Reflections on the development and implementation of an early warning system for ecstasy and related drug markets in Australia

Exploring the use of drug trend data in the regional alcohol and other drug workforce

OBJECTIVE

Drug trend data can inform appropriate policies to minimise drug-related harm, as well as assist in early detection and prevention. While Australia has a number of monitoring systems, none operate in regional areas. The aim of this study was to explore how drug trend and other data are used by the regional alcohol and other drug workforce.

METHOD

Twenty-one key experts from regional Queensland were interviewed between November 2014 and August 2015. Key experts worked in or had contact with the broader alcohol and other drugs field in the Darling Downs area of Queensland. Interviews were analysed thematically.

SETTING

Darling Downs, Queensland.

RESULTS

Two themes emerged from the analysis. There were differences in workforce needs, with those in the law and criminal justice areas believing they had access to good, current data. Those in the health sector differed, although the majority indicated that there did appear to be a knowledge gap related to their location in a regional area.

CONCLUSIONS

Trends in the use of, and harms related to, substance use are well captured in urban areas, but less so in regional areas. This inhibits both our understanding of where substance use is changing, as well as how to best plan and respond.

Reasons for not using ecstasy: a qualitative study of non-users, ex-light users and ex-moderate users

Background

Although ecstasy is often consumed in the electronic music scene, not everyone with the opportunity to use it chooses to do so. The objective of this study was to understand the reasons for non-use or the cessation of use, which could provide information for public health interventions.

Methods

A qualitative reference method was used. Our “snowball” sample group consisted of 53 people who were split into three subgroups: non-users (NU, n = 23), ex-light users (EX-L, n = 12) and ex-moderate users (EX-M, n = 18). Individual, semi-structured interviews were conducted, transcribed and subjected to content analysis with the aid of NVivo8.

Results

Adverse health effects and personal values were given as reasons for non-use in the three groups. Non-users (NU) and ex-light users (EX-L) provided reasons that included fear of possible effects as well as moral, family and religious objections. Ex-moderate users (EX-M) cited reasons related to health complications and concomitant withdrawal from the electronic music scene. However, most of the ex-moderate users did not rule out the possibility of future use.

Conclusions

Potential effects and undesirable consequences appear to guide the decisions within the different groups. Prevention might target these motivations. Individuals who have used ecstasy indicate that social and environmental factors are the most important factors.

The Canadian Recreational Drug Use Survey: Aims, Methods and First Results

In late 2006, pilot research was initiated in two western Canadian sites (Vancouver and Victoria) to systematically monitor patterns and trends in three specific illicit drug user populations: club and rave party attendees, adolescent street involved injection and non-injection drug users, and adult injection drug users. These sentinel groups were selected because of elevated rates of alcohol and other drug use within these populations and contexts, and the high levels of associated risks and harms. Drawing from international monitoring and surveillance systems, novel research instruments were developed for each population and were administered in face-to-face interviews at each study site. This paper presents an overview of the broad research methodology for the “high risk” monitoring research as well as select findings for the “club drug” sample. The piloted research design yielded high quality data, particularly in relation to recent patterns of drug use behaviour (items on drug use “yesterday” and “last weekend”). The success of these novel items highlights the value of the present study and its relevance for similar studies across the country.

The Australian Illicit Drug Reporting System: Monitoring Trends in Illicit Drug Availability, Use and Drug-Related Harm in Australia 1996–2006

We describe trends in illicit drug use revealed by the Australian Illicit Drug Reporting System (IDRS) between 1996 and 2006. We begin by briefly outlining the rationale, development, and testing of the IDRS, which integrates information from: interviews with a sentinel population of injecting drug users (IDU); key experts in health and law enforcement; and indicators that include information on drug purity and price, plus indicators of drug-related harm, such as fatal and nonfatal overdoses. These sources of information are critically discussed at annual meetings of researchers, policy makers and practitioners in the field. We describe what the IDRS has revealed about the use of heroin, cocaine, methamphetamines, and injected pharmaceutical preparations (opioids and benzodiazepines) over the period 1996–2006. We also illustrate how IDRS data can be combined with pharmaceutical prescription data to evaluate the effectiveness of policies designed to reduce benzodiazepine injecting. We also very briefly describe recent experience with monitoring trends on “dance party” drug use that extends the methods of IDRS by combining data from interviews with party drug users, key experts, and leading indicators of drug use.

Patterns of ecstasy use and associated harm: results of a Brazilian online survey

The aim of this study was to gather information about ecstasy users in Brazil, particularly on issues related to risks associated to the use of the drug, so as to offer a basis to prevention projects. A total of 1,140 Brazilian ecstasy users answered an online questionnaire from August 2004 to February 2005. Participants were predominantly young single heterosexual well-educated males from upper economical classes. A categorical regression with optimal scaling (CATREG) was performed to identify the risks associated with ecstasy use. "Pills taken in life" had a significant correlation with every investigated risk, particularly ecstasy dependence, unsafe sex, and polydrug use. "Gender," "sexual orientation," and "socioeconomic class" were not predictive of risk behavior. The Internet proved to be a useful tool for data collection. Given the recent increase in ecstasy availability in Brazil, a first prevention campaign directed toward the drug is urgent. At least in a preliminary Brazilian intervention, the campaign must be conducted at night leisure places, mainly frequented by youngsters from upper socioeconomic classes. The results do not call for information material with specific targets, such as gender or sexual orientation. The study's limitations have been noted.

The epidemiology of methamphetamine use and harm in Australia

INTRODUCTION AND AIMS

There has been considerable media attention recently upon possible increases in methamphetamine use in Australia. Much of this debate has focused upon extreme cases of problematic crystal methamphetamine use, without reference to the broader population context. This paper provides data on methamphetamine use in Australia, and documents trends in methamphetamine-related harms.

DESIGN AND METHODS

Data used were from: (1) Australian Customs Service drug detections; (2) Australian Crime Commission drug seizure, arrest and clandestine laboratory detections data; (3) National Drug Strategy Household Survey (NDSHS) and Australian Secondary Student Alcohol and Drug Survey (ASSADS); (4) data from the Illicit Drug Reporting System (IDRS) and Ecstasy and related Drug Reporting System (EDRS); and (5) data from NSW Emergency Department Information System, National Hospital Morbidity Database and Australian Bureau of Statistics causes of death databases.

RESULTS

There appears to have been an increase in both importation and local manufacture of meth/amphetamine. Population data show that meth/amphetamine use remains low and stable. However, clear increases in crystal methamphetamine use have occurred among sentinel groups of regular drug users. Frequent crystal use among regular injecting drug users is associated with earlier initiation to injecting, greater injection risk behaviours and more extensive criminal activity. In recent years, indicators of meth/amphetamine-related harm have stabilised, following steady increases in earlier years.

DISCUSSION AND CONCLUSIONS

Some methamphetamine users experience significant problems related to their use; harms are particularly prevalent among regular IDU. Methamphetamine users, however, are a diverse group, and strategies need to be appropriately targeted towards different kinds of users.