NDARC Technical Report No. 244 (2006)
EXECUTIVE SUMMARY
Demographic characteristics of regular ecstasy users (REU)
In 2005 the regular ecstasy users interviewed for this study were: mainly male (57%); aged an average of 24 years; had completed an average of 11 years schooling with more than half (64) having a post-secondary qualification; and were mainly employed (59%). This profile is essentially the same as that found last year with the exception of the proportion of REU that were male, which was 73% in 2004. Thirteen percent of this years REU had been incarcerated (16% in 2004), 9% were in some form of drug treatment (1 person in 2004) and 38% had injected a drug at some time in their lives (35% in 2004).
Patterns of drug use among REU
Polydrug use was the norm among the regular ecstasy users interviewed this year, with respondents having ever used a median of 8 drug classes and recently used a median of 5 drug classes. Sixty-one percent of the sample nominated ecstasy as their preferred drug compared to 47% in 2004. Speed powder was the next most popular this year. Large proportions have reported recent use of alcohol, cannabis, tobacco, and methamphetamines in all years. Again this year, drugs typically seen as ecstasy-related drugs (cocaine, 3,4- methylenedioxyamphtemine (MDA), ketamine and gamma-hydroxy-butyrate(GHB)) showed a low incidence of recent use.
Ecstasy
On average, the sample of regular ecstasy users started to use ecstasy at 19 years and began using it regularly when they were 20 years in both 2004 and 2005. In 2005 the proportion using ecstasy weekly or more increased (39% in 2004 vs. 52% in 2005); the quantity usually used decreased (2 tabs in 2004 vs. 1 tab in 2005) as did heavy use (3 tabs in 2004 vs. 2 tabs in 2005). Bingeing with ecstasy remained stable (44% this year vs. 46% in 2004). A higher proportion (61%) reported that ecstasy was their favourite drug in 2005 (47% in 2004). In both years most of the sample used other drugs with ecstasy (89% in 2004 vs. 96% in 2005) and whilst coming down from ecstasy (68% in 2004 vs. 89% in 2005), however, proportion increased in 2005. Over the last two years the route of administering ecstasy has remained stable with swallowing continuing to be the most popular method and consistent proportions reporting ever (21% vs. 24%) and, recently, (16% vs. 15%) injecting it. In 2004 and 2005, nightclubs were the most popular usual and last ecstasy use venue. In 2004 the most common perceived benefits associated with ecstasy use were enhancement of mood and fun, and in 2005 it was fun, enhanced communication/ more social and enhanced sexual experience. The most common perceived risk with ecstasy use in 2004 was the unknown drug contaminants or cutting agents in the tab, and in 2005 it was a fatal overdose, followed by unknown drug contaminants/cutting agents and dehydration.
Price, purity and availability of ecstasy
Ecstasy was most commonly purchased in tablet form for $50 and this price was stable in the six months preceding interview in both years. In both years the current purity of ecstasy was rated medium, although there was an increase in those nominating it as low in 2005. In both years this purity had reportedly been fluctuating. Most users reported the availability of ecstasy as very easy to easy, and that this had been stable over the past six months in both years.
Ecstasy markets and patterns of purchasing
A majority of users said they scored ecstasy from a friend in both years, in 2004 it was mostly scored at a nightclub and in 2005 in was mostly scored at a friends home. This year the most common method of purchasing ecstasy did not involve paying for it, most REU received ecstasy as a gift from a friend or partner. In 2005 REU purchased, on average, three tabs from three sources, buying for themselves and others, between 7 and 24 times in the past six months. The only two factors that were deemed by REU to increase the price of ecstasy were a high 3,4-
methylenedioxymethamphetamine (MDMA) content, and if ecstasy became less available generally.
Methamphetamine
In 2005 the majority of the sample had used speed (73%, 72% in 2004) in the past six months and substantial proportions had used crystal (29%, 45% in 2004) and base (32%, 35% in 2004). The average age for methamphetamine initiation remained consistent in 2004 and 2005 - speed 18 years, base 20 years and crystal 20 years.
