NDARC Technical Report No. 247 (2006)
EXECUTIVE SUMMARY
Demographic characteristics of regular ecstasy users (REU)
Consistent with past years, the majority of regular ecstasy users interviewed for the ACT PDI in 2005 were male. The sample was predominantly heterosexual, from an English speaking background, and were aged between their late teens and mid-twenties. Almost ninety percent of the sample had completed at least their high-school education, and at the time of interview the majority of REU were either studying at a tertiary level or employed full-time. A minority of the sample reported ever having contact with the criminal justice system, and only one REU indicated that they were currently accessing a drug treatment facility.
Patterns of drug use among REU
Polydrug use was universal among the 2005 ACT PDI sample. REU had used a mean of nine drugs in their lifetime and a mean of six drugs in the previous six months. Although REU reported the use of a wide number of substances, only a minority of the sample reported ever having injected drugs. Ecstasy was clearly the drug of choice for this sample, followed by cannabis and cocaine. The majority of the sample indicated that they typically used other drugs both in combination with ecstasy and also to facilitate their comedown. Alcohol, tobacco and cannabis were the drugs that were most commonly used by REU in the context of ecstasy use and also during the comedown period. Almost half the sample reported having binged on ecstasy and related drugs in the six months prior to interview. Ecstasy was used in extended binge episodes of drug use by almost all REU who reported recent binge activity. Other drugs commonly used in these binge episodes were methamphetamine powder, cannabis, alcohol, cocaine and methamphetamine base.
Ecstasy
Ecstasy pills had been used by the entire sample in the past six months, and pill form was the most commonly used form of ecstasy by REU. Smaller proportions of the sample reported ever having used ecstasy powder (36%) or having used ecstasy powder in the past six months (24%). In the six months prior to interview, the median number of days of any form of ecstasy use was thirteen. Almost half the sample reported using ecstasy on a monthly to fortnightly basis in the past six months, with approximately one-third of the sample using ecstasy on a greater than fortnightly to weekly basis. The median number of ecstasy tablets consumed in a typical session of use was two, whereas a median of three tablets were taken by REU in the heaviest session of use.
Price, purity and availability of ecstasy
The median reported price for a tablet of ecstasy has remained stable in the ACT since 2003 at $35 a tablet. Also consistent with previous years, almost the entire sample in 2005 reported that ecstasy was very easy to easy to obtain in the ACT. The majority of the sample reported that the ease with which ecstasy could be obtained had remained stable or had become easier. Ecstasy was primarily obtained by REU through friends, known dealers and acquaintances. The current purity of ecstasy was reported by REU to be at medium to high levels, and approximately onequarter of the sample indicated that the purity of ecstasy had consistently fluctuated in the past six months.
Ecstasy markets and patterns of purchasing
REU had paid for the ecstasy they used in the previous six months through a number of sources, most commonly: paid employment; as a gift from friends; borrowing money from friends; government allowance; or receiving money from parents. In the six months prior to interview, REU had purchased ecstasy from a median of four people. Participants indicated that when purchasing ecstasy they typically bought it for themselves and others, and they typically purchased a median of five pills on each purchase occasion. Similar proportions of REU reported typically buying ecstasy on a monthly or less than monthly basis, on a greater than monthly to fortnightly basis, or on a greater than fortnightly to weekly basis in the past six months. Sixty seven percent of the entire sample reported that they were able to purchase other drugs from their main ecstasy dealer. Other drugs that were commonly available to REU at the time of ecstasy purchase were methamphetamine powder, cannabis, cocaine, crystal methamphetamine and base methamphetamine.
Methamphetamine
Methamphetamine is available in three forms: methamphetamine powder (speed), methamphetamine base (base) and methamphetamine crystal (ice). Nine in ten REU reported ever having used speed, and seven in ten REU reported using speed in the past six months. Recent speed users reported a median of five days of use in the six months prior to interview. Snorting was the primary mode of administration, although there were significant increases this year in the proportion of REU who reported having swallowed and smoked speed. In 2005, there were increases in the amounts of speed used by REU in both typical and heaviest episodes of recent speed use. Participants reported using a median of 1 gram of speed in a typical session of use (an increase from half a gram in 2004) and 1.6 grams in the heaviest session of use (also an increase from half a gram in 2004). Speed was used during binges by over half those REU who reported recently having binged on ecstasy and related drugs, and was also frequently used in combination with ecstasy.
