Recent Ecstasy Use Research Articles

Relationships between patterns of cannabis use, abuse and dependence and recent stimulant use: Evidence from two national surveys in Ireland.

Background and objectivesEpidemiological studies show that the use of cannabis is related to the use of other illicit drugs, including stimulants such as cocaine and ecstasy. However, few studies have examined how patterns of cannabis use relate to the use of stimulants. In this research we determined relationships between patterns of cannabis use and recent stimulant use, drawing on data from two large nationally representative surveys. We also explored how frequency of cannabis use relates to stimulant use and whether subjects with a cannabis use disorder (CUD)–defined as cannabis abuse or dependence–are more likely to be recent users of cocaine or ecstasy.Materials and methodsWe analysed data from Ireland’s 2010/11 and 2014/15 National Drug Prevalence Surveys,which recruited 5,134 and 7,005 individuals respectively, aged 15 years and over, living in private households. We included only those people who reported some past cannabis use. Multivariable logistic regression analysis was used to examine associations between patterns of cannabis use and recent stimulant use.ResultsAmong survey participants who had used cannabis in the last month, 17.9% reported recent cocaine use, while almost one-quarter (23.6%) reported recent ecstasy use. There was a significant linear relationship between patterns of cannabis use and recent use of cocaine, ecstasy or any stimulant, with last month cannabis users displaying greater odds (OR = 12.03, 95% CI: 8.15–17.78) of having recent stimulant use compared to last year (OR = 4.48, 95% CI: 2.91–6.91) and former (reference) cannabis users. Greater frequency of cannabis use in the last 30 days was also significantly related to the use of stimulants. In addition, results demonstrated an association between CUD and recent use of cocaine or ecstasy (OR = 2.28, 95% CI: 1.55–3.35).ConclusionsFindings from this study suggest a relationship between patterns and frequency of cannabis use and recent use of stimulants and an association between CUD and stimulant use. As the use of cannabis with stimulants may increase the risk of negative health consequences, education in community and medical settings about polydrug use and its increased risks may be warranted.

The Detection of Novel Stimulants in Oral Fluid from Users Reporting Ecstasy, Molly and MDMA Ingestion.

"Ecstasy" and "Molly" are common drug slang terms used among club and rave cultures to denote preparations believed to contain 3,4-methylenedioxymethamphetamine (MDMA). However, users of Ecstasy and Molly have increasingly tested positive for novel psychoactive substances (NPS), notably novel stimulants. To evaluate hypothesized non-specific and interchangeable use of the terms Ecstasy, Molly and MDMA, self-reported drug use was compared against toxicological findings in biological specimens. Oral fluid specimens were collected from participants attending large multi-day electronic dance music festivals in Miami, FL; Tampa, FL; and Atlanta, GA. Participants additionally completed a structured survey about recent recreational drug use. Collected specimens were screened for therapeutic drugs, common drugs of abuse and NPS using liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF). Positive screen results were confirmed by validated liquid chromatography-tandem mass spectrometry (LC-MS-MS) methods for MDMA, MDA, methylone, dimethylone, ethylone, butylone, dibutylone, eutylone, pentylone, N-ethyl pentylone (ephylone), alpha-PVP and 4-fluoroamphetamine (4-FA). During this 4-year study, 223 participants provided an oral fluid specimen and indicated recent use of Ecstasy, Molly and/or MDMA/MDA. Of these subjects, 203 (91.0%) indicated only one of these drug terms; while 20 (9.0%) participants indicated a combination of multiple terms. Of the 203 participants designating only one drug term, 123 (60.6%) reported Molly use, 55 (27.1%) reported MDMA use and 25 (12.3%) reported Ecstasy use. Seven participants reported the use of MDA, but these responses were paired with MDMA responses due to detection of MDA as a metabolite of MDMA. The results from this study indicate that there are inconsistencies between admission to drug use and toxicological findings in this population. Of the 223 participants who indicated use of Ecstasy, Molly and/or MDMA/MDA, MDMA without a novel stimulant was confirmed in 121 (54.3%) participants, while 66 (29.6%) tested positive for at least one novel stimulant.

