NDARC Technical Report No. 277
EXECUTIVE SUMMARY
The 2006 NSW Trends in Ecstasy and Related Drug Markets report represents the seventh year in which data has been collected in New South Wales on the markets for ecstasy and related drugs. The Ecstasy and Related Drugs Reporting System (EDRS; formerly the Party Drugs Initiative, or PDI) is the most comprehensive and detailed study of ecstasy and related drug markets in NSW. Using a similar methodology to the Illicit Drug Reporting System (IDRS), the EDRS monitors the price, purity and availability of ‘ecstasy’ (MDMA) and other related drugs such as methamphetamine, cocaine, GHB and ketamine. It also examines trends in the use and harms of these drugs. It utilises data from three sources: a) surveys with regular ecstasy users (REU); b) surveys with key experts who have contact with regular ecstasy users through the nature of their work; and c) the analysis of existing data sources that contain information on ecstasy and other drugs. Regular ecstasy users are recruited as they are considered a sentinel group to detect illicit drug trends. The information from the REU is therefore not representative of ecstasy and other drug users in the general population, but is indicative of emerging trends that may warrant further monitoring.
The findings from each year not only provide a snapshot of the drug markets in NSW, but in total they help to provide an evidence base for policy decisions; for helping inform harm reduction messages; and help to provide directions for further investigation when issues of concern are detected. Continued monitoring of the ecstasy and related drug markets in NSW will help add to our understand of use of these drugs; the price, purity and availability of these drugs and how these may impact on each other; and the associated harms which may stem from the use of these drugs.
Demographic characteristics of regular ecstasy users
The 2006 results indicate that regular ecstasy users, a population defined in this study by at least monthly use of tablets sold as ‘ecstasy’, tended to be young, relatively well-educated, and likely to be employed or engaged in full-time study. Few participants were in treatment for drug-related problems, and only a small proportion had previously been incarcerated. The demographic characteristics of the sample have changed little since 2000, though a slight increase in age, and a decrease in the proportion identifying as heterosexual, has been observed.
Patterns of drug use among REU
As in previous surveys, participants could be characterised as extensive polydrug users; however, participants were not necessarily regular users of these other drugs. Ecstasy was the drug of choice for more than two-fifths of the sample. Large proportions reported the very regular use of alcohol, cannabis and tobacco in the six months prior to interview.
Ecstasy
Ecstasy was first used at a median of 18 years of age, and was first used regularly at a median age of 19 years. Ecstasy had been used for a median of 15 days in the six months preceding interview; 47% reported using ecstasy between monthly and fortnightly, 32% reported using ecstasy between fortnightly and weekly, and 19% reported using ecstasy once per week or more.
Ecstasy was first used at a median of 18 years of age, and was first used regularly at a median age of 19 years. Ecstasy had been used for a median of 15 days in the six months preceding interview; 47% reported using ecstasy between monthly and fortnightly, 32% reported using ecstasy between fortnightly and weekly, and 19% reported using ecstasy once per week or more.
Participants reported using a median of two ecstasy tablets in a ‘typical’ session of use and three and a half tablets in a ‘heavy’ session of use. In the six months preceding interview, all participants had swallowed ecstasy, 37% had snorted ecstasy, 3% had injected ecstasy and 2% had smoked ecstasy. Most (85%) participants reported typically using other drugs when they used ecstasy, and 68% reported that they typically used other drugs when coming down from ecstasy.
Price, purity and availability of ecstasy
The median price paid for a single ecstasy tablet was $30 in 2006, with large proportions of participants reporting that this price had remained stable in the six months preceding interview. Ecstasy was commonly obtained from people known to participants, such as friends, in private locations, such as friends’ homes.
There was variation regarding users’ subjective reports of the purity of ecstasy and KE reports reflected this inconsistency. The median purity of seizures of tablets containing MDMA/phenethylamines analysed by both AFP and NSW Police have remained stable since 2002/03. Many tablets sold as ‘ecstasy’ will not contain any MDMA. Users’ reports of ‘purity’ are consistent with this.
There was variation regarding users’ subjective reports of the purity of ecstasy and KE reports reflected this inconsistency. The median purity of seizures of tablets containing MDMA/phenethylamines analysed by both AFP and NSW Police have remained stable since 2002/03. Many tablets sold as ‘ecstasy’ will not contain any MDMA. Users’ reports of ‘purity’ are consistent with this.
