EXECUTIVE SUMMARY
This report presents the results from the tenth year of a study monitoring ecstasy and related drug (ERD) trends in Victoria. A feasibility trial of this research was conducted in 2000 and 2001 in New South Wales, Queensland and South Australia, and in 2002 the study was continued in those jurisdictions. In 2003 a two-year national trial of the study commenced, with the addition of capital cities in Western Australia, the Northern Territory, the Australian Capital Territory, Tasmania and Victoria; the study continued following successful implementation of the national trial. In 2012, 100 regular ecstasy users (REU) were interviewed in Victoria. Key findings from 2012 REU interviews, key expert (KE) interviews and external indicator data are included in this report.
Demographic characteristics of REU
The 2012 REU sample was comprised of people who had a mean age of 24 years (range=17-41 years), slightly younger than in 2011. Other characteristics were consistent with those measured in 2011; REU tended to be well educated, from an English-speaking background, and few reported being in drug treatment in 2012.
Patterns of drug use among REU
In addition to ecstasy, in 2012 most REU reported having recently used alcohol, tobacco and cannabis (as in 2011). In 2012 four REU reported recent use of crystal MDMA, which was not reported in previous years. Methamphetamines were also commonly used by REU; the prevalence of recent use of methamphetamines remained high but was not significantly greater in 2012 (prevalence of speed (methamphetamine) use was 77% compared to 69% in 2011; prevalence of crystal methamphetamine/ice or crystal meth use was 48% compared to 38% in 2011). While recent use of crystal meth was not significantly greater than in 2011, it was 2.5 times greater than the 2010 figure (18%). In regards to other drug use, there was a notable decline in reporting of recent use of d-lysergic acid (LSD) between 2011 and 2012 (57% vs. 38% respectively), heroin (15% vs. 5%) and mephedrone (68% vs. 29%) among REU who reported ever using these drugs in 2012. Among those who reported ever using 2CB (n=15) in 2012, 67% reported recent use compared to 6% in 2011.
Ecstasy
As in previous years, the 2012 REU sample reported first using ecstasy regularly at a mean age of 18 years, swallowing a median of two pills on a typical session and typically swallowing other drugs in conjunction with ecstasy (95%). In 2012, 35% of REU reported ecstasy as their “favourite” drug compared to 31% in 2011. The price per ecstasy pill increased from $25 in 2011 to $30 in 2012. A greater percentage of REU reported perceiving ecstasy purity to be high in 2012 than in 2011 (28% vs. 6% respectively) and fewer REU reported ecstasy to be difficult to obtain (9% vs. 20% respectively). Ecstasy seizures analysed by Victoria Police Forensic Services Department indicated a doubling in purity between the 2010/2011 and 2011/2012 financial years (15% and 33% respectively). Consistent with previous years, REU reported most commonly obtaining ecstasy from friends (66%), at friends‟ homes (33%), and using ecstasy at nightclubs (39%).
Methamphetamine
REU were asked about different forms of methamphetamines: speed, crystal meth and methamphetamine base.
As in previous years, in 2012 REU reported using a median of 0.5g of speed in a typical session. REU reported using speed on a median of six days in the past six months in 2012, lower than the median of 11 days in 2011. REU reported typically paying $200 per gram for speed in 2012, unchanged from the previous years. Fewer REU reported the purity of speed as high quality in 2012 than in 2011 (30% vs. 38% respectively). Over two-thirds (70%) of REU reported that ease of access of speed was stable in the past six months. REU reported most commonly purchasing speed from friends (51%) and last obtaining it at a friend‟s home (38%). REU most commonly reported using speed at nightclubs (26%), at home (20%) or friends‟ homes (18%).
In 2012, REU reported using a median of 1.5 points1 of crystal meth in a typical session, slightly lower than the two points reported in 2011. The median reported days of using crystal meth increased from eight days in the past six months in 2011 to 8.5 days in 2012. The most commonly reported route of administration for crystal meth in the past six months was smoking (98% in 2012 vs. 87% in 2011). The median reported price per point of crystal meth was $100, unchanged from 2011. In 2012, REU reported crystal meth being of high purity (63% vs. 57% in 2011). In 2012, 55% of REU reported that ease of access of crystal meth was stable in the past six months. REU reported most commonly purchasing crystal meth from friends (45%) and obtaining it at friends‟ homes (45%). REU most commonly reported using crystal meth at friends‟ homes (50%).
Only 13 REU reported recent use of methamphetamine base and few were able to respond to questions about price, purity and availability in 2012 (n=6).
Methamphetamine seizures analysed by Victoria Police Forensic Services Department have increased in purity from 39% in the 2010/2011 financial year to 57% in 2011/2012.
