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Proudfoot P, Heubeck B, Ward J, Degenhardt L. Ecstasy Use, Outcome Expectancies, and Sexual Risk Taking. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2010.00016.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Phoebe Proudfoot
- Department of Psychology, The Australian National University, Canberra
| | - Bernd Heubeck
- Department of Psychology, The Australian National University, Canberra
| | - Jeff Ward
- Department of Psychology, The Australian National University, Canberra
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2
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Rigg KK, Mills A. Sexual Risk Behaviors among African Americans Who Use MDMA (Molly/Ecstasy): Implications for HIV Prevention. SOCIAL WORK IN PUBLIC HEALTH 2020; 35:282-292. [PMID: 32543311 DOI: 10.1080/19371918.2020.1781013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Numerous studies have linked sexual risk taking to recreational use of MDMA. Questions remain, however, regarding the extent and type of sexual risk behaviors that occur among MDMA users, especially African Americans who use the drug. Because the MDMA literature has historically relied on samples with little minority representation, little is known about Black MDMA users and their sexual risk taking. The primary goal of this study, therefore, was to describe patterns of sexual risk behaviors among African Americans who use MDMA. This study used survey data to identify (a) which sexual risk behaviors occurred among Black MDMA users and (b) the prevalence of each behavior. Qualitative interview data are also presented to contextualize the role that MDMA and the club/nightlife environment might play in contributing to these behaviors. Results show that sexual risk taking (e.g., sex without a condom, "hooking up," sex on MDMA, and group sex) was prevalent and that the mind-set and context in which MDMA was consumed are contributing factors. The current study adds to the limited amount of data on African Americans who use MDMA and is a step toward better understanding the link between MDMA and sexual risk taking. These data can be used to inform social workers in their efforts to prevent HIV in this population.
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Affiliation(s)
- Khary K Rigg
- Department of Mental Health Law & Policy, Louis de la Parte Florida Mental Health Institute, University of South Florida , Tampa, Florida, USA
| | - Alexandra Mills
- Department of Psychology, University of Miami , Coral Gables, Florida, USA
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3
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Strandberg AK, Elgán TH, Feltmann K, Jayaram Lindström N, Gripenberg J. Illicit Drugs in the Nightlife Setting: Changes in Employee Perceptions and Drug Use over a Fifteen-Year Period. Subst Use Misuse 2020; 55:2116-2128. [PMID: 32811266 DOI: 10.1080/10826084.2020.1793365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Illicit drug use is common in nightlife settings and associated with various public health-related problems, making this an important arena for prevention. Purpose/objectives: To assess perceived prevalence of illicit drug use in the Stockholm nightlife setting, use of and attitudes toward illicit drugs among employees at licensed premises. Also, to make comparisons with two identical measurements from 2001 and 2007/08, and to explore potential differences related to own drug use, type of licensed premise, age or gender. Methods: Cross-sectional surveys were conducted at three time-points: 2001, 2007/08, and 2016/17, comprising employees at licensed premises in Stockholm participating in STAD's Responsible Beverage Service training program. A total of 665 persons (mean age 28 years, 53% women) were included in the 2016/2017 measurement. Results: A majority of the respondents reported having observed patrons intoxicated by illicit drugs in the last six months, and agreed that patrons intoxicated by illicit drugs should be asked to leave licensed premises. The belief that one had observed patrons intoxicated by illicit drugs was more common among respondents who had themselves been using illicit drugs during the last year, and also among employees at nightclubs. Furthermore, comparisons with previous time-points showed a significant increase in the proportion of employees using illicit drugs. Almost half of the respondents in the youngest age group (18-24 years) reported illicit drug use during the last year. Conclusions/importance: Observation and use of illicit drugs are common among employees in the Stockholm nightlife setting and has increased significantly during the past decade.
