NDARC Technical Report No. 220 (2005)
EXECUTIVE SUMMARY
In 2000 the Illicit Drug Reporting System (IDRS) was expanded from previous years to explore the feasibility of monitoring trends in the market for ecstasy and related drugs using the existing IDRS methodology. This report presents the findings of the second year of data collection in Perth, W.A. Like the IDRS, these trends are based on three data sources:
- Quantitative interviews with 100 current regular ecstasy users.
- Qualitative interviews with 6 key experts (KEs) who have regular contact with ecstasy users and are employed in areas including health, outreach, and law enforcement.
- Analysis of various indicator data from health and law enforcement sources.
Demographic characteristics of regular ecstasy users
For the purpose of this study 'regular ecstasy users' are a population defined by their regular use of tablets sold as ecstasy. The inclusion criteria consisted of the use of ecstasy at least monthly during the previous 6 months, having resided in the Perth metropolitan region for at least 12 months prior to the interview, and being aged 16 years or older.
The current sample of ecstasy users was similar in many cases to the sample of the previous survey year. Respondents were a mean age of 22 years in 2004 which was not significantly different the 21 years in the previous year. The sample was comprised of 59% males (53% in 2003). Many (97%) were of English speaking backgrounds (99% in 2003) and 89% reported a heterosexual identity (83% in 2003). Forty nine percent of the sample reported obtaining some form of post secondary education which consisted of 24% with trade or technical training and 25% having attended university or college. In the previous year 48% of respondents had completed some form of post secondary training. Approximately one quarter (24%) of the sample in 2004 was unemployed at the time of the interview, a finding similar to the 22% who reported the same in 2003.
However, differences were found on a number of variables. Only 1% reported being of Aboriginal or Torres Islander (ATSI) descent, representing a decline from the previous survey year (9%). The mean number of school years completed was 11.5, less than that of the previous year (12.1). The proportion of respondents reporting a previous prison history or conviction (16%) had increased from the previous survey year (4%).
Patterns of drug use among regular ecstasy users
Both lifetime and recent use of a range of drugs was reported by respondents, suggesting that the current sample engages in poly drug use. Recent use of substances reported by over half of respondents include: alcohol (92%), cannabis (85%), crystal methamphetamine (80%), methamphetamine powder (78%), and tobacco (73%). Other drug use was reported by respondents although the proportions were lower. Overall, the mean number of drug classes ever used by respondents was 8.8 and the mean number used during the 6 months preceding the interview was 6.7.
Twenty two percent of respondents reported ever injecting any drug. Among those, there was a significant increase in the proportions of respondents who had reported recently injecting (i.e. during the last 6 months) across survey years (62% in 2003 versus 91% in 2004).
Ecstasy
No significant differences were found in patterns of use across the surveys in 2003 and 2004. Ecstasy was nominated by the highest proportion of respondents as the 'drug of choice' (44%) in the current survey year. Respondents used a median of 12 (range 0.5-21) days with 61% reporting that they typically used more than one tablet during a use period. Ecstasy was used weekly or more often by 21% of respondents. Many respondents (93%) reported that they typically administer the drug orally although 14% reported injecting ecstasy at some time. Many respondents reported typically using other drugs with ecstasy (86%) and during the acute recovery period after ecstasy use (80%), highlighting the polydrug using behaviour of the group.
Price, purity and availability of ecstasy
The median price of ecstasy reported in 2004 was $50 per tablet and this was rated as having remained stable during the previous 6 months by 62% of respondents. The current purity of ecstasy was rate as 'high' by the highest proportion of respondents (48%). Although 34% reported it as 'fluctuating' during the previous 6 months, this was closely followed by 32% who believed the purity of ecstasy had increased. Obviously, user assessments of drug purity are subjective, incorporating various factors such as drug tolerance, etcetera.
Ecstasy was described as being 'very easy' to obtain by 54% of respondents. Many respondents (64%) in the 2004 survey year reported the availability situation as having remained unchanged or 'stable' during the past 6 months.
Many respondents (89%) reported purchasing their ecstasy from friends, a finding similar to that reported in 2003 (91%). A change was found in the proportions of respondents who use a number of other sources. Fewer respondents reported using 'known dealers' to obtain their ecstasy in 2004 (53%) versus 2003 (63%). An increase occurred in the respondents sourcing from 'unknown dealers' in 2004 (33%) versus 2003 (9%). An increase was also seen in the proportions sourcing the drug from 'acquaintances' in the current survey year (47%) compared to 2003 (36%).