In both years, a quarter (25% in 2004, 27% in 2005) reported that they had used speed weekly or more in the six months preceding the interview. In 2005, 17% had used base (25% in 2004) and 8% used crystal (12% in 2004) at the same frequency. In 2005 the average usual amount of speed used increased from half a gram to one gram, and the heavy amount used remained stable at one gram.
Bingeing with speed amongst the recent speed users declined from 53% in 2004 to 41% in 2005. In both years the average amount of base used in a typical and heavy session was one point. In 2004, 22% had recently binged with base, in 2005 this figure increased to 33%. On average crystal users reported typically using one point in both years. In 2004 two points were used in a heavy episode, decreasing to one and a half points in 2005. Recent bingeing with crystal remained constant (20% vs. 19%).
Recent injection of all forms of methamphetamine by recent users increased in 2005 compared to the previous year - speed 14% vs. 35%, base 22% vs. 54%, and crystal 24% vs. 35%. However, swallowing remained the predominant recent route of administration for all forms of methamphetamine.
Forty-six percent of the current sample (41% in 2004) had ever used pharmaceutical stimulants at an average age of 19 years. Recent users would use 4 tabs in a usual and heavy use episode (10 tabs usual, 12 tabs heavy in 2004). Thirty-six percent reported using weekly or more. A majority of the recent users swallowed pharmaceutical stimulants and one-quarter had recently injected them.
In 2005 speed was most commonly purchased for a median of $200 per gram ($100 in 2004), base for a median of $75 per point ($50 in 2004) and crystal for a median of $80 per point ($50 in 2004). A majority of those commenting in both years said this price had been stable in the previous six months.
When commenting on the purity, in both years the most nominated categories were for speed low and stable, for base medium and stable, and for crystal high and stable. Speed users in both years reported the availability as very easy to easy and stable, base users in 2005 reported the availability as easy or difficult and stable (easy and stable in 2004), and crystal users in 2005 reported the availability as difficult and stable (easy and stable in 2004). In 2005 all methamphetamines were mostly scored from friends at a friends home. The same was seen in 2004 with the exception of base which was mainly scored from known dealers.
Cocaine
In the current year, lifetime cocaine use remained stable at 39% and recent use decreased (15% vs. 11%) compared to last year. Amongst those that recently used, cocaine use was infrequent with a median of three days use in the preceding six months in 2005, compared to one day in 2004.
In 2005, usual (0.5 grams vs. 2 grams) and heavy (0.75 grams vs. 3.5 grams) median quantities used increased compared to last year. Only one person had recently binged with cocaine over the last two years.
Over the last two years recent users most commonly snorted cocaine, and in 2005 recent injecting decreased (36% vs. 11%).
In 2004 cocaine was usually used at home or at private parties, in 2005 it was mostly used in a nightclub or at home.
The median price for a gram of cocaine increased, in 2004 it was reported to be $250 and in 2005 it was $375. Most users reported that the price of cocaine had been stable in 2004 and 2005.
The purity of cocaine was reported to be medium in 2004 and medium to low in 2005. In both years most respondents didn't know about the change in purity over the last the six months.
In 2004, most participants who commented on the availability stated that cocaine was difficult to very difficult to obtain, and in 2005 even higher proportions rated it as very difficult. In both years the availability had reportedly been stable over the past six months.
Ketamine
Lifetime (32% vs. 13%) and recent (18% vs. 7%) use of ketamine decreased from 2004 to 2005. Frequency and quantity of ketamine use declined; recent users in 2005 had used it for a median of one day (two days in 2004) and used one bump in usual and heavy episodes (two bumps in 2004). Swallowing was the most common recent route of administration in 2004 and 2005, but injecting and snorting were popular as well.
In the last two years, respondents reported usually using ketamine at home, with a few also using at other locations.