Base methamphetamine was less commonly used by REU, with forty-five percent of the 2005 sample reporting ever having used base and approximately one-quarter reporting recent use. The majority of recent base users had used this substance infrequently (less than monthly) in the six months prior to interview with a median of three days of use being reported. Swallowing was the most common route of administration reported by base users. There was also a significant increase in the proportion of REU who had recently snorted base, and a trend towards base smoking was also observed. The majority of base users quantified their use of the substance in terms of points. A median of one point of base was used in a typical episode of use, whereas a median of two points were used by REU in the heaviest session of recent use. Almost one in five REU who had used ecstasy and related drugs in extended binge episodes reported using base methamphetamine during these binge sessions. Of those REU who commonly used other drugs in combination with ecstasy, ten percent indicated that they used base methamphetamine in this way.
Crystal methamphetamine had been used by almost half the sample, and by approximately onequarter of the sample in the past six months. Since 2003, the proportion of the ACT PDI sample reporting the recent use of crystal methamphetamine, or ice, each year has continued to significantly decrease. The majority of recent ice users had used this substance infrequently with a median of three days of use in the past six months. In the 2005 PDI the most common mode of recent ice administration was smoking, followed by swallowing and snorting. This represented a change from previous years in which swallowing was the dominant route of ice administration. In the previous six months, one point was the median amount of ice consumed in both typical and heaviest sessions of use by REU. When compared to powder and base methamphetamine, relatively small percentages of REU reported using ice during binge episodes or in combination with ecstasy.
The median price for a point of methamphetamine was reported to be stable at $35 for speed and crystal methamphetamine and $40 for base methamphetamine. Consistent with past years, this year the majority of respondents reported the current purity of each form of methamphetamine to be medium to high. The reports of REU indicated that the purity of base and crystal methamphetamine was relatively stable and that the purity of speed had remained stable or decreased over the previous six months. The availability of each form of methamphetamine was reported to be stable and easy to very easy to obtain, with indications that base methamphetamine was becoming easier to obtain in the ACT. Like ecstasy, methamphetamine was primarily obtained by REU from known dealers and friends.
Cocaine
Approximately two-thirds of the 2005 PDI sample had ever tried cocaine, and almost half the sample reported using cocaine in the previous six months. Those REU who had recently used cocaine had used the substance on a median of three days in the preceding six months, and the majority had used on a less than monthly basis during this period of time. Snorting remained the most common route of administration, and there was a significant increase this year in the proportion of REU who had recently smoked cocaine. The median amount of cocaine used in a typical episode of use was half a gram, which increased to one gram when referring to the heaviest episode of use. One in five REU who had binged on ecstasy and related drugs in the previous six months reported using cocaine during these binge sessions. Of those REU who commonly used other drugs in combination with ecstasy, eleven percent indicated that they used cocaine in this way. The median price for a gram of cocaine has remained stable in the ACT since 2003 at $250 per gram. The reports of REU indicated that the current purity of cocaine in the ACT is stable at medium to high levels. The response of REU in regards to the current availability of cocaine in the ACT was mixed, which is also consistent with reports of participants in previous years. Cocaine was typically purchased by REU from known dealers and friends in the six months prior to interview.
Ketamine
Approximately one-third of the sample had ever tried ketamine, and less than one-fifth of the sample reported having used ketamine in the past six months. Almost all recent ketamine users had used this substance on a less than monthly basis in the past six months, with REU reporting a median of two days of use in this period of time. Swallowing and snorting remained the most popular forms of ketamine administration. The majority of ketamine users quantified their use of this drug in terms of bumps. One bump was the median amount of ketamine used by REU in both the typical and the heaviest session of use in the past six months. Reflecting the low levels of ketamine use among ACT REU, only small proportions of the sample reported having used ketamine during binge sessions of substance use or in combination with ecstasy. The median reported price for a pill of ketamine increased from $20 in 2004 to $30 per pill in 2005. Despite this change, the majority of REU believed that the price of ketamine had remained stable over the previous six months. REU reported that the purity of ketamine had remained stable in the ACT at high levels. Consistent with previous years, REU were divided in terms of their response to the current ease of availability of ketamine in the ACT. Known dealers and friends were the primary sources through which REU obtained ketamine in the past six months.