No change was found in the proportions of respondents using a friend's home as a venue to obtain ecstasy (75% in 2003 versus 72% in 2004). However, the proportions reporting use of nightclubs as a venue to purchase increased across survey years (43% in 2004 compared to 33% in 2003). A decrease occurred among those reporting that they purchased ecstasy on the street in 2004 (5%) versus 2003 (14%).
Methamphetamine
There was no significant difference in the proportion of respondents who reported ever having used methamphetamine powder in 2004 than in the 2003 survey year (88% versus 93%). No significant difference was found in the proportions reporting recent use of the drug (i.e. during the past 6 months) across survey years (78% in 2004 versus 83% in 2003).
Fewer respondents reported having snorted methamphetamine powder during the previous 6 months (81% in 2004 compared to 88% in 2003). No change occurred in the proportions reporting swallowing across survey years (56% in 2004 versus 63% in 2003) No significant change occurred in the proportions reporting injecting across survey years (17% in 2004 versus 13% in 2003). Neither did any significant change occur in the proportions smoking (37% in 2004 versus 28% in 2003).
Lifetime use of methamphetamine base was reported by 46% of respondents, which was not significantly different from that in 2003 (54%). The proportions reporting recent use across survey years (31% in 2004 versus 32% in 2003) also remained unchanged.
Of those who used methamphetamine base during the previous 6 months, 58% reported having snorted the drug, a finding not significantly different to 2003 (50%). Neither was there any significant change in the proportions of respondents who swallowed methamphetamine base across survey years (52% in 2004 versus 63% in 2003). Recent injecting (29% in 2004 versus 19% in 2003) also remained unchanged. Smoking methamphetamine base was the only significant change, having increased to 26% in 2004 from 13% in 2003.
There was no significant change in lifetime use of crystal methamphetamine (89%) in 2004 compared to the 2003 survey year (91%). No significant difference was found in the proportions reporting use during the previous 6 months (80% in 2004 versus 77% in 2003).
Of those who had used crystal methamphetamine recently, the 56% who reported snorting the drug represented a significant decrease from 2003 (70%). There was no significant change across survey years in the proportions reporting swallowing crystal methamphetamine (43% in 2004 versus 49% in 2003). Rates of injecting also remained unchanged (19% in 2004 compared to 14% in 2004). Smoking crystal methamphetamine did increase significantly to 92% in the current year from 74% in the 2003 survey year.
The median price per point for methamphetamine powder was reported by 22 respondents as $50. For methamphetamine base, the median price per point was $50 (n=6) and for crystal methamphetamine, the median price per point was also $50 (n=43). All of these median prices were the same as those reported in the 2003 survey year.
In terms of any changes to the price of methamphetamine during the 6 months preceding the interview, 60% of the 60 respondents who commented believed the price of methamphetamine powder to be unchanged or 'stable'. This was also the case for both methamphetamine base, where 57% (n=14) believed the price to have remained 'stable, and crystal methamphetamine where 64% (n=61) reported it as having remained 'stable' during the 6 months preceding the interview.
Variation occurred in self-reports of purity according to type of methamphetamine. For both methamphetamine crystal and base, purity was rated as 'high' at the time of interview by the highest proportion of respondents (59% for crystal and 43% for base). Methamphetamine powder was thought to be of 'medium' purity by the highest proportion of respondents (47%).
Both methamphetamine powder and base were rated as being currently 'easy' to obtain by the highest proportion of respondents (42% for methamphetamine powder and 57% for methamphetamine base. Crystal methamphetamine was believed to be 'very easy' to obtain by 61% of respondents who commented. This situation was rated as having remained 'stable' during the 6 months preceding the interview for all forms of methamphetamine by the highest proportions of respondents (48% for methamphetamine powder, 71% for methamphetamine base, and 52% for crystal methamphetamine).
Cocaine
Lifetime use of cocaine was reported by 36% of respondents, not significantly different to that reported in 2003 (44%). Recent cocaine use (16% in 2004 versus 17% in 2004) also remained unchanged.
The median price per gram of cocaine was $300 (n=7), a situation which remained 'stable' during the previous 6 months according to 43% of respondents. In 2003, 6 respondents commented, reporting a median price of $325 per gram. However, in 2003, 50% (n=14) of respondents commenting 'did not know' whether any changes in price occurred during the 6 months preceding the interview. As in 2003, the small number of respondents able to comment on price of cocaine suggests caution in interpreting these results as they may be unreliable.
