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

High ambient temperature facilitates the acquisition of 3,4-methylenedioxymethamphetamine (MDMA) self-administration

RATIONALE

MDMA alters body temperature in rats with a direction that depends on the ambient temperature (T_A). The thermoregulatory effects of MDMA and T_A may affect intravenous self-administration (IVSA) of MDMA but limited prior reports conflict.

OBJECTIVE

To determine how body temperature responses under high and low T_A influence MDMA IVSA.

METHODS

Male Sprague-Dawley rats were trained to IVSA MDMA (1.0mg/kg/infusion; 2-h sessions; FR5 schedule of reinforcement) under T_A 20°C or 30°C. Radiotelemetry transmitters recorded body temperature and activity during IVSA.

RESULTS

MDMA intake increased under both T_A during acquisition, but to a greater extent in the 30°C group. The magnitude of hypothermia was initially equivalent between groups but diminished over training in the 30°C group. Within-session activity was initially lower in the 30°C group, but by the end of acquisition and maintenance, activity was similar for both groups. When T_A conditions were swapped, the hot-trained group increased MDMA IVSA under 20°C T_A and a modest decrease in drug intake was observed in the cold-trained group under 30°C T_A. Subsequent non-contingent MDMA (1.0-5.0mg/kg, i.v.) found that rats with higher MDMA IVSA rates showed blunted hypothermia compared with rats with lower IVSA levels; however, within-session activity did not differ by group. High T_A increased intracranial self-stimulation thresholds in a different group of rats and MDMA reduced thresholds below baseline at low, but not high, T_A.

CONCLUSIONS

High T_A appears to enhance acquisition of MDMA IVSA through an aversive effect and not via thermoregulatory motivation.

Motivations for Selling Ecstasy among Young Adults in the Electronic Dance Music Club Culture in Brazil

This article describes data on the motivations for selling ecstasy among young adults in the electronic dance music (EDM) club culture in Brazil. Individual interviews were conducted with 20 individuals recruited for their involvement in the EDM club scene. Eligible participants were aged 18-39 and reported ecstasy and/or LSD use one or more times in the past 90 days. Exclusion criteria included current treatment for drug/alcohol problems and cognitive impairment or clinically evident psychiatric disorder. Mean age was 22.92 (SD 2.77), 60% were male, 45% reported 12 or more years of education, 50% did not have a primary partner, 50% were living alone, and all had friends who also used ecstasy. Three main themes emerged: (1) "easy" transition from ecstasy user to seller; (2) desire to achieve popularity and fame; and (3) need to sell ecstasy to maintain the high cost of EDM club scene participation. This is one of the first studies of ecstasy sellers in Brazil. The results demonstrate the ease with which the participants transition from ecstasy user to seller. Given the potential health and social dangers associated with ecstasy use, public health campaigns to prevent ecstasy use and policy initiatives to limit the ecstasy supply are warranted.

Association of ecstasy seizure rates with district Human Development Index in the municipality of São Paulo, Brazil, from 2000 to 2007

This study aimed to analyze whether ecstasy consumption is associated with the socioeconomic status in the Municipality of São Paulo, Brazil, from 2000 to 2007. We used an official, reliable and unbiased source supplied by the Department of Narcotics of the State of São Paulo (Denarc) database and the Human Development Index of the districts (HDId) where the seizures occurred. A Spearman correlation test between the average number of ecstasy seizures per million of inhabitants with the HDId was used. There were 190 seizures (totaling 47,934 tablets) spread out in 53 of the 96 districts and 51.6% were concentrated in only 8 districts. The higher rates of ecstasy seizures were directly associated with districts with high HDId that confirmed the association of ecstasy consumption with the socioeconomic status. Itaim-Bibi, Jardim Paulista and Moema were the top three districts with the highest HDId. In these districts, the number of tablets per seizure ranged from as few units to thousands, revealing that not only consumption but also traffic coexist at the same place. Districts with many nightclubs can also influence the incidence of seizures. This knowledge can be useful to help the police from other Brazilian cities to combat ecstasy trafficking.