In 2004, the median price per bump was reported at $200, and in 2005 one participant reported the price at $80 per gram. Most did not know if this price had recently changed.
Ketamine purity was rated high in both years, and stable in 2004, but decreasing in 2005. Ketamine availability was described as difficult to very difficult to obtain in both years, and that this had been stable over the prior six months.
GHB
In 2005 15% of the sample reported lifetime use of GHB (20% in 2004), and only 4% had used GHB in the six months preceding interview (6% in 2004). GHB had been recently used for a median of two days (three days in 2004), and recent users were using 10mls in usual and heavy episodes (11.1mls in 2004).
Among the few that reported GHB use, all had recently swallowed the drug in both years and one person reported recently injecting it in 2005.
Over the last two years, recent users had usually and last used GHB at home and private parties.
One person reported on the price of GHB over the last two years; in 2004 it was $3 per ml, and in 2005 it was $50 per cap, with no consistent comments around price change in both years.
In 2004 GHB purity was rated as medium or fluctuating, and in 2005 it was medium to low and stable.
In 2004 and 2005 comments regarding GHB availability were mixed. No REU has reported ever using 1,4-butanediol (1,4B) in the NT. Last year one REU reported using Gamma-butyrolactone (GBL), no one reported ever using it this year.
LSD
In 2005 lifetime d-lysergic acid (LSD) use remained stable (63% vs. 61%) and recent use decreased (31% vs. 15%) compared to 2004. LSD had been recently used for a median of two days (one day in 2004), and recent users were using one tab in usual use (same as 2004), and one and a half tabs in heavy episodes in 2005 (one tab in 2004).
In 2004 and 2005 a majority of recent users would swallow LSD with small proportions reporting injecting and snorting.
Bingeing with LSD amongst recent users increased from 9% in 2004 to 25% in 2005. Small proportions of recent users had recently injected LSD in both years, although most reported swallowing it.
LSD was most commonly used in nightclubs in both years, however, in 2005 home and private parties were equally common use venues.
In both years LSD was most commonly purchased in tab form for $25 and this price was reportedly stable, however, 25% said this price had recently increased in 2005.
In 2005 higher proportions nominated LSDs current purity as high and medium compared to 2004, and reported that this had been stable over the past six months. In 2005 higher proportions nominated LSDs current availability as easy, and less rated it as difficult compared to 2004. This situation had reportedly been stable over the past six months. In 2005 LSD was typically scored from a friend at a friends home (compared to own home last year).
MDA
Twelve percent reported lifetime use of MDA (28% in 2004), but only one percent had used MDA in the six months preceding interview (10% in 2004) in 2005. Swallowing was the most common recent route of administration over the last two years.
In 2005 the quantity of MDA used in usual episodes increased from one cap to two caps. In heavy use episodes it remained the same at two caps.
Among those that used MDA, use was infrequent over the last two years; three days in the six months preceding interview in 2004 and one day in 2005.
A cap of MDA was reportedly purchased in 2004 for a median of $55 and $50 in 2005 (n=1), and this price had been stable over the prior six months in 2005.
In 2004 and 2005 only one respondent commented on MDA purity, reporting it as high, and this purity had been reportedly increasing over the prior six months in the current year. Over the last two years one person in each year reported that MDA was very easy to obtain, in 2004 one person also stated it was difficult to obtain. In 2005 the sole person commenting believed that MDA had recently become even easier to obtain.
Patterns of other drug use
Over the three years of the study, cannabis, alcohol and tobacco use has remained high. Proportions for lifetime and recent use of other drugs varied amongst the 2005 sample: cannabis (99%, 79%); alcohol (99%, 99%); Tobacco (88%, 76%); Heroin (22%, 5%); Amyl nitrate (31%, 6%); Nitrous oxide (31%, 4%); Methadone (12%, 4%); Buprenorphine (10%, 7%); Other opiates (22%, 10%); Anti-depressants (28%, 10%); Benzodiazepines (28%, 17%); and mushrooms (37%, 10%).