Subjective assessments of current purity and any changes in that purity were provided by only 7 respondents. Lack of consensus made it difficult to draw any reliable conclusions. Similarly, current availability of cocaine was commented on by only 7 respondents. Four respondents rated it as 'difficult'. This was followed by two who rated it as 'very difficult'. In terms of perceived changes in availability during the previous 6 months, 6 of the 7 respondents rated it as 'stable'. Again, the small numbers here suggest caution in interpreting these subjective purity data.
Ketamine
Lifetime use of ketamine was 21%, a proportion not significantly different from that in 2003 (25%). No significant differences were found across survey years in terms of recent ketamine use (10% in 2004 versus 12% in 2003). Although 10 respondents reported using ketamine during the previous 6 months, only one participant elected to respond to a series of questions about price, purity, availability, location of use and source of the drug this making it impossible to make further comments about the market for ketamine in WA. This was largely similar to the situation in 2003 where information concerning ketamine was minimal.
GHB
In 2004 11% of respondents reported lifetime use of GHB, a proportion that was significantly lower than that in 2003 (20%). In terms of recent use, only 5% reported using during the 6 months preceding the interview, an this remained unchanged to that found in 2003 (8%).
Although 5 respondents reported using GHB during the previous 6 months, only one participant elected to respond to a series of questions about price, purity, availability, location of use and source of the drug, precluding further discussion of the market for GHB in WA. This situation for GHB was similar to that in 2003 where information concerning the drug was minimal.
LSD
Lifetime use of LSD was reported by 50% of respondents in 2004 representing a decrease from that in 2003 (62%). A decrease occurred among respondents reporting recent use (11% in 2004 versus 22% in 2003). The median price of LSD in 2004 was $25 per tab and was believed to have increased by 35% of respondents who commented.
In terms of current purity, 25% of respondents reported the current purity of LSD as 'medium' while a further 25% reported it as 'high'. However, it should be noted that while 20 respondents believed they possessed adequate knowledge concerning the purity of the drug, only 11 respondents had actually used the drug during the 6 months preceding the interview. Thus, respondent information may not be the most reliable source in this case. Further, although 30% of respondents believed the current purity of LSD had remained 'stable' during the previous 6 months, 25% of the sample suggested it had 'decreased' and a further 25% rated it as having 'fluctuated'. Current availability of LSD was reported as being 'difficult' (45%) or 'very difficult' (40%) at the time of interview. Availability was rated as 'stable' during the 6 months preceding the interview by 55% of respondents who commented.
MDA
Lifetime use of MDA was reported by 19% of respondents, representing an increase from the previous survey year (12% in 2003). A significant increase was also found in recent use of MDA (6% in 2004 versus 1% in 2003).
Only three respondents elected to respond to a series of questions about price, purity, availability, location of use and source of the drug. Further, only two of these respondents reported they had actually used the drug during the previous 6 months. These extremely small numbers calls into question the reliability of information in this area.
Patterns of other drug use
Lifetime use of alcohol was reported by 99% of respondents which was unchanged from that of 2003 (99%). Recent use was also unchanged across survey years (92% in 2004 versus 94% in 2003). The median number of days use during the past six months was 24. Alcohol was also reported by substantial numbers of respondents in the context of their ecstasy use. Specifically, 40% of respondents reported typically using alcohol with ecstasy, and of those who did, 55% reported typically consuming more than 5 standard drinks. Alcohol was also typically used by 26% of respondents to 'come down' from ecstasy, and of those 62% reported typically consuming more than 5 standard drinks.
Most respondents (97%) reported lifetime use of cannabis, a proportion that was not significantly different to that in 2003 (99%). However, recent use had declined significantly from 91% in 2003 to 85% in 2004. The median number of days used during the past 6 months was 47. Sixty three percent reported having used three times per week or more often. While 32% of respondents reported they typically used cannabis with ecstasy, 63% reported typically using it during the acute recovery period after ecstasy use.
Many respondents (85%) reported lifetime use of tobacco and this was not significantly different to that in 2003 (83%). Recent use of tobacco was also unchanged (73% in 2004 versus 70% in 2003). The median number of days use during the previous 6 months was 180. Forty three percent reported typically using tobacco with ecstasy and 38% reported they typically use it during the acute recovery period after ecstasy use.
A decline in lifetime use of benzodiazepines was found (35% in 2004 versus 48% in 2003). However, there was no difference in use during the previous 6 months across survey years (29% in 2004 compared to 32% in 2003). The median number of days use reported during the past six months was three (1-180). Few respondents (2%) reported typically using benzodiazepines while using ecstasy and only 7% reported typically using them during the acute recovery period following the use of ecstasy.