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Affiliation(s)
- Anna K Strandberg
- Department of Clinical Neuroscience, Karolinska Institutet, STAD, Stockholm Prevents Alcohol and Drug Problems, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, SE, Sweden
| | - Tobias H Elgán
- Department of Clinical Neuroscience, Karolinska Institutet, STAD, Stockholm Prevents Alcohol and Drug Problems, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, SE, Sweden
| | - Kristin Feltmann
- Department of Clinical Neuroscience, Karolinska Institutet, STAD, Stockholm Prevents Alcohol and Drug Problems, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, SE, Sweden
| | - Nitya Jayaram Lindström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, SE, Sweden
| | - Johanna Gripenberg
- Department of Clinical Neuroscience, Karolinska Institutet, STAD, Stockholm Prevents Alcohol and Drug Problems, Stockholm, Sweden.,Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, SE, Sweden
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4
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Brief interventions for young adults who use drugs: The moderating effects of resilience and trauma. J Subst Abuse Treat 2019; 101:18-24. [PMID: 31174710 DOI: 10.1016/j.jsat.2019.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 03/22/2019] [Accepted: 03/22/2019] [Indexed: 02/01/2023]
Abstract
Among participants in an intervention clinical trial (N = 602), we examined resilience as a moderator of substance use outcomes by intervention condition and between participants with and without severe traumatic stress (STS). Eligibility included men and women ages 18-39 with recent multidrug use; drug treatment enrollees were excluded. Outcome measures were past 90-day frequencies of substance use and abstinence. Putative moderators were measured using the Resilience Research Centre's Adult Resilience Measure (RRC-ARM) and the Traumatic Stress Scale from the Global Appraisal of Individual Needs (GAIN). Analyses employed hierarchical linear models. High resilience predicted better substance use outcomes, and the ordering of intervention effects for high resilience participants was stepwise by intervention condition intensity. Participants with low resilience scores had poorer outcomes, and those outcomes were largely unaffected by intervention condition. Participants without STS experienced the interventions similarly to the overall sample. Regardless of the level of resilience, however, participants with STS did not benefit from the interventions. The findings point to the importance of screening for both resilience and traumatic stress prior to intervention to maximize the impact of brief interventions for substance users, and also to link those needing more intensive approaches to additional services and professional care.
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Kurtz SP, Buttram ME, Pagano ME, Surratt HL. A randomized trial of brief assessment interventions for young adults who use drugs in the club scene. J Subst Abuse Treat 2017; 78:64-73. [PMID: 28554606 PMCID: PMC5516962 DOI: 10.1016/j.jsat.2017.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 04/28/2017] [Accepted: 05/11/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Efficacious interventions to reduce drug use and its consequences for club drug using populations are not apparent in the literature. We tested interviewer- (CAPI) and self-administered (ACASI) comprehensive health and social risk assessments as distinct interventions compared to waitlist control. METHODS 750 men and women ages 18-39 with multidrug use and heterosexual behavior were randomized in equal proportions to the three conditions. Instrumentation included well-tested measures of drug use, risky sex, mental distress and substance dependence. RESULTS The sample was 56% male; mean age=25. Reported risk behaviors and health consequences did not differ by assessment modality. Adjusted HLM analyses showed a significant main effect of assigned condition on all outcomes. CAPI participants had greater reductions in drug use, risky sex, mental distress and substance dependence symptoms, and greater increases in abstinence, compared to ACASI intervention or control participants at 12months, except that the CAPI and ACASI conditions had similar efficacy for reductions in drug use. Effect sizes for CAPI versus ACASI participants were d=0.2-0.3, and between CAPI and controls d=0.2-0.4. Effect sizes for improved outcomes between ACASI compared to controls were small to non-significant. CONCLUSIONS The study established the therapeutic benefit of interviewer interaction in reducing risky behavior among this young drug using population. The study demonstrated the efficacy and acceptability of a low threshold intervention in reducing drug use, sexual risk and related co-morbidities among a not-in-treatment young adult population that exhibits severe and complex levels of drug use, but that is also highly resistant to intervention.
