NDARC Technical Report No. 275
EXECUTIVE SUMMARY
This report presents the results of an ongoing study monitoring ecstasy and related drug markets within WA. It is part of a nationwide study, which commenced in NSW, Queensland and Victoria in 2000, with the addition of other states and territories in 2003. In 2000, the pre-existing Illicit Drug Reporting System (IDRS), designed to monitor use of the main illicit drugs in Australia, was expanded to explore the feasibility of monitoring trends in the ‘party drugs’ market. The current report provides findings for the third year of data collection in WA obtained from three sources:
- quantitative interviews with 100 current regular ecstasy users residing in the Perth metropolitan area;
- qualitative interviews with key experts 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’ (REU) are a population defined by their use of tablets sold as ecstasy on at least a monthly basis. The sample recruited for the current survey was found to be mostly similar to that of the previous year. The current sample comprised of 60% males and 86% identified as heterosexual. Almost the entire sample (95%) was of English speaking background and only 2% reported Aboriginal and/or Torres Strait Islander descent. There was a significant increase in age with a mean of 24.7 years in the current sample compared to 22.7 years in 2005.
Unchanged from last year, the mean number of school years in the current sample was 11.5 years. Almost three-quarters (73%) had completed secondary education, half (51%) had completed a course post-secondary school and 19% were currently in full-time education. There was a significant increase in the proportion currently full-time employed from 33% in 2005 to 52% in 2006. However, the rate of unemployment was similar, reported by 14% of the current sample compared to 15% last year. There was a significant increase in the proportion reporting previous imprisonment, however, these rates were very low (8% in 2006 versus 2% in 2005). Similarly, small proportions across survey years reported currently being in drug treatment, as reported by 5% of the current sample.
Patterns of drug use among REU
Across survey years, REU represent a sample that consistently engages in polydrug use. Among the 2006 sample, lifetime use had a mean of 10 drugs and the mean number of drugs used in the last six months (recent use) was 6.7 drugs. Neither of these use patterns was significantly different from that found last year. Over half the current sample reported recent use of ecstasy (100%), alcohol (99%), cannabis (86%), tobacco (74%), crystal methamphetamine (77%), speed powder (65%) and pharmaceutical stimulants (60%).
There was only one significant increase in drug use between the current and last year’s sample, which was in lifetime use of tobacco. In contrast, several significant decreases in drug use were found. In 2006, there were significant decreases in both lifetime and recent use of speed powder, and recent use of LSD. Prevalence of MDA and ketamine have consistently been low among REU in WA; however, lifetime and recent use of both these drug types significantly decreased in 2006. There were also significant decreases in lifetime and recent use of amyl nitrate and ‘other opiates’, and in recent use of nitrous oxide and heroin.
Rates of both lifetime and recent injection were comparable across survey years. In 2006, 20% of respondents reported ever injecting a drug compared to 22% last year, and 14% reported injecting in the last six months compared to 12% last year.
Ecstasy
Patterns of ecstasy use were mostly similar to that found last year. Pills were by far the most common form of ecstasy used, and almost the entire sample (98%) nominated swallowing as the main method of administration. The majority (70%) of respondents typically used more than one tablet during a session with a mean of 2 tablets used in a session. In the current sample, ecstasy was used a mean of 20.5 days (19.9 days in 2005), and 35% of respondents reported using ecstasy weekly (30% in 2005).
There was a significant decrease in the proportion nominating ecstasy as their ‘drug of choice’ from 51% in 2005 to 41% in 2006. Increases were found for cannabis (9% in 2005 versus 19% in 2006) and alcohol (7% in 2005 versus 15% in 2006). As with previous years, the majority of respondents reported typically using other drugs with ecstasy (94%) and during recovery or ‘‘come down’’ from ecstasy use (86%). Drugs most commonly used on both these occasions were alcohol and cannabis. Just under half the current sample (45%) reported ‘bingeing’ on ecstasy in the last six months, defined as use for more than 48 hours without sleep.