Lifetime use of antidepressants was reported by 25% of respondents although this proportion was not significantly different to that in 2003 (30%). Use reported during the previous 6 months was also unchanged (13% in 2004 compared to 17% in 2003). The median number of days used during the past six months was 180 (1-180). Of those 13 respondents, 62% were taking antidepressants as prescribed. Very few respondents reported typically using antidepressants with ecstasy (1 respondent) or during the acute recovery period after ecstasy use (1 respondent).
Lifetime use of amyl nitrite was reported by 36% of respondents, although this was unchanged from that in 2003 (43%). There was also no significant change in proportions reporting recent use (15% in 2004 versus 16% in 2003). The median number of days use during the past six months was 4 (1-50). The median age of first use was 18 (13-30) years. Only 7% of respondents reported typically using amyl nitrite with ecstasy. Only 2% reported using it during the acute recovery phase after ecstasy use.
Although many respondents reported lifetime use of nitrous oxide (62%) it was not significantly different to that found in 2003 (65%). No change was found in recent use of nitrous oxide (43% in 2004 versus 43% in 2003). The median number of days used during the previous six months was 5 (1-100). The median age of first use was 17 (13-27) years. Some 19% of respondents reported typically using nitrous oxide with ecstasy and 11% reported using the drug in the acute recovery phase after ecstasy use.
A significant decline occurred in lifetime use of other opiates from 31% in 2003 to 18% in 2004. However, no significant difference was found in proportions of recent use (10% in 2004 compared to 17% in 2003). The median number of days use during the past six months was two (1-180). The median age of first use was 18 (14-28) years. No respondents reported typically using other opiates in conjunction with ecstasy and only one reported typically using them during the acute recovery period after ecstasy use.
Lifetime use of other drugs was reported by 27% of respondents and 17% reported using other drugs during the past six months. Other drugs were used a median of two (1-59) days during the past six months. Although the responses were varied, 13 respondents listed 'magic mushrooms' as the drug used. The median age of first use was 19 (14-30) years.
Criminal and Police Activity
No significant difference was found between the 30% of respondents in 2004 and the 38% in 2003 who said they committed criminal activity during the month prior to the interview. Reports of drug dealing fell from 36% in 2003 to 25% in 2004. However, the proportions of respondents reporting the commission of property crimes during the previous month increased significantly from 5% in 2003 to 10% in 2004. No significant difference was found in the proportions of respondents reporting engaging in drug dealing to pay for their ecstasy during the 6 months preceding the interview (25% in 2003 and 17% in 2004).
Respondent perceptions of changes in police activity towards regular ecstasy users was similar across survey years in the sense that the highest proportion of respondents in 2004 reported the situation as having remained 'stable' (38%) compared to 34% in 2003. Similar to the situation in 2003, many respondents believed that police activity had 'no impact' on their ability to score drugs (82% in 2003 and 89% in 2004).
Implications
Polydrug use continues to be a common practise in which regular ecstasy users engage despite being aware of the potential risks and side effects of the drugs they use. Use in the previous 6 months of different drugs reported by over half of respondents included: alcohol (92%), cannabis (85%), crystal methamphetamine (80%), methamphetamine powder (78%), and tobacco (73%).
Of particular note is that 40% of respondents reported typically using alcohol with ecstasy, and of those who did, 55% reported typically consuming more than five standard drinks. Alcohol was also typically used by 26% of respondents to 'come down' from ecstasy, and of those 62% reported typically consuming more than five standard drinks. The high rate of alcohol use is of interest given that in the past it had not traditionally been a part of the ecstasy scene. Thus, it may be useful to explore the meaning of alcohol within this setting.
Recent use of crystal methamphetamine in WA continues to be the highest of all Australian jurisdictions as well as reporting the highest average number of days use of the drug during the 6 month period. Also of note is the possible movement away from snorting crystal methamphetamine towards smoking. Similarly, significant increases were seen in the proportion of recent users reporting smoking of methamphetamine base in the previous 6 months. These increases in reports of smoking as a form of administration for these forms of methamphetamine are consistent with anecdotal reports from peer outreach workers Smoking is a more potent mode of administration which is more likely to result in escalation to dependence, all of which presents challenges to health providers.
Most respondents reported purchasing their drugs from friends. However, it is the case that increases occurred in the proportions who reported also sourcing ecstasy, methamphetamine powder and crystal from 'unknown' dealers, speaking to the issue that users may have little control over the drugs they receive.
Citation: Chanteloup, F. and Lenton, S. (2005) WA Trends in Ecstasy and Related Markets 2004: Findings from the Party Drugs Initiative (PDI), Sydney: National Drug and Alcohol Research Centre.