Tablets sold as ecstasy have remained readily available in Sydney since 2000. Consistent with previous years, the majority of participants reported that ecstasy was ‘very easy’ or ‘easy’ to obtain.
Imported tablets are more likely to contain MDMA than locally manufactured imitation tablets that contain methamphetamine. The number and weight of customs seizures of ecstasy seized at the border has increased in recent years, suggesting either changes in customs activity, improvements in detection, more ecstasy being imported into the country, or a combination of these factors. The supply of imported MDMA tablets is also supplemented by domestic production: NSW police reported that the ratio of methamphetamine tablets sold as ‘ecstasy’ to ‘ecstasy’ tablets containing MDMA decreased in 2001/02. This may indicate an increase in imported MDMA, some manufacture of local MDMA, or that tablets containing methamphetamine are being sold as such. Consistent with the possibility that local manufacture is occurring, there have been seizures of the precursors required to manufacture MDMA, and in 2005/06 NSW Police reported nine clandestine MDMA laboratories detected in NSW (Australian Crime Commission 2003). This suggests that there are local manufactures of ecstasy attempting to compete with importers of the drug.
Participants identified both benefits and risks associated with ecstasy use. Commonly identified benefits included enhanced feelings of closeness and bonding with others, while commonly identified risks included the unknown contaminants and cutting agents which can be found in ecstasy.
Methamphetamine
A majority (88%) of participants reported having ever used methamphetamine powder (‘speed’), with 55% reporting use in the six months prior to interview. Recent users had used on a median of five days of use in the six months prior to interview. Snorting (80%) and swallowing (64%) were the more prevalent routes of administration, with only a small number (7%) injecting speed in the six months prior to interview.
A majority (88%) of participants reported having ever used methamphetamine powder (‘speed’), with 55% reporting use in the six months prior to interview. Recent users had used on a median of five days of use in the six months prior to interview. Snorting (80%) and swallowing (64%) were the more prevalent routes of administration, with only a small number (7%) injecting speed in the six months prior to interview.
Speed was commonly used in nightclubs (78%) and, to a lesser extent, participants’ own homes (39%) and friends’ homes (37%). It was most commonly purchased from friends in friends’ homes.
Amongst those who commented, speed was purchased for a median of $40 per point, or $60 per gram; the price of speed was largely reported to have remained stable in the six months prior to interview. Current purity varied, with reports ranging from low to high, though purity was largely thought to have remained stable in the six months prior to interview. Speed was largely reported to be ‘very easy’ to ‘easy’ to obtain; availability was considered to have remained stable in the six months prior to interview.
Half (50%) of the sample reported having ever used methamphetamine base, with one-quarter (24%) reporting its use in the six months prior to interview. Base was used on a median of three and a half days in the six months preceding interview. Base was commonly swallowed (79%), though proportions did report snorting (38%) and smoking (21%) base in the six months prior to interview. Small proportions (8% of recent base users) had injected it in the six months prior to interview.
Base was used in a variety of both public and private locations, such as nightclubs (47%), participants’ own homes (40%), private parties (33%) and friends’ homes (33%). Base was mostly obtained from friends (67%) in a variety of locations, such as friends’ homes (33%) and agreed public locations (33%).
Amongst those who commented, base was purchased for $37.5 per point or $100 per gram, with the price reported to have remained largely stable in the six months prior to interview. Current purity was reported to be high, though mixed reports were obtained regarding purity change in the six months prior to interview. Base was reported to be largely ‘very easy’ to ‘easy’ to obtain, and most reported that this had remained stable in the six months prior to interview.
Amongst those who commented, base was purchased for $37.5 per point or $100 per gram, with the price reported to have remained largely stable in the six months prior to interview. Current purity was reported to be high, though mixed reports were obtained regarding purity change in the six months prior to interview. Base was reported to be largely ‘very easy’ to ‘easy’ to obtain, and most reported that this had remained stable in the six months prior to interview.
Two-thirds (68%) of the sample had ever used crystal methamphetamine, and more than half (56%) reported using it in the six months prior to interview (on a median of six days). Smoking (88%) was the most frequently mentioned route of administration reported by recent users, though one-quarter (27%) of recent users had injected in the six months prior to interview.
Unlike speed and base, crystal was frequently used in more private locations, such as participants’ own home (63%) and friends’ homes (50%). Crystal was obtained from known dealers (46%) and friends (42%) in private locations (dealers’ homes, 38%, and friends’ homes, 31%).