Young adults' trajectories of Ecstasy use: A population based study

Young adults' Ecstasy use trajectories have important implications for individual and population-level consequences of Ecstasy use, but little relevant research has been conducted. This study prospectively examines Ecstasy trajectories in a population-based sample. Data are from the Natural History Study of Drug Use, a retrospective/prospective cohort study conducted in Australia. Population screening identified a probability sample of Ecstasy users aged 19–23years. Complete data for 30months of follow-up, comprising 4 time intervals, were available for 297 participants (88.4% of sample). Trajectories were derived using cluster analysis based on recent Ecstasy use at each interval. Trajectory predictors were examined using a generalized ordered logit model and included Ecstasy dependence (World Mental Health Composite International Diagnostic Instrument), psychological distress (Hospital Anxiety Depression Scale), aggression (Young Adult Self Report) and contextual factors (e.g. attendance at electronic/dance music events). Three Ecstasy trajectories were identified (low, intermediate and high use). At its peak, the high-use trajectory involved 1–2days Ecstasy use per week. Decreasing frequency of use was observed for intermediate and high-use trajectories from 12months, independently of market factors. Intermediate and high-use trajectory membership was predicted by past Ecstasy consumption (>70 pills) and attendance at electronic/dance music events. High-use trajectory members were unlikely to have used Ecstasy for more than 3years and tended to report consistently positive subjective effects at baseline. Given the social context and temporal course of Ecstasy use, Ecstasy trajectories might be better understood in terms of instrumental rather than addictive drug use patterns.

Severity of club drug dependence and perceived need for treatment among a sample of adult club drug users in Shanghai, China

Examine the severity of club drug dependence and perceived need for treatment, and further identify their determinants among a sample of club drug users in Shanghai, China. Two hundred and seventy-six club drug users were recruited using respondent-driven sampling (RDS). Severity of dependence on club drugs was measured using the Severity of Dependence Scale (SDS). 69.9% reported dependence on club drugs (i.e., SDS ≥ 4) and 36.6% reported severe dependence (i.e., SDS ≥ 6). One-eighth (12.7%) perceived need for drug treatment. Severe dependence on club drugs was more likely among those who reported recent use of ecstasy and those who had more depressive symptoms, but less likely among those reporting recent use of methamphetamine. Perceived need for treatment was more likely among those who lived with a spouse or boy/girlfriend, but less likely among those had prior drug treatment experience and more severe club drug dependence. Our findings suggest that educational activities should be implemented to raise public awareness about the powerful addictive properties of club drugs, along with efforts to reduce stigma towards drug abuse and psychiatric disorders. Programs to motivate drug users to seek treatment and encourage treatment linkage are urgently needed.

Laying the Groundwork for an HIV Prevention Intervention: A Descriptive Profile of the Los Angeles House and Ball Communities

African American young men who have sex with men (AAYMSM) represent the largest proportion of new HIV infections among MSM. While evidence-based interventions are lacking, all too often HIV interventions are implemented in a community without thoroughly understanding its needs, risks and assets. AAYMSM are not homogenous; subgroups exist that may require different approaches to be effective. The House and Ball communities represent one such subgroup. A community-engaged, mixed-methods approach was used. Participant observations, qualitative interviews (N=26), and a survey at House/Ball events (N=252) were completed. Survey data broadly describe the community. For example: 69% of survey respondents identify as gay; 25% as bisexual; 13% reported recent use of ecstasy and 11% recently participated in sex exchange. The depth of qualitative data is key for intervention development. For example, while the survey provides broad descriptions of respondents' involvement in the House and Ball communities, leaders provided in-depth descriptions of the structure of the House and Ball scene-something vital to the development of HIV prevention programs within these communities. This kind of rigorous study is recommended prior to implementing an intervention. Findings are discussed in relation to leveraging the communities' supportive aspects to design culturally relevant HIV prevention programs.

Consistency and Change in Club Drug Use by Sexual Minority Men in New York City, 2002 to 2007

We used repeated cross-sectional data from intercept surveys conducted annually at lesbian, gay, and bisexual community events to investigate trends in club drug use in sexual minority men (N = 6489) in New York City from 2002 to 2007. Recent use of ecstasy, ketamine, and γ-hydroxybutyrate decreased significantly. Crystal methamphetamine use initially increased but then decreased. Use of cocaine and amyl nitrates remained consistent. A greater number of HIV-positive (vs HIV-negative) men reported recent drug use across years. Downward trends in drug use in this population mirror trends in other groups.

Depressive and anxiety symptomatology in ecstasy users: the relative contribution of genes, trauma, life stress and drug use

Previous research has identified elevated rates of depressive and anxiety symptoms amongst ecstasy users; however, few studies have examined which factors increase the likelihood of experiencing such symptoms. The current study aimed to determine the relationship between ecstasy use and depressive/anxiety symptomatology after controlling for known environmental and genetic (polymorphism of the serotonin transporter gene) risk factors for depression and anxiety disorders. Participants consisted of a community sample of 184 18-35-year olds who had taken ecstasy at least once in the past 12 months. Participants completed an interview and questionnaires and provided a saliva sample. Mood symptoms were assessed using the Mood and Anxiety Symptom Questionnaire. Timeline methods were used to collect information on lifetime and recent ecstasy use, as well as recent other drug use and life stress. Trauma exposure was measured using the Composite International Diagnostic Interview--Trauma List. Genomic DNA was extracted from participant saliva samples. Neither lifetime nor recent ecstasy use was associated with the severity of current mood symptoms, either alone or in combination with genetic risk factors. Rather, lifetime trauma, recent stressful life events, the frequency of tobacco use and recent polydrug use significantly predicted the severity of depressive and anxiety symptoms. These results highlight the need to consider the role of environmental factors when examining the relationship between ecstasy use and mood symptoms. Whether ecstasy exacerbates such symptoms in vulnerable individuals requires further investigation using prospective designs.

