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Ecstasy and Related Drugs Reporting System (EDRS) National Report 2013

Image: Ecstasy and related Drugs Reporting System logo
Author: Natasha Sindicich, Lucy Burns

Resource Type: Drug Trends National Reports

Executive Summary  Introduction

The Australian Drug Trends in Ecstasy and Related Drug Markets 2013 report presents the findings from the eleventh year in which data have been collected in all states and territories in Australia on the markets for ecstasy and related drugs (ERD). The Ecstasy and Related Drugs Reporting System (EDRS) is the most comprehensive and detailed study of ERD markets in Australia.
 
Using a similar methodology to the Illicit Drug Reporting System (IDRS), the EDRS monitors the price, purity and availability of ‘ecstasy’ (3,4-methylendioxymethamphetamine; MDMA) and other drugs such as methamphetamine, cocaine, gamma-hydroxybutyrate (GHB), d-lysergic acid (LSD), 3,4-methylendioxyamphetamine (MDA) and ketamine. It also examines trends in the use and harms of these drugs. It utilises data from three sources: (a) surveys with regular psychostimulant users (RPU); (b) surveys with key experts (KE) who have contact with RPU through the nature of their work; and (c) the analysis of existing data sources that contain information on ERD. The EDRS is designed to be sensitive to emerging trends, providing data in a timely manner, rather than describing issues in extensive detail.
 
It is important to note that the results from the EDRS surveys are not representative of ERD users and their other drug use in the general population, but this is ‘not’ the aim of these data. These data are intended to provide evidence that is indicative of emerging issues that warrant further monitoring. REU/RPU are a sentinel group that provides information on patterns of drug use and market trends.
 
The findings from each year not only provide a snapshot of the ERD market in Australia, but in total they help to provide an evidence base for policy decisions; help to inform harm reduction messages; and to provide directions for further investigation when issues of concern are detected. Continued monitoring of the ERD markets in Australia will help add to our understanding of the use of these drugs; the price, purity and availability of these drugs; and how these may impact on each other; and the associated harms which may stem from the use of these drugs.
 
Drug trends in this publication are cited by jurisdiction, although they primarily represent trends in the capital city of each jurisdiction, where new drug trends are likely to emerge. Patterns of drug use may vary among other groups of REU in the capital cities and in regional areas.
 
Demographics of EDRS participants and patterns of drug use
  • EDRS participants in 2013 continue to be a group that are aged in their mid-20s (mean age of 25 years), predominantly male (67%), the majority identifying as heterosexual (88%) and being single (60%). Small proportions reported currently being in drug treatment which was mainly drug counselling.
  • The participants interviewed were well educated: 44% had obtained post-secondary qualifications; while 15% were full-time students.
  • One quarter (26%) of the national sample was currently in full-time employment. The mean weekly income was $550. The main source of income was salary/wages (64%). Half were renting (51%) or living in the parental/family home (41%).
  • In 2013, participants were recruited primarily through word-of-mouth although we have seen a significant increase in online recruitment and a decrease in street press over time.
  • Data across time show that key demographic characteristics of the sample have remained relatively stable.
 
Consumption pattern results
  • Ecstasy remained the drug of choice (32% in 2013). Cocaine experienced a decrease in relation to drug of choice and is now 5th in preference behind alcohol and LSD.
  • The drugs most likely to have ever been used and to have been used in the preceding six months were alcohol, followed by cannabis and tobacco.
  • Poly drug use is reported by this sample at a fortnightly to weekly frequency.
  • Almost half of the sample commented on changes in the drug market over the preceding six months to interview, the main themes included: new drugs on the market such as 2C-B, DMT and caps, and an increase in prevalence of traditional stimulant drugs such as ketamine and ecstasy.
 