‘Nightclubs’ were reported by the majority of the sample as both the usual and most recent location of ecstasy use, as found last year. However, there were increases in the proportions nominating ‘friend’s home’ and ‘private parties’ as locations of use, and a decrease in ‘raves’. This may indicate that, aside from continued use in nightclubs, there is a trend toward use of ecstasy in private locations.
Price, purity and availability of ecstasy
The median price of ecstasy remained the same as last year at $40 per tablet. In both years, price was rated as ‘stable’ during the previous 6 months by the majority of respondents (61% in 2006). The greatest proportion of the current sample rated the current purity of ecstasy as ‘fluctuates’ (36%) in contrast to last year’s sample rating current purity as ‘medium’ (40%). In both years, the greatest proportion rated purity over the previous six months as ‘fluctuating’ (45% in 2006 versus 36% in 2005). There was a shift in perception of availability towards it as decreasing. Current availability of ecstasy was rated by 47% in 2006 as ‘very easy’ compared to 62% in 2005, and recent availability was rated as ‘stable’ by 55% in 2006 compared to 72% in 2005.
‘Friends’ remained the most common person from whom to score ecstasy; however, this significantly decreased from 93% in 2005 to 81% in 2006. There was a significant increase in the proportion nominating ‘acquaintances’ from 24% in 2005 to 37% in 2006. ‘Friend’s home’ was the most common location for scoring ecstasy, reported by 71% in both years. Among the current sample, ecstasy was purchased from a median of 3 people in the previous six months and a median of 5 tablets were purchased as a time. Over three-quarters (77%) reported usually purchasing ecstasy for ‘self and others’.
Methamphetamine
There were significant differences between sample years regarding use of speed powder, but not use of either base methamphetamine or crystal methamphetamine. There were significant decreases in both lifetime use (87% in 2006 versus 94% in 2005) and recent use (65% in 2006 versus 85% in 2005) of speed in the current sample, and these rates were the lowest reported since data collection commenced in WA in 2003. In contrast, rates of base use were highly similar, with 56% of the current sample reporting lifetime use (59% in 2005) and 32% reporting recent use (38% in 2005). The vast majority in both years reported lifetime use of crystal (89% in 2006 versus 88% in 2005), while there was a non-significant increase in recent use (77% in 2006 versus 69% in 2005).
Methods of use differed across forms and were consistent with those reported last year. Snorting (86%) was the most common method of administration for speed, swallowing (63%) for base, and smoking (88%) for crystal. ‘Nightclubs’ were reported as the most common usual location of use for both speed and base, while ‘friend’s home’ was nominated by most for crystal.
The median price per ‘point’ (0.1 gram) for all types of methamphetamine (powder, base and crystal) has consistently remained at $50 across all survey years. The median price for a gram of speed was the same as last year at $300. There was a slight increase in the median price of a gram of base from $325 to $350, and an increase in a gram of crystal from $350 to $400. With regards to changes in the price of methamphetamines during the previous 6 months, the majority of respondents reported the price as ‘stable’ for all forms.
There was a perceived decrease in current purity of both speed and base. In the current sample, 30% rated current purity of speed as ‘medium’ followed by 24% rating it as ‘low’, compared to 40% of last year’s sample rating it as ‘medium’ and 20% rating it as ‘low’. Current purity of base was rated by 44% of the current sample as ‘medium’ and by 25% as ‘low’, while equal proportions of last year’s respondents rated it as ‘medium’ and ‘high’ (41% each). Ratings of crystal were comparable, with 40% of current respondents rating it as ‘high’ (39% in 2005) and 31% as ‘medium’ (26% in 2005).
All forms of methamphetamine were rated as either ‘very easy’ or ‘easy’ to obtain by the majority of respondents. Similarly, availability over the previous six months was rated as ‘stable’ for all forms by the greatest proportion of respondents. Persons from whom methamphetamine was purchased were the same across forms, with ‘friends’, ‘known dealers’ and ‘acquaintances’ the most common sources reported. Accordingly, ‘friend’s home’ was the most common location for purchasing all forms.
