available on the health risks of ecstasy use. The few data that are available show that ecstasy is not a safe substance. However, compared to opiates (heroin, morphine), the risk of acute ecstasy-related adverse health incidents per ecstasy user and per ecstasy use session is relatively low.

Bir ÇEMATEM kliniğinde yatan ergen hastalarda madde kullanım eğilimleri, psikososyal travmalar, psikiyatrik komorbiditeler ve cinsiyet farklılıkları

Objective: The aim of the present study was to determine sociodemographic and clinical characteristics, substance use patterns, psychosocial traumas, and gender differences among adolescent inpatients at an addiction treatment center. Method: Participants were 105 adolescents consecutively admitted and hospitalized at the Children and Adolescent Alcohol and Drug Dependency Research Treatment and Training Center of Bakirkoy Prof Dr. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery between February and December 2017. Kiddie-Schedule for Affective Disorders and Schizophrenia, present and lifetime version, Hamilton Anxiety and Depression Rating Scales, Conners-Wells’ Adolescent Self-Report Scale, Adolescent Dissociative Experiences Scale, Childhood Trauma Questionnaire, Addiction Profile Index-Practitioner Form, and Inventory of Parents and Peer Attachment were administered to all participants. Results: Of all cases, 31.4% were girls. Criminal history, a diagnosis of conduct disorder, substance use in the family, emotional abuse, and heroin use were frequently revealed. Among the girls, the substance use period was shorter and ecstasy use, traumatic experiences, diagnosis of post-traumatic stress disorder (PTSD) and severity of comorbidities were prominent; among the boys, synthetic cannabinoid use was more prevalent. While synthetic cannabinoid and alcohol use were frequent among the cases with a diagnosis of attention deficit hyperactivity disorder, heroin use was prominent among cases with depression diagnosis and ecstasy use among cases with PTSD. Conclusion: Among children and adolescents, substance use trends, childhood traumatic experiences, and severity of comorbidities may differ according to gender. It is important to take these differences into consideration in the treatment process.

MDMA – hopes and fears associated with therapeutic use in mental disorders

MDMA (3,4-methylenedioxymethamphetamine) is a psychoactive substance classified as a hallucinogen. MDMA acts in the brain through a variety of neurochemical mechanisms, reducing anxiety, giving a sense of oneness with other people, expanding empathy, sharpening the senses and intensifying the experience of emotions. Therefore, the use of the MDMA assisted psychotherapy is being considered in selected disorders, such as Posttraumatic Stress Disorder (PTSD), Social Anxiety Disorder (SAD) in people with Autism Spectrum Disorder (ASD), and in treatment of alcoholic addition. Although the recreational use of ecstasy may lead to numerous life-threatening side effects, data available in the literature suggest that psychoactive substances may be safely administered in clinical settings. This article aims to review current research on the MDMA assisted psychotherapy. The first part of the article concludes data on MDMA assisted psychotherapy from available clinical trials. The second one sums up hopes and fears associated with the administration of MDMA in clinical settings that were discussed in the current clinical discourse. It seems that further studies are needed to determine the long-term safety and effectiveness of MDMA assisted psychotherapy.

P865 Ecstasy s use an unusual cause of dilated cardiomyopathy a case report

Abstract Background 3,4-methylenedioxymethamphetamine is a stimulant used illegally around the world, including Morocco. Cardiomyopathy and heart failure may occur following chronic MDMA use and may cause many other acute cardiac complications. Case report A 30-year-old man, with a history of MDMA use, 2 tablets/week since 2 months, and 6 tablets the week before admission, presentedwith severe dyspnea at rest. The first evaluation shows a sinus tachycardia with tachypnea and signs of global heart failure, loud systolic murmur heard over the apex andcrackles at the base of the lungs were observed. The blood tests performed, including erythrocyte sedimentation rate, blood picture, liver function and kidney function tests, protein, iron, phosphocalcic balance, glucose, and thyroid hormones,were within normal range. Moreover, immunological assays [immunoglobulin M (IgM) and immunoglobulin G (IgG) anti-Epstein–Barr virus] and toxoplasmosis were negative. Cytomegalovirus IgM was also absent, and IgG titer value was also absent. Electrocardiogram (ECG) tracing showed a complete left bundle branch block (LBBB)with a regular sinus rhythm (100 bpm). Transthoracic echocardiography showed dilated cardiomyopathy with severe systolic dysfunction (12% by Simpson’s method) (Fig. 1). Additional evaluation in the hospital excluded other etiologies of the cardiomyopathy. Thus, his condition was referred to the MDMA use. The patient now is a heart transplant candidate. Conclusion There are several reports that show an increase in frequency of MDMA use, suggesting that cardiomyopathy and acute heart failure secondary to the Ecstasy use may be a new medical concern. Thus, proper history of illicit drug intake is crucial in the diagnosis of unexplained cardiomyopathies.