Ecstasy
  • Ecstasy in some form was used by 99% of participants even though there was a change in the eligibility criteria.
  • Ecstasy tablets were used on a median of 12 days in the six months prior to interview, i.e. approximately fortnightly. Ten percent of participants reported using ecstasy more than weekly (pills only).
  • Ecstasy was again used in a variety of forms, this was the first year ecstasy in the form of crystals/MDMA rock was investigated. Use of this form was popular, particularly so in the eastern states.
  • Participants reported using a median of 2 tablets in a typical session of use, a median of two lines, and one capsule in average sessions of use.
  • The median age at which ecstasy was first used was 18 years, and was used regularly (at least monthly) at a median age of 18 years. No sex differences were found.
  • Ecstasy remained to be seen as a ‘social’ drug with participants reporting ‘most’ (44%) of their friends have consumed it.
  • The median price of a tablet of ecstasy nationally was $25 ranging from $20 in SA to $40 in the NT. A capsule nationally was a median of $30 and ecstasy (MDMA) powder was reported at a median price of $250 per gram a decrease from $300 per gram in 2012. MDMA crystal/rock was $260 per gram. The majority of the participants in all jurisdictions reported that the price of ecstasy had remained stable in the preceding six months.
  • With reports of ecstasy purity, we saw a significant increase in those reporting purity as ‘medium’ and a significant decrease in those reporting purity as ‘low’. There continued to be a mixed view as to the purity change over the last six months.
  • The majority continued to report that ecstasy was ‘easy’ to ‘very easy’ to obtain (86%). The majority in all jurisdictions reported that availability had remained ‘stable’ (55%) in the six months prior to interview.
  • Ecstasy was purchased from a range of people (median 3 people), between monthly and fortnightly most commonly from friends, on a monthly basis with a median of four pills purchased in one session.
  • It was also used in a range of locations, most commonly in nightclubs.
 
Methamphetamine
Speed powder
  • Just over one-third (37%) of the sample reported the use of speed in the six months prior to interview. The median days of use was three. As in 2012, VIC was the jurisdiction with the highest reported use of speed powder. The mean age of first use was 18 years.
  • Among recent speed users, snorting (65%) and swallowing (44%) were the most common routes of recent (last six months) administration. The amount used in an average session was 0.5 gram and the amount used in a heavy session was one gram.
  • Price (median) of a gram of speed nationally was $200 and ranged from $150 in NSW to $700 in WA, with 76% reporting that prices were stable.
  • Purity reports of speed were mixed with 36% reporting speed as ‘medium’ and 37% reporting purity as ‘high’. Most reported purity of speed had remained stable.
  • Availability was still considered to be ‘easy’ to ‘very easy’ to obtain (88%). The majority considered speed availability to have remained ‘stable’ in the past six months.
 
Base
  • Four percent of participants reported using base in the six months prior to interview, a significant decrease to 2012. The median days of use was two days. SA (11%) was the jurisdiction with the highest reported base use. The median age of first use was 19 years.
  • Among recent base users, swallowing was the most commonly nominated route of administration (ROA) (46%) followed by smoking (42%). The average amount used in a typical and heavy session was two points.
  • Base is the least common form of methamphetamine used by participants.
  • Price (median) of base was commonly reported in points, nationally was $80 per point ranging from $80 in TAS to $90 in SA. Most participants reported that this had remained ‘stable’.
  • Purity was considered to be ‘high’ for base, and this was considered to have remained ‘stable’.
  • Availability reports for base were ‘easy’ to ‘very easy’ to obtain. Interestingly, participants reported this to have remained ‘stable’ over the past six months.
 
Ice/crystal
  • Twenty-three percent of the national sample reported recent ice/crystal use. The median days of use among those who had recently used was four days (less than monthly). VIC (45%) was the jurisdiction with the most recent ice/crystal use reported. The median age of first use was 20 years.
  • The most common ROA for ice/crystal was smoking (92%). The average amount used in a typical session was one point and for a heavy session two points.
  • Price (median) of ice/crystal was commonly reported in points, nationally it was $100 per point ranging from $80 in VIC and the ACT to $100 in most other jurisdictions except the NT where it was $200. Most participants reported that this had remained ‘stable’.
  • Most participants reported that ice/crystal purity was ‘high’ and that this had remained ‘stable’.
  • The majority of participants commenting reported that ‘ice/crystal’ was ‘easy’ to ‘very easy’ to obtain and that this had remained ‘stable’.
  • ATS seizures at the Australian border have increased significantly in 2012/13 in both number and weight.
 
