NDARC Technical Report No. 113 (2001)
EXECUTIVE SUMMARY
The 2000 IDRS was expanded to examine the feasibility of monitoring trends in the market for party drugs using the extant IDRS methodology. In the first of the two year trial, the study successfully accessed the appropriate sentinel population of party drug users, who were able to provide information about the price, purity and availability of ecstasy and other party drugs, along with self-reported patterns of drug use and associated harms. Key informants who, through the nature of their work, have regular contact with ecstasy users, were also identified, and were willing to provide information about these users that was used to validate and contextualise the users' reports. Extant indicator data sources relating to ecstasy were identified and accessed, including seizure purity data, telephone drug and alcohol information service data, and National Drug Strategy Household Survey data. Although there are not as many relevant indicator data sources for ecstasy as there are for a drug such as heroin, the sources that were identified were successfully triangulated against the reports of users and key informants to provide a comprehensive snapshot of the market for party drugs. Thus, the first year of the trial indicated that the IDRS can successfully monitor illicit drug markets other than those which it has to date been used to monitor, namely heroin, amphetamine, cocaine and cannabis.
The results of the party drugs module of the IDRS indicated that party drug users, a population defined in this study by regular use of tablets sold as 'ecstasy', tend on the whole to be young, relatively well-educated, and likely to be employed or engaged in studies. The majority of subjects had not had contact with police or other social authorities, did not come from socially deprived backgrounds, and few engaged in crime other than drug dealing. None were currently in treatment for a drug-related problem, and only a small proportion had previously been incarcerated.
The results suggest further that a broad range of people engage in regular ecstasy use. The 94 subjects in the present sample typically began to use ecstasy in their late teens, and current frequency of use varied from once per month to several days per week; more than one-third of the sample used ecstasy at least once a week. Almost half had used ecstasy continuously for more than 48 hours in the preceding six months. One-third had used more than four tablets in a single use episode in the preceding six months, and more than half reported that they 'typically' used more than one tablet. Consistent with other reports, use of ecstasy was primarily through oral routes, but 12% had injected ecstasy. However, very few subjects reported that they had used ecstasy mainly by injection in the preceding six months.
This sample could accurately be described as extensive polydrug users, half of which had a preference for ecstasy. On average, subjects had tried ten drugs in their lifetime and had used seven in the preceding six months. Substantial minorities of the sample regularly used drugs such as alcohol, cannabis, tobacco, amphetamine, and cocaine concurrently with ecstasy, and drugs such as cannabis, alcohol and benzodiazepines to ease the 'come down' or recovery period following
acute ecstasy intoxication.
On average, subjects reported nine recent physical and five recent psychological side-effects which they perceived as due, at least in part, to their use of ecstasy.
These side-effects were consistent with those described in earlier reports of ecstasy users, although it is certainly the case that current Australian research reports a higher incidence of side-effects among users than earlier research conducted internationally. Ecstasy-related occupational, relationship and financial problems were also reported relatively frequently by the present sample, and although many of these were 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 results relating to demographic characteristics, patterns of ecstasy and other drug use, and ecstasy-related harm, were notable for their similarities to the results of a study of ecstasy users conducted by NDARC in Sydney in 1997. Given such marked similarities, it seems reasonable to suggest that the main change in Sydney's party drug market since 1997 has been its expansion. Both users and key informants in the present study consistently reported that the number of people using ecstasy has increased recently and that, in recent years, ecstasy has become a mainstream drug firmly established in the illicit drug landscape in Sydney. These reports 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. In short, similar sorts of people are using ecstasy and other drugs in similar sorts of ways to 1997; it is just that, now, there are more of them than there were three years ago.
The expansion of the market for ecstasy may explain its $10 decrease in price since 1997. Forty dollars is currently the standard price for a single tablet of ecstasy, whereas in 1997 a tablet cost $50. Tablets sold as ecstasy have remained readily available since that time, although it seems highly likely that the proportion of tablets which are manufactured locally has increased since 1997 and that there has been a concomitant decrease in the proportion of tablets available which actually contain MDMA. On the other hand, seizures of ecstasy made in NSW suggest that those tablets which do contain MDMA have steadily increased in purity since 1996, with an average purity in 1999/00 of 37%. It is extremely likely that the majority of these tablets are imported into Australia, generally from Europe and/or the United Kingdom. The small numbers of subjects who felt confident enough of their knowledge about other party drugs to comment on their price, purity and availability indicates relatively limited exposure to such drugs among this sample.
In conclusion, patterns of extensive polydrug use and substantial rates of drug-related harm were reported by the current sample of ecstasy users, as they were in a separate study of the same population conducted in 1997. Although authorities have continued to fight to reduce the importation and local manufacture of drugs such as ecstasy in this country, they remain readily available to interested consumers, and in fact have become cheaper, purer, and more widely used since this time. The importance of continued monitoring of such a dynamic market, the current participants of which may experience significant harms, both presently and in the future, cannot be understated.