Cocaine
Both lifetime and recent use of cocaine were similar to that reported last year. In the current sample, 55% reported lifetime use (57% in 2005) and 29% reported use of cocaine in the previous six months (35% in 2005). Snorting was reported by all as the most common method of administration, and ‘nightclubs’ and ‘own home’ were equally reported by the greatest proportion as usual location of use (43% each).
The median price per gram of cocaine was the same as last year at $350. In contrast to last year, the majority of the current sample was unable to comment on price change over the last six months (58%), while the majority last year rated it as ‘stable’ (60%). Ratings of purity were highly similar with equal proportions of 37% rating current purity as ‘low’ and ‘medium’ (38% each in 2005). As with price, the greatest proportion was unable to comment on recent changes in purity (42%), while 50% of last year’s respondents rated it as ‘stable’.
In 2006, current availability of cocaine was rated by the majority as ‘difficult’ (63%) and 26% rated it as ‘very difficult’. In 2005, current availability was rated by 43% as ‘difficult’ and by 36% as ‘easy’. This suggests that cocaine has become less available in WA and may account for the inability of respondents to comment on price and purity over the previous six months. Among the current sample, 21% each reported ‘friends’, ‘known dealers’ and ‘acquaintances’ as persons from whom cocaine was purchased.
Ketamine
Rates of ketamine use had been consistently low among REU in WA and the current sample reported the lowest rates since collection commenced in 2003. Lifetime use of ketamine significantly decreased from 25% in 2005 to 14% in 2006, and recent use from 11% in 2005 to 4% in 2006. Only one respondent commented on locations of use, purchasing practices and aspects of price, purity and availability. It was therefore not possible to draw conclusions regarding the ketamine market in WA.
GHB
Similarly, rates of GHB use remained low among REU in WA. In 2006, only 5% reported lifetime use of GHB (10% in 2005) and 2% reported use of GHB in the
previous six months (3% in 2005). No respondents commented on items referring to locations of use, purchasing practices, or aspects of the GHB market in WA.
LSD
Lifetime use of LSD was similar to last year, as reported by 67% of the current sample and 71% of last year’s sample. There was a significant decrease in recent use, with 25% of the current sample reporting use of LSD in the previous six months compared to 35% in 2005. The current sample reported use during both a typical and a heavy session as 1 tab. All respondents reported swallowing as the only method of administration in the last six months. ‘Own home’ (46%) and ‘friend’s home’ (31%) were the most common locations of usual use.
The median price of LSD decreased to $20 per tab, compared to $25 last year. Just under half those who commented reported price during the previous six months as ‘stable’ (45%), compared to 29% of last year’s sample. Ratings of current LSD purity were comparable across survey years. In 2006, 50% reported current purity as ‘high’ (54% in 2005) and 35% as ‘medium’ (23% in 2005). Reports of purity over the preceding six months were varied and inconclusive. There was some indication of an increase in availability of LSD in WA. In 2006, 40% rated current availability as ‘easy’ compared to 34% in 2005, and 25% rated it as ‘difficult’ compared to 34% in 2005. ‘Friends’ were nominated by the majority as the most common source for purchasing LSD (77%).
MDA
Lifetime use of MDA significantly decreased to 6% of the current sample compared to 19% in 2005. No respondent in 2006 reported use of MDA in the previous six months compared to 11% in 2005. No respondent commented on locations of use, purchasing practices or aspects of the MDA market in WA.
Cannabis
Prevalence of cannabis use had been consistently high among REU samples in WA and this remained the case in 2006. Lifetime use was reported by 100% of the current sample and recent use by 86%. There was a decrease in frequency of use, with a median of 48 days use in the last six months among current REU compared to 60 days in last year’s sample. Use of cannabis with ecstasy was reported by 40% of those who used other drugs in conjunction with ecstasy, and 71% of those who used drugs to ‘come down’ from ecstasy reported use of cannabis during this period.