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Affiliation(s)
- Steven P Kurtz
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 7255 NE 4th Avenue, Suite 112, Miami, FL 33138, USA.
| | - Mance E Buttram
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, 7255 NE 4th Avenue, Suite 112, Miami, FL 33138, USA.
| | - Maria E Pagano
- Department of Psychiatry, Division of Child Psychiatry, Case Western Reserve University, 10524 Euclid Avenue #1155A, Cleveland, OH 44106, USA.
| | - Hilary L Surratt
- Center for Health Services Research, Department of Internal Medicine, University of Kentucky, 740 South Limestone Avenue, Lexington, KY 40536, USA.
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Kubicek K, McDavitt B, Carpineto J, Weiss G, Iverson EF, Kipke MD. Making Informed Decisions: How Attitudes and Perceptions Affect the Use of Crystal, Cocaine, and Ecstasy among Young Men Who Have Sex with Men. JOURNAL OF DRUG ISSUES 2016; 37:643-674. [DOI: 10.1177/002204260703700308] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although the use of illicit substances, particularly those commonly categorized as “club drugs”, among men who have sex with men (MSM), is well established in the literature, little is known about the decision making process that is used in deciding whether or not to use a particular substance. In this study, we examine the positive and negative attitudes and perceptions among young men who have sex with men (YMSM) in regards to three specific drugs: crystal methamphetamine, cocaine, and ecstasy. The findings reported here emerged from the baseline quantitative interviews and an accompanying qualitative phase of the Healthy Young Men's study (HYM), a longitudinal study examining risk and protective factors for substance use and sexual risk among an ethnically diverse sample of YMSM. Findings are discussed in relation to framing how service providers and others can design new and innovative interventions to prevent young men from initiating substance use.
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7
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May AL, Parrott AC. Greater sexual risk-taking in female and male recreational MDMA/ecstasy users compared with alcohol drinkers: a questionnaire study. Hum Psychopharmacol 2015. [PMID: 26216562 DOI: 10.1002/hup.2432] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
AIMS Previous studies have shown increased sexual risk-taking in experienced MDMA/ecstasy users. The main objectives of this study were to compare levels of sexual risk-taking between a young student sample of predominantly heterosexual MDMA users and alcohol-drinker controls and investigate potential gender differences. METHODS Recreational drug use and sexual risk questionnaires were completed by 20 MDMA users (10 females, 10 males) and 20 non-user controls (10 females, 10 males). They were predominantly university students, aged between 20-22 years, mainly heterosexual (n = 37), with three bisexual participants. RESULTS MDMA users displayed significantly greater levels of sexual risk-taking than the alcohol-drinker controls. It involved significantly higher rates of casual sex, non-condom use during sex, and penetrative sexual risks. This increase in sexual riskiness occurred to a similar extent in males and females. CONCLUSIONS These findings indicate that both female and male ecstasy/MDMA users reported more risky sexual behaviours, than the non-user controls. Further research into the sexual behaviour and sexual risk-taking of heterosexual MDMA users should be conducted because much of the past literature has focused on homosexual participants.
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Affiliation(s)
- Aimee L May
- Department of Psychology, Swansea University, Swansea, UK
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8
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Ding Y, He N, Detels R. Adolescent Sexual Debut and Initiation into New-Type Drug Use among a Sample of Young Adults. J Psychoactive Drugs 2015; 47:182-6. [PMID: 26098832 DOI: 10.1080/02791072.2015.1049725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We examined the association between adolescent sexual debut and age at new-type drug initiation among a sample of young adult new-type drug users. A total of 276 participants were recruited using respondent-driven sampling (RDS) in Shanghai, China. The analyses were restricted to a total of 201 participants aged between 18 and 30 years. The average age at sexual debut and age at first new-type drug use were 18.8 and 20.9 years, respectively. About 94% of participants reported having sexual experience (n=188); of those, 137 (72.9%) had sexual debut before they first used new-type drugs, while 32 (17.0%) initiated both events at the same age. After adjustment for age, income, education, and sexual orientation, adolescent sexual debut was independently associated with younger age at new-type drug initiation. Adolescent sexual debut is associated with early onset of new-type drug use. Our findings underscore the importance of implementing sex-education programs for adolescents in schools in China.
