NDARC Technical Report No. 226 (2005)
EXECUTIVE SUMMARY
This report presents the results from the second year of a 2-year study to commence monitoring party drug trends in Victoria. A feasibility trial of this research was conducted in 2000 and 2001 in NSW, QLD and SA, and in 2002 the study was conducted in those jurisdictions. 2003 marked the first time the study was conducted on a national level, with the addition of Western Australia, the Northern Territory, the Australian Capital Territory, Tasmania and Victoria.
The demographic characteristics, patterns of drug use and perceptions of the price, purity and availability of ecstasy and related drugs among a sample of regular ecstasy users are described in this report. Their severity of drug dependence, perceptions of the effects of drug use (eg., benefits and risks), health risk behaviours and criminal behaviour are also reported. These findings are triangulated with information from key expert (KEs) and secondary indicator data sources to minimise biases and weaknesses inherent to each source of data and provide an understanding of the current party drug markets in Melbourne, Victoria. Where appropriate, 2004 findings are compared to findings from the previous year and implications of the results and the nature and characteristics of party drug markets are discussed.
Demographic characteristics of regular ecstasy users
The 2004 Victorian regular ecstasy user (REU) sample was typically aged in their midtwenties and lived either in rental accommodation or in their family home. Most had completed high school, a substantial proportion had completed post-secondary qualifications and participants were typically employed and/or studying full-time.
Patterns of drug use among REU
Polydrug use was the norm among the 2004 PDI participants, a trend that was confirmed by KEs. The REU sample reported lifetime use of a median of 11 drug types and recent use of seven (same as in 2003). A small number (15%) of REU had ever injected drugs, a result that was considerably less than for the 2003 sample (43%), but more in line with reports from other states. The discrepancy in these results is potentially due to sampling bias (where a result is an artefact of sample idiosyncrasies rather than reflecting genuine population parameters). General patterns of drug use between 2004 and 2003 were comparable, however, the 2004 sample showed some increase in recent GHB use (and less opiate use, presumably in line with fewer injecting drug users in the sample). Ecstasy was the primary drug of choice for about half the 2004 sample, followed by cannabis and methamphetamine powder. About half the sample reported recent binging on ecstay and related drugs, most often using ecstasy, methamphetamine powder and alcohol.
Ecstasy
The 2004 REU sample first used ecstasy, on average, in their late teens, with regular use typically commencing in the late teens and early twenties. Just over half the sample used ecstasy more than fortnightly, with about one in five using ecstasy at least once a week. On average, the REU sample used 2 pills during a typical session, and more than three quarters typically used more than one pill (a substantial increase on 2003; Table 3). There was considerable variation in the quantities of ecstasy pills reported being used during a 'heavy' session, from one to 40, with over half of the sample reporting using four or more pills. Nearly all participants reported swallowing as their main route of ecstasy administration, although nearly three-quarters reported snorting ecstasy in the preceding six months. Ecstasy was most often used in nightclubs and at dance parties, and was the most commonly used drug during binges (followed by methamphetamine powder and crystal meth). Almost all participants used other drugs in combination with ecstasy (most commonly tobacco, alcohol and methamphetamine powder) and during recovery (most commonly tobacco, cannabis and alcohol).
All REU perceived risks associated with their use of ecstasy, most commonly cognitive impairment, emotional problems and acute physical harms. All REU also perceived benefits associated with ecstasy use, most commonly related to enhanced mood and sociability, enhanced appreciation of music and dance and increased energy.
Price, purity and availability of ecstasy
The 2004 REU sample mostly purchased ecstasy at friends' homes, nightclubs and dance parties, typically from friends or known dealers. Ecstasy was reported to cost approximately $30 per pill with most REU reporting stable prices. Nearly all REU and KEs described ecstasy as 'very easy' or 'easy' to obtain. Substantial proportions of REU and KEs considered the purity of ecstasy to fluctuate, although REU tended to rate the current purity as medium to high.
Methamphetamine
Nearly all the REU sample reported lifetime and recent use of methamphetamine powder (speed) and the majority reported lifetime and recent (past six months) use of crystal meth. Base was less widely used with just under half reporting lifetime use and about one third reporting recent use. Only a small proportion of the REU sample reported speed as their main drug of choice, fewer reported crystal meth and none reported base as their main drug of choice. Nearly half of the sample reported usually using speed in conjunction with ecstasy and speed was the second most popular drug used during binges (behind ecstasy).
As with ecstasy, there was considerable variability in the reported frequency of methamphetamine use. However, the majority of those that had used speed recently had done so fortnightly or less, with crystal meth and base typically being used less frequently (once a month or less often). There was also considerable variability in reports of quantities used during typical and heavy use episodes.