The mean age for first using tobacco, alcohol and cannabis has been early teens over the last two years. On average, all other drugs were first used by REU in their late teens, except for methadone and other opiates (early twenties) and buprenorphine (30 years).
The most frequently used other drugs, at a median of 180 days in the last six months, were tobacco and buprenorphine, closely followed by cannabis at 150 days. In 2004 this order was tobacco followed by cannabis, followed by buprenorphine.
The least frequently used other drugs, with a median of one days use in the last six months, were nitrous oxide and mushrooms, closely followed by methadone (2 days), and other opiates (4 days). In 2004 this order was nitrous oxide flowed by amyl nitrate followed by methadone then other opiates.
Proportions of the 2004 and 2005 sample who had ever injected other drugs were similar: alcohol (4%, 2%); heroin (17% both years); methadone (6%, 7%); buprenorphine (4%, 6%); other opiates (11%, 13%); anti-depressants (1%, 4%) and benzodiazepines (9%, 5%). These figures are all lower than 2003.
The 2005 sample showed an increase in hazardous drinking behaviour, with 83% (66% in 2004) of the recent alcohol users drinking more than five standards drinks while under the influence of ecstasy, and 58% (15% in 2004) would do the same whilst coming down from ecstasy. The 2004 sample reported using other drugs such as aerosols, physeptone, rohypnol, mushrooms, Xanax, glue, steroids, kava, travelcalm, and butane. Two respondents in the 2005 sample reported other drug use: petrol and steroids.
Drug information-seeking behaviour
Ten percent (10%) of the sample would always find out about the content and purity of other party drugs before taking them, and 20% would do the same before taking ecstasy. The most common ways of finding out about the content/purity of ecstasy was through friends who had already taken it, and through dealers. Only four participants had used testing kits, and one stated they always used testing kits. A third of the sample stated they would find testing kits useful if they were available locally. Eighty percent (80%) of the sample advised that the ecstasy they bought had a different content to what they expected at least sometimes. The majority of respondents didnt care what was in the ecstasy they took as long as they had a good time.
Risk behaviour
Over one-third (38%) of the sample had ever injected a drug using a median of four different drugs in 2005 (35% and a median of five drugs in 2004). The mean age for first injecting any drug was 19 years in 2004 and 17 years in 2005. Recent injecting increased from 24% in 2004 to 29% in 2005. Speed was the most common recently injected drug over the last two years and also the most frequently injected drug in 2005. Most injectors had learnt to inject from a friend or partner and half had first injected under the influence, most commonly alcohol and cannabis. While most recent injectors would inject themselves, 17% never did so.
Substantial proportions would share injecting paraphernalia, no one reported borrowing a used needle, but 22% had lent used needles. While most people injected in a home, substantial proportions would inject at public venues. The majority of recent injectors had been tested for hepatitis C virus (HCV) and human
immunodeficiency virus (HIV) and had been vaccinated against hepatitis B virus (HBV).
Almost all REU had penetrative sex in the prior six months, most with one or two partners. The majority never used condoms with regular partners but always used condoms with casual partners. A high proportion had sex under the influence of drugs, most commonly ecstasy, and generally once a month or more.
In the last six months, a majority of the sample had driven over the limit of alcohol and also within one hour of taking drugs , most commonly ecstasy and cannabis.
Health-related issues
In 2005 sixteen people had overdosed in the last six months (compared to 9 in 2004), with alcohol and ecstasy being the most common main drugs involved. REU in 2005 elicited a mean ecstasy Severity of Dependence Scale (SDS) score of 2.43 (1.85 in 2004), with 1% (7% in 2004) reaching a score indicative of problematic use, and 22% (11% in 2004) obtaining a score indicative of dependence.
Recent methamphetamine users in 2005 elicited a mean methamphetamine SDS score of 2.6, with 5% reaching a score indicative of problematic use and 25% obtaining a score indicative of dependence (4% and 13% respectively in 2004).
