NDARC Technical Report No. 142 (2002)
EXECUTIVE SUMMARY
In 2000, the National Drug Law Enforcement Research Fund (NDLERF) funded a two year, two state trial to examine the feasibility of monitoring emerging trends in the markets for ecstasy and other 'party drugs' using the existing IDRS methodology. The trial was funded in NSW and QLD by NDLERF, and the Drug and Alcohol Services Council (DASC) provided funding to allow the trial to proceed in SA. Individual state results are reported elsewhere (Topp & Darke, 2001, Topp et al 2002a, Rose & Najman 2002a, McAllister et al 2001, Longo et al 2001, Longo et al 2002). This report presents an overview of the results of the two-year trial and a discussion of the feasibility of marketing the markets for party drugs using the IDRS methodology. The reports focuses on two main issues:
(1) METHODOLOGY
The report examines the feasibility of monitoring trends in the market for party drugs using the extant IDRS methodology. It discusses the strengths and weaknesses of such a system, and considers the methodological issues involved; and
(2) RESULTS
The report presents the results of the two year trial in NSW, QLD and SA. To demonstrate the value of collecting comparable data over time, key results of a comparable study of ecstasy users conducted in Sydney in 1997 are also presented. The report discusses data relating to trends over time in the demographic characteristics and patterns of drug use among party drug users, their criminal behaviour, and perceived party drug-related harms. The implications of the results for our understanding of the nature and characteristics of party drug markets are discussed.
1. Methodology
The trial was designed to follow the methodology employed in the main IDRS. Accordingly, we sought to triangulate data collected from three different sources:
- a quantitative survey of a sample of an appropriate sentinel population of drug users (equivalent to the injecting drug users that are interviewed in the main IDRS in terms of possessing a broad knowledge of a range of drugs). The sentinel population chosen was people who regularly used tablets sold as ’ecstasy’.
- a qualitative survey of key informants (KIS) who, through the nature of their work, have regular contact with party drug users; and
- a collation of extant indicator data sources, such as may be available from health and law enforcement agencies, from specialist surveys of drug use, and so on.
Thus, with minor adjustments to the extant methodology, the IDRS was adapted to examine the feasibility of monitoring trends in the markets for ecstasy and other party drugs. Regular ecstasy users were administered a quantitative interview schedule. Qualitative interviews were conducted with KIS and the data were used to contextualise and validate the reports of users. There are fewer sources of relevant indicator data for party drugs than for other drugs such as heroin. In some instances this prevented a triangulation of data sources, the strength of the main IDRS.
Overall, the results of the feasibility component of the trial suggest that the capacity of the party drugs IDRS to collect detailed, reliable and valid data about party drug markets is a direct function of the size of those markets. The trial has demonstrated that a system that employed this methodology would allow the successful monitoring of trends in the markets for party drugs that are relatively widely used, but would be less sensitive in monitoring trends in the markets for party drugs that are used by only small proportions of the total population.
Currently, ecstasy is a party drug that is used widely enough that reliable and valid information relating to its market can be collected. Drugs such as ketamine and GHB, at this stage, appear not to be used widely enough among party drug users, to allow the collection of anything other than indicative information relating to their markets from this study. This is due to the relatively small number of participants in the party drugs survey with reliable knowledge of these markets. To examine in detail the patterns of use and associated harms of the less common party drugs, a sample recruited on the basis of their use of each drug would be required. The prevalence of use of party drugs such as ketamine and GHB may continue to increase, and may reach the point where a sufficient proportion of the total population of party drug users was able to provide information about them for that information to be considered reliable. Were this to be the case, the methodology employed in this trial would allow the reliable monitoring of key market indicators such as their price, purity and availability. However, while markets remain limited it is argued that indicative information about these markets constitutes sufficient monitoring. The methodology employed in this trial would detect any significant expansion of these markets, and, if and when that occurred, the need for more detailed data collections specific to a particular drug market could be reassessed.
2. Results
A total of 544 ecstasy users were recruited and interviewed in the two years of the trial. One hundred and ninety four participants were involved in the 2000 survey (NSW, n=94; QLD, n=50 and SA, n=50). In 2001 there were 350 participants recruited (NSW, n=163; QLD, n=117 and SA, n=70).
Demographic characteristics
The results of the two year trial indicate that party drug users, a population defined in this study by the regular use of tablets sold as 'ecstasy', tend to be young, relatively well-educated, and likely to be employed or engaged in studies. The majority of participants had not had contact with police or other social authorities, did not come from socially deprived backgrounds, and few engaged in crime other than low-level drug dealing. Few participants were currently in treatment for a drug-related problem and a small proportion had previously been incarcerated.