Amongst those who commented, crystal was purchased for $50 per point, or $350 per gram; price was reported to have remained stable in the six months prior to interview. Current purity was reported to be ‘high’ to ‘medium’ and had remained stable. Crystal was reported to be ‘very easy’ to ‘easy’ to obtain, and this too had remained stable.
Varying proportions of the sample were able to report on price, purity and availability of all three methamphetamine forms. Where small numbers are reported, caution should be taken when interpreting results.
Cocaine
The prevalence of lifetime cocaine use has remained stable across time, though in 2006 a decrease was observed in the proportion of participants reporting recent use (from 55% to 45%). This decrease was consistent not only with the majority of key experts who commented on cocaine use, but with other data sources such as the National Drug Strategy Household Survey and the Sydney Gay Community Periodic Survey, suggesting a decline in use amongst other groups.
Cocaine was most commonly used in nightclubs (52%, followed by friends’ homes (35%), and was most frequently purchased from friends (75%) at friends’ homes (75%).
The prevalence of lifetime cocaine use has remained stable across time, though in 2006 a decrease was observed in the proportion of participants reporting recent use (from 55% to 45%). This decrease was consistent not only with the majority of key experts who commented on cocaine use, but with other data sources such as the National Drug Strategy Household Survey and the Sydney Gay Community Periodic Survey, suggesting a decline in use amongst other groups.
Cocaine was most commonly used in nightclubs (52%, followed by friends’ homes (35%), and was most frequently purchased from friends (75%) at friends’ homes (75%).
Amongst those who commented, cocaine was purchased for $300 per gram, and reports of price change varied from remaining stable (27%) to increasing (15%). Reports of current purity also varied, though one-third suggested purity had remained stable in the six months prior to interview. Regarding availability, one-third (35%) of those who commented suggested it was ‘easy’ to obtain while similar proportions (32%) reported it was ‘difficult’ to obtain; however, availability was reported to have remained stable in the six months prior to interview.
Ketamine
The prevalence of lifetime ketamine use decreased in 2006, with 57% reporting having ever used ketamine. Reports of recent ketamine use also decreased, declining from 39% in 2005 to 27% in 2006. This represents the lowest proportion of the sample reporting recent use in the past five years. The majority of recent users used ketamine less than once per month. Snorting ketamine was the most common route of administration amongst recent users; no participants had injected ketamine in the six months prior to interview. Ketamine was commonly purchased from friends in friends’ homes; use occurred in a range of locations, such as nightclubs (73%), raves (43%), participants’ own homes (27%) and friends’ homes (27%).
The prevalence of lifetime ketamine use decreased in 2006, with 57% reporting having ever used ketamine. Reports of recent ketamine use also decreased, declining from 39% in 2005 to 27% in 2006. This represents the lowest proportion of the sample reporting recent use in the past five years. The majority of recent users used ketamine less than once per month. Snorting ketamine was the most common route of administration amongst recent users; no participants had injected ketamine in the six months prior to interview. Ketamine was commonly purchased from friends in friends’ homes; use occurred in a range of locations, such as nightclubs (73%), raves (43%), participants’ own homes (27%) and friends’ homes (27%).
Amongst those who commented, ketamine was purchased for $175 per gram, and more than half reported that the price had remained stable in the six months prior to interview (56%). Most (69%) reported that the current purity was high, with more than half (56%) reporting that purity had remained stable in the six months prior to interview. Reports concerning current availability varied, from ‘very easy’ (31%) and ‘easy’ (31%) to ‘difficult’ (38%), though half (50%) reported that availability had remained ‘stable’ in the six months prior to interview.
GHB
Two-fifths (40%) of the sample reported lifetime GHB use, and one-fifth (21%) reported recent GHB use. There was an increase in recent use from 13% in 2005 to 21% in 2006. Despite low general population use of GHB, the increase observed in recent use was consistent with key expert reports. Three-quarters (71%) of recent users reported using less than monthly.
Two-fifths (40%) of the sample reported lifetime GHB use, and one-fifth (21%) reported recent GHB use. There was an increase in recent use from 13% in 2005 to 21% in 2006. Despite low general population use of GHB, the increase observed in recent use was consistent with key expert reports. Three-quarters (71%) of recent users reported using less than monthly.