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Affiliation(s)
- Yingying Ding
- a Lecturer, Department of Epidemiology , School of Public Health, and The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University , Shanghai , China
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9
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Sexual risk behaviors among club drug users in Shanghai, China: prevalence and correlates. AIDS Behav 2013; 17:2439-49. [PMID: 23247360 DOI: 10.1007/s10461-012-0380-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We surveyed 276 club drug users in Shanghai, China. Overall, 43.8 % reported ≥2 sex partners in the past 30 days, and 48.9 % reported having sex with non-regular partners, 67.4 % of whom had unprotected sex. Having ≥2 recent sex partners was associated with being 35 years or older, male, living with friends or others, introduced to club drug use by non-regular sex partners, using methamphetamine recently, self-identified as gay/lesbian or bisexual, had sexual debut before 20 years old, and recently had sex under the influence of drugs. Having unprotected sex with non-regular partners in the past 30 days was associated with lower education levels, having sex to obtain drugs, and lower levels of HIV/AIDS knowledge. Club drug users should be targeted for intervention programs. Future research needs to identify other protective and risk factors for sexual risk behaviors and design interventions to reduce club drug use and associated sexual risk behaviors.
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10
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Hittner JB, Schachne ER. Meta-analysis of the association between ecstasy use and risky sexual behavior. Addict Behav 2012; 37:790-6. [PMID: 22424824 DOI: 10.1016/j.addbeh.2012.02.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 02/08/2012] [Accepted: 02/27/2012] [Indexed: 11/19/2022]
Abstract
A random-effects meta-analysis was conducted to examine the association between ecstasy use and risky sexual behavior. Analysis of 17 studies revealed a small to moderate sized effect (mean weighted r=0.211, 95% CI: 0.085-0.336). Random-effects homogeneity testing was non-significant, thus formal moderator analyses were not performed. Moreover, numerical and visual diagnostics suggested that publication bias was not a concern. It is hoped that the present meta-analytic findings and recommendations will encourage investigators to broaden their research methodologies and will stimulate new insights into the association between ecstasy use and risky sexual behavior.
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Affiliation(s)
- James B Hittner
- Department of Psychology, College of Charleston, SC 29424, USA.
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11
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Pechansky F, Remy L, Surratt HL, Kurtz SP, Rocha TBM, Von Diemen L, Bumaguin DB, Inciardi J. Age of Sexual Initiation, Psychiatric Symptoms, and Sexual Risk Behavior among Ecstasy and LSD Users in Porto Alegre, Brazil: A Preliminary Analysis. JOURNAL OF DRUG ISSUES 2011; 41:217. [PMID: 22287797 PMCID: PMC3266349 DOI: 10.1177/002204261104100204] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Ecstasy and LSD use is widespread in large Brazilian cities, but there is limited information on their use among young, middle-class, club goers in Brazil. We conducted standardized face-to-face interviews with 200 male and female ecstasy and/or LSD users, focusing on drug use and sexual history, current risk behaviors, and psychiatric symptomatology. Participants with early sexual debut (before 14) were more likely to report lifetime use of marijuana and powder and crack cocaine than those with later sexual initiation. Early sexual debut was associated with past year sexual risk behaviors, including having sex while high (Prevalence Ratio (PR)=1.3), having two or more sex partners (PR=1.3), as well as history of sexual abuse (PR=13.6). Depression and anxiety scores were similar by age of sexual initiation. The implications of these findings are discussed.
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12
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Wu ZH, Grady JJ, Rosales S, Berenson AB. Ecstasy use and its correlates among young, low-income women. Subst Use Misuse 2011; 46:404-10. [PMID: 20735212 DOI: 10.3109/10826084.2010.501680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We examined the association of illicit drug use with stress and sexual behaviors among 407 women, aged 18?31, who attended family-planning clinics in southeast Texas between June 2002 and May 2003 (n = 407). Paired comparisons of each of three types of drug users (of ecstasy, marijuana only, and other illicit drugs except ecstasy) with nonusers were assessed by logistic regressions. After controlling for demographics, both ecstasy users and marijuana-only users had a higher score on the stress scale than nonusers. All drug users were at higher risk of more lifetime sexual partners than those who had never used drugs, while those who had used ecstasy were more than twice as likely to have had prior sexually transmitted infections as those who had never used drugs. This study demonstrates that young, low-income women who use ecstasy experience higher levels of stress than nonusers. Stress level is correlated with drug use and participation in risky sexual behaviors. If stress is associated with drug use and risky sexual behavior, interventions designed to reduce substance use and risky sexual behavior in these women may need to also address factors that lead to increased stress. The study's limitations were noted.
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Affiliation(s)
- Zhao Helen Wu
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas 77555-0587, USA.
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Abstract
This study examines the role that self-esteem plays in HIV-related risk taking among users of the drug, Ecstasy. The first part of the analysis focuses on the relationship of self-esteem to HIV risk-taking. The second part examines predictors of self-esteem in this population. Conducted between 2002 and 2004, the research is based on a sample of 283 young adult Ecstasy users who completed approximately two-hour-long, face-to-face interviews via computer-assisted structured interviews. Study participants were recruited in the Atlanta, Georgia metropolitan area using targeted sampling and ethnographic mapping. Results indicated that self-esteem is associated with a variety of risky practices, including: the number of sex partners that people had, individuals' likelihood of having multiple sex partners, the number of different illegal drugs people used, and their condom use self-efficacy. The multivariate analysis conducted to ascertain the factors that impact participants' levels of self-esteem yielded six factors: educational attainment (positive), coming from a family-of-origin whose members got along well (positive), the extent of alcohol problems (negative), the number of positive effects experienced as a result of Ecstasy use (positive), the number of negative effects experienced as a result of Ecstasy use (negative), and the extent of experiencing symptoms of post-traumatic stress disorder (negative).
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Emory University, Atlanta, GA, USA.
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Abstract
Club drug use and correlates were examined among 251 Hispanic college students on the Texas-México border. Participants completed questionnaires on substance use, club drug attitudes and beliefs, sexual risk-taking behaviors, depressive symptoms, and acculturation. One-quarter of participants reported club drug use. Regression analyses demonstrated that frequency and history of lifetime use were consistently associated with more permissive drug attitudes and other substance use but not sexual risk-taking, depression symptoms, or acculturation. Acculturation was negatively associated with frequency of club drug use, yet positively associated with use of other illicit substances. Avenues for future studies are suggested.
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Affiliation(s)
- Michelle R Resor
- Department of Psychology, The University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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Perrone D. Gender and sexuality in the field: a female ethnographer's experience researching drug use in dance clubs. Subst Use Misuse 2010; 45:717-35. [PMID: 20222781 DOI: 10.3109/10826081003595127] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This article provides an account of a female ethnographer's experience accessing participants and observing drug-using behaviors in highly sexualized dance clubs. Specifically, it describes how the researcher as a gendered and sexualized self can compromise safety and inhibit access while also serving as an advantage to establishing rapport. The author describes how various methods were employed to appear as part of the cultural scene and access participants, while avoiding, and responding to, unwanted sexual advances. To address such challenges, the author provides both practical and procedural suggestions for researchers and research institutions.
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Affiliation(s)
- Dina Perrone
- Department of Criminal Justice, Bridgewater State College, Bridgewater, Massachusetts 02325, USA.
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Klein H, Elifson KW, Sterk CE. Young adult Ecstasy users' enhancement of the effects of their Ecstasy use. J Psychoactive Drugs 2009; 41:113-20. [PMID: 19705673 DOI: 10.1080/02791072.2009.10399904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examines drug effect-enhancing behaviors practiced by young adult users of the drug, Ecstasy. Between August 2002 and August 2004, 283 face-to-face interviews were conducted with active Ecstasy users. Study participants were recruited in the Atlanta, Georgia metropolitan area using a targeted sampling approach. The large majority of study participants (87%) engaged in at least one behavior specifically designed to bolster the effects of their Ecstasy use, with 61% of the study participants reporting having engaged in at least three such behaviors during the past 30 days. Taking steps to boost one's Ecstasy-related high was associated with binging on Ecstasy and a variety of adverse outcomes, such as experiencing a greater number of negative consequences resulting from Ecstasy use and experiencing more Ecstasy-related drug dependency symptoms. Multivariate analysis revealed several factors associated with greater involvement in effects-boosting behaviors, including race (not being African American), spending time with other drug users, using Ecstasy for its touch-enhancing qualities, enjoyment of the music-and-Ecstasy-use experience, and childhood maltreatment experiences. The implications of these findings for treatment, prevention, and intervention for drug problems among Ecstasy users are discussed.
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Affiliation(s)
- Hugh Klein
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Bohnert ASB, Tracy M, Galea S. Circumstances and witness characteristics associated with overdose fatality. Ann Emerg Med 2009; 54:618-24. [PMID: 19540622 DOI: 10.1016/j.annemergmed.2009.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 04/22/2009] [Accepted: 05/05/2009] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE Emergency physicians have an opportunity to provide overdose fatality prevention interventions to individuals at risk for experiencing or witnessing an overdose to reduce fatality. The present study uses data about the most recent overdose observed by a sample of inner-city drug users to determine the circumstances of overdose that are associated with overdose fatality. METHODS Participants (n=690) aged 18 years or older were recruited with targeted street outreach. All participants had used heroin or cocaine in the previous 2 months and had witnessed at least 1 overdose. Survey data included the circumstances of the last overdose witnessed, including actions taken, drug use behavior, the location of the event, and whether or not the overdose was fatal (the outcome measure). RESULTS One hundred fifty-two (21.7%) of the witnessed overdoses were fatal. Witness powdered cocaine use (adjusted odds ratio=1.6; 95% confidence interval [CI] 1.0 to 2.6) and injection drug history (adjusted odds ratio=0.5; 95% CI 0.3 to 0.9) were associated with the last witnessed overdose being fatal. Witnessed overdoses that occurred in public or abandoned buildings compared with homes were more likely to be fatal (adjusted odds ratio=1.9; 95% CI 1.0 to 3.5), as were overdoses in which witnesses sought outside medical help (adjusted odds ratio=1.5; 95% CI 1.0 to 2.1). CONCLUSION Future prevention interventions may fruitfully target users of powdered cocaine, drug users without a history of injecting, and individuals who use drugs in public or abandoned buildings for brief interventions on responding when witnessing an overdose to reduce mortality.
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Affiliation(s)
- Amy S B Bohnert
- VA National Serious Mental Illness Treatment Research and Evaluation Center, Ann Arbor, MI 48105, USA.
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Chintalova-Dallas R, Case P, Kitsenko N, Lazzarini Z. Boltushka: a homemade amphetamine-type stimulant and HIV risk in Odessa, Ukraine. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2008; 20:347-51. [PMID: 18976896 DOI: 10.1016/j.drugpo.2008.09.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2008] [Revised: 09/03/2008] [Accepted: 09/08/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND Homemade amphetamine-type stimulants (ATSs) have been reported in Russia and Eastern Europe for decades. Recipes differ geographically and over time producing differing active ingredients. Vint and jeff (active ingredients methamphetamine and methcathinone, respectively) are two such homemade ATSs originally produced from over-the-counter cold medications and household chemicals. METHODS During a Rapid Policy Assessment and Responses (RPAR) project in Odessa, Ukraine, researchers found use of boltushka, a novel homemade ATS. Fourteen supplemental qualitative interviews were conducted, including ten interviews with boltushka injectors and four interviews with pharmacists. We report patterns of boltushka use among local injection drug users (IDUs) as well as the role of laws, regulations, and current pharmacy practices. RESULTS Legal restrictions on over-the-counter cold medicines in Ukraine led to products containing phenylpropanolamine (PPA), which oxidised with KMnO(4) (potassium permanganate), produces a weak ATS, cathinone, called boltushka. Boltushka's ingredients are easily available in pharmacies or on the black market. IDUs reported a mean age at first use of 16 years old (range 12-21). While published data are scant, anecdotal evidence reported here include amphetamine-like effects on energy and appetite, binging patterns of use, and some reports of shaking and other neurological damage consistent with earlier reports from exposure to KMnO(4). Users reported sharing syringes and other non-sterile injection practices. No users reported specific treatment or prevention programs for boltushka users. CONCLUSIONS Although Ukrainian government regulations have limited access to precursor chemicals, IDUs have continued to make and use boltushka. The actual extent and demographics of boltushka use are unknown. Besides risk of bloodborne disease, the health effects of injected homemade ATSs and their constituent chemicals are poorly documented. Interventions beyond available harm reduction efforts may be required. Education/treatment specific to boltushka users and screening for other physical harms are critical interventions.