Drug use and the influence on kissing among men who have sex with men in Melbourne, Australia.

The use of drugs is not uncommon among gay, bisexual and other men who have sex with men (MSM). Kissing has been recently identified as a risk factor for gonorrhoea. This study aimed to examine the proportion of MSM who used drugs and how specific drugs influence the likelihood of kissing. We conducted a cross-sectional survey among MSM attending the Melbourne Sexual Health Centre between March 2016 and February 2017. Participants reported their use of eleven specific drugs in the last three months and whether they felt the drug influenced them to kiss someone. Four thousand, three hundred and ninety-one MSM were included in the analysis; 63.1% ( n = 2772) used at least one drug in the last three months and 36.6% ( n = 1605) used ≥2 drugs. Poppers (44.8%), marijuana (30.8%) and ecstasy (19.1%) were the three most common drugs used among MSM in the last three months. 80.4% of ecstasy users and 74.3% of gammahydroxybutyrate users reported the drug made them much more likely to kiss someone. The majority of MSM reported that the use of heroin (63.6%) and Viagra/Cialis (60.7%) did not influence their kissing behaviour. Drug use is common among sexually active MSM in Melbourne. Most reported the use of ecstasy would increase their likelihood of kissing someone.

Prevalence of self-reported movement dysfunction among young adults with a history of ecstasy and methamphetamine use

BackgroundIllicit stimulant use is associated with long-lasting changes in movement and movement-related brain regions. The aim of our study was to investigate the prevalence of movement dysfunction in this population. We hypothesized that prevalence of self-reported movement dysfunction is higher among stimulant users than non-stimulant users. MethodsThree groups of adults completed a survey containing questions about demographics, health, drug use, and movement. The groups consisted of ecstasy users with no history of methamphetamine use (ecstasy group, n = 190, 20 ± 3 yrs.), methamphetamine users (methamphetamine group, n = 331, 23 ± 5 yrs.), and non-stimulant users (control group, n = 228, 25 ± 8 yrs.). Movement data was analyzed with logistic regression. ResultsIn the unadjusted logistic regression model, group had a significant effect on fine hand control, tremor, and voice/speech questions, but not on other movement domain questions. The prevalence of tremor and abnormal fine hand control was significantly higher in the ecstasy and methamphetamine groups than in the control group (p < 0.018), and changes in voice/speech was more prevalent in the ecstasy group than in the control group (p = 0.015). Age and use of cannabis and hallucinogens were confounding variables. However, inspection of chi-square tables suggests that the effect of these parameters on the movement data is likely to be minor. ConclusionsThe prevalence of self-reported tremor and changes in fine hand control and voice/speech is significantly higher in stimulant users than in non-stimulant users. Inclusion of these common and noticeable changes in body function may aid public health campaigns that target prevention or harm minimization.

Differential Risk for Drug Use by Sexual Minority Status among Electronic Dance Music Party Attendees in New York City

Background: Drug use among electronic dance music (EDM) party attendees is common; however, studies are needed to examine associations between drug use and sexual orientation as this can inform prevention and harm reduction efforts in the lesbian, gay, and bisexual (LGB) community. Methods: Data were examined from a repeated cross-sectional study of 3066 young adult EDM party attendees surveyed entering nightclubs and dance festivals in New York City between 2016 and 2018. Of these participants, 277 identified as gay/lesbian, 293 identified as bisexual, and 83 identified as other sexuality. We examined how sexual orientation relates to past-year use of various ‘traditional’ drugs (e.g., ecstasy/MDMA/Molly) and new psychoactive substances (NPS; e.g., “bath salts”) in a bivariable and multivariable manner, stratified by sex. Results: Compared to heterosexual males, gay males were at higher odds for use of ecstasy, GHB, and methamphetamine; bisexual males were at higher odds for use of LSD and unknown powders, and males identifying as “other” sexuality were at higher odds for use of mushrooms and 2C drugs. Compared to heterosexual females, lesbians were at higher odds for use of mushrooms and GHB; bisexual females were at higher odds for use of cocaine, LSD, mushrooms, and tryptamines, and females identifying as “other” sexuality were at higher odds for use of cocaine and tryptamines. Conclusions: We determined differential risk of use of different drugs among those who attend EDM parties according to sexual orientation. Findings can be used to tailor prevention messaging to specific groups within the LGB community.