GHB was commonly purchased from friends and known dealers in private locations, and use tended to occur more in private locations such as participants’ own homes (62%) and friends’ homes (46%), though nightclubs (46%) were also reported as a location of usual use. Small numbers were able to comment on price, purity and availability, and thus caution should be used when interpreting data. However, the median price of a ‘vial’ of GHB was $25 and two-fifths (39%) of those who commented reported that price had remained stable in the six months prior to interview. Two-thirds (69% of those who commented) reported the current purity to be ‘high’, though varying reports were given regarding purity change in the six months prior to interview. Concerning availability, reports were mixed, though two-thirds (67% of those who commented) reported that availability had remained stable in the six months prior to interview.
LSD
Two-thirds (65%) reported the lifetime use of LSD, though recent use was considerably lower, with only 17% reporting recent use. Two-thirds (65%) of recent users reported using LSD less than once per month in the six months prior to interview. LSD was commonly reported to be used at friends’ homes (50%), in public places (50%) and outdoors (43%).
Two-thirds (65%) reported the lifetime use of LSD, though recent use was considerably lower, with only 17% reporting recent use. Two-thirds (65%) of recent users reported using LSD less than once per month in the six months prior to interview. LSD was commonly reported to be used at friends’ homes (50%), in public places (50%) and outdoors (43%).
Of those who commented, LSD was purchased for $20 per tab, and almost half (46%) of those who commented suggested that price had remained ‘stable’ in the six months prior to interview. Data collected since 2000 has shown a steady increase in the price of LSD, from $10 per tab in 2000-01, $15 in 2002-2003, and $20 in 2004-2006. Reports concerning current purity were mixed, with reports (from those who commented) ranging from ‘high’ (36%), ‘medium’ (25%) to ‘fluctuating’ (11%). Reports concerning purity change were also mixed. Half (50%) of those who commented reported that LSD was ‘difficult’ to obtain and more than half of those who commented (54%) reported that availability had remained ‘stable’ in the six months prior to interview.
MDA
Despite an increase in the lifetime use of MDA (42% in 2006 compared to 32% in 2005), the proportion reporting recent used did not increase (19% in 2005 to 14% in 2006). Of those who reported recent MDA use, all except one participant reported use on a less-than-monthly basis. Use occurred mostly in nightclubs (67%). Friends (50%) and known dealers (33%) were the most frequently nominated source of MDA, and half (50%) scored from friends’ homes.
Despite an increase in the lifetime use of MDA (42% in 2006 compared to 32% in 2005), the proportion reporting recent used did not increase (19% in 2005 to 14% in 2006). Of those who reported recent MDA use, all except one participant reported use on a less-than-monthly basis. Use occurred mostly in nightclubs (67%). Friends (50%) and known dealers (33%) were the most frequently nominated source of MDA, and half (50%) scored from friends’ homes.
The price for a ‘cap’ of MDA in 2006 was $40, with almost half (46%) of those who commented reporting that price had remained ‘stable’ in the six months prior to interview. Of those who commented on purity, 73% reported the current purity to be ‘high’ and the majority (73%) reported that purity had remained ‘stable’ in the six months prior to interview. Reports concerning current availability were mixed, though 46% of those who commented reported that availability in the six months prior to interview remained ‘stable’.
Cannabis
The lifetime prevalence of cannabis use has remained stable across sampling years, with the majority (95%) in 2006 reporting lifetime use. Recent use decreased in 2006, with 73% reporting cannabis use in the six months prior to interview, a decrease observed from 82% in 2005. Median days of use in the past six months also decreased, from 48 days in 2005 to 24 days in 2006; 18% of recent cannabis users were daily users.
The lifetime prevalence of cannabis use has remained stable across sampling years, with the majority (95%) in 2006 reporting lifetime use. Recent use decreased in 2006, with 73% reporting cannabis use in the six months prior to interview, a decrease observed from 82% in 2005. Median days of use in the past six months also decreased, from 48 days in 2005 to 24 days in 2006; 18% of recent cannabis users were daily users.
For the first time in 2006, the EDRS reported on the price, purity and availability of cannabis, and, in line with the Illicit Drug Reporting System, participants were asked to distinguish between commercial ‘hydroponic’ cannabis and outdoor-grown ‘bush’ cannabis. Hydro and bush were mostly purchased from friends in friends’ homes. Hydro was more expensive per ounce than bush ($300 vs. $210), and of those who commented, more participants reported the price of hydro remaining ‘stable’ (77%) in the six months prior to interview than for bush (43%).