Ecstasy (MDMA) and oral health

3,4-methylenedioxymethamphetamine (MDMA), more commonly known as 'ecstasy' or XTC, is frequently used by young adults in the major cities. Therefore, it is likely that dentists might be confronted with individuals who use ecstasy. This review describes systemic and oral effects of ecstasy. Life-threatening complications include hyperthermia, hyponatraemia and liver failure. In addition, psychotic episodes, depression, panic disorders and impulsive behaviour have been reported. Oral effects include xerostomia, bruxism, and an increased risk of developing dental erosion. Mucosal changes have also been reported. Recent use of ecstasy may interfere with dental treatment. Finally, the potential use of saliva for non-invasive detection of ecstasy is discussed.

Ecstasy use and its Association with Sexual Behaviors Among Drug Users in New York City

In the past two decades, recreational use of ecstasy has become a growing concern in the United States, although most studies assessing ecstasy use have focused on white, middle-class adolescents who use ecstasy during raves and in clubs. We assessed the prevalence of recent ecstasy use among predominantly minority heroin, cocaine, and crack users in New York City and the association between ecstasy and sexual risk above and beyond that of the other drugs. Between 2002 and 2004, injection and non-injection heroin, crack and cocaine users (N= 534) completed a risk behavior questionnaire that included items on ecstasy use. Logistic regression was used to investigate the relation between current ecstasy use and sexual behaviors. Of 534 illicit drug users, 69.7% were aged 25 years or older, 65.2% were Hispanic, 27.9% Black and 77.4% male; 36.7% were injectors. 17.2% of respondents reported recent (last six months) ecstasy use. In a multivariable logistic regression model, current ecstasy use was associated both with initiating sex before age 14 (adjusted odds ratio (AOR) = 1.51) and having two or more partners in the past two months (AOR = 1.86) after adjusting for age at study entry, current cocaine and marijuana use and being an injection drug user. This study suggests that ecstasy use may be more prevalent among urban drug users. Ecstasy use in urban settings, beyond clubs and raves, should continue to be monitored.

Estimating the Prevalence of Ecstasy Use Among Juvenile Offenders

To date, no studies have examined Ecstasy use among criminal justice populations. Focusing on individuals under criminal justice supervision is useful because “new” illegal drugs will typically takeroot in a criminal population before diffusing to the general population. In the current study, self-report drug use data and urine specimens were collected from 209 juvenile offenders surveyed through Maryland's Offender Population Urinalysis Screening (OPUS) Program. Prevalence estimates are generated and associations between Ecstasy use, demographic characteristics, and alcohol and other drug use are explored. Sixteen percent of the sample reponed using Ecstasy within the past 12 months, an estimate almost three times as high as grade school and high school students surveyed through the Monitoring the Future survey. Compared to nonusers, Ecstasy users were significantly more likely to be female (45% versus 20%, p<0.01), White (82% versus 22%, p<0.001), and out of school (39% versus 20%, p<0.05). Associations were also found between Ecstasy use and the use of other drugs. These findings suggest that the recent use of Ecstasy among juvenile offenders is higher than estimated use in the general student population, and that youthful offenders may represent an important population for potential intervention.

Ecstasy abuse and dependence among adolescents and young adults: applicability and reliability of DSM-IV criteria.

As part of an ongoing National Institute on Drug Abuse study on the reliability of DSM substance use disorders, 173 adolescents and young adults have been interviewed to date with the CIDI-Substance Abuse Module (SAM) to determine use and abuse of and dependence on 'club drugs' and other substances. Respondents are recruited from a substance abuse program, high school ads, college dorm flyers, the internet and chain referral. Retest interviews after 5 days determined the reliability of responses. Ecstasy use was reported by 52 respondents (30%); of these users 52% were female and 23% were non-white. Nearly all users (94%) reported recent Ecstasy use. Among Ecstasy users, 'continuing to use despite knowledge of physical or psychological harm' was the most prevalent dependence criterion (63%), with excellent retest agreement (kappa = 0.66). Withdrawal (59%) and tolerance (35%) were also commonly reported dependence criteria. Hazardous use was the most commonly reported abuse symptom. Most surprising were the rates of Ecstasy use disorders: 43% met DSM-IV criteria for dependence; 34% met criteria for abuse; only 23% met neither. This is the first effort to assess the reliability of Ecstasy abuse and dependence, and the first to determine abuse and dependence using criteria specific to Ecstasy. The importance of additional studies and the relevance of such work to DSM-V are discussed. Copyright 2001 John Wiley & Sons, Ltd.