Most participants reported the price of speed and crystal meth had remained stable in the preceding six months. The current purity of speed and crystal meth was mostly reported as medium or high, and the majority of participants reported speed as 'very easy' to obtain, whereas crystal meth was considered more difficult to access. Very few participants were able to comment on the price, purity or availability of base.
Cocaine
A majority of the sample reported lifetime use of cocaine, and just under half reported recent use. Those that reported recent use, however, tended to have used cocaine infrequently, with half using cocaine only once in the preceding six months. These findings are consistent with the KE reports. Reported cocaine prices show that cocaine is a relatively expensive drug. The purity of cocaine was reported as low to medium, with most participants reporting stable or fluctuating purity over the preceding six months. Cocaine was considered relatively difficult to access, and availability was reported to have remained stable.
Ketamine
The majority of the sample reported lifetime use of ketamine, although less than half of the sample reported recent use. The majority of recent ketamine users reported in frequent use (once a month or less). Ketamine is most often snorted and most commonly purchased from friends and used in friends' homes. Current purity of ketamine was considered medium to high, and nearly half the sample reported that ketamine had become more difficult to obtain in the preceding six months.
GHB
The prevalence of recent and lifetime use of GHB was greater in 2004 compared to 2003, with over one third of the REU sample reporting lifetime use and more than one quarter reporting GHB use in the preceding six months. Although most used GHB less than once a month, 20% of those reporting recent binging reported usually using GHB when doing so. GHB was reported as relatively cheap (modal price of $2.50 per millilitre) and prices were reported as stable. There were inconsistent reports of the purity of GHB, and most participants reported that GHB was 'very easy' to obtain.
LSD
The majority of the sample reported lifetime use of LSD and less than half reported recent use. The majority of the sample reported LSD use once a month or less. LSD was used across a wide variety of settings and more commonly 'outdoors' compared to other ecstasy and other related drugs. Price of LSD was most commonly reported as stable, and purity was considered high and stable. There was little consistency in reported availability of LSD, and LSD was most commonly purchased from friends.
MDA
MDA was less commonly used compared to other ecstay and related drugs, with just over one third reporting lifetime use and only 16% reporting recent use. Those reporting recent use did so infrequently. Due to the small numbers of participants reporting use of MDA, reliable reporting of characteristics of the MDA market and MDA use is limited.
Patterns of other drug use
Alcohol was almost universally used by the REU sample, and frequency of use was high. Most participants reported drinking alcohol when using ecstasy, and most of these participants reported usually consuming five standard drinks or more when doing so. One quarter also reported consuming alcohol during the comedown from ecstay and related drugs.
Similarly, almost all participants reported lifetime use of cannabis and more than three quarters reported recent use. The frequency of recent use was also high. More than one third of the sample reported usually using cannabis when using ecstasy and more than half reported cannabis use during comedown.
Almost all participants reported lifetime use of tobacco, most reported recent use, more than half were daily smokers, and KEs reported high levels of tobacco smoking by REU.
Over half the sample reported lifetime use of benzodiazepines and 41% reported recent but infrequent use. Very few participants reported benzodiazepine use when using ecstasy, with its use more common during comedown.
Over one quarter of the sample reported lifetime use of antidepressants. Of the few reporting recent use, most were prescribed antidepressants.
About half of the participants reported lifetime use of inhalants (nitrous oxide and amyl nitrate), and about one-quarter reported recent but infrequent use. Very few participants reported using inhalants in combination with ecstasy or during comedown.
Opiate use was not common among REU. Less than one in five reported lifetime use of heroin and less than 10% reported recent use. Similar proportions reported use of other opiates like codeine and morphine. Very few participants reported use of methadone or buprenorphine.
Risk Behaviour
Few REU reported lifetime or recent injecting of drugs, and the prevalence of risky injecting practices among these participants was low. Most REU had had penetrative sex in the past six months, although few reported anal sex. Condom use was common with casual sex partners, although about one in 10 reported never using condoms with casual sex partners. Penetrative sex under the influence of ecstay and related drugs (most commonly ecstasy) was also common. Of concern is that nearly two thirds of the sample reported driving soon after taking a drug in the past six months, most commonly after using ecstasy or speed.
Health Related Issues
One in four participants had overdosed on a party-drug in the previous six months, most commonly GHB, 1,4B or ketamine. All those who had overdosed on GHB did so in conjunction with the use of other drugs. Only 12% of the sample had accessed a health service in relation to drug use in the preceding six months, most commonly first aid.
Self-reported dependency scores were very low for ecstasy and generally low for methamphetamines, although 19% of the sample was classified as methamphetamine dependent.
Between a third and a half of the REU sample identified work/study, relationship/social and financial problems associated with their drug use.