GHB
The data that have been collected for the ACT PDI since 2003 suggest that GHB is a drug that appears to be used relatively infrequently by ACT REU. As in previous years, only a minority of the 2005 PDI sample reported lifetime or recent use of GHB. Recent users reported a median of two days of GHB use in the six months prior to interview, and swallowing was the universal mode of administration. The median amount of GHB used for both the typical and heaviest sessions of use was 12.5 millilitres. One participant reported that they had used GHB during extended binge episodes of drug use, or regularly in combination with ecstasy. Only five respondents were able to comment on the price, purity and availability of GHB in the ACT in 2005, and results therefore need to be interpreted with caution.
LSD
Almost one-third of the 2005 PDI sample reported the recent use of LSD, and almost half the sample reported ever having used LSD. The majority of recent LSD users had used this substance on a less than monthly basis in the previous six months, and reported a median of two days of use during this period of time. Swallowing was the universal mode of administration. REU had used a median of one tab of LSD in both a typical and the heaviest sessions of recent use. One in ten REU who reported having recently binged on ecstasy and related drugs had used LSD during these binge episodes, and only a minority of REU reported typically using LSD in combination with ecstasy. The median price for a tab of LSD has remained stable in the ACT since 2003 at $20 per tab. REU estimated the current purity of LSD to be medium to high levels and reported either that the purity of LSD had remained stable over the past six months or was decreasing. Although the majority of REU reported that LSD was currently difficult to obtain, REU reports also suggested that LSD had recently become easier to get in the ACT. LSD was most commonly purchased by REU from known dealers and friends in the six months prior to interview.
MDA
In 2005 there was a significant decrease in the proportion of the PDI sample reporting ever having used MDA when compared to the 2004 sample. Despite this difference, the rates of recent MDA use remained stable at low levels in the ACT across the 2004 and 2005 samples. Among those REU who had recently used MDA, the median days of use in the past six months was one. The majority of recent users had swallowed MDA with approximately one-fifth of recent users reporting having snorted MDA. The median amount of MDA used in a typical episode of use was one capsule, which increased to two capsules in the heaviest episode of recent use. As in 2004, only a small number of respondents were able to comment on the current price, purity and availability of MDA. Therefore, the following results should be interpreted with caution. The median reported price of MDA remained stable in the ACT at $40 per cap. The majority of respondents reported that the current purity of MDA was stable at medium to high levels. The reports of REU suggested that MDA had remained consistently difficult to obtain in the ACT. In the past six months, REU had primarily obtained MDA through known dealers and friends.
Patterns of other drug use
Almost the entire sample had used alcohol in the six months prior to interview. Alcohol was commonly used (in many cases to excess) in the context of ecstasy use and also to facilitate the ecstasy comedown. Approximately one-third of those REU who reported bingeing on ecstasy and related drugs in the past six months had used alcohol during these binges. As observed by KE, the use of cannabis and tobacco was common in the PDI population. Similar to alcohol, cannabis was commonly used during binge episodes of drug use, in combination with ecstasy, and was also the drug that most REU used to manage the residual effects of their ecstasy use. As in the 2003 and 2004 PDI, the use of other drugs such as benzodiazepines, anti-depressants and other opiates was minimal in the 2005 population. The rates of lifetime use of inhalants such as amyl nitrate and nitrous oxide were significantly lower in the 2005 PDI population when compared to the 2004 sample. The proportion of the sample that had recently used inhalants, however, remained at the similar low levels reported in the 2004 PDI.
Drug information-seeking behaviour
For the first time in 2005 PDI participants were asked questions relating to how they obtained information on the drugs they had used in the past six months. Over half the sample reported that they had actively tried to gain information on the drugs they purchased (excluding ecstasy) prior to taking them. In terms of seeking information on the content of ecstasy tablets, a much higher proportion of the sample (81%) reported that they actively sought information on the contents of the ecstasy they had purchased. Of those REU who did find out about the content of their ecstasy, the most common methods of obtaining information were asking friends, asking their dealer and checking on websites. Approximately one-quarter of those REU who obtained information on the content of their ecstasy tablets reported using testing kits as a source of information. Almost half this group reported that they were aware the use of testing kits had limitations.
Risk behaviour
Only a small number (6%) of REU reported ever having injected a drug, and 4% reported injecting drugs in the six months prior to interview. A median of three drugs had ever been injected while those who reported having injected in the past six months had also injected a median of three drugs. Almost half the lifetime injectors reported that they were under the influence of other drugs the first time they ever injected. When asked how they first learnt to inject, the majority of lifetime injectors reported that their friends or partner had taught them.
