Tri-city study of Ecstasy use problems: A latent class analysis (original) (raw)
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Perceived risk associated with ecstasy use: A latent class analysis approach
This study aims to define categories of perceived health problems among ecstasy users based on observed clustering of their perceptions of ecstasy-related health problems. Data from a community sample of ecstasy users (n=402) aged 18 to 30, in Ohio, was used in this study. Data was analyzed via Latent Class Analysis (LCA) and Regression. This study identified five different subgroups of ecstasy users based on their perceptions of health problems they associated with their ecstasy use. Almost one third of the sample (28.9%) belonged to a class with “low level of perceived problems” (Class 4). About one fourth (25.6%) of the sample (Class 2), had high probabilities of “perceiving problems on sexual-related items”, but generally low or moderate probabilities of perceiving problems in other areas. Roughly one-fifth of the sample (21.1%, Class 1) had moderate probabilities of perceiving ecstasy health-related problems in all areas. A small proportion of respondents (11.9%, Class 5) had high probabilities of reporting “perceived memory and cognitive problems”, and of perceiving “ecstasy related-problems in all areas” (12.4%, Class 3). A large proportion of ecstasy users perceive either low or moderate risk associated with their ecstasy use. It is important to further investigate whether lower levels of risk perception are associated with persistence of ecstasy use.
Ecstasy and new patterns of drug use: a normal population study
Addiction, 1999
Aims. (i) To describe illegal drug use patterns in an adolescent normal population sample with special emphasis on MDMA, ecstasy; (ii) to investigate where ecstasy is introduced in a hypothesized drug use sequence, and (iii) to contrast the predictors of ecstasy use with those of other illegal substances. Special attention was given to the relationship to subcultural music preferences and house-party-going. Design. A school-based survey of the total cohort of adolescents enrolled in the school system in a city. Participants. 10 812 adolescents, age 14± 17 years, response rate 94.3%. Setting. Oslo, the capital and only metropolitan town in Norway. Measurements. Social class was measured by the occupation standard ISCO 88, questions were posed as regards frequency of alcohol use and alcohol intoxication, cigarette smoking and use of cannabis, amphetamines, ecstasy and heroin. Alcohol problems were measured by a shortened version of Rutgers Alcohol Problem Index (RAPI), conduct problems were measured according to the four categories of acts forming the basis of the diagnosis conduct disorder in DSM-IV, internalizing mental health problems were measured using items from Hopkins Symptoms Checklist (HCL). A number of questions were asked as regards subcultural music preferences and house-party-going. Statistical models. A hypothesized cumulative sequence in drug use was investigated by means of latent class analysis, and the predictors of the various patterns of drug use were estimated and compared by means of multinominal logistic regression analysis. Findings. The use of ecstasy was often intermingled with the use of cannabis, amphetamines and heroin, in a pattern of polydrug use. The latent class analysis revealed the following drug use sequence: (1) alcohol, (2) cigarettes, (3) cannabis, (4) amphetamines, (5) ecstasy and (6) heroin. There was no signi® cant association between ecstasy use and parental social class or residential area of the town. All patterns of illegal drug use were highly associated with cigarette smoking, alcohol use, alcohol problems and conduct problems, whereas the associations with internalizing mental health problems were of less magnitude. Multinominal logistic regression analysis revealed that the use of ecstasy (E) was signi® cantly more weakly associated with cigarette smoking than were the use of cannabis only (C), amphetamines (A) and the combination of ecstasy and amphetamines (A 1 E). The association between E and conduct problems (CP) was weaker than the association between CP and A and A 1 E. Finally, there were associations between E and A 1 E and House/Techno preferences and house-party-going, which were not found for C and A. Conclusions. Ecstasy is used by adolescents who use other legal and illegal substances in a polydrug-use pattern. The substance is introduced late in a hypothesized drug use sequence. Even so, ecstasy use seems to differ from the use of, e.g. amphetamines, in that the association with smoking and conduct problems is weaker and that the associations with subcultural music preferences and house-party-going are much stronger.
Human Psychopharmacology: Clinical and Experimental, 2001
As part of an ongoing National Institute on Drug Abuse study on the reliability of DSM substance use disorders, 173 adolescents and young adults have been interviewed to date with the CIDI-Substance Abuse Module (SAM) to determine use and abuse of and dependence on`club drugs' and other substances. Respondents are recruited from a substance abuse program, high school ads, college dorm¯yers, the internet and chain referral. Retest interviews after 5 days determined the reliability of responses. Ecstasy use was reported by 52 respondents (30%); of these users 52% were female and 23% were non-white. Nearly all users (94%) reported recent Ecstasy use. Among Ecstasy users,`continuing to use despite knowledge of physical or psychological harm' was the most prevalent dependence criterion (63%), with excellent retest agreement ( 0.66). Withdrawal (59%) and tolerance (35%) were also commonly reported dependence criteria. Hazardous use was the most commonly reported abuse symptom. Most surprising were the rates of Ecstasy use disorders: 43% met DSM-IV criteria for dependence; 34% met criteria for abuse; only 23% met neither. This is the ®rst effort to assess the reliability of Ecstasy abuse and dependence, and the ®rst to determine abuse and dependence using criteria speci®c to Ecstasy. The importance of additional studies and the relevance of such work to DSM-V are discussed.
Drug and Alcohol Review, 2010
Introduction and Aims. Considerable concern has been raised about associations between ecstasy use and mental health. Studies of ecstasy users typically investigate varying levels of lifetime use of ecstasy, and often fail to account for other drug use and sociodemographic characteristics of participants, which may explain mixed findings. The current study aimed to examine the relationship between patterns of recent (last six months) ecstasy use and psychological distress among current, regular ecstasy users, controlling for sociodemographic risk factors and patterns of other drug use. Design and Methods. Data were collected from regular ecstasy users (n = 752) recruited from each capital city in Australia as part of the Ecstasy and related Drugs Reporting System (EDRS). Psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Data were analysed using multinomial logistic regression. Results. Seven per cent of the sample scored in the ‘high’ distress category and 55% in the ‘medium’ distress category. Patterns of ecstasy use were not independently associated with psychological distress. The strongest predictors of distress were female sex, lower education, unemployment, ‘binge’ drug use including ecstasy (use for >48 h without sleep), frequent cannabis use and daily tobacco use. Discussion and Conclusions. Regular ecstasy users have elevated levels of psychological distress compared with the general population; however, ecstasy use per se was not independently related to such distress. Other factors, including sociodemographic characteristics and other drug use patterns, appear to be more important. These findings highlight the importance of targeting patterns of polydrug use in order to reduce drug-related harm among regular ecstasy users.[George J, Kinner SA, Bruno R, Degenhardt L, Dunn M. Contextualising psychological distress among regular ecstasy users: The importance of sociodemographic factors and patterns of drug use. Drug Alcohol Rev 2010]
Contextual profiles of young adult ecstasy users: A multisite study
Addictive Behaviors, 2011
These analyses assess contextual profiles of 612 young adult Ecstasy users, 18-30 years of age, from St. Louis (USA), Miami (USA) and Sydney (Australia). Bivariate analyses revealed different contextual factors influencing Ecstasy use. Friends were the most common sources of Ecstasy at all sites and most used with friends. St. Louis and Miami use mostly occurred in residences, whereas in Sydney use was mostly at clubs, bars or restaurants. Ecstasy consumption at public places and in cars, trains or ferries was significantly higher in Miami (89% and 77%) than in St. Louis (67% and 65%) and Sydney (67% and 61%). At all sites, simultaneous use of LSD/ mushroom and nitrous oxide with Ecstasy was common; concurrent amphetamines predominated in Sydney and heroin/opiates in St. Louis Contextual factors influencing Ecstasy use among young adults vary by geographic region. Their inclusion may help tailor effective prevention programs to reduce or ameliorate Ecstasy use.
Young Adult Ecstasy use Patterns: Quantities and Combinations
Journal of Drug Issues, 2006
The objectives of this paper are to describe ecstasy use patterns among young adult (18–25 years) users and to compare use patterns and self-reported effects according to the frequency (number of days used in the last 90 days) and intensity (typical number of pills taken per sitting) of ecstasy use. Computer-assisted structured interviews were conducted with 261 young adult active ecstasy users in Atlanta, Georgia. A typical dose of ecstasy intake was two pills, often followed by a booster dose. In addition, binging on ecstasy was reported. Ecstasy was mentioned as the primary drug of choice by one fifth of respondents. Poly-drug use dominated, and a substantial proportion of the respondents reported symptoms of ecstasy dependence. Differences in sociodemographic characteristics, poly-drug use, and reported effects of ecstasy use were found according to frequency and intensity of ecstasy use. Findings from this paper are important for the development of effective prevention efforts,...
