Tasmanian Trends in Ecstasy and Related Drug Markets 2005: Findings from the Party Drugs Initiative (PDI)

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Resource Type: Technical Reports

NDARC Technical Report No. 251 (2006)

EXECUTIVE SUMMARY

Demographic characteristics of regular ecstasy users (REU)
The sample of 100 REU interviewed in the present study were typically in their early- to midtwenties with ages ranging from 18 to 44 years. Participants were generally well educated and either employed on a full-time or part-time/casual basis or currently engaged in full time study. Few participants had come into contact with the criminal justice system or drug treatment agencies. These demographic characteristics are generally consistent with those reported among REU in the previous two years of the study. However, there was less unemployment, injecting drug use and current drug treatment among the 2004 and 2005 samples, in comparison to the 2003 sample, possibly reflecting less overlap between the IDU and REU populations in the latter two years of the study.

Patterns of drug use among REU
While the participants were selected on the basis of ecstasy use, and over half nominated ecstasy as their drug of choice, polydrug use was the norm among the REU interviewed. Participants had used a median of nine drug types (out of 20 drug types) at some stage of their lives and a median of six drug types in the six months preceding the interview. Recent use of alcohol, cannabis, tobacco, and methamphetamine powder was common, and one-fifth had recently used methamphetamine base, benzodiazepines, and cocaine. Less than one-fifth had recently used amyl nitrite, pharmaceutical stimulants, anti-depressants, ketamine, and crystal methamphetamine. The recent use of GHB, MDA, methadone, opium, buprenorphine, and other opiates, was low, and there was no recent use of heroin, 1,4B, and GBL among the sample.

Over the three years of the study there have been trends in the use of some drug types. The proportion reporting recent use of crystal methamphetamine decreased from over one-half of the sample in 2003 (52%) to one-tenth (10%) in 2005. Similarly, the proportion reporting recent use of MDA (21% vs. 3%) and amyl nitrate (43% vs. 16%) have also decreased, whereas recent use of cocaine (7% vs. 20%), and nitrous oxide (25% vs. 41%) have increased. Consistent levels of use of most other drug types were observed, though slight increases in the use of methamphetamine powder, anti-depressants, and ketamine were observed between 2004 and 2005.

Ecstasy
The participants interviewed in the present study had first started to use ecstasy on a regular basis at 20 years on average, and a large majority had been using ecstasy for two years or more at the time of interview. The entire sample had recently used ecstasy in tablet form and one-tenth had recently used ecstasy capsules or powder. The frequency of ecstasy use was varied and ranged from monthly to several times a week. On average, ecstasy had been used slightly more than fortnightly with a median of two tablets taken orally in a typical session. Snorting of ecstasy was also common, with three-quarters of the sample recently snorting the drug. This may be an issue of concern due to potential damage to mucous membranes, a steeper dose-response curve, and the increased risk of blood-borne viral infections. There was an increase in the number of people that reported recently shelving/shafting (refers to vaginal/anal administration) ecstasy in comparison to 2004. This route of administration is potentially more harmful than ingestion, as detoxification by the liver is less for substances absorbed in the large intestine.

There were some concerning patterns of use among the sample. One-quarter (29%) had used ecstasy on a weekly basis or more frequently, two-thirds (67%) typically used more than one tablet in a typical session of use, and one-third (37%) had recently used ecstasy in a 'binge session' (continuous 48 hour period of drug use without sleep). Whereas the long-term effects and risks of extended ecstasy use are largely unknown, evidence from toxicology studies in rats and neuropsychological studies in humans indicate that the safest pattern of use for minimising harm is to use the drug infrequently and in small amounts. Thus, those using the drug frequently or in large amounts for extended periods of time may be at a greater risk for neurological and neuropsychological harm.

Ecstasy was typically consumed in combination with other drugs. Alcohol, cannabis, and tobacco were commonly used in a typical session of ecstasy use. One-tenth (12%) typically used methamphetamine powder when under the influence of ecstasy compared to one-quarter among the 2003 (25%) and 2004 samples (24%). The use of benzodiazepines and cannabis when 'coming down' from ecstasy was also reduced slightly in comparison to 2004. The high (78%) and increasing proportion of respondents reporting concomitant ecstasy and binge alcohol use has been a key issue of concern over the past three years of the study. Larger quantities of alcohol can be consumed when under the influence of psychostimulants without experiencing immediate effects of intoxication; however, the harms associated with this use still occur (both in terms of the harms from alcohol use and exacerbation of dehydration from ecstasy use). Additionally, most of the overdose episodes reported by REU in the current study involved alcohol and/or polydrug use.