Cocaine
In 2012, REU reported using a median 0.5 grams of cocaine in a typical session, which was half the median reported amount in 2011 but consistent with previous years. REU reported using cocaine on a median of three days in 2012 compared to 2.5 days in 2011. The majority of users reported snorting cocaine (96%). The median reported cost of cocaine in 2012 was $350 per gram, slightly higher than the $320 recorded in 2011. About half (48%) of REU who were able to comment perceived current cocaine purity to be “medium” and reported the purity of cocaine was stable in the preceding six months. REU reported most commonly obtaining cocaine from friends (55%) or obtaining cocaine at friends‟ homes (29%). The most commonly reported last location of cocaine use was in a nightclub (39%) or at a friend‟s home (23%).
Cocaine seizures analysed by Victoria Police Forensic Services Department during the 2011/2012 financial year was 49% (range=19%-82%), higher than in the previous financial year (35% in 2010/2011).
Ketamine
In 2012, 35% of REU reported recent use of ketamine, slightly higher than the 26% recorded in 2011. Ketamine was used on a median of two days in the preceding six months in 2012 compared to a median of four days in 2011. REU most commonly quantified their use of ketamine in “bumps”,2 reporting using a median of 2.5 bumps during a typical session. Only 13 REU were able to answer questions on trends in ketamine price, purity and availability.
Gamma-hydroxy-butyrate (GHB)
Only seven REU reported recent use of GHB in 2012. KE reported GHB use to be low in the past 12 months and only used by particular groups of users (e.g., people who attended raves).
LSD
Recent users of LSD reported irregular use of the drug on a median of three days in the preceding six months in 2012, comparable to the number of days of use reported in previous years. The median reported price per tab3 was $15 in 2012, unchanged from 2011. Eighty-three per cent of LSD users reported the purity of LSD as medium to high in 2012, consistent with previous years. LSD was reported to be easy to source by 71% of LSD users in 2012 compared to 83% in 2011, typically from friends (60%) and at live music events (26%) or at a friend‟s home (20%). The 2012 REU sample reported their most recent LSD use to be at a live music event (31%) or at home (17%).
Cannabis
Reports of cannabis use were common among REU in 2012 (85%). REU reported using cannabis on a median of 72 days (three times a week) in 2011, which was higher than the 48 days reported by REU in 2011. Eighty-five per cent of recent users reported smoking cannabis. REU reported typically paying $15 for a gram of either hydroponic or bush cannabis. In 2012, the potency of cannabis was typically reported as being medium to high for hydroponic cannabis (82%) and for bush cannabis (77%), consistent with past years. KE reported that cannabis was the second most frequently reported drug of concern for drug treatment services. KE also reported cannabis was commonly used with crystal meth and cannabis to be more prevalent in road collisions in recent years. The majority of REU reported cannabis was very easy to obtain, commonly obtaining it from friends (42% for hydroponic and 63% for bush cannabis) and at a friend‟s home (42% for hydroponic and 50% for bush cannabis).
Alcohol
As in previous years, all of the 2012 REU reported lifetime use of alcohol and 97% reported recent use, initiating drinking at the age of 14.5 years. REU reported drinking on a median of 48 days (two times per week) in the preceding six months in 2012, unchanged from 2011. A higher percentage of REU reported drinking alcohol during a stimulant drug binge in 2012 compared to 2011 (82% vs. 66% respectively). Alcohol continues to be one of the drugs most commonly reported as problematic by KE. KE reported alcohol use to be widespread among REU and often used with other drugs, leading to violence and increased risk of overdose.
Health and other issues
Some REU have reported serious consequences related to their drug consumption. Recent stimulant drug overdose was reported by 18% of REU in 2012; they typically attributed their overdoses to ecstasy or crystal meth. Recent depressant drug overdose was reported by 18% of REU in 2012; they typically attributed their overdose to alcohol. In 2012, REU were administered the 10-item Kessler Psychological Distress Scale (K10) to measure the level of psychological distress that they may have experienced in the preceding four weeks; 45% were classified as experiencing moderate, 20% high and 10% very high psychological distress. Seventeen per cent of 2012 REU reported they had accessed a health or medical service in relation to their ERD use in the preceding six months.
In 2011, the Victorian specialist alcohol and other drug telephone counselling service DirectLine received calls identifying ecstasy (1.5%), amphetamine and/or other stimulants (12%), cocaine (0.8%) and cannabis (10.9%) as drugs of concern. Data from ambulance attendances at non-fatal drug-related events suggest that attendances involving ecstasy declined by almost half in 2010 compared to 2009 (236 vs. 409 respectively) but remained relatively stable at around 212 attendances in 2011. In contrast, attendances involving amphetamines have increased since 2009 (425 attendances), with 533 attendances occurring in 2010 and 768 attendances in 2011.