Information regarding market aspects of cannabis in WA was obtained for the first time in the EDRS in 2006. Hydroponic cannabis was bought at a median price of $280 per ounce, while bush cannabis was bought at a median of $225 per ounce. Over threequarters of respondents reported price over the last six months as ‘stable’ for both forms. Current purity of hydroponic cannabis was rated by the majority as ‘high’ (70%), while bush was rated as ‘medium’ (57%). Recent purity of both forms was rated by 55% as ‘stable’. Current availability of both forms was rated as ‘very easy’ by the greatest proportion of respondents (60% hydroponic versus 48% bush), and two-thirds rated recent availability of both forms as ‘stable’. ‘Friends’ and ‘friend’s home’ were the most common source and location for purchasing both forms of cannabis.
Patterns of other drug use
As in previous survey years, alcohol use was highly prevalent; all respondents in 2006 reported lifetime use of alcohol and 99% reported use during the last six months. During this period, alcohol was used a median of 60 days, which equates to 2.5 days a week. Alcohol was the most common drug used with ecstasy, as reported by 77%. Among these respondents, 68% reported usually consuming more than 5 standard drinks. A smaller proportion of those who reported use of other drugs during ‘come down’ from ecstasy nominated alcohol (38%) and, among these, 52% reported typically consuming more than 5 standard drinks.
The Alcohol Use Disorders Identification Test (AUDIT) was included in the 2006 EDRS to screen for risky drinking practices among the REU sample. Proportions were fairly evenly spread across categories: 28% scored at ‘low risk’, 30% at ‘risky/hazardous’, and 21% each at ‘high-risk/harmful’ and ‘high-risk’. With regards composite scores, 75% scored at a risky level for ‘alcohol-related problems’, 73% for ‘consumption’ and 20% for ‘dependence’. These findings indicate that the majority of REU engaged in potentially harmful drinking practices.
There was a significant increase in lifetime use of tobacco, reported by 97% of the current sample compared to 86% in 2005. Rates of recent use were highly similar, as reported by 74% of the current sample compared to 72% in 2005. The median number of days tobacco was used during the previous 6 months remained at 180, and 61% of the current sample were daily smokers. Of those using other drugs with ecstasy, 56% reported use of tobacco, and of those using other drugs during ‘come down’, 54% reported use of tobacco.
Pharmaceutical stimulants such as dexamphetamine and methylphenidate drugs were included in the survey as a distinct drug class from last year. Lifetime use of these drugs remained high with 92% reporting lifetime use (89% in 2005); however, there was a significant decrease in recent use reported by 60% in 2006 (74% in 2005). The median number of days used during this time period was 10 compared to 6 in last year’s sample. Pharmaceutical stimulants did not appear to be used in the context of ecstasy use, with smaller proportions than last year reporting use with and during ‘come down’ from ecstasy. Of those using drugs with ecstasy, 17% reported use of pharmaceutical stimulants (28% in 2005) and 8% of those reporting use of drugs during ‘come down’ reported pharmaceutical stimulants (17% in 2005).
With regards use of other pharmaceutical medicines, there was a non-significant increase in lifetime use of benzodiazepines from 49% in 2005 to 57% in 2006. Recent use was comparable with 32% in 2006 reporting use in the previous six months and 39% in 2005. In 2006, the median number of days used during this period was 10 compared to 4 days in 2005. Use of benzodiazepines with ecstasy was only reported by one respondent, and 13% reported use during ‘come down’ from ecstasy.
There were no significant differences across survey years for use of antidepressants, with lifetime use reported by 29% in 2006 compared to 32% in 2005, and recent use by 14% in 2005 compared to 13% in 2005. The median number of days used during the past six months was substantially higher at 125 in 2006 compared to 24 in 2005. Among the current sample, three respondents reported using antidepressants both with and during ‘come down’ from ecstasy.
Use of ‘other opiates’ including morphine, pethidine and over-the-counter medications containing codeine, has fluctuated over survey years. In 2006, there were significant decreases in both lifetime and recent use, following significant increases among last year’s sample. Lifetime use was reported by 24% in 2006 compared to 41% in 2005, and recent use by 13% in 2006 compared to 27% in 2005. No respondent in the current sample reported typically using these drugs either with ecstasy or during ‘come down’.