The influence of viewing a headline about ecstasy/Molly adulteration on future intentions to use

ABSTRACTBackground: Ecstasy (3,4-methylenedioxymethamphetamine [MDMA]), commonly referred to as Molly in the US, is commonly adulterated with drugs potentially more dangerous than MDMA. Synthetic cathinones (“bath salts”) are common adulterants, and use of these compounds tends to be stigmatized. We investigated whether presenting information on the extent of ecstasy being adulterated with “bath salts” affects intentions to use.Methods: A total of 1,025 adults entering electronic dance music parties were surveyed in 2018. Using an experimental posttest-only design with random assignment, half were randomly assigned to view a published Vice headline about ecstasy/Molly commonly being adulterated with “bath salts.”Results: Overall, 30.5% of the sample reported past-year ecstasy use, and before viewing the headline, 16.4% agreed that ecstasy/Molly commonly contains “bath salts.” While controlling for pre-test knowledge of “bath salt” adulteration, viewing the headline reduced the odds of intention to use ecstasy/Molly only among non-past-year ecstasy users (Odd ratio [OR] = 0.54; p = .048). Viewing the headline increased the odds (OR = 1.81, p = .030) of past-year ecstasy users’ intention to test their ecstasy for adulterants.Conclusions: Knowledge that ecstasy is commonly adulterated may help reduce the risk for future use among non-recent users and increase the willingness of users to test their ecstasy. This information can be used to target those at risk for ecstasy/Molly use.

Age and Factors Associated with First Non-marital Sex Among Iranian Youth

Non-marital sex can cause social harm in many contexts. The present study measures the age of first non-marital sex in Iranian youth and identifies factors associated with younger age of onset. A cross-sectional survey was conducted in 13 provinces of Iran in 2013 by multistage cluster sampling. A total of 3026 youth age 19–29 years old were selected and agreed to complete a questionnaire. The prevalence of non-marital sex was 16.2% and did not differ between women and men. Younger current age (adjusted hazard ratio [AHR] 2.63, 95% CI 2.27, 3.13), having tested for HIV (AHR 1.87, 95% CI 1.43, 2.45), ecstasy use (AHR 1.85, 95% CI 1.09, 3.21), and methamphetamine use (AHR 5.81, 95% CI 4.39, 7.72) were significantly associated with younger age of first non-marital sex. Determination of the age of onset and associated factors for non-marital sex can help guide effective sexual and reproductive health education, preventative programs, and mitigate harm to youth. Programs for youth should also address substance use, notably methamphetamine and ecstasy, which were strongly correlated with younger age of non-marital sex.

Stroboscopic light effects during electronic dance music festivals and photosensitive epilepsy: a cohort study and case report

ObjectivesElectronic dance music (EDM) concerts are becoming increasingly popular. Strong stroboscopic light effects are commonly part of these shows, and may provoke seizures in individuals with photosensitive epilepsy. This study...

Re-traumatization Cycle: Sexual Abuse, Post-Traumatic Stress Disorder and Sexual Risk Behaviors among Club Drug Users