Criminal and Police Activity
Few participants reported legal or police problems associated with their drug use. The few reported arrests among the REU sample in the preceding 12 months were predominantly related to use and possession of drugs. Less than one in five REU reported paying for ecstasy through dealing drugs. Most REU believed police activity around ecstay and related drugs had increased in the past six months, although an overwhelming majority believed that police activity had not affected their ease of access to ecstay and related drugs. Police KEs reported that their activity predominantly concentrated on high to middle end dealers.
Conclusion
The results reported here describe trends in the party-drug use in Victoria, and provides comparisons with the findings of the 2003 report. Many characteristics of party-drug use reported in last years report and elsewhere (e.g., Breen et al., 2003) are confirmed here. Regular ecstasy users sampled tend to be in their mid-twenties, with substantial proportions studying towards or having completed tertiary qualifications and are typically employed and/or full-time students.
Polydrug use was the norm among ecstasy users. Ecstasy and cannabis were the primary drugs of choice, and binging on drugs was common. A small proportion of the 2004 REU sample injected drugs, far fewer than in the 2003, but more consistent with prevalence in other states. Variations here are likely due to sampling bias.
Many ecstasy and related drugs ecstasy and related drugs, were identified as readily available, although some classes of drug appear more difficult to access or highly variable in their availability. Similarly, there was a degree of variability in the frequency with which some drugs were used. Ecstasy, speed and cannabis were used regularly, whereas, cocaine was used infrequently and opportunistically. GHB was the only drug to show a meaningful increase from 2003 in the proportion of REU reporting recent use.
Risk behaviours, health related problems and criminal activity among REU were relatively uncommon. However, a concerning proportion of REU reported driving soon after taking drugs. Problems associated with party-drug use were reported by a substantial proportion of participants, and centred on work, study and social relationships.
Implications
The second year of the Victorian PDI study has provided further indication of the characteristics of party-drug use in Victoria. Characteristics such as polydrug use, binging, the frequency and locations where some drugs are used and the availability different drugs have shown a degree of consistency across the two years of data collection. Other characteristics such as the degree to which REU engage in injecting drugs were inconsistent across time and warrant further exploration.
With increasing community interest in the patterns and characteristics of party drug use, the Victorian PDI represents a key knowledge base from which to further explore these local markets. The primary aim of the PDI was to provide a 'snapshot' of the characteristics of regular ecstasy use in Australia. Although the data collection methods described in this report have several limitations, the findings provide information that can be used to inform other research with the capacity to provide greater precision in trend monitoring or target emergent questions relating to regular ecstasy use (see below). Given the significant demonstrated potential for health and other harms associated with ecstasy and related drug misuse, there is an imperative for broadening existing drug trend monitoring systems to facilitate a more sensitive mechanism for detecting trends in this area. Research with this apparently heterogenous population will benefit from the enhancement of recruitment and data collection methods. Examinations of the efficacy of incorporating social network and core group theory to sampling ecstasy using populations warrants consideration.
The findings of the 2004 Victorian PDI study suggest the following recommendations:
- Polydrug use by REU, associated harms and explorations of harm reduction strategies warrant further investigation.
- In the context of the first point, more thorough and targeted research examining to true extent of injecting drug use in ecstasy-using populations requires attention.
- The increase in the prevalence of GHB use and its potential harms warrants close attention in future surveillance. Such research should further consider the use of GHB-like substances (e.g., 1,4B), and the uncertainty among many REU regarding exactly what drug they are consuming and the associated harms.
- Although more explicit harms associated with other drug classes (e.g., legal problems, overdose risk) appear to be of lesser concern among REU, potentially less visible problems related to work/study and relationship/social outcomes need further exploration to get a complete picture of the harms associated with regular ecstasy use. Such an inquiry should also examine the perceptions and recognition of such harms by REU.
- Driving under the influence of ecstasy or related drugs is a major concern. Targeted research is needed in this area, particularly in the context of Victoria's new 'drug-driving' testing initiatives and the impact such initiatives have on behaviour.
- Given that the aim of the National PDI is to provide a 'snapshot' of the characteristics of regular ecstasy use in Australia, these results should spawn other research with the capacity to provide greater precision in trend monitoring in this area. Such research should have the resources and capacity to employ more robust sampling methodologies and more detailed qualitative ethnographic enquiries of the social context of regular ecstasy use. This is particularly important given the heterogeneity of the ecstasy using population, whereby individuals may come from diverse social and geographical settings, belong to varied and disparate social networks, and undertake a wide range of drug use behaviours, patterns and routes of administration.
Citation: Stoove, M., Laslett, M-A. and Barrett, M. (2005) Victorian Trends in Ecstasy and Related Drug Markets: Findings from the Party Drugs Initiative (PDI), Sydney: National Drug and Alcohol Research Centre.