Cocaine
  • Just over one-third (36%) of the national sample reported cocaine use in the six months prior to interview, similar to the level reported in 2012. VIC (46%), NSW (42%) and QLD (40%) were the jurisdictions that reported the most amount of recent use.
  • Among recent users, cocaine had typically been snorted (78%), or swallowed (11%). The median age of first use was 21 years.
  • Frequency of cocaine use remained low at a median of two days (sporadic use) during the six months prior to interview. The majority (80%) had used less than once per month. There were no reports of daily use.
  • The median amount of cocaine used in a typical session of use was half a gram and in a heavy session it was one gram with no change to 2012.
  • Cocaine was the drug of choice for 6% of the EDRS sample, which was a significant decrease from 13% reported in 2012.
 
Ketamine
  • Over one-third (36%) of the national sample reported lifetime use of ketamine, and 19% reported using ketamine recently, a significant increase from 2012. The median age of first use was 19 years.
  • Ketamine use was predominantly reported in NSW and VIC. All other states had lower levels of recent use.
  • Amongst recent ketamine users, the majority (86%) snorted, while one-fifth (23%) had swallowed it.
  • Among users, ketamine had been used on a median of two days in the past six months; the majority (83%) had used ketamine less than once per month. There were two reports of more than weekly use.
  • Proportion of reported recent use of ketamine had declined in all jurisdictions from 2003-2009, and stayed relatively consistent from 2010-2013.
  • Price of a gram of ketamine ranged from a median national price of $180 to $47.50 in WA to $200 in VIC. The price was reported as stable by 77% of the participants that commented.
  • The current purity of ketamine has continued to be reported as ‘high’ (61%), and this was reported to have remained ‘stable’ by the majority that commented.
  • It was reported that ketamine was ‘easy’ to obtain. Participant availability was reported as having remained ‘stable’ in the preceding six months.
  • Ketamine continued to be predominantly obtained from friends; purchase typically occurred in private locations, such as friends’ homes. Locations of last use were divided between public locations (nightclubs) and private locations (friends’ homes).
 
GHB
  • Fourteen percent of the national sample reported lifetime use of GHB, with 6% reporting recent use. The median age of first use was 20 years.
  • Most recent use was reported in NSW and VIC. There were no reports of recent use in the TAS and the ACT.
  • Recent use occurred on a median of two days in the six months preceding interview; 77% reported using less than once per month.
  • Recent GHB users reported using a median of 4 ml in a typical episode of use and a median of 5 ml in the heaviest recent episode of use. GHB was only consumed orally.
  • Seventeen participants were able to comment on the median price of a millilitre of GHB of between $5 (nationally) to $11.50 (in NSW). Half of participants reported that the price had remained stable.
  • Purity was this year reported as ‘medium’ (41%) and then ‘high’ (35%). Comments about purity change were that it was ‘stable’.
  • Of those who commented on GHB availability, reports were that it was easy to obtain. Availability change was reported as ‘stable’.
  • GHB was obtained from friends and known dealers and from private locations. Location where GHB was mostly last used was also in private locations.
 
LSD
  • Seventy percent of the national sample reported the lifetime use of LSD; with a significant increase in recent use of LSD from 34% in 2012 to 43% in 2013 (p<0.05). The median age of first use was 18 years.
  • The median days of LSD use amongst recent users was three. Recent users reported using a median of one tab in a typical session and two tabs in the heaviest recent session of use.
  • Recent use has been steadily increasing from 28% in 2003 to 43% in 2013, increasing every year, until the significant decline to 34% in 2012. Recent use levels appears relatively even across Australia.
  • LSD as drug of choice has been stable each year from 4% in 2007 to 7% in 2013.
 