Patterns of ecstasy use
There was variation in patterns of party drug use. Typically participants first used ecstasy in their late teens, and their current frequency of use varied from once per month to a few days per week. Twenty four percent of the 2000 sample and 32% of participants in 2001 reported that they had used ecstasy between weekly and fortnightly in the six months preceding the interview, and a majority had binged on ecstasy (i.e. used ecstasy continuously for more than 48 hours without sleep) in the preceding six months. More than half of participants reported that they 'typically' used more than one tablet. Consistent with earlier reports, participants primarily administered ecstasy orally. Although substantial proportions of participants (14% in 2000, 13% in 2001) reported they had injected ecstasy at some time, however very few participants reported that injection was their preferred route of ecstasy administration.
Patterns of polydrug use
Participants could be characterised as extensive polydrug users, over half of whom nominated ecstasy as their favourite or preferred drug. Substantial minorities regularly used other drugs concurrently with ecstasy, including alcohol, cannabis, tobacco, methamphetamine, and amyl nitrate. Most participants also used other drugs to ease the ’come down’ or aversive recovery period following acute ecstasy intoxication, including cannabis, alcohol, tobacco and benzodiazepines. These apparently normative patterns of polydrug use emphasise the need for research and education on the effects and risks of such practices.
Figures relating to the prevalence and frequency of use of party drugs other than ecstasy suggested that although the use of drugs such as ice and GHB appears to have increased, there are relatively few dedicated users. Much of the use of these drugs appears to be opportunistic in nature, and they are not as widely or as consistently available as ecstasy. Users of these drugs are invariably experienced users of ecstasy, the ’staple’ drug, or fundamental core, of the party drug market.
Price, purity and availability of ecstasy
Across all three states, the price of a tablet either remained stable (QLD) or decreased (NSW, SA) between 2000 and 2001. In recent years, there has been a steady decrease in the average price in NSW of a single ecstasy tablet, from $50 in 1997, to $40 in 2000, to $35 in 2001. In SA an ecstasy tablet sold for $45 in 2000 and $40 in 2001, while in QLD the price was reported to be $40 in both years. Tablets sold as ecstasy are readily available in all three states; the majority of users and key informants in both 2000 and 2001 described the drug as ’very easy’ or ’easy’ to obtain. However, the proportion of the burgeoning ecstasy market that is sourced by locally produced ’duplicate’ tablets has increased markedly since 1997. The Australian Bureau of Criminal Intelligence (ABCI, 2002) recently estimated that up to 80% of tablets sold as ecstasy in Australia are locally manufactured duplicate tablets that contain low-dose methamphetamine, sometimes in combination with another drug such as ketamine, rather than MDMA (3,4- methylenedioxymethamphetamine), the compound to which the term ’ecstasy’ originally referred. Almost all of the tablets that contain MDMA are likely to have been imported; few clandestine manufacturers in Australia have access to the necessary precursors or the required expertise to produce true MDMA.
The average purity of seizures of tablets actually containing MDMA analysed by NSW forensic laboratories has steadily increased since the mid-1990s, rising from an average of 26% purity in 1996/97, to 42% in 2000/01. In QLD in 1999/2000 103 samples were analysed with the majority (76%) between 20%-39.9% purity while in 2000/01, 75% of the 68 samples were between 20-49.9% purity (Rose & Najman 2002). In SA, the purity of seizures increased from 32% in 1998/99 to 37% in 1999/2000 (Longo et al 2002).
’Imports’ (imported tablets) tend to be more highly sought after than locally manufactured imitations, with users willing to pay more for a tablet they believe is imported. The supply of imported MDMA tablets cannot match demand, and the market for ’duplicate’ pills remains strong among users who are not overly fussy about which particular stimulant combination is contained in the tablets they consume.
Price, purity and availability of other party drugs
Relatively small numbers of participants felt confident enough of their knowledge about party drugs other than ecstasy to comment on their price, purity and availability, suggesting relatively limited exposure to such drugs. Much of the use of less common party drugs, such as MDA or ketamine, appears to be opportunistic in nature, and therefore infrequent relative to the use of the widely used party drug ecstasy. Many people who report the recent use of such drugs do not deliberately seek them out, and hence, are unfamiliar with market indicators such as changes in their price, purity and availability. The low prevalence rates of the regular use of these drugs are indicative of the small size of their markets.
Self-reported harms related to ecstasy and other drug use
In both years of the trial, participants reported a broad range of recent physical and psychological side-effects which they perceived as due, at least in part, to their use of ecstasy. There was a high level of consistency in the side-effects reported in the two years of the trial; for example, loss of energy, trouble sleeping, mental confusion and irritability had been experienced in the preceding six months by the majority of both samples. Reported side-effects were also consistent with those described in earlier reports of ecstasy users, although it appears that current Australian research reports a higher incidence of side-effects among users than earlier, international research. Ecstasy-related occupational, relationship and financial problems were reported among both samples, and although many of these problems could be considered relatively minor, some constituted significant disruptions to functioning, including loss of employment, the ending of relationships, and the inability to pay for food or rent.