Ecstasy was typically used at music-related venues including dance parties, nightclubs and live music events, but was also used at a range of other locations including private parties and private residences. REU reports and anecdotal comments of KE suggest an increase in the use of ecstasy at locations other than dance/events and nightclubs, in particular private residences and public bars. Qualitative comments of both KE and REU suggest that the use of ecstasy in has become more 'mainstream' or 'socially acceptable', with a broadening demographic of people consuming the drug locally, including younger and older people. Despite this, data from the National Drug Strategy Household Survey (NDSHS) indicate that the estimated prevalence of ecstasy use in Tasmania has remained at least half that of the national average in recent years.

Price, purity and availability of ecstasy
Whereas there was evidence for an expanding ecstasy market in 2004 - marked by decreased price, increased purity, and increased availability of the drug relative to 2003 (Matthews & Bruno, 2005) - the market appears to have tightened in 2005, with a slight increase in price and decrease in purity and availability observed relative to 2004.

The median price for one tablet of ecstasy was $45 compared to $40 in 2004 and $50 in 2003, and this price was considered to have remained stable during the preceding six months. The median price reported by KE was $40. Both REU and KE indicated that the price per pill was less when bought in larger quantities.

REU reports on the purity of ecstasy in 2005 were varied, with purity considered to be medium, fluctuating, or high. However, a greater proportion indicated that ecstasy was medium rather than high in purity among the 2005 sample in comparison to 2004. KE typically indicated that the purity of ecstasy fluctuated.

Both KE and REU indicated that ecstasy is 'easy' or 'very easy' to obtain and that recent availability had remained stable. Reports of both KE and REU indicate an increase in availability of ecstasy in 2004 when compared to 2003 and a slight decrease in the proportion reporting that ecstasy was 'very easy' to obtain in 2005.

There has been a substantial increase in the number of ecstasy tablets seized by Tasmania Police over the last two financial years, and, whereas this had minimal impact on the number of arrests made in relation to ecstasy in the 2003/04 reporting period, there were a greater number of consumer (5) and provider (7) arrests reported in the 2004/05 reporting period relative to previous years (although these numbers remain low).

Ecstasy markets and patterns of purchasing
Consistent with previous years, ecstasy was typically purchased from friends and obtained from friends' homes. A large majority (89%) reported paying for ecstasy using money earned through paid employment. One-quarter (25%) reported dealing drugs for ecstasy profit (offsetting the cost of their own use of the drug) compared to 15% among the 2004 sample. Two-thirds (66%) indicated that they typically purchased ecstasy for themselves and others, and the remainder (34%) typically purchased ecstasy only for themselves. Although the ecstasy market is predominantly based on individuals sourcing the drug for other friends while making no cash profit, those that purchase ecstasy in larger quantities may be putting themselves at greater risk of being arrested as a provider rather than a consumer of the drug.

Methamphetamine
Consistent with previous years, the use of methamphetamine was common among the group or REU sampled in 2005. A large majority had ever used some form of methamphetamine and three-quarters had used some form of methamphetamine in the preceding six months. The median frequency of methamphetamine use was relatively low at six days in the preceding six months (approximately monthly) and it was typically swallowed or snorted and consumed in small quantities (0.1g).

Three-quarters had recently used methamphetamine powder, one-fifth had recently used methamphetamine base, and one-tenth had recently used the more potent crystal methamphetamine form. The frequency of methamphetamine powder use was slightly lower in 2005 when compared to the 2004 sample. The lifetime (29%) and recent (10%) use of crystal methamphetamine among the 2005 sample was considerably lower in comparison to 2003 when over half (52%) had recently used the drug. Those that had recently used crystal methamphetamine in 2005 had typically injected or swallowed the drug, whereas the most common route of administration in the first two years of the study was smoking. Whereas methamphetamine powder and base were typically used at venues such as dance events or nightclubs, crystal methamphetamine was more likely to be used at private residences.