Of those who commented, 55% reported the potency of bush to be ‘high’ compared to 40% who reported bush to be ‘high’. There was greater variation in reports for bush potency than for hydro potency. Though for both cannabis types, the majority reported potency to have remained ‘stable’ in the six months prior to interview. Differences were observed in reports of current availability – 68% of those who commented reported that hydro was ‘very easy’ to obtain compared 33% of those who commented on bush; the majority who commented on both types reported availability to have remained ‘stable’ in the six months prior to interview.
Patterns of other drug use
Almost all participants reported lifetime and recent use of alcohol. A large proportion of the sample usually consumed alcohol with ecstasy, and half of the sample consumed alcohol at levels considered hazardous and possibly indicating dependence. Large proportions of the sample reported lifetime and recent tobacco use, with two-thirds of recent tobacco users reporting daily use. One-quarter of the sample reported recent benzodiazepine use and one-fifth of the sample reported recent anti-depressant use. Regarding inhalant use, higher proportions reported recent amyl nitrate use compared to recent nitrous oxide use (37% vs. 6%). Small proportions of the sample reported recent heroin, methadone and other opiate use. Similarly, small proportions reported recent mushroom and recent pharmaceutical stimulant use.
Almost all participants reported lifetime and recent use of alcohol. A large proportion of the sample usually consumed alcohol with ecstasy, and half of the sample consumed alcohol at levels considered hazardous and possibly indicating dependence. Large proportions of the sample reported lifetime and recent tobacco use, with two-thirds of recent tobacco users reporting daily use. One-quarter of the sample reported recent benzodiazepine use and one-fifth of the sample reported recent anti-depressant use. Regarding inhalant use, higher proportions reported recent amyl nitrate use compared to recent nitrous oxide use (37% vs. 6%). Small proportions of the sample reported recent heroin, methadone and other opiate use. Similarly, small proportions reported recent mushroom and recent pharmaceutical stimulant use.
Risk behaviour
One in four (25%) respondents reported having injected a drug at some time in their lives and 18% reported injecting drug use in the six months preceding interview. Injecting drug use first occurred at a median age of 21 years. The most common drug ever injected was crystal (84% of lifetime injectors) followed by speed (80% of lifetime injectors). More than half (58%) of lifetime injectors had been under the influence of other drugs when they first injected, mostly commonly alcohol, ecstasy and cannabis.
One in four (25%) respondents reported having injected a drug at some time in their lives and 18% reported injecting drug use in the six months preceding interview. Injecting drug use first occurred at a median age of 21 years. The most common drug ever injected was crystal (84% of lifetime injectors) followed by speed (80% of lifetime injectors). More than half (58%) of lifetime injectors had been under the influence of other drugs when they first injected, mostly commonly alcohol, ecstasy and cannabis.
Crystal was the drug most commonly injected in the past six months amongst recent injectors (83%), followed by cocaine (39%), heroin (39%) and speed (39%). Most (82%) recent injectors injected themselves ‘every time’; 18% reported that they typically injected alone. Needles were mostly obtained from chemists (56%) or NSPs (44%). Twenty percent of the sample had never been vaccinated against hepatitis B, with a further 13% reporting that they had not finished the vaccination schedule. Twenty-seven percent had never been tested for hepatitis C, and a further 32% reported that their last test had been more than one year ago. Twenty percent had never been tested for HIV, and a further 27% reported that their last test had been more than one year ago.
More than four-fifths (88%) had engaged in penetrative sex in the six months prior to interview. Of those, more than one-third (35%) reported having one partner during this time, and one-quarter (26%) reported having six or more partners in this time. The proportion reporting always using a condom or other form of protection was higher with a casual partner (64%) than with a regular partner (28%). Of those who had had penetrative sex in the past six months, 85% had had penetrative sex while under the influence of drugs. Ecstasy (80%), cannabis (33%) and crystal (32%) were the drugs most frequently mentioned.
Two-thirds (64%) had driven a car in the six months prior to interview, and of those, 64% had driven under the influence of alcohol and 69% had driven within one hour of taking an illicit drug. Of those who had driven within an hour of taking an illicit drug, ecstasy (71%), cannabis (43%), crystal (43%) and speed (39%) were commonly nominated.
