KEY FINDINGS AND IMPLICATIONS
In 2014, for the twelfth consecutive year, the Australian Capital Territory (ACT) Ecstasy and Related Drugs Reporting System (EDRS) provides an opportunity to examine trends within the ACT through interviews with a sentinel group of people who regularly use ecstasy or other psychostimulant drugs (‘regular psychostimulant users’ RPU), interviews with key experts (KE), and the collation of indicator data. This is done with the aim of informing further research and contributing to the evidence base from which policy decisions can be made. The continued monitoring of ecstasy and related drug markets within the ACT for changes in the price, purity, availability, use patterns and issues associated with drug use will add to our understanding of drug markets and our ability to inform policies to minimise harms. The findings of the 2013 ACT EDRS indicate that further attention is required in the following areas:
As in previous years, the majority of ACT EDRS participants in 2014 were polydrug users. However, in 2014 we observed a sharp decrease in the proportion of RPU who reported that the last time they used ecstasy or other psychostimulants, they had used other drugs at the same time (70% in 2014 compared to 94% in 2013, p<0.05). The drugs most commonly used in combination with psychostimulants by RPU were ecstasy, tobacco, alcohol, and cannabis. Polydrug use can increase or alter adverse effects in ways that are often unpredictable and problems relating to intoxication may be enhanced due to the drug interactions arising from polydrug use. Treatment approaches and harm reduction interventions need to take this into account, especially in relation to the effects of drugs, safer use, withdrawal, and overdose risk.
Last year (2013) we began gathering data on MDMA crystals in response to reports indicating the arrival of this form in the market. The introduction of MDMA crystals did not see an increase in overall use of ecstasy, suggesting that RPU are using diverse forms and current data indicates some may be changing their preferred form.
The use of alcohol remains problematic amongst RPU, with use occurring once to twice a week. Furthermore, high proportions of RPU report using alcohol during binge sessions. In the 2014 EDRS, RPU were administered the Alcohol Use Disorders Identification Test (AUDIT). Using this measure, 9% of respondents scored in Zone 4 of the AUDIT, indicating the need for evaluation for possible alcohol dependence. KE also reported that alcohol use was common amongst RPU and that binge drinking was frequent and problematic.
Alcohol was one of the main drugs associated with recurring social and relationship problems, legal problems and increased exposure to risky situations. While it is important to focus on the risks associated with illicit drug use, the excessive use of alcohol is of great concern amongst this group, as this type of polydrug use carries a high level of risk.
The use of cannabis also remains problematic. The median frequency of use has decreased in 2014 for the second consecutive year to approximately two to three times a week but this decrease is not considered statistically significant. However, when considered within the context of a downward trend may prove to be noteworthy. As in previous years, cannabis was commonly reported as a drug associated with recurring social and relationship problems, legal problems, increased exposure to risky situations and recurring problems associated with lack of responsibility at home, work or study. Efforts to target users with information concerning harms associated with its use, including dependence and comorbid mental health problems, remain important.
In 2014 smaller proportions of RPU reported using antidepressants, heroin, methadone, buprenorphine, other opioids, GHB, MDA, ketamine and pharmaceutical stimulants. While only small numbers of this group report using the abovementioned drugs, an increased risk exists as these drugs are being used in conjunction with other drugs. This simultaneous polydrug use is associated with increased risks through the additive and synergetic effects of combining these drugs together. Efforts to target users with information concerning the harms and risks associated with polydrug use remain vital.