Less respondents were able to confidently comment on the price, purity and availability of methamphetamine base and crystal methamphetamine in comparison to methamphetamine powder. The median price for one 'point' (0.1 g) of methamphetamine powder was $40, which is consistent with the price reported in 2004 and less in comparison to the price of $50 reported in 2003. This price was considered to have remained stable in the preceding six months. Consistent with previous years, the median price for 0.1 gram of methamphetamine base and crystal methamphetamine was higher at $50.

Consistent with previous years, the purity of methamphetamine base and crystal methamphetamine was considered to be higher than methamphetamine powder. There was little evidence for any recent changes in the purity of any methamphetamine form.

Methamphetamine powder was considered to be 'easy' or 'very easy' to obtain, reports on the availability of methamphetamine base were varied, and crystal methamphetamine was typically considered to be 'difficult' or 'very difficult' to obtain. The current and previous year's data, as well as anecdotal reports of KE, suggest that the availability of crystal methamphetamine to REU in Hobart has decreased substantially since 2003.

Cocaine
There was evidence for a slight increase in the use of cocaine among the 2005 REU sample compared to previous years of the study. Two-fifths (43%) of the 2005 REU sample had ever used cocaine, compared to one-third (32%) among the 2004 cohort. A greater proportion of males had ever used cocaine in comparison to females. One-fifth (20%) had used cocaine during the six months preceding the interview compared to one-tenth among the 2004 (10%) and 2003 (7%) cohorts. Cocaine had been used relatively infrequently with a median frequency of one day in the preceding six months. Cocaine was typically snorted and a median of 0.2 to 0.5 grams used in a typical session.

Few respondents were able to confidently comment on the price, purity, and availability of cocaine in Hobart and as such these estimates should be interpreted with caution. The price for a gram of cocaine ranged from $220 to $500 and this price was considered to have remained stable during the last six months. Reports on the purity of cocaine were varied but it was typically considered to be medium or high and to have remained stable in recent months. Both REU and KE considered the availability of cocaine to be low in Tasmania, which is consistent with indicator data suggesting a low level of cocaine-related harms and low prevalence of cocaine use among the Tasmanian population. However, considering the slight increase in the recent use of cocaine among the 2005 REU sample, continued monitoring of cocaine markets in Tasmania is warranted.

Ketamine
One-quarter of the 2005 REU sample (24%) had ever used ketamine and one-tenth (11%) had used the drug in the six months preceding the interview. Ketamine was used on an average of three occasions in the preceding six months in relatively small amounts. This, along with anecdotal reports of KE, suggests predominately experimental use by a small number of people amongst this REU cohort. Ketamine was typically swallowed or snorted at private residences and could be purchased in tablet or powder form.

Due to the small number of respondents commenting, estimates of the price, purity and availability of the drug in Hobart should be interpreted with caution. The median price for a ketamine tablet was $20 (range $20-35) and the median price for a gram of ketamine was $190 (range $150-280) and this was thought to have remained stable during the preceding six months. The purity of ketamine was considered to be high or medium and to have remained stable in recent months. Ketamine was typically considered by those that commented to be difficult to obtain.

The availability and use of ketamine among REU in Hobart appears to have decreased since 2003, with a substantial reduction observed in lifetime and recent use of ketamine, and fewer respondents able to confidently report on the price, purity and availability of the drug between the 2003 and 2004 samples. While ketamine was used relatively infrequently by a small proportion of people among the 2005 sample, there was a slight increase in use and number of people commenting on the drug in 2005 when compared to the 2004 cohort, indicating a need for future monitoring of ketamine markets in Tasmania.

GHB
Consistent with the low level of use reported among the 2003 and 2004 REU cohorts, less than one-tenth of respondents interviewed in 2005 had ever used GHB and only two males had used GHB (orally in liquid form) on two occasions during the six months preceding the interview. There was no lifetime or recent use of GHB-like substances such as 1,4B or GBL among the 2005 REU cohort. A single participant reported on the price, purity or availability of GHB in Hobart, making it difficult to delineate clear trends. Patterns of use among REU and anecdotal comments of key experts indicate low availability of GHB in Tasmania and predominantly experimental use by few people. However, considering the potentially harmful nature of GHB, future monitoring of GHB markets in Tasmania is important.