Drug information-seeking behaviour
One-quarter (24%) of the sample ‘always’ found out the content and purity of ecstasy, while 13% ‘always’ found out the content and purity for drugs other than ecstasy. Amongst those who did report finding out the content and purity of ecstasy, dealers (53%) and friends (45%) were common sources of information, though 39% did report using internet websites and 23% used pill testing kits.
One-quarter (24%) of the sample ‘always’ found out the content and purity of ecstasy, while 13% ‘always’ found out the content and purity for drugs other than ecstasy. Amongst those who did report finding out the content and purity of ecstasy, dealers (53%) and friends (45%) were common sources of information, though 39% did report using internet websites and 23% used pill testing kits.
Health-related issues
For the first time in 2006, the EDRS included the Kessler Psychological Distress Scale, a questionnaire designed to measure the level of distress and severity associated with psychological symptoms. Forty-five percent scored in the ‘low’ range, 48% scored in the ‘medium’ range and 7% scored in the ‘high’ range. Key expert reports suggested that issues of concern amongst illicit drug users may be depression, anxiety and paranoia.
For the first time in 2006, the EDRS included the Kessler Psychological Distress Scale, a questionnaire designed to measure the level of distress and severity associated with psychological symptoms. Forty-five percent scored in the ‘low’ range, 48% scored in the ‘medium’ range and 7% scored in the ‘high’ range. Key expert reports suggested that issues of concern amongst illicit drug users may be depression, anxiety and paranoia.
One-fifth (22%) of the sample had ever overdosed on ecstasy and other drugs, though only four participants had done so in the six months preceding interview. The main substances involved were GHB (n=2), ecstasy (n=1) and alcohol (n=1). No participants reported seeking medical assistance for an overdose in the six months preceding interview.
One-quarter (26%) of the sample had accessed medical or health services specifically in regards to their drug use in the six months prior to interview. The majority accessed their General Practitioner (GP) (n=12), with the main drug of concern being crystal (33%) and the main issue of concern being dependence.
Almost half (46%) had experienced social/relationship problems related to their drug use in the six months prior to interview; 46% reported financial problems related to their drug use, 37% reported educational/occupational problems related to their drug use, and 4% reported legal/police problems related to their drug use.
Criminal activity, policing and market changes
One-fifth (21%) reported dealing drugs in the six months prior to interview, though frequency of occurrence was relatively low. Property crime, fraud and violent crime was reported by a small proportion of the sample; 7% reported having been arrested in the six months prior to interview.
One-fifth (21%) reported dealing drugs in the six months prior to interview, though frequency of occurrence was relatively low. Property crime, fraud and violent crime was reported by a small proportion of the sample; 7% reported having been arrested in the six months prior to interview.
There was a decrease in the proportion of the sample reporting that police activity had ‘increased’ in the six months preceding interview, and similar to previous years, a large proportion (86%) reported that police activity had not made it difficult for them to personally obtain drugs in the six months prior to interview.
Two-thirds (64%) reported that they had observed drug detection ‘sniffer’ dogs in the six months preceding interview on an average of four occasions. Of those, 89% reported that they took some form of precaution if they were aware that dogs would be at an event they intended to go to.
Conclusions
There is increasing evidence that the ecstasy market has increased or stabilised in recent years. The cumulation of data from users, key expert reports, population surveys, and indicator data, suggests that use of ecstasy is increasing and that it is being used more heavily, possibly in ways that heighten users’ risk of harm. The results from the EDRS show that regular ecstasy users use, and are able to obtain, a wide variety of other drugs; furthermore, these drugs can often be obtained from a wide range of people and are used in a variety of different locations. Continued monitoring of the market for ecstasy will ensure policymakers are well placed to respond to changes in the market or to the nature and extent of ecstasy-related harms in a timely fashion.
There is increasing evidence that the ecstasy market has increased or stabilised in recent years. The cumulation of data from users, key expert reports, population surveys, and indicator data, suggests that use of ecstasy is increasing and that it is being used more heavily, possibly in ways that heighten users’ risk of harm. The results from the EDRS show that regular ecstasy users use, and are able to obtain, a wide variety of other drugs; furthermore, these drugs can often be obtained from a wide range of people and are used in a variety of different locations. Continued monitoring of the market for ecstasy will ensure policymakers are well placed to respond to changes in the market or to the nature and extent of ecstasy-related harms in a timely fashion.