Background: Club drug users are high risk and vulnerable population for adverse drug-related consequences and sexual risk behaviors. Few investigations have addressed the possible interrelationship between early trauma and PTSD among young club drug using populations. Objective: Exposure to traumatic experiences – especially in childhood, has been linked to risk behaviors exposure and substance use disorder. This study aimed to assess and compare drug use patterns and the presence of childhood sexual abuse (CSA) experiences among ecstasy and LSD users with and without Posttraumatic Stress Disorder (PTSD). Method: This cross-sectional study employed targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals. The Global Appraisal of Individual Needs questionnaire was used as the primary assessment instrument. Participants were from 18 to 39 years of age, had used ecstasy and/or LSD in the 90 days prior to the interview, and were not in treatment for alcohol and other drug problems. Results: Out of the 240 participants, 123 (51.2%) presented PTSD symptoms. Those presenting PTSD were younger, less educated, with lower income, and presented higher drug use severity than those without PTSD symptoms. Moreover, a higher prevalence of sexual risk behavior was verified among those with PTSD. There was an association between PTSD symptoms and CSA history, where 64.2% of individuals with PTSD also presented CSA, compared to 47% among those without PTSD (p = .028). Individuals with co-occurring history of CSA and PTSD symptoms reported earlier use of ecstasy, LSD, and cocaine compared to individuals with a history of CSA but without PTSD. Conclusions: In the present study, participants with a history of PTSD demonstrate a history of CSA, as well as pronounced severity in several areas – precocity of use, severity of addiction, and greater exposure to situations of sexual risk. Thus, a cycle of traumatization may be established through early potential trauma, which can remain unprocessed and contribute to earlier and more severe substance use and sexual risk behaviors. Identification of PTSD symptoms and risk for HIV and other STIs among young club drug users is critical to address focused treatment approaches for this vulnerable population.

SUN-LB031 An Atypical Case of Diabetic Keto-Alkalosis with Severe Hypernatremic Hyperosmolarity in a Patient with Amphetamine Abuse

Introduction- Acid base disturbances have a complex interplay in Diabetic Ketoacidosis (DKA). Substance abuse in DKA is associated with more severe metabolic acidosis with higher acidosis-ketosis gap. Severe hypernatremia and alkalosis are rare in DKA but were exhibited in our case. Case- A 31-year-old female with Type 1 diabetes and schizophrenia was hospitalized after she was found to be minimally responsive at home. She had abdominal pain and polyuria since few days and wasn’t compliant with her medications. There was no history of vomiting, diarrhea, alkali ingestion, laxative or diuretic use. On admission, she was severely dehydrated, obtunded and only responsive to painful stimuli. Initial biochemical findings: serum glucose 1323 mg/dl (n 70-140 mg/dl), sodium 135 mEq/L (n 136-148 mEq/L, corrected sodium 154, bicarbonate 32 mEq/L (n 22-28 mEq/L), serum osmolality 379 (n 275-295 mOsm/Kg), beta hydroxybutyrate 62.56 mg/dl (n <=4.17 mg/dl), anion gap 30 (n 12-16) and delta gap of 24. Venous blood gas showed: pH-7.40 (n 7.31-7.41), pCO2-62 (n 41-51), HCO3-38.4 (23-27). She was adequately managed and was fully awake and alert with closed anion-gap within 24 hours of admission. Serum sodium initially peaked to 163 but normalized over the next 36-42 hours. She was also admitted with HHS (Hyperglycemic Hyperosmolar State) 3 months before and 1 month after this admission. Urine drug screen was positive for amphetamines in all 3 admissions. Discussion- Our patient exhibited mixed metabolic acidosis (elevated anion gap, ketonemia), metabolic alkalosis (elevated bicarbonate, elevated delta gap) and compensatory respiratory acidosis. Osmotic diuresis due to glycosuria and amphetamine abuse led to severe volume depletion and bicarbonate reabsorption leading to severe contraction alkalosis. Studies have shown that methamphetamine use leads to elevated plasma cortisol and corticosterone levels via hyper-activation of the hypothalamic-pituitary-adrenal axis. Ecstasy use has been shown to cause an acute increase in cortisol levels of around 150% in sedentary humans and 800% in dance clubbers. Excess glucocorticoids promote Hᶧ secretion from kidneys via mineralocorticoid receptors contributing to alkalosis. DKA/HHS patients usually present with eunatremia/hyponatremia. Adult schizophrenics who receive psychostimulants have been shown to develop polydipsia and hyponatremia. Ecstasy intoxication can precipitate both DKA and hyponatremia in Type1 diabetics. Combined DKA/HHS and hypernatremic hyperosmolarity has been reported due to huge intake of sugar-rich carbonated beverages to quench thirst especially in pediatric population. There is frequent association between decompensated diabetes and illicit drug use. Substance abuse should be suspected in young Type 1 diabetics presenting with recurrent hyperglycemic emergencies especially with atypical biochemical features. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Patterns of Polysubstance Use Among Non-Hispanic White and American Indian/Alaska Native Adolescents: An Exploratory Analysis.

