EXECUTIