Increasing Ecstasy Use Among Glasgow Drug Injectors

“Ordinary” People with “Normal” Lives? a Longitudinal Study of Ecstasy and other Drug use among Norwegian Youth

Ecstasy users have been described as “ordinary people” with “normal lives” in recent literature, but little empirical evidence exists to support this portrayal. One may assume, however, that such a rosy portrayal is more likely to fit individuals who consume drugs that are more commonly used (e.g., cannabis). With this in mind, we have explored characteristics of different categories of drug users by analyzing data from a general population study of young people in Norway (n = 2,761). Respondents were assessed three times over a period of seven years (mean age at time 3 = 21.6 years). Results showed that ecstasy users, cannabis users, and users of “traditional” hard drugs were all relatively unremarkable with respect to socio-economic characteristics. On the other hand, they all tended to have a less favorable family background than nonusers of drugs, and their rates of past and present legal substance use, mental health problems, and antisocial behavior were also much higher. Individuals who included ecstasy in their drug-taking repertoire had a somewhat more deviant profile than other drug users, indicating that their public image of being ordinary and well adjusted is highly overstated. This image did not fit “pure” cannabis users very well either.

"A costly turn on": patterns of use and perceived consequences of mephedrone based head shop products amongst Irish injectors

BACKGROUND

Mephedrone injecting has recently been reported in Romania, Slovenia, Guernsey and Ireland. The research reported here aimed to describe the experiences of a group of Irish injecting drug users, who were injecting mephedrone based headshop products prior to the introduction of legislative controls in Ireland, with particular focus on pre- and post-legislative use, effects of injecting mephedrone, settings and contexts for injecting, polydrug use and serial drug injecting, risk perceptions and harm reduction practises.

METHODS

Following a predevelopment phase with a Privileged Access Interviewer, in-depth interviews using a phenomenological approach were conducted with eleven attendees of a low threshold harm reduction service.

RESULTS

The findings describe the abuse potential of these mephedrone based headshop products when used by intravenous injection. Although participants were aware of risks and safe injecting practises, compulsive re injecting with excessive binge use over long periods of time was common. Nasal to injection route transitions, intense paranoia, violent behaviour and aggression, emergence of Parkinson type symptomatologies (in the form of spasms and 'wobbling'), and permanent numbness in lower extremities were reported. Multi and serial drug injecting with heroin was used in efforts to manage the intense rush and avoid unpleasant comedown. Participants reported limb abscesses, vein clotting, damage and recession resulting from product toxicity, crystallisation of the products when diluted and flushing practises. Seven participants were homeless, with groin and street injecting common. Following legislative changes use of mephedrone products declined due to closure of headshops, increased street prices, concerns around contamination and the emergence of new street stimulant drugs.

CONCLUSION

Continued monitoring of drug displacement patterns in post legislative time frames is advised, alongside longitudinal ethnographic research to track the diffusion of mephedrone and other cathinone derivatives within injecting networks. Further investigation of the adverse health consequences of these drugs on injection is warranted.

Agony and ecstasy: a review of MDMA effects and toxicity

BACKGROUND

Ecstasy is a recreational drug with an anecdotal reputation for safety. However, reports of adverse effects and fatalities have increased in the medical and popular press.

METHOD

Literature search and review.

RESULTS

Acute Ecstasy toxicity does not appear to be due to overdose and cannot be solely attributed to the nature of the usual ambient environment. Adverse effects include hyperthermia, seizures, cardiac arrhythmias, hepatotoxicity, hyponatraemia and many psychiatric disorders. Ecstasy causes serotonergic neurotoxicity in the brains of animals at doses close to those used by humans, but its long-term effect on the human brain is unknown.

CONCLUSION

Ecstasy toxicity should be considered in the differential diagnosis of a variety of medical and psychiatric conditions. Given its popularity, both the acute and the potential long-term effects are a cause for concern.

Ecstasy use in Australia: patterns of use and associated harm

This study explored patterns of ecstasy use and associated harm through the administration of a structured interview schedule to 329 ecstasy users, recruited from three Australian cities. A broad range of ecstasy users were interviewed, but on the whole, the sample was young, relatively well educated and most were employed or students. Patterns of use were varied, although extensive polydrug use was the norm. High rates of intravenous drug use were recorded, which may relate to an over-representation of chaotic intravenous polydrug users. Subjects had experienced an average of eight physical and four psychological side-effects, which they attributed to their ecstasy use in the preceding 6 months. Approximately 40% of the sample also reported financial, relationship and occupational problems. Young, female, polydrug users and those who binged on ecstasy for 48 h or more appeared most at risk of experiencing harm that they related to their ecstasy use. One-fifth of the sample had received treatment for an ecstasy-related problem, most often from a GP or natural therapist, and 7% were currently in treatment. One quarter wanted to reduce their use because of financial, relationship and psychological problems. A total of 15% wanted formal treatment for an ecstasy-related problem and 85% requested more information. These results have implications for the development of policies to respond to drug use among this population.

Mortality and survival among a cohort of drug injectors in Glasgow, 1982-1994

There has been much speculation about the nature and extent of mortality among drug injectors in Glasgow. In order to determine injectors' mortality rate and compare this rate to the general population, identifier information from 459 drug injectors who received treatment for drug misuse in Glasgow between 1982 and 1994 was linked to the Scottish Mortality Register. The average duration of follow-up from cohort entry was 5.5 years and 10.2 years from commencement of drug injection. By the end of 1994, 53 cohort members had died. The average annual mortality rate of 1.8% was the same as that observed in a London cohort followed-up from 1969 to 1991. However, the excess mortality ratio (EMR) of 22.0 was almost double the London rate (11.9) because of the much lower average age of mortality (26.3 vs. 38.2 years). There was no significant time trend in EMR. Kaplan-Meier hazard analyzes show that younger patients and those who were HIV positive had significantly elevated mortality rates. The main cause of death was overdose, although it is unclear how many were accidental and how many intentional. Three of the six fatalities among HIV positive injectors were AIDS related. This study enables the first realistic assessment of the hypothesis that drug-related deaths in Glasgow are especially high. In relation to other populations of drug injectors, the annual mortality rate is comparable, although the average age of mortality is much lower in Glasgow. Consequently, in comparison to the general population, the mortality rate of drug injectors is higher in Glasgow compared to other cities.