LSD and other psychedelics
Over half of the 2005 REU sample had used LSD at some stage of their lives and one-third had used LSD in the six months preceding the interview, which is slightly greater in comparison to the 2003 sample. A significantly greater proportion of males had ever and recently used LSD in comparison to the proportion of females. One tab or drop of liquid of LSD was taken orally in a typical session of use, and LSD had been used on a median of 1 day in the preceding six months, which is lower than the frequency of use of 2.5 days among the 2004 sample.

The median price for one tab/drop of LSD was $25, compared to a median of $20 reported among the 2003 and 2004 samples. The purity of LSD was perceived by REU to be 'medium' or 'high' and there was some indication for an increase in the perceived purity of the drug relative to 2004. LSD was typically considered to be 'easy' or 'very easy' to obtain and the perceived availability of LSD seems to have increased when compared to the previous two years of the study.

Three-fifths of respondents had ever used psilocybin mushrooms and two-fifths had used mushrooms during the six months preceding the interview. A greater proportion of males had ever used mushrooms in comparison to females. Mushrooms had been used on a median of three days in the preceding six months or approximately every two months. Both REU and KE noted a recent increase in the use of mushrooms at the time of the interview, often attributed to a seasonal increase in their availability. Over half of the sample, and a greater proportion of males than females, had used some form of psychedelic (either LSD or mushrooms) in the last six months.

Whereas an increase in the experimental use and availability of the hallucinogen 2-CI was noted among the 2004 sample, just a single participant had recently used the drug among the 2005 sample.

MDA
The lifetime and recent use of MDA among the 2005 sample was considerably lower in comparison to that reported among the 2004 and 2005 samples. Less than one-tenth of the 2005 REU sample had used MDA at some stage of their lives and only three males recently used MDA. Use of MDA was more common among males and 'older' respondents in comparison to females and 'younger' respondents. MDA had typically been used twice or less in the six months preceding the interview, with one capsule consumed orally in a typical session of use. Few respondents were able to confidently comment on the price, purity or availability of MDA, making it difficult to delineate clear trends. However, based on the decline in the use of MDA since 2003, and the comments of several KE, the local availability of MDA in Tasmania appears to be relatively low.

Patterns of other drug use
A majority of participants had recently used alcohol, cannabis, and tobacco. Alcohol had been used on median of two days per week in the six months preceding the interview. Cannabis had been used on a median of one day per week and the frequency of use was greater for males in comparison to females. Tobacco had recently been used by four-fifths of the sample and over half the sample had smoked tobacco on a daily basis in the last six months, with others smoking tobacco less frequently. The proportion of daily smokers among the REU interviewed in the present study is greater in comparison to both national and Tasmanian estimates of prevalence, suggesting a greater prevalence of this risky health behaviour among this population. There has been a reduction among REU in the recent use of amyl nitrite from two-fifths (43%) in 2003 to less than one-fifth (16%) in 2005. Three-quarters of those that had inhaled amyl nitrite, had done so less than once a month during the last 6 months. The proportion of the sample reporting recent use of nitrous oxide has increased from one-quarter (25%) to two-fifths (43%) in 2005. On average, nitrous oxide had been used less than monthly.

One-quarter of the sample had recently used benzodiazepines, on a median of three days per month in the last six months. Recent use of benzodiazepines was more common among 'younger' in comparison to 'older' participants. One-tenth of the sample had recently used antidepressants, compared to only four participants among the 2004 sample. Seven out of the twelve participants that had recently used anti-depressants had used them on a daily basis.

The use of other pharmaceuticals and opioid drugs was relatively rare among the REU interviewed in the current study, and those that had recently used these drugs had generally done so infrequently. Sixteen percent had recently used pharmaceutical stimulants (such as dexamphetamine or methylphenidate), with a median frequency of approximately once every two months. Only small proportions of the sample had recently used methadone (1%), and there was no recent use of heroin or buprenorphine. The recent use of pharmaceutical opiates (9%) and alkaloid poppy derivatives (6%) was slightly more common but relatively infrequent.