Almost one-third of the 2005 PDI sample reported that they had not been vaccinated against the hepatitis B virus (HBV). A similar proportion (36%) had completed the HBV vaccination schedule, 14% reported that they had started but not finished the HBV schedule, and 18% were unsure of whether they had completed the schedule. Over half the sample reported that they had never been tested for the hepatitis C virus (HCV); 21% of the sample had been tested in the previous twelve months, and 13% had been tested more than twelve months ago. A minority (8%) of the sample were unsure as to whether they had ever been tested for HCV. Thirty-three percent of participants indicated that they had been tested for the human immunodeficiency Virus (HIV) at some point in their lifetime, and two participants identified as HIV positive.
Almost the entire sample reported having had penetrative sex in the six months prior to interview. The majority (72%) of sexually active REU reported having sex with two or more partners in the past six months. Approximately one-quarter (24%) of sexually active participants in this years sample had recently (in the past six months) engaged in anal sex. The majority (76%) of sexually active REU reported having sex while under the influence of ecstasy and/or related drugs in the past six months.
Sixty-two percent of those REU who had driven a car in the past six months had driven under the influence of an illicit drug (52% of the entire sample) and 44% had done so while over the legal limit of alcohol. Ecstasy was the most common illicit drug that REU reported driving under the influence of, followed by cannabis and methamphetamine powder.
Health-related issues
Seventeen percent of the sample reported that they had ever overdosed on ecstasy or related drugs and 9% of the sample reported having overdosed on ecstasy or related drugs in the past six months. Ecstasy was the drug most commonly overdosed on, followed by alcohol, LSD, ketamine and GHB. Approximately half the REU who had recently overdosed reported the use of two or more drugs at the time of overdose.
In the 2005 ACT PDI all participants completed the Severity of Dependence Scale (SDS) in relation to ecstasy and methamphetamine. As in 2004, the median score obtained on the Ecstasy SDS for the 2005 PDI sample was 1 (range 0-11). The median frequency of ecstasy use in this population was approximately on a fortnightly basis, and therefore the low SDS scores obtained for this group are consistent with this. Almost all (97%) recent methamphetamine users completed the Severity of Dependence Scale SDS for methamphetamine. An SDS score of four or greater is indicative of problematic amphetamine use and, for this sample, the median SDS score obtained was 0 (range 0-11). However, ten participants obtained SDS scores that classified them as methamphetamine dependent.
A minority of the sample (2%) had experienced legal/police problems in the preceding six months and just over one-third (35%) of the sample reported that they had recently experienced relationship/social problems due to their drug use. Approximately one-third (36%) of participants also reported experiencing financial problems in the past six months. The drugrelated problems most frequently experienced by REU in 2005 were occupational/study problems, with over one in four (41%) REU having experienced these problems in the six months prior. Ecstasy was the drug that REU most commonly attributed their experience of problems to.
Criminal activity, policing and market changes
Over one-quarter (29%) of the 2005 PDI sample reported having engaged in some form of criminal activity in the month prior to interview, which was a significant increase when compared to 11% reporting recent criminal activity in 2004. Similarly, when compared to last years sample (9%), there was a significant increase in the proportion of REU (25%) who this year indicated that they had sold drugs for cash profit in the month prior to interview. Consistent with previous years, the rates of arrest were minimal in this sample. The majority of REU indicated that they were unable to comment on changes to the level of recent police activity, or that the level of police activity had remained stable. There was a significant decrease this year, however, in the proportion of REU who reported that police activity towards ecstasy and other related drug users had remained stable in the preceding six months. As in the 2003 and 2004 PDI, only a minority of the sample reported that recent police activity had made it more difficult for them to score illicit drugs.
Implications
The 2005 ACT PDI highlighted a number of concerning issues that warrant mention in relation to the use of ecstasy and related drugs in the Territory. The first is the level of sexual risk-taking observed among this group. Significant proportions of the sample this year reported having unsafe sex with casual and regular sex partners under the influence of ecstasy and related drugs. STI rates continue to rise in Australia, and given that the majority of REU had multiple sexual partners in the past six months this group appears to be at increased risk for contracting sexually transmitted infections. Finally, over half the sample also reported having driven under the influence of ecstasy and related drugs in the previous six months. In light of the high levels of self-reported drug driving reported by the sample, it is important that credible campaigns designed to educate this population about the risks associated with drug driving are implemented.
Citation: Proudfoot, P., Ward, J. Staniforth, A. & Buckingham, K. (2006). ACT Trends in Ecstasy and Related Drug Markets 2005: Findings from the Party Drugs Initiative (PDI), Sydney: National Drug and Alcohol Research Centre.