Cannabis
  • Cannabis was the second most used drug by the EDRS sample recently (85%). While reported recent use remained ‘stable’, the proportion of reported daily use significantly decreased compared to 2012 (24% in 2012 versus 19% in 2013, p<0.05).
  • Among recent (six month) users, cannabis had typically been smoked (99%), and swallowed (33%). The median age of first use by regular users was 15 years.
  • Among those who had used cannabis in the six months preceding interview, use occurred on a median of 48 days during this time, i.e. approximately twice weekly use.
  • Cannabis was the drug of choice for 23% of the sample.
  • The majority of respondents were able to differentiate between hydro and bush cannabis when being asked about cannabis market characteristics.
  • Nationally, prices for hydro were generally (slightly) more expensive than those for bush cannabis. Prices were reported to have remained ‘stable’ over the preceding six months.
  • As in 2012, participants in all jurisdictions generally perceived the potency of hydro to be ‘high’ and bush was most commonly reported to be ‘medium’. The potency for both forms was generally reported to have remained stable over the last six months.
  • Hydro and bush were both reported by the majority to be ‘easy’ or ‘very easy’ to obtain, and the availability of both forms was reported to have remained ‘stable’.
  • Both hydro and bush cannabis were most commonly bought from friends, and used in private locations.
 
Other drugs
  • MDA lifetime use was 20% of the national sample, with 12% reporting recent use on a median of two days and a median of two caps of use in an average session.
  • Almost the entire sample (99.9%) participants reported lifetime use of alcohol, and 96.5% reported alcohol use in the six months preceding interview. The mean age of first use was 14 years. The median days of alcohol use was 48 days (twice weekly). Daily drinking was reported by 6% of the sample. Eighteen percent nominated alcohol as their drug of choice.
  • Eighty-eight percent reported lifetime tobacco use and 77% had used tobacco in the six months preceding interview. Over half (52%) of recent tobacco users were daily smokers, with median days use being 180 (i.e. daily).
  • Over half (54%) of the sample reported lifetime benzodiazepine (both licitly and illicitly obtained) and one-third (32%) reported recent illicit use. Injecting and snorting were reported as routes of administration for illicit use. Daily use of illicit and licit benzodiazepine use was minimal (4%). The type most used was diazepam for both forms.
  • One-tenth (9%) of the national sample reported recent licit use and two percent reported illicit use of antidepressants. Licit use was higher than illicit use in 2012 and 2011. ROA was mainly swallowing for both forms.
  • One quarter (25%) of the EDRS sample reported recent nitrous oxide use in the six months preceding interview on a median of three days, comparable with 2012 results. Use was highest in VIC (45%).
  • Recent use of amyl nitrate (nationally) was reported by almost one-fifth (17%) in 2013. Use was occasional on a median of three days mostly in NSW (45%).
  • Twenty-seven percent of the national sample reported recent mushroom use, comparable to 2012. Use occurred on a median of two days, and 85% of recent users had used less than once per month.
  • Other drugs discussed in this section include heroin and other opiates, methadone, buprenorphine, pharmaceutical stimulants, Over the counter (OTC) codeine, OTC stimulants and steroid use.
 
New psychoactive substances (NPS)
  • Terminology has changed in the EDRS from Emerging Psychoactive Substances (EPS) to New Psychoactive Substances (NPS) to relate to this drug class given the universal reference to NPS.
  • In 2013, the number of EDRS participants that have consumed an NPS in the previous six month period was 37% and 16% for synthetic cannabis.
  • NPS use is spread across all states, whilst with synthetic cannabis it appeared to be concentrated in most states except WA and SA.
  • Drugs most used in this class included: 2C-B, DMT and 2C-I
  • Effects of these drugs based on user ratings included quite high/enjoyable for the pleasurable effects of NPS, the negative comedown effects were not considered any worse than expected and high ratings were given to taking the drug,. With synthetic cannabis, the pleasurable effects were given low scores, the negative comedown effects were given high scores implying they were worse than NPS. The low ratings for repetitive use implied they would not be taken again.
 