IntroductionThe prevalence of polysubstance use is well described, but less is known about correlates and patterns of polysubstance use. Previous research characterized latent subgroups of substance users by the type substance used. Racial disparities in the prevalence of polysubstance use exist, particularly for American Indian/Alaska Native (AI/AN) populations. The objective of our study was to describe differences in patterns of polysubstance use between non-Hispanic white and AI/AN adolescents.MethodsWe obtained data from the 2013 Youth Risk Behavior Survey (YRBS). We analyzed substance use patterns (cigarettes, alcohol, marijuana, cocaine, inhalants, heroin, methamphetamines, ecstasy, steroids, and injected drugs) separately among 375 AI/AN and 15,633 non-Hispanic white adolescents. We calculated pairwise correlations. Exploratory factor analysis identified latent factors of polysubstance use patterns.ResultsThe use of all substances by AI/AN adolescents was the same or higher than use by non-Hispanic white adolescents, particularly for cocaine, heroin, and steroids. We found strong correlations between use of heroin and injected drugs and between use of cocaine and ecstasy among both populations. We found a latent factor for cigarettes, alcohol, and marijuana and another factor for broad polysubstance use among both populations. We found a factor for steroids and injected drugs among AI/AN adolescents, a factor for cocaine and ecstasy among non-Hispanic white adolescents, and a unique factor for methamphetamines.ConclusionDifferences in substance use patterns exist between AI/AN and non-Hispanic white adolescents, particularly for illegal drug use. If validated in future research, information on these differences could be used to inform tailored intervention programs aimed at preventing substance use.

Planned and Unplanned Drug Use during a Night out at an Electronic Dance Music Party

Background: Electronic dance music (EDM) parties at nightclubs and festivals are high-risk scenes for drug use. Although intention to use drugs (such as ecstasy) has been shown to be the most proximal determinant of use, little is known regarding the extent to which drug use is unplanned in this high-risk scene. Methods: We surveyed 954 adults entering EDM parties in New York City in 2017 and asked about planned drug use that night. A quarter (n = 236) completed the optional online follow-up survey which asked about drug use during their outing. We examined prevalence and correlates of planned and unplanned use. Results: A fifth (21.0%) of attendees reported planning to use a specific drug the night of the party and over a third (35.4%) reported using a drug later that night. A quarter (26.6%) used in an unplanned manner. Unplanned marijuana use was most common (10.7%), followed by unplanned use of ecstasy (7.3%), cocaine (4.7%), amphetamine (1.4%), LSD (1.3%), and MDA (1.1%). Unplanned initiation of ecstasy and PMA also occurred. Unplanned drug use was more likely to occur among those recruited outside of nightclubs compared to festivals. Non-heterosexual participants and those with a college degree or higher were also more likely to engage in unplanned marijuana use compared to heterosexual and less educated participants, respectively. Conclusions: Unplanned drug use is common at EDM parties. Results can inform prevention and harm reduction in these scenes as unplanned use may exacerbate potential adverse outcomes related to drug use and often extreme party environments.

Use of illicit amphetamines is associated with long-lasting changes in hand circuitry and control

ObjectiveThe study aim was to determine if use of illicit amphetamines or ecstasy is associated with abnormal excitability of the corticomotoneuronal pathway and manipulation of novel objects with the hand. MethodsThree groups of adults aged 18–50 years were investigated: individuals with a history of illicit amphetamine use, individuals with a history of ecstasy use but minimal use of other stimulants, and non-drug users. Transcranial magnetic stimulation was delivered to the motor cortex and the electromyographic response (motor evoked potential; MEP) was recorded from a contralateral hand muscle. Participants also gripped and lifted a novel experimental object consisting of two strain gauges and an accelerometer. ResultsResting MEP amplitude was larger in the amphetamine group (6M, 6F) than the non-drug and ecstasy groups (p < 0.005) in males but not females. Overestimation of grip force during manipulation of a novel object was observed in the amphetamine group (p = 0.020) but not the ecstasy group. ConclusionsHistory of illicit amphetamine use, in particular methamphetamine, is associated with abnormal motor cortical and/or corticomotoneuronal excitability in males and abnormal manipulation of novel objects in both males and females. SignificanceAbnormal excitability and hand function is evident months to years after cessation of illicit amphetamine use.