Implications
The regular ecstasy users in the current sample have been using ecstasy on average for six years. During this time, users may have formulated their own harm strategies to alleviate negative effects of ecstasy and other drug use, based perhaps not only on first hand experiences but experiences observed amongst social groups and other wider networks of other illicit drug users. The challenge is to present credible information to users.
The regular ecstasy users in the current sample have been using ecstasy on average for six years. During this time, users may have formulated their own harm strategies to alleviate negative effects of ecstasy and other drug use, based perhaps not only on first hand experiences but experiences observed amongst social groups and other wider networks of other illicit drug users. The challenge is to present credible information to users.
In 2006, data from both the regular ecstasy users surveyed and reports from key experts indicated an increase in the proportion of drug users engaging in the use of GHB. What is unclear is whether this increase is due to new users partaking in the use of the drug, or whether the increases observed are due to users admitting to using the drug. Previous research has suggested a ‘hidden’ culture of GHB use that resulted from the growing intolerance many users and establishments had towards this drug. Such intolerance was reported to be, in part, due to the increased overdoses which were caused from GHB use. Users may therefore partake in private locations, such as their own homes, without disclosing use to non-using peers.
An increase in GHB use presents two important implications. Firstly, novice users of the drug need to be educated about the harms which can result from its use. (Degenhardt, Darke et al. 2002) found that despite having a limited experience with the drug, 99% of recent GHB users reported at least one side effect from its use. (Degenhardt, Darke et al. 2003) also found that half of recent GHB users had experienced an overdose. Liechti (2006) found that approximately one-quarter of intoxications with illicit drugs presenting to an emergency department in the United States resulted from a GHB overdose. As such, it is important to disseminate credible harm reduction information to users about the drug in such a way that users will be receptive to the information.
The second important implication concerns GHB use in a polydrug context. Other depressant drugs, such as alcohol and opiates, may potentiate GHB toxicity (Miotto, Darakjian et al. 2001). Even closely spaced doses of GHB can have greater than additive effects. The difficulty in determine concentration of the drug may cause users to underestimate the dose-dependent effects of the drug (Gonzalez & Nutt, 2005). Given that ecstasy users in Australia have been found to have extensive polydrug using histories (Degenhardt, Barker et al. 2004), it is important that users are made aware of the negative effects which can occur from combining GHB with other drugs, especially other depressants like alcohol.
The challenge now is to present credible, reliable education and re-education initiatives concerning GHB use and related harms to users who may well have an extensive polydrug use history as well as an extensive drug using career. Users need to be given information which enables them to make informed decisions regarding their drug use without relying on anecdotal evidence and myths.
Results from the current study suggest that users are aware that what they purchase and consume as ‘ecstasy’ may not necessarily contain MDMA, however large proportions rely on anecdotal reports from friends and dealers to inform them of drug content and purity. This is despite many participants indicating that a major risk of consuming ecstasy is the unknown contaminants, and the proportions indicating that they would not consume pills if they contained other substances such as methamphetamine and ketamine.
Consuming a drug, which may contain a range of other substances, presents difficulties for users when attempting to anticipate not only drug effects, but also the effects of polydrug consumption. Given that users may not wish to use, or have access to, equipment to test drug content, users need to be presented with credible evidence of the adulterants which have been found in ecstasy rather than have them rely on anecdotal evidence. Results from analyses, such as those conducted by Victorian Police Forensic Services Department, may be used to inform users of substances detected in pills, providing them with credible evidence with which they can make informed decisions about their drug use.
The findings from the current study suggest that many users lack appropriate knowledge regarding drug possession and the law. The EDRS has consistently shown that regular ecstasy users are not only a polydrug using group, but also a polydrug purchasing group, able to purchase a wide range of drugs from their main source. Furthermore, the current findings suggest that users purchase drugs, not only for themselves, but for other as well, and that discount for bulk purchases are available. This places users at a heightened risk for more serious penalties if they were to be apprehended by police. Many may be underestimating the quantity needed to have a charge upgraded from possession to trafficking. Given that the vast majority of this group have little to no contact with law enforcement, dissemination of the law surrounding illicit substances may need to come from other sources with which users come into contact.
Citation: Dunn, M. and Degenhardt, L. (2007) NSW Trends in Ecstasy and Related Drug Markets 2006: Findings from the Ecstasy and Related Drugs Reporting System (EDRS). Sydney: National Drug and Alcohol Research Centre.