Fifteen percent (15%, 24% in 2004) of the 2005 sample had accessed a health or medical service (most commonly GPs and emergency departments) in the past six months in relation to their party drug use. Proportions experiencing all drug-related problems decreased this year, with the most common being financial (38%, 45% in 2004) and social/relationship (33%, 49% in 2004) problems.
Criminal activity, policing and market changes
Criminal activity in the in the past month decreased from 35% in 2004 to 15% in 2005; it consisted mostly of drug dealing in both years. A fifth of the 2005 participants would deal drugs for cash profit to pay for their ecstasy. The proportion of REU that had been arrested in the previous 12 months increased from 15% in 2004 to 17% this year. Forty four percent (44%) of the 2005 sample thought that police activity towards REU had increased recently (48% in 2003), however, 83% said this had not made it harder for them to score their drugs (64% in 2003).
Conclusion and Implications
Findings in relation to the main characteristics of the ecstasy and related drug markets in Darwin, i.e. price, purity and availability, are generally consistent this year with 2004. As in 2004, ecstasy, cannabis and the methamphetamines are the drug types commonly used by regular ecstasy users and are still rated as readily available. The market characteristics of these drugs have been essentially stable other than showing some apparent price movement among the methamphetamines, with the point prices of base and crystal increasing. Related drug types such as GHB, ketamine, and LSD are present in Darwin, but used infrequently and by small proportions of the PDI sample.
However, some specific changes are noted in relation to drug use among this years sample, specifically:
- the proportion of the sample using ecstasy weekly increased (from 39% in 2004 to 52% this year);
- recent pharmaceutical stimulant use has increased from 14% to 35%; and
- increased proportions had recently used other drugs either with ecstasy (89% to 96%) or while coming down from ecstasy (68% to 89%) .
Similarly, there were some changes in the risk behaviours reported by this years sample, specifically:
- the proportion reporting recent overdose increased from 12% in 2004 to 20%;
- and the proportions of recent methamphetamine users who used injections as a route of administration increased speed from 14% to 35%, base from 22% to 54% and crystal from 24% to 35%; and
- there were also increases in the proportions rated as dependent on the Severity of Dependence Scale for ecstasy (from 11% to 22%), speed (4% to 27%), base (0% to 30%) and ice (17% to 22%).
The changes seen in polydrug use, and recent overdoses, are both mainly accounted for by increased use of alcohol. The proportion of the sample consuming more than 5 drinks with their ecstasy use increased from 79% to 97% and the proportion reporting alcohol as the main drug involved in their overdose increased from 11% to 50%. In addition, majorities of the sample reported that in the six months before interview they had driven under the influence of either alcohol (68%) or another drug (58%).
As was the case in 2004, these results suggest that ecstasy and related drug use is well established in Darwin and that certain risk behaviours may be increasing. At the same time, only 9% of respondents were in treatment at the time of interview and the proportion who reported seeking help in relation to their drug use declined this year from 24% in 2004 to 15% in 2005 with no one reporting that they sought information about risks associated with ecstasy and related drug use. Given what may be an emerging gap between risk behaviours in this group and help or treatment seeking behaviours it would be appropriate that:
- health professionals, services and other relevant agencies should be encouraged to further develop their capacity to detect ecstasy use amongst their clientele; and
- health promotion resources specific to ecstasy and related drug use, particularly among young people, be developed and distributed.
Given also that pharmaceutical stimulant use and methamphetamine injection has increased attempts should be made to understand the use of diverted pharmaceuticals by this group and improve the monitoring of injection related health problems.
As in previous years, it is recommended that the market and use characteristics of ecstasy and related drugs continue to be monitored.
Citation: Newman, J. and Moon, C. (2006) Northern Territory Trends in Ecstasy and Related Drug Markets 2005: Findings from the Party Drugs Initiative (PDI), Sydney: National Drug and Alcohol Research Centre.