Self-reported prevalence of dependence of MDMA compared to cocaine, mephedrone and ketamine among a sample of recreational poly-drug users

BACKGROUND

Evidence regarding MDMA (ecstasy) dependence and the most suitable criteria for its assessment are controversial. This study aimed to assess the prevalence of last year symptoms of dependence upon MDMA compared to cocaine, mephedrone and ketamine among a large global non-treatment seeking sample.

METHODS

A cross-sectional anonymous online survey was promoted by a UK-based dance music website between 15 November 2010 and 1 January 2011. Endorsement of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) dependence criteria was sought from all last year users of MDMA, cocaine, mephedrone and ketamine. Reporting ≥3 dependence symptoms was indicative of dependence. Logistic regression models with Generalized Estimating Equations were used to compare dependence symptoms between groups.

RESULTS

MDMA users were more likely to report ≥3 DSM-IV dependence symptoms compared to users of cocaine (odds ratio OR 0.81, 95% confidence interval CI 0.71-0.93), mephedrone (OR 0.91, 95%CI 0.78-1.06) and ketamine (OR 0.52, 95%CI 0.44-0.62) (p<0.001). MDMA users were less likely to report desire to use less or get help compared to users of other substances (p<0.001). MDMA got the highest rating of pleasurable high (mean 8.2±1.7) and lowest rating for risk of harm (mean 2.7±2.4).

CONCLUSIONS

Our results highlight the self-reported dependence potential of MDMA but low desire to use less or get help. MDMA's pleasurable effects may compensate for drug-related problems and, therefore, DSM-IV criteria may not be suitable for assessing MDMA dependence. Further research is needed on the ability of DSM-V to assess MDMA dependence.

Correlates of unprotected sex in a sample of young club drug users

OBJECTIVES

To assess the demographic characteristics, psychiatric symptoms, substance use patterns, and sexual risk behaviors in a sample of club drug users to identify factors associated with unprotected sex during the 12 months prior to the interview.

METHODS

This cross-sectional study employed the targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals using an adapted, semi-structured version of the Global Appraisal of Individual Needs questionnaire. The sample comprised 240 male and female young adults who had used ecstasy and/or LSD in the 90 days prior to the interview and who were not receiving treatment for alcohol or drug abuse.

RESULTS

Of the 240 subjects selected (mean age: 22.9±4.5 years), 57.9% were men; of the male subjects, 52.5% reported having had unprotected sex in the previous 12 months. Of the total sample, 63.33% reported having had unprotected sex. Multivariate regression analysis showed that anal sex (PR = 1.26; 95% confidence interval (CI): 1.044-1.543; p = 0.017) and the use of alcohol/drugs to make sex last longer (PR = 1.430; 95% CI: 1.181-1.732; p<0.001) are associated with unprotected sex.

CONCLUSIONS

The implementation of intervention strategies aimed at reducing sexually risky behaviors should take into consideration the specific characteristics of drug users and should include the development of safer sex negotiation skills.

Effects of a community prevention intervention on public awareness, knowledge, and risk perception of club drug use by youth in Taiwan

This study evaluated the effects of mobilizing community coalitions and implementing prevention intervention concerning public awareness, knowledge, and perception of the risks associated with club drug use by Taiwanese urban youth. A quasi-experimental design was used. Three communities in Taipei city were included in the present study. A total of 328 residents successfully participated in the baseline survey (April 2008), and 276 residents were successfully interviewed for the follow-up survey (September 2008). The generalized estimating equation (GEE) method was used. The percentage of the intervention respondents who reported having seen or heard antidrug messages increased significantly between the time of the baseline survey (63.7%) and the follow-up survey (77.4%), while the percentage of attendance at antidrug events increased from 23.1% to 38.7% during the same time interval. In addition, community knowledge and perception of the problem of club drug use by youth rose significantly between the baseline and the follow-up in the intervention communities. The study's limitations are noted.