Correlates of ecstasy use in the Swedish general population

Shifts in Drug Use Behavior Among Electronic Dance Music Partygoers in New York During COVID-19 Social Distancing

Background: Little is known about how COVID-19-related social distancing has affected illegal drug use. We surveyed electronic dance music (EDM) partygoers-a population known for high levels of drug use-to determine whether their drug use patterns had changed during state-mandated social distancing in New York. Methods: Individuals were recruited online and screened for eligibility throughout April and May 2020. We surveyed 128 eligible adults and queried, retrospectively, whether their drug use behavior had changed during COVID-19-related social distancing. Results: Most participants reporting past-three-month use reported decreased frequency of use during COVID-19-related social distancing. Specifically, 78.6% reduced frequency of use of cocaine, 71.1% reduced frequency of use of ecstasy/MDMA/Molly, and 68.0% reduced frequency of use of LSD. Although some participants reported increased frequency of use of cocaine (7.1%), ecstasy (7.9%), or LSD (12.0%), 35.0% reported increased frequency of cannabis use. Most (66.7%) of those reporting cocaine use reduced the amount used. The majority of those reporting use of cannabis, ecstasy, cocaine, and/or LSD reported that drug cost (80.0-84.0%) and drug quality (84.2-92.0%) did not change during social distancing. Having a college degree was associated with higher odds for decreasing frequency of cannabis use. Older participants (ages ≥23) were at lower odds for decreasing frequency of cocaine use, as were those earning >$500 per week, and participants who attended EDM events biweekly or more often were at higher odds for decreasing frequency of LSD use. Conclusions: Participants in this sample tended to reduce party drug use during COVID-19-related social distancing.

Diffusion of Ecstasy in the Electronic Dance Music Scene

Ecstasy (MDMA, Molly) is among the most prevalent drugs used by people who attend electronic dance music (EDM) events; however, little recent research has examined diffusion of ecstasy in this high-risk population. Methods: 1,020 EDM event-attending adults (aged 18-40) were surveyed in NYC in 2018 using time-spacing sampling. Participants were asked about past-year ecstasy use, and those reporting use were asked where they initiated use and whether their first use was planned. They were also asked whether they have ever given someone their first dose and whether they were likely to use in the future. Prevalence and correlates of these outcomes were estimated among those reporting past-year use. Results: An estimated 31.0% of participants used ecstasy in the past year. Of these, 42.9% used ecstasy for the first time in an unplanned manner and initiation most commonly occurred at EDM festivals (33.4%), followed by nightclubs (24.3%). An estimated 39.4% reported having given someone their first dose of ecstasy and 60.2% reported being likely to use again. Hispanic and Asian participants were at higher risk for their first dose being unplanned, and those who used LSD in the past year were at higher risk for giving someone their first dose (aPR = 1.78, 95% CI = 1.20-2.65). Older participants (aPR = 1.03, 95% CI = 1.01-1.06), females (aPR = 1.46, 95% CI = 1.13-1.89), and those who used LSD in the past year (aPR = 1.42, 95% CI = 1.14-1.76) were more likely to report being likely to use again in the future. Conclusions: Results provide insight regarding diffusion and initiation of ecstasy in the EDM scene. Findings can inform prevention and harm reduction efforts.

Attitudes and Beliefs About New Psychoactive Substance Use Among Electronic Dance Music Party Attendees

BACKGROUND

Attitudes and beliefs about drug use have been shown to be robust correlates of use of drugs such as alcohol, marijuana, and cocaine; however, little is known regarding attitudes or beliefs about new psychoactive substances (NPS). We sought to examine attitudes and beliefs about NPS and how they relate to self-reported use in a high-risk population-electronic dance music (EDM) party attendees.

METHOD

1,048 individuals (age 18-40) were surveyed entering EDM parties in New York City in 2016. We queried lifetime use and attitudes and beliefs specific to NBOMe, 2C series drugs, "bath salts" (synthetic cathinones), tryptamines, dissociative NPS, and synthetic cannabinoids.

RESULTS

More than half the sample reported being unfamiliar with NPS other than "bath salts" and synthetic cannabinoids. "Bath salts" received the highest ratings of strong disapproval (34.3%), followed by synthetic cannabinoids (23.3%), compared to other NPS (10-14%). "Bath salts" were perceived to be a great risk by 43.1% of the sample, followed by synthetic cannabinoids (27.0%), and other NPS (12-16%). "Bath salts" were reportedly least likely to be used if offered (2.9%). In multivariable models, reporting no disapproval towards use was associated with increased odds of reporting use of 2C drugs, "bath salts", and tryptamines. Having friends who use and reporting intent to use or willingness to use if offered were also associated with use of various NPS classes.

CONCLUSIONS

This study delineated attitudinal and belief-related correlates of use of various NPS classes. Results can inform prevention effects as NPS continue to emerge.

Self-Reported Ecstasy/MDMA/"Molly" Use in a Sample of Nightclub and Dance Festival Attendees in New York City

BACKGROUND

Ecstasy (MDMA) use has regained popularity in the United States, particularly in the form of "Molly," which is often marketed as pure MDMA. Surveys have generally not included "Molly" in the definition of ecstasy, so rates of use may be underestimated. As popularity of ecstasy increases, research is needed to examine use among those at highest risk for use-nightlife attendees.

METHODS

We surveyed 679 young adults (age 18-25) entering nightclubs and festivals holding electronic dance music (EDM) parties in New York City in 2015. A variation of time-space sampling was utilized. We examined prevalence and correlates of self-reported lifetime ecstasy use.