Mental disorders in ecstasy users: a prospective-longitudinal investigation
Drug and Alcohol Dependence, 2002
Objectives: To investigate the relationship between ecstasy use and mental disorders in a representative sample of adolescents and young adults. Method: Data for this investigation were drawn from the Early Developmental Stages of Psychopathology (EDSP) study, an epidemiological Á/longitudinal study in which 14 Á/24 year-olds were examined prospectively over a period of about 4 years. Results are based on N 0/2462 participants who completed the whole study period and for whom drug use behavior could be determined. Results: (1) Ecstasy users, compared with non-users, were at significantly increased risk of DSM-IV substance related disorders, including alcohol use disorders (52.6 vs. 15.6%; OR0/5.6, 95% CI 0/3.8 Á/8.1). Further, ecstasy users also had a higher risk of alcohol use disorders, when compared with users of other illicit substances (52.6 vs. 40.3%; OR 0/1.7, 95% CI 0/1.1 Á/2.4). (2) Ecstasy users had significantly higher rates for almost all DSM-IV mental disorders examined when compared with non-users (any non-substance use disorder: 68.7 vs. 44.5%; OR0/3.1, 95% CI0/2.1 Á/4.4) and compared with users of other illicit drugs (any non substance use disorder: 68.7 vs. 55.5%; OR 0/1.8, 95% CI 0/1.2 Á/2.6). (3) Ecstasy users also reported significantly higher rates of prescription medicine use, though they did not use more medical services than non-drug users. (4) Analyses of temporal patterns of ecstasy use and disorder onset revealed that the first use of ecstasy was secondary to the onset of DSM-IV mental disorders in the majority of cases. Still, subjects with mental disorders at baseline also showed a significantly increased risk for initiation of ecstasy use during the 4-year follow-up period. Conclusions: Care should be taken in cross sectional studies in interpreting mental disorder signs and symptoms merely as a consequence of ecstasy use, as ecstasy use might be associated with the use of multiple substances, and onset of mental disorder is more likely to precede rather than to follow use of ecstasy and related substances.
Shifting characteristics of ecstasy users ages 12-34 in the United States, 2007-2014
Drug and alcohol dependence, 2017
Ecstasy/MDMA has been one of the most prevalent party drugs for decades, and powder ecstasy recently increased in popularity. We examined trends in use to determine who to best target for prevention and harm reduction. Secondary analysis of the 2007-2014 National Survey on Drug Use and Health, a repeated cross-sectional, nationally representative probability sample, was conducted. Linear trends in past-year ecstasy use and trends in demographic and other past-year substance use characteristics among ecstasy users were examined among participants ages 12-34 (N=332,560). Past-year prevalence of ecstasy use was stable across years at 2% (P=0.693). Over time, the proportion of ecstasy users with a college degree increased from 11.5% in 2007/08 to 24.5% in 2013/14 (P<0.001). The proportion of users who were age 12-17 decreased, as did proportions of users who are non-Hispanic black, and reported income <$20,000/year (Ps<0.001). Prevalence of past-year use of marijuana, LSD, keta...
Dimensions of Multiple Drug Use and a Typology of Drug Users
Addiction, 1987
An accurate evaluation of the effectiveness of substance abuse treatment depends largely upon the construction of measures which will capture the complexity of multiple substance use patterns. Of 256 subjects assessed for a drug abuse treatment programme, 90% had used drugs from four or more of eight classes (Alcohol, Cannabis, Hallucinogens, Narcotics, Sedative Hypnotics, Solvents, Stimulants, Tranquillizers) during the past year. A principal components analysis of frequency data from the drug classes indicated four orthogonal factors, explaining 72% of the variance. Cluster analysis (Ward's method) grouped subjects into five clusters, provisionally labelled A (predominantly alcohol), ADR (combining high use of alcohol,‘depressant’ and ‘recreational'drugs), D (predominantly ‘depressant’ drugs), R (mainly ‘recreational’ drugs) and S (very high use of solvents). Four of the clusters (A, D. R. S) combined drugs similar to the principal component factors, with a fifth cluster (ADR) indicating high use of all drug classes except solvents. The clusters also differed in several important ways, including age, social class, social stability, age at onset of drug problem, number of drug classes used, and present severity of drug and alcohol problems.