Participants were also asked about use of inhalants, including nitrous oxide and amyl nitrate. While lifetime use of amyl nitrate remained similar across samples (57% in 2006 versus 63% in 2005), there was a significant decrease in recent use from 34% in 2005 to 23% in 2006. With regards to amyl nitrate, significant decreases were found for both lifetime and recent use. Lifetime use was reported by 34% in 2006 compared to 46% in 2005, and recent use by 8% in 2006 compared to 17% in 2005. These inhalants were not commonly used either with ecstasy or during ‘come down’.
Prevalence of use of heroin, buprenorphine and morphine has remained consistently low amongst REU samples. In 2006, 10% reported lifetime use of heroin and this was comparable to the 10% reported in 2005. There was a significant decrease in recent use from 6% in 2005 to 1% in 2006. Rates of buprenorphine remained low with lifetime use reported by 3% and recent use by 1% in 2006. This was also the case for methadone use, with 4% of the current sample reporting lifetime use and 2% reporting recent use.
Magic mushrooms were included in the survey as a separate drug class from 2005. Rate of lifetime use was the same as last year, reported by 53%, and recent use reported by 13% in 2006 compared to 14% in 2005. Six respondents reported use of drugs other than those listed in the survey and these were DMT, 2CB, Novocain and PCP.
Drug information-seeking behaviour
Commencing in last year’s survey, REU were asked how often they find out the content and purity of ecstasy and other party drugs before taking them. Approximately half the sample (47%) reported ‘never’ finding out the content and purity of other party drugs, compared to 18% ‘never’ seeking this information for ecstasy. Over a third of the sample (36%) reported ‘always’ finding out this information for ecstasy and 22% reported ‘most times’. Of those who sought this information for ecstasy, almost all reported ‘friends’ as the most common source (94%). Over half reported obtaining information from ‘dealers’ (59%), ‘other people’ (59%), ‘websites’ (55%) and ‘personal experience’ (55%). Only a small proportion (13%) reported personal use of testing kits; however, 50% stated they would find them a useful resource if available locally.
Risk behaviour
Respondents reported on risk behaviours related to injecting, sexual practices, and driving behaviour. In 2006, 20% reported ever injecting (22% in 2005) and 14%
reported injecting in the last six months (12% in 2005). Speed powder was the most common drug ever injected and first injected, while crystal methamphetamine was the most common drug recently injected and last injected. Almost the entire sample of recent injectors reported self-injection every time and half reported usually injecting alone. Less than half of the total sample in 2006 had completed hepatitis B vaccination or been tested for hepatitis C and HIV in the last year.
In 2006, 95% reported having penetrative sex in the last 6 months and the greatest proportion had one partner during this period (44%). The majority had engaged in penetrative sex while using drugs (80%) and a third of these respondents had done so 3 to 5 times in the previous six months. Ecstasy was the most commonly reported drug used on these occasions (76%).
Of the current sample, 85% had driven a car in the last 6 months. Within this group, 51% reported driving under the influence of alcohol on a median of 4 occasions during the previous six months. The majority (61%) reported that they had undergone roadside breath testing in this period and, of these respondents, 15% reported being over the legal blood alcohol limit. Over three-quarters (79%) reported driving within one hour of taking a drug and the median was 10 times in the last six months. The most commonly reported drugs were ecstasy (79%) and cannabis (63%). Of those who had driven soon after taking drugs, the majority (60%) reported that their driving was ‘not at all impaired’.
Health-related issues
In 2006, 16% of REU reported accessing a medical or health service in relation to their drug use during the last 6 months. The most common services accessed were GP and drug/alcohol worker, reported by 50% each, and the main drugs of concern were ‘other opiates’ (63%) and crystal (56%). The reasons for accessing a service were mostly psychological issues, with 75% reporting seeking help for depression and 38% for psychosis.
The Kessler Psychological Distress Scale was included in the 2006 EDRS as a screening tool for symptoms of depression and anxiety. Of the total sample, the majority scored at ‘medium risk’ (54%), followed by ‘no/low risk’ (37%) and ‘high risk’ (9%).