RESULTS

Self-reported lifetime ecstasy use was common (42.8%, 95% CI: 32.8, 52.7). Use was most common among older participants, frequent party attendees, and those reporting higher levels of exposure to users. Those surveyed outside of festivals were less likely to report use compared to those surveyed outside of nightclubs (AOR = 0.37, p = .015). Over a third of ecstasy users (36.8%)reported use in pill, powder, and crystal form. Ecstasy users were also more likely to report use of other drugs, including novel psychoactive substances (e.g., 2C series drugs, synthetic cathinones ["bath salts"]). Half (50.4%) reported suspecting (21.9%) or finding out (28.5%) that their ecstasy had ever contained a drug other than MDMA.

CONCLUSION

A large percentage of nightlife attendees in NYC report lifetime ecstasy use. Findings should inform prevention and harm reduction programming. Further research is needed as ecstasy continues to change (e.g., in form, purity, and name).

Correlates of new psychoactive substance use among a self-selected sample of nightclub attendees in the United States

BACKGROUND AND OBJECTIVES

Although new psychoactive substances (NPS) continue to emerge at a rapid rate, US national surveys only measure the use of non-specific categories of NPS and are not designed to access high-risk populations. In this paper we report lifetime use of specific NPS (of 58) and examine correlates of use among a high-risk population: nightlife attendees.

METHODS

The self-selected sample from the Global Drug Survey (2013) consisted of 2,282 respondents in the US, aged 16-60 years, who reported nightclub attendance in the last year. Multivariable logistic regression models determined unique predictors of lifetime use.

RESULTS

Lifetime use of a wide range of NPS was reported (any NPS; 46.4%), including synthetic cannabinoids (24.8%), tryptamines (eg, 4-AcO-DMT, 23.0%), psychedelic phenethylamines (eg, 2C-B, 25I-NBOMe; 21.7%), euphoric stimulants (eg, BenzoFury; 16.2%), and synthetic cathinones (eg, methylone; 10.5%). Females (AOR = 0.49 [.41, .60]) and older respondents (age 22-60; AOR = .73 [.59, .89]) were at lower odds of reporting any lifetime NPS use. Frequent nightclub attendance was associated with increased odds of reporting lifetime NPS use overall (eg, weekly compared with less than once a month, AOR = 2.33 [1.70,3.19]), but not specifically with synthetic cannabinoid use.

DISCUSSION AND CONCLUSIONS

Among a self-selected sample of nightclub attendees, a large range of novel substances were reported, and young attendees, males, and those who attended more frequently were at increased odds of reporting use.

SCIENTIFIC SIGNIFICANCE

Harm reduction initiatives are needed to reduce risk of harm in this population, where environmental characteristics may augment risks associated with consuming lesser-known psychoactive substances. (Am J Addict 2016;25:400-407).

Self-reported use of novel psychoactive substances among attendees of electronic dance music venues

BACKGROUND

Novel psychoactive substances (NPSs) continue to emerge in the United States and worldwide. Few epidemiological studies have examined the prevalence and correlates of use.

OBJECTIVE

We examined the extent of NPS use in a high-risk population-attendees of electronic dance music (EDM) parties at nightclubs and festivals.

METHODS

We surveyed 682 adults (age 18-25) entering EDM events at nightclubs and festivals in New York City (NYC) in 2015. A variation of time-space sampling was used. We examined the prevalence of self-reported use of 196 NPS and correlates of any NPS use.

RESULTS

Over a third (35.1%) of participants reported lifetime use of any NPS. Self-reported use of synthetic cannabinoids was most prevalent (16.3%), followed by psychedelic phenethylamines (14.7%; 2C series: 10.3%, 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine [NBOMe] series: 9.0%, Dox series: 3.5%), synthetic cathinones ("bath salts", 6.9%), other psychedelics (6.6%), tryptamines (5.1%), and dissociatives (4.3%). 2C-I was the most prevalent 2C series drug (5.1%); methylone was the most prevalent synthetic cathinone (3.3%), 2-MeO-ketamine was the most prevalent dissociative (3.7%), and 1P-lysergic acid diethylamide (LSD) (2.9%) was the most prevalent non-phenethylamine psychedelic. Risk factors for NPS use included Ecstasy/MDMA/Molly, LSD, and ketamine use; identifying as bisexual (compared to heterosexual), reporting higher frequency of nightclub/festival attendance, and being surveyed outside of a festival (compared to those surveyed outside of nightclubs).

DISCUSSION

NPS use is prevalent in the nightclub and festival scenes in NYC. Since individuals in these scenes-especially frequent attendees-are at high risk for use, prevention and harm reduction services need to be geared toward this population.

Non-medical prescription drug use (NMPDU) and poor quality of life in the Swedish general population

BACKGROUND AND OBJECTIVES

Quality of life has become an increasingly important measurement in the substance use field. The main aim of the present study was to examine the relationships between non-medical use of prescription analgesics and sedatives and poor quality of life in the general population.

METHODS

Data were drawn from a Swedish national household survey conducted in 2008-2009. A stratified sample of 58,000 individuals aged 15-64 was randomly selected, with a response rate of 38.3% (n = 22,095). We examined the relationships between non-medical prescription drug use and quality of life in a logistic regression analysis, controlling for other substance use and sociodemographic variables.

RESULTS

In the final logistic regression model, both non-medical use of prescription analgesics and sedatives were independently associated with poor quality of life. Non-medical use of prescription sedatives was the strongest correlate of poor quality of life among the substance use variables.

DISCUSSION AND CONCLUSIONS

The associations between non-medical prescription drug use and poor quality of life might imply a need to better identify and provide treatment for this group, especially individuals with non-medical prescription sedative use, which seems to be a particularly strong correlate of poor quality of life.

SCIENTIFIC SIGNIFICANCE

Using a large, general population sample, the present paper is one of few to examine the relationships between non-medical prescription drug use and quality of life.