Marijuana, cocaine, and ecstasy in this day and age: A quantitative investigation of the “aging out” process

ABSTRACTObjective: Building upon the normalization literature, the present study tests the relationship between age and the use of marijuana, cocaine, and ecstasy. The purpose of the research is to (1) evaluate whether age remains a strong predictor of illicit drug use and (2) to test the claims made by the normalization thesis about the extension of drug use into adulthood and the delay of the “aging out” phase of drugs.Method: The data for the study was retrieved from the 2015 Canadian Tobacco, Alcohol and Drugs Survey (CTADS). The statistical method used in the study was logistic regression.Findings: The findings of the study suggest that age remains a relevant predictor of marijuana, cocaine, and ecstasy use. While the findings suggested that 18–22 year olds have the highest likelihood of past-year recreational drug use, the models predicted that large proportions of Canadians in their twenties, thirties, forties, and even fifties have also used recreational drugs in the past year.Conclusions: The findings provide support for the normalization thesis’ claims about the extension of illicit drug use into adulthood and the delaying of the “aging out’ phase. Future studies are warranted to better understand the “aging out” process for recreational drug use.

The spurious relationship between ecstasy use and neurocognitive deficits: A Bradford Hill review

Numerous studies have suggested that MDMA can cause neurocognitive deficits. However, the available data can only suggest an association – rather than a causal relationship – between MDMA use and neurocognitive deficits. The reliability and robustness of this association was evaluated using Bradford Hill’s criteria for determining causation in epidemiology research. Several limitations in the literature were found. Studies have recruited people who abuse ecstasy – an illicit drug that does not always contain MDMA. There is inherent risk in consuming impure or falsely identified substances; and using this as a source as for scientific opinion may introduce biases in our understanding the actuals risks associated with MDMA. Importantly, given that ecstasy research is predominately retrospective, baseline functioning cannot be established; which may be influenced by a variety of preexisting factors. Many studies introduce statistical errors by inconsistently dichotomizing and comparing light and heavy ecstasy users, making dose-response relationships inconclusive. When interpreting the ecstasy literature effect sizes are a more meaningful indicator of neurocognitive functioning rather than relying on p-values alone. Most meta-analyses have failed to find clinically relevant differences between ecstasy users and controls. There is also consistent evidence of publication bias in this field of research, which indicates that the literature is both biased and incomplete. Finally, suggestions for improving the ecstasy literature are provided.

Physical and psychosocial factors associated with psychostimulant use in a nationally representative sample of French adolescents: Specificities of cocaine, amphetamine, and ecstasy use

PurposePatterns of psychostimulant (PST) use, psychological and physical factors, and family relationships were investigated in a nationally representative sample of adolescents. The differences between users of cocaine (Cc), ecstasy/MDMA, and amphetamine (EA) were analyzed, taking into account gender differences. MethodsSubstance use, psychological factors (lifetime suicide attempts, suicidal thoughts in the previous year, visits to a mental health professional), physical factors (health and body shape perceptions (BSP), body mass index (BMI)), and family relationships (existence of disagreements with parents, relationships with mother and father) were investigated in 26,351 17-year-old French adolescents. ResultsLifetime suicidal behavior was strongly associated with EA use only. Suicidal ideation in the previous year was associated with Cc use among both boys and girls and associated with EA use among girls. Compared to Cc users, more EA users were overweight, while more Cc users were underweight compared to EA users. BSP, BMI, and EA use were related in girls only. Having a good or very good relationship with both mother and father was negatively associated with Cc use in boys and girls. Girls who had a good or very good relationship with their fathers seemed to be less prone to use EA. Boys with a good or very good relationship with their mothers seemed to be less prone to use EA. ConclusionThe results of the present study could serve as a basis for prevention and harm reduction strategies/programs targeting youth use and for the adaptation of these strategies/programs according to substance and gender.

Cluster randomised controlled trial of an online intervention to prevent ecstasy and new psychoactive substance use among adolescents: final results and implications for implementation

ObjectivesTo evaluate the effectiveness of the online Climate Schools: Ecstasy and Emerging Drugs module over 2 years, and examine the impact of intervention dose on outcomes.DesignCluster randomised controlled trial.SettingSecondary schools...