Health related trends associated with ERD use
  • Of the national sample, 43% had ever experienced a non-fatal drug overdose. 30% reported having ever overdosed on a stimulant drug, and 26% had done so in the preceding 12 months.\
  • Ecstasy was the main drug to which participants attributed the stimulant overdose (OD). Most stimulant OD occurred in private locations. The most common overdose symptoms reported were increased heart rate and temperature. Of those that sought immediate treatment, most were attended to by an ambulance.
  • Twenty-three percent of the national sample reported having ever overdosed on a depressant drug and 22% reported recent (last 12 months) overdose. Recent overdoses were most commonly attributed to alcohol (81%). Most depressant OD occurred in private locations. The most commonly reported symptom was vomiting. Of those that sought treatment, most were attended to by an ambulance.
  • Of the national sample 11% had accessed either a medical or health service in relation to their drug use during the six months preceding interview. GPs (74%) were the service most accessed by this group for any reason, followed by dentists (6%) and Emergency Departments (EDs) (5%). Of those that did access GPs to discuss drug use, ecstasy and alcohol were the primary drugs of concern in most cases.
  • In 2011/12, treatment seeking for ecstasy use (as the principal drug of concern) remained low in the general population at 3% of closed treatment episodes.
  • A small proportion of participants (8%) were classified as currently experiencing very high psychological distress on the Kessler Psychological Distress Scale (K10). Approximately one third reported no or low distress (34%).
  • Almost a third (30%) of the sample reported experiencing a mental health problem in the preceding six months; depression and anxiety were the most commonly reported.
 
Risk behaviour
  • Thirteen percent of the national sample reported having injected at some time in their lives; 7% of the national sample reported injecting in the six months preceding interview. The median age of first injection was 19 years of age. Among those who had injected in the preceding six months, the last drug injected was speed (36%) which differed from 2012 in which it was ice/crystal.
  • Syringes were typically obtained from a Needle and Syringe Program (NSP) (66%). Of those who had injected in the preceding six months very few respondents reported using a needle after someone else in the month preceding interview.
  • Two-thirds (62%) of participants reported penetrative sex in the six months preceding interview with at least one casual partner. A large majority of those had casual sex last time under the influence of mostly ecstasy, alcohol and cannabis. Over half had used protection on this occasion.
  • Just under three-quarters (74%) had driven a car in the last six months, 34% of those had reported being under the influence of alcohol, and 57% had driven shortly after taking an illicit drug on a median of five occasions. The most commonly reported illicit drugs after which these participants had driven were cannabis and ecstasy. A small number reported positive notifications were from being saliva drug tested. Participants that reported their behaviour had changed due to drug driving testing proportionately reported ‘not driving after using drugs’ followed by ‘waiting a few hours’ and ‘getting a taxi’.
 
Law-enforcement related trends associated with ERD use
  • One-third (34%) of the sample reported engaging in some form of criminal activity in the month prior to interview.
  • Drug dealing and property crime were the most common crime reported across all jurisdictions, with smaller proportions reporting having committed fraud or a violent crime in the last month.
  • Eleven percent of the national sample had been arrested in the past year, compared with 14% in 2012. The most common charges reported were property, alcohol and driving offences.
  • Consumer arrests increased for amphetamine-type stimulants (ATS), hallucinogens and cannabis.
 
Special topics of interest
  • Exposure to injecting was a topic of interest identified previously in the EDRS. Half of RPU participants reported knowing ‘a few’ people who injected. Motivations for not injecting as well as injecting were reported.
  • NPS health effects continued to be an area of topical interest. Factors that influenced the purchase and use of NPS are discussed as well as health effects (levels of tolerance and addiction) of specifically Mephedrone and 2C-B were reported. The intensity during the ‘high’ of these drugs is also reported.