Drug information-seeking behaviour
Two-thirds (67%) of the REU sample indicated that they had 'sometimes' bought a drug and it turned out to have different effects than they expected, in the last six months. Whereas one-third (36%) of the REU interviewed in 2005 actively sought information about the content/purity of 'batches' of ecstasy pills 'most times' or 'always', the remainder did so half the time or less (37%) or 'never' (27%). Participants typically obtained this information from friends, dealers, and other people, as well as websites and personal experience. Five REU reported recent use of pill testing kits. Three out of these five respondents were aware of some limitations of testing kits, and there was evidence that some participants would not take a pill if testing revealed that it contained ketamine (n=2) or if there was no reaction (n=3).

The majority of the REU sample was receptive to harm reduction information. Three-quarters (72%) indicated that they would find pill testing kits personally useful if available locally. Other information resources that were considered useful by REU were information pamphlets, websites, health outreach workers at events, and posters. Whereas the qualitative comments of some KE suggested a reduction in drug information-seeking behaviour and an increase in high risk behaviours among REU, several REU commented on the lack of information available to them on the effects of drugs and ways in which to consume them more safely. REU were particularly interested in finding out more information on the long-term effects of drug use (physical, psychological, neuropsychological, and neurological) and also considered it to be important that new consumers were aware of the acute effects of drug use and ways in which to use drugs more safely.

Risk behaviour
Less than one in ten regular ecstasy users (8%) had recently used substances intravenously compared to a similar proportion among the 2004 cohort and one in 5 among the 2003 cohort. Methamphetamine was typically the first drug ever injected and the most common drug ever and recently injected. The sharing of needles was relatively rare; however, three out of five had recently shared other injecting equipment such as spoons, tourniquets, and water. One-third of these recent injectors had always required others to inject them in the last six months. All recent injectors had obtained injecting equipment from NSP outlets in the preceding six months and none reported difficulty in obtaining needles during this time.

A large majority (97%) of REU had been sexually active during the six months preceding the interview and most of these (83%) reported recent penetrative sex under the influence of ecstasy and related drugs. Participants were more likely to report some use of protective barriers with a casual partner (81%) in comparison to a regular partner (68%). Participants were slightly less likely to use protective barriers with a regular partner when under the influence of party drugs (68% vs. 58%), but were just as likely to use protective barriers with a casual partner (81% vs. 81%) when under the influence of party drugs. Whereas one-third of participants (32%) had been for a sexual health check up in the last year, one-half (51%) had never had a sexual health check up. Two-thirds of the sample had never been tested for hepatitis C or HIV. A single participant reported testing positive for hepatitis C.

Of those that had driven a car, over half (58%) reported driving at a time when they perceived themselves to be over the legal alcohol limit during the last six months. Over half (55%) also reported driving within an hour of taking ERDs in the last 6 months. Most commonly, participants reported driving under the influence of ecstasy, cannabis and methamphetamine powder. Based on a median split for age, a greater proportion of 'older' participants had recently driven under the influence of drugs in comparison to 'younger' participants, and those who had driven under the influence of drugs had also been using ecstasy longer and had recently used ecstasy and cannabis more frequently. On average, the risks associated with drug driving were considered by REU to be 'low' for cannabis, 'moderate' for ecstasy and methamphetamine, and 'high' for alcohol and LSD.

Health-related issues
Less than one-fifth of the sample (16%) reported that they had overdosed (passed out or fallen into a coma) on any drug in the six months preceding the interview. The main drugs involved in recent overdoses were alcohol (25%), cannabis (25%) and benzodiazepines (19%). Two participants (13%) reported ecstasy to be the main drug involved in an overdose episode. The majority of overdose episodes (81%) were associated with the use of more than one drug, most typically alcohol (63%), cannabis (50%) and ecstasy (25%).

Close to half (47%) of the REU sample had recently experienced no or few psychological symptoms of dependence in relation to their ecstasy use, as measured by the ecstasy Severity of Dependence Scale (SDS). However, over one-tenth (14%) reported experiencing significant symptoms of dependence in relation to ecstasy. High ecstasy SDS scores were associated with greater frequency and quantity of ecstasy use, binge drug use, methamphetamine use and high methamphetamine dependence scores.