Criminal activity, policing and market changes
Rates of criminal activity have consistently been low among REU samples. In 2006, 26% reported committing a crime in the last month (32% in 2005). Of these respondents, ‘drug dealing’ was the most commonly reported activity (23%) and most engaged in this activity less than once a week (40%). Of the current sample, 14% had been arrested in the last 12 months and the most common offence reported was driving under the influence of alcohol.
In 2006, similar proportions rated recent police activity toward REU as ‘stable’ (41%) and ‘increased’ (34%). Approximately three-quarters of the sample reported that police activity did not make scoring drugs more difficult (73%). A quarter of the sample reported seeing sniffer dogs during the six last months, and most had seen them on one occasion during this period (60%).
Implications
Regular ecstasy users are a group commonly characterised by polydrug use and this has consistently been supported by the PDI/EDRS surveys. While use of other drugs remained common among the current sample, significant decreases were found in the prevalence of such use, particularly in regards to those drugs previously referred to as ‘party drugs’. Rates of use for MDA and ketamine have always been low in WA, but use of these drugs decreased further in 2006 as did recent use of speed powder and LSD. This was not accompanied by any significant increases in the use of other drugs and was in contrast to last year when significant increases were found for both cocaine and LSD use.
As found in previous years, the two most common drugs used by the current sample aside from ecstasy were alcohol and cannabis. While ecstasy decreased as the preferred drug among this sample, significant increases were found for the proportion nominating alcohol or cannabis as their drug of choice. Additional information related to these drugs was included in the 2006 EDRS. Firstly, information was obtained regarding market aspects of cannabis and indicated that both hydroponic and bush forms were considered cheap, easily accessible, and of medium to high purity. Secondly, the Alcohol Use Disorders Identification Test (AUDIT) was included in the 2006 survey and the majority of the sample was found to be engaging in various risky drinking practices. Given the high rates of use of these drugs (both in the context of ecstasy and independently) their availability and their preference, use of alcohol and cannabis remain worthwhile targets for harm reduction strategies.
‘Friends’ remained a commonly reported source for purchasing all major drug types including ecstasy, methamphetamine, cocaine, and LSD; however, increases were observed for obtaining drugs from ‘known dealer’s’ and ‘acquaintances’. While this may represent a shift in the perception of the nature of these relationships, it may be that more REU were seeking alternative sources of supply. Interestingly, while ‘friends’ was also nominated as the main source for seeking information about content and purity of drugs, increases were found in the proportions nominating ‘dealers’ and ‘other people’ as sources of such information. These findings might suggest that drug networks had expanded and were no longer restricted to those with whom users felt they had a previously established association. A similar shift away from more personable aspects was found in reasons reported for taking ecstasy. While ‘enhanced closeness and bonding’ was the most commonly reported benefit in last year’s sample, there was a marked decrease in its nomination among the current sample and, increases in reported benefits specific to effects of the drug such as ‘increased energy and staying awake’.
Rates of injecting remained low and were comparable to those reported in previous years. Nevertheless, changes were found in relation to injecting behaviour among the current sample. Most notably, half the current sample of recent injectors reported usually injecting alone compared to none reporting such last year. Only 36% of the current sample reported usually injecting with ‘close friends’ compared to 73% last year. Across samples, ‘own home’ was reported by the majority as the usual location of injection. In contrast to last year, crystal methamphetamine was the most common drug reportedly injected in the previous six months compared to speed powder reported last year. Given the risks associated with use of crystal, particularly in relation to mental health, it is concerning that, together, these findings indicated that the majority of current REU injectors were injecting crystal alone in their own homes.
Lastly, the Kessler Psychological Distress Scales (K10) was included in this year’s survey as a screening tool for symptoms of depression and anxiety. Just over half of the current sample of REU scored within the ‘medium risk’ range for these psychological problems. While only a small proportion reported accessing a medical or health service in relation to their drug use in the last six months, three-quarters of those that did had sought help for depression. In accordance with this, among the total REU sample, ‘depression’ was the most commonly nominated risk perceived to be associated with ecstasy use. Given these findings, further investigation of mental health among this sample is suggested and may need to be addressed within treatment settings.
Citation: George, J. & Lenton, S. (2007) WA 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.