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Elifson KW, Klein H, Sterk CE. Condom Use Self-Efficacy among Young Adult Ecstasy Users. JOURNAL OF DRUG ISSUES 2008. [DOI: 10.1177/002204260803800403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Relying upon a sample of 283 young adult ecstasy users, this research examines three primary research questions: How high/low are young adult ecstasy users' levels of condom use self-efficacy? How does condom use self-efficacy relate to actual condom use in this population? What factors underlie condom efficacy levels in this population? The study entailed face-to-face interviews that were completed with the use of computer-assisted structured interviews (i.e., CASI). Study participants were recruited in the Atlanta, Georgia metropolitan area between August 2002 and August 2004 using a targeted sampling and ethnographic mapping approach. Interviews took approximately two hours to complete. Condom use self-efficacy levels were found to be fairly high in this population. A strong, direct relationship was observed between condom use self-efficacy and actual condom use. Using a multiple regression approach, five factors were found to be predictive of greater condom use self-efficacy in this population. These were educational attainment, amount of communication in one's family of origin, having asked about one's most recent casual sex partner's HIV serostatus, no prior drug treatment, and level of self-esteem.
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Jacinto C, Duterte M, Sales P, Murphy S. “I'm Not a Real Dealer”: The Identity Process of Ecstasy Sellers. JOURNAL OF DRUG ISSUES 2008. [DOI: 10.1177/002204260803800203] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We present findings from a qualitative study of 80 women and men who sold Ecstasy in private settings. In this paper we explore Ecstasy sellers' identity processes and pathways to dealing. Interviewees believed “real dealers” sold in public settings to people they did not know and relied on drug sales as their main source of income. We found that 76% of the sample resisted the dealer identity due to the stigma associated with dealing, Ecstasy's benign reputation, selling in private settings, and customer bases that comprised mainly friends. The majority of the sample “drifted” into dealing and did not consciously decide to sell. Additionally, most interviewees did not implement precautionary sales strategies that characterize drug dealing operations described in our own and other investigators' research on drug markets. Ecstasy sellers created new, more positive identity constructions for themselves, which is also an important focus of this paper.
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Abstract
Résumé
De nombreux travaux ethnologiques et psychologiques ont porté sur les répercussions des usages de drogues et, plus récemment, des médicaments sur les fonctions sexuelles. Nous présentons dans cet article les principales dimensions dégagées sur cette question. Dans un premier temps, les substances aphrodisiaques principales sont envisagées à partir des perspectives ethnologiques et expérimentales. Cette recension montre la diversité des contextes et des produits employés, de même que la variabilité des effets. La seconde section porte sur les drogues de synthèse contemporaines, à leurs contextes d’utilisation ainsi qu’aux conséquences sur la sexualité et la prise de risques face aux infections transmissibles sexuellement (ITS) et au VIH/sida. La troisième partie porte sur les développements pharmacologiques qui modulent la fonction sexuelle de même que sur les usages détournés des médicaments à des fins sexuelles récréatives. Ce survol des recherches contemporaines met en évidence la place importante de l’érotisme dans la consommation des différentes substances et l’intérêt de développer un programme d’études plus précis dans ce domaine.
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Affiliation(s)
| | - Catherine Garnier
- Professeure associée, Directrice du Programme CRSH Grands Travaux sur la chaîne des médicaments, Université du Québec à Montréal
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