Risk behaviour
Fewer REU reported ever injecting a drug in 2012 than in 2011 (13% vs. 27% respectively). Only seven REU reported having injected a drug in the preceding six months in 2012.
Over half (57%) of 2012 REU reported that they had completed the vaccination schedule for the hepatitis B virus (HBV), mainly reporting vaccination during childhood (54%). Forty-three per cent of the 2012 REU sample reported that they had ever been tested for the hepatitis C virus (HCV); 63% of these tests occurred in the preceding 12 months and no one reported a positive HCV result. Forty-one per cent of the 2012 REU sample reported that they had ever been tested for HIV; 73% of these tests occurred in the preceding 12 months and no one reported a positive HIV result. Forty-nine per cent of the 2012 REU sample reported ever having a sexual health check-up (such as a swab, urine, or other blood test), and 73% of these tests were in the past year. The majority (90%) reported that they had never been diagnosed with a sexually transmitted infection.
Sixty-nine per cent of the 2012 REU sample reported recent penetrative sex with a casual partner in the past six months. Of those who reported recent penetrative sex with a casual partner, 57% reported using a condom the last time they had sex when sober. Sixty-five participants reported having had sex with a casual partner while under the influence of drugs/alcohol in the past six months. Among this group, 57% reported using a condom with a casual partner the last time they had sex while using drugs.
Seventy per cent of the 2012 REU sample reported having driven a car/motorcycle/vehicle in the six months prior to being interviewed, a rate similar to previous years. Reports of risky driving practices among the REU sample were common, with 42% reporting driving while over the legal limit of blood alcohol limit (for their licence type) in the preceding six months and 55% reporting driving soon after consuming illicit drugs.
Risky alcohol use was also measured among the REU sample in 2012. Eighty per cent of REU scored eight or more on the World Health Organization‟s (WHO) Alcohol Use Disorders Identification Test (AUDIT), which refers to levels at which alcohol intake may be considered hazardous, a figure consistent with that measured in 2011 (78%).
Law enforcement-related trends associated with ERD use
In 2012, 17% of the REU sample reported that they had been arrested in the past 12 months and half reported engaging in any type of crime in the last month. Drug dealing was the most common type of crime reported by the REU sample (35%). Consistent with previous years, 42% of REU reported they believed police activity towards REU to be stable in the past six months.
Conclusions
The results reported here describe ERD use and trends in 2012 in Melbourne, Victoria, and provide comparisons with the findings of the previous ERDS studies. The key findings were as follows. Crystal meth use in 2012 remained at the level reached after a significant increase between 2010 and 2011. REU reported a return of high-purity ecstasy into the market and a decline in recent use of LSD, heroin and mephedrone. REU‟s reports suggest the emergence of 2CB in Melbourne‟s ERD scene. As in previous years, alcohol was commonly associated with drug-related harms, which is particularly concerning as more REU reported drinking alcohol during a stimulant drug binge in 2012 than in 2011. REU reported low access to health services relating to their ERD use.
Implications
This tenth consecutive Victorian EDRS study has provided further indication of the patterns and characteristics of ERD use and related consequences in Melbourne. Patterns of polydrug use, binge drug use, the frequency and locations where drugs are reportedly used, and the availability of many drugs, have largely remained stable across the 10 years of data collection. Other characteristics, such as the possible return of high ecstasy and methamphetamine purity, high percentage of alcohol use at potentially harmful levels evident in recent years, and the increased use of some emerging psychoactive substances (EPS), warrant further exploration. The EDRS has also provided unique information on a range of issues of relevance to ERD-using populations, such as drug-driving behaviour and sexual health risks.
The Victorian EDRS represents a key knowledge base from which to further explore patterns and characteristics of ERD use in the state. The primary aim of the national EDRS is to provide a “snapshot” of the characteristics of regular ecstasy use in Australia. Although the data collection methods described in this report have limitations, the findings provide information that can be used to inform other research with the capacity to target emergent questions relating to regular ecstasy use (see below).
On the basis of the findings of the 2012 Victorian EDRS we recommend:
- further exploration of methods to reduce and prevent the use of alcohol at harmful levels;
- tailored research and surveillance activities capable of capturing information on emerging psychoactive substances such as 2CB as they emerge and their use expands;
- raising health workers‟ awareness of popular emerging substances to increase their ability to detect related drug overdoses and enhance surveillance activities;
- further research into the health and behavioural effects of EPS in order to gain a greater understanding of these drugs, and develop clinical and public health responses;
- further investigation into how to improve REU‟s utilisation of health services;
- further investigation of how to educate REU about the risks associated with behaviour such as sexual intercourse while under the influence of drugs; and
- targeted research examining the high levels of drug- and drink-driving reported by participants, in addition to analysis of attitudes towards current roadside drug-testing.