Three-fifths of those who had recently used methamphetamine had experienced no symptoms of psychological dependence in relation to methamphetamine as measured by the methamphetamine SDS. However, over one-tenth (12%) reported experiencing significant symptoms of dependence in relation to methamphetamine. High methamphetamine SDS scores were associated with greater frequency of methamphetamine use, use of methamphetamine in combination with ecstasy, recent binge drug use, and recent injecting drug use. Close to one-fifth (17%) of the 2005 REU sample had accessed health services in relation to drug use in the preceding six months, compared to one-tenth (10%) among the 2004 cohort. The most commonly accessed service was a GP (n=10). Five participants reported accessing first aid or emergency services in relation to drug use. Participants were most likely to access services in relation to the use of ecstasy (n=9), polydrug use (n=8), or cannabis (n=4).

Two-thirds of the sample (68%) had recently experienced work/study problems in relation to drug use, two-fifths had recently experienced financial (43%) or social/relationship (43%) problems, and less than one-tenth (6%) had recently experienced legal/police problems in relation to drug use. Problems were most commonly attributed to ecstasy, alcohol, cannabis, and methamphetamine powder. Whereas the majority of these problems were relatively minor, small proportions experienced more serious problems such as ending a relationship, being kicked out of home, leaving school, being sacked/quitting work, or having no money to pay for food or rent.

Criminal activity, policing and market changes
Consistent with previous years, the self-reported criminal activity among the 2005 REU sample was relatively low. With the exception of dealing drugs, less than one-tenth (9%) of the REU interviewed had committed criminal offences during the one month preceding the interview and less than one-tenth (9%) had been arrested during the preceding 12 months. Key experts generally indicated that there was no or little crime among the group of REU that they were familiar with. Less than one-tenth (8%) of the 2005 REU sample reported dealing drugs for cash profit during the month preceding the interview, compared to greater proportions among the 2003 (25%) and 2004 (16%) samples. In contrast, a larger proportion indicated that they had paid for ecstasy through dealing drugs for ecstasy profit (to offset the cost of their own use) among the 2005 (25%) in comparison to the 2004 sample (15%). One-quarter of the REU sample (27%) and several KE perceived that there had been an increase in police activity towards ecstasy users in the last six months. The perceived increase in activity was generally related to covert surveillance, particularly at events and venues, as well as an increase in the number of 'busts' of both consumers and providers. However, the majority of REU indicated that police activity had not recently made it more difficult for them to obtain drugs.

Conclusion
The REU interviewed for the current study were generally young, employed or studying, and not currently in drug treatment or legal trouble. While ecstasy was the preferred drug of most, polydrug use was the norm and the use of alcohol, cannabis, tobacco and methamphetamine common. The current harm reduction messages in regard to ecstasy suggest that use of the drug infrequently and in small amounts may assist in minimising the risk of neurological and neuropsychological harm. This is of concern as a notable proportion of those interviewed were using ecstasy more than weekly, using multiple tablets on an occasion of use, and using for extended periods (more than 48 hours) without sleep. Moreover, the rate of binge alcohol consumption in combination with ecstasy has been increasing since 2003 and may also exacerbate health harms. However, the level of harm experienced by the majority of participants was relatively low, with few recent overdose episodes, few people accessing health services in relation to drug use, only relatively minor work/study, financial, and social problems experienced by most users, and most not experiencing significant symptoms of dependence in relation to either ecstasy or methamphetamine. The use of alcohol and polydrug use were associated factors for most of those that had recently overdosed on any drug. Those that had accessed health services in relation to drug use had typically seen a GP. While many consumers actively sought harm reduction information about the risks and effects of the drugs that they chose to use, these messages were not necessarily reaching other consumers.

Implications
It is important to remember that the aim of the PDI is to investigate the patterns of drug use, drug markets and associated risks and harms among a sentinel group of participants that use ecstasy on a regular basis; as such, this population is not necessarily representative of all users of ecstasy and related drugs and the prevalence of ecstasy and other drug use can not be directly inferred. However, the study is designed to identify emerging trends and important issues and the findings of the 2005 PDI suggest five key areas for future policy:

1. Funding of specific health programs to meet the needs of local consumers
There are currently no services that specifically cater to users of ecstasy and related drugs in Hobart, and, aside from volunteer organisations at predominantly large scale events, there is currently very little dissemination of harm reduction information to these populations. This indicates a clear need for funding and a proactive response in terms of the implementation of harm reduction strategies. Although approximately half of the REU interviewed in the current study were actively seeking harm reduction information in relation to the substances that they chose to use, these messages were not necessarily reaching other consumers. Despite this, the majority of REU indicated that that they were receptive to such information. Considering that drug information was typically sought from peers or peer-run organisations and the fact that REU do not typically come into contact with traditional health services, it is likely that harm reduction programs will attain maximum impact if delivered through peer-based organisations and mediums appropriate to the target group, such as internet sites and outreach workers or information at events. Such a peer-led service would be extremely well-placed to target the following specific risk behaviours identified in the current study: polydrug and binge drug use, binge drinking, safe sex, sharing of injecting equipment and the potential risks of snorting and shafting as routes of administration. The provision of sharps containers and condoms at nightclubs and venues, as well as simple reminders in poster form, may help to reduce risky behaviours among this population. However, these practices are most likely to be implemented effectively if a non-selective minimum standard for providing harm reduction information and equipment was adopted in nightclubs and other entertainment venues.

2. Further monitoring and investigation of drug driving amongst REU
Over half of participants reported driving under the influence of ecstasy and related drugs, indicating the need for future monitoring and research in this area. Specifically, research into the actual degree of risk associated with driving under the influence of these drugs, as well as factors associated with the decision to drive and the characteristics of these individuals, may be particularly important, so that they may be better targeted for education campaigns. The REU interviewed in the present study considered the risks associated with driving under the influence of cannabis, ecstasy, and methamphetamine to be lower than that of alcohol. In light of recent legislation with regard to drug testing on Tasmanian roads, the PDI offers a unique opportunity to monitor changes in the incidence of drug driving among regular ecstasy consumers as well as their perceptions of the risks associated with driving under the influence of drugs.

3. Monitoring and dissemination of party drug trend information
The use and availability of the more potent crystal methamphetamine form, and substances such as ketamine and MDA, seems to have decreased since 2003, and the use of potentially harmful substances such as GHB are currently relatively low in Tasmania. Whereas the use and availability of cocaine is also relatively low, there were indications for an increase in the proportion reporting infrequent use of cocaine among the 2005 REU sample. It is imperative that the use and availability of such drugs is continually monitored in future years in order to identify any emerging trends in a timely fashion. It is also important that health and emergency services and venue and event staff are informed of such emerging trends in illicit drug markets.

4. The provision of pill testing kits
While there are some limitations to the use of commercially available ecstasy 'testing kits',currently there is often very little information available to consumers in regard to the substances contained within the tablets that are sold on the local market, and two-thirds of the participants in the current study indicated that they had sometimes bought a drug and it turned out to have different effects than expected. Limitations aside, use of these kits may allow consumers to be more informed about the tablets that they choose to use, and it was apparent that the consumers interviewed would act on information from testing kits, not taking a pill if it appeared to have an unexpected or unwanted content. Testing kits can be purchased over the internet but are currently not available from any local source. There may be some benefit in making these available locally on a not-for-profit or cost-recovery basis, or facilitating provision of testing at dance and related events. The use and/or supply of testing kits under these circumstances would also allow for the limitations of these kits to be conveyed more thoroughly and effectively to consumers.

5. Pragmatic drug education programs
Several KE noted an increase in the use of ecstasy by younger people, with some suggesting that high risk behaviours were more common among younger users of the drug. Cohesive education programs within schools may allow younger users to make informed and safer choices in relation to drug use. To maximise the credibility of the information provided, education programs are likely to be most effective if they peer-delivered, accurate, and explore issues that are of local relevance. By contrast, illicit drug education programs based around ’fear arousal’ have been shown to be ineffective (or to even have contradictory effects: Ashton, 1999; Skiba, Monroe & Wodarski, 2004; West & O’Neal, 2004), and these, and associated sensationalised reporting of drug use in the media, have the real potential to undermine the credibility of this and other research, as well as detracting from the potential for successful harm reduction to occur from such endeavours.

Citation: Matthews, A. and Bruno, R. (2006) Tasmanian Trends in Ecstasy and Related Drug Markets 2005: Findings from the Party Drug Initiative (PDI), Sydney: National Drug and Alcohol Research Centre.