NDARC Technical Report No. 136 (2002)
EXECUTIVE SUMMARY
In 2000, the National Drug Law Enforcement Research Fund funded a two-year trial in NSW and QLD to examine the feasibility of monitoring trends in the market for party drugs using the extant IDRS methodology. Detailed results of the first year of the trial in NSW are reported elsewhere (Topp & Darke, 2001).
The report presents the results of the two-year trial and those of a comparable study conducted in 1997. Results include 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.
Demographic characteristics
The results of the trial indicated 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 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 low-level drug dealing. Only two subjects were currently in treatment for a drug-related problem, neither of which were related to ecstasy, and a small proportion had previously been incarcerated.
Patterns of ecstasy use
Subjects in the trial reported great variation in patterns of party drug use. They typically began to use ecstasy in their late teens, and their current frequency of use varied from once per month to a few days per week. Close to one third reported that they had used ecstasy at least once a week in the six months preceding the interview, and a majority had used ecstasy continuously for more than 48 hours in the preceding six months. More than one-third of subjects had used five or more 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 earlier reports, subjects primarily administered ecstasy orally. Although one in ten reported having injected the drug at some time, very few subjects reported that injection was their preferred route of ecstasy administration.
Patterns of polydrug use
Subjects could be characterised as extensive polydrug users, over half of whom nominated ecstasy as their favourite or preferred drug. On average, subjects had used ten drugs in their lifetime and had used seven in the preceding six months. Substantial minorities regularly used other drugs concurrently with ecstasy, including alcohol, cannabis, tobacco, methamphetamine, and amyl nitrite. Most subjects 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 GHB, ketamine and ice 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
In recent years, there has been a steady decrease in the average price in Sydney of a single ecstasy tablet, from $50 in 1997, to $40 in 2000, to $35 in 2001. Tablets sold as ecstasy have remained readily available in Sydney since 1997; across all three studies, the great majority of users 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 applied. Almost all of the tablets that actually contain MDMA are likely to have been imported; few clandestine manufacturers in Australia have access to the necessary precursors nor 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. '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, having taken on a life of its own 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 subjects felt confident enough of their knowledge about party drugs other than ecstasy to comment on their price, purity and availability, suggesting of 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 preferred party drug ecstasy. Many subjects who participated in this trial would be willing to expend considerable effort to obtain ecstasy, but relatively few would place the same emphasis on obtaining LSD or GHB. Consequently, 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, subjects 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, trouble sleeping, muscle aches, 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 relatively frequently 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
One of the few instances in which it was possible to triangulate data from all three sources was with respect to reports of the expansion of the market for ecstasy. Both users and KIS in the two year trial and in the 1997 study 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 Sydney'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 2001, 2000 and 1997 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 substantially greater numbers than in 1997.
Although overall rates of polydrug use remained stable between 1997 and 2001, the results suggested that the availability and use of specific drugs varied over that time. Between 1997 and 2001, the prevalence and frequency of use of some drugs decreased, including LSD, MDA and inhalants such as amyl nitrite and nitrous oxide. However, over the same period, the prevalence of use of other drugs, including GHB, ketamine and ice, have steadily increased. 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 an ever-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 both the importation and local manufacture of ecstasy, the drug most fundamental to party drug markets, it has remained readily available in Sydney since 1997. Over that time, the price per tablet fell from $50 to $35, and 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 from the mid-1990s onward. The average purity of seizures of MDMA (3,4-methylenedioxymethamphetamine, the compound to which the term 'ecstasy' originally exclusively referred) analysed in NSW steadily increased from 26% in 1996/97 to 42% in 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 highly 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 local 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 so-called '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 allow the implementation 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.