The expansion of the party drug market
It was possible to triangulate data from all three sources (ecstasy users, KIS and indicator data) regarding reports of the expansion of the market for ecstasy. Both users and KIS in the two year trial consistently reported that the number of people using ecstasy had increased and that, in recent years, ecstasy has become a mainstream drug firmly established in Australia's illicit drug landscape. These impressions are validated by the results of the 1998 NDS Household Survey, which indicated that prevalence of both lifetime and recent use of ecstasy in Australia had doubled since the 1995 survey. The 2001 survey also suggested an increase in lifetime prevalence of ecstasy use since 1998 (to 6.1% of the general population), despite the fact that the lifetime prevalence of use of almost all illicit drugs appeared to decrease over the same timeframe. The demographic characteristics and self-reported patterns of drug use of ecstasy users interviewed in 2000 and 2001 were strikingly similar, suggesting that the main change in the market has been its size rather than in its nature. In 2001, similar sorts of people reported using ecstasy and other drugs in similar ways to those interviewed earlier, but all indications were that they currently exist in greater numbers.
Although overall rates of polydrug use remained stable between 2000 and 2001, the results suggested that the use of specific drugs varied over that time. Between 2000 and 2001, the prevalence and frequency of use of some drugs appeared to have decreased in some jurisdictions, including LSD (in NSW and QLD), MDA (in all states) and inhalants such as amyl nitrate and nitrous oxide (in NSW and SA). However, over the same period, the prevalence of use of other drugs, including GHB and ice, have appeared to haveincreased in all states. It seems that as the demand for and/or availability of one illicit drug wanes, the demand for and/or availability of another increases, creating its own niche in a changing range of party drug options. Ecstasy is the fundamental ’staple’ of the party drug market and is consistently widely available. The demand for and availability and use of other party drugs appear more limited and erratic, and there are relatively few dedicated users of these drugs.
Conclusion
Despite Australia’s continued effort to reduce the importation and local manufacture of ecstasy, the drug most fundamental to party drug markets, in recent years it has remained readily available in NSW, SA and QLD. Between 2000 and 2001, the price per tablet decreased or remained stable in all states, and between 1998 and 2001, the prevalence of self-reported use among the general population increased to 6.1% (AIHW, 2002). The weight in kilograms of detections of MDMA made at the border by the Australian Customs Service steadily increased between the financial years 1997/98 and 2000/01.
Since the mid-1990s, the market for ’ecstasy’ has been characterised by an increasing proportion of locally manufactured ’duplicate’ tablets that do not contain MDMA at all. Originally designed to meet the unmet demand for true MDMA (the majority of which is imported into Australia), the preponderance of ’duplicate’ tablets has been associated with the evolution and growth of a less discerning marketplace. Independent of the demand for MDMA, there is now also marked demand for tablets that users are equally as likely to call ’pills’ as ’ecstasy’, and which may contain a range of stimulant cocktails. Although within this market, ’real Es’ (tablets containing MDMA) are more expensive and more sought-after than a ’pill’, it is likely that a substantial proportion of consumers have never used real MDMA; and that an equally sizeable, if not larger, proportion of less informed users would not recognise it if they had. Thus, in the recent evolution of Australia’s ecstasy market, demand that was originally specific to MDMA took on a life of its own when domestic clandestine manufacturers discovered that some users were willing to purchase an easy-to-manufacture proxy ’pill’ rather than refrain from using ’ecstasy’ altogether. Those to whom ’pills’ proved unacceptable eventually left the market, to be replaced by naïve participants with no experience of any other than contemporary market conditions. The memory of the subjective experience of MDMA, and the capacity to recognise its unique effects in the event that they are re-experienced, is likely to be held by a declining proportion of socalled ’ecstasy’ users.
Despite the variability in the contents of tablets sold as ’ecstasy’, it remains the case that the market demand for the tablets continues to grow, and that substantial proportions of samples of users report ecstasy-related harm. Continued monitoring of this market will enable the collection and dissemination of information that will provide the appropriate basis for the development of timely policy responses to market developments. The value of the main IDRS became increasingly apparent as the number of years over which comparable data has been collected increased (Darke et al., 2002 a,b,c; Topp et al., in press; Topp & McKetin, in press). It seems likely that this would also prove the case in the party drugs IDRS if in the future the collection of comparable data on an annual basis was maintained.
Citation: Breen, C., Topp, L. and Longo, M. (2002) Adapting the IDRS methodology to monitor trends in party drug markets: Findings of a two-year feasibility trial, Sydney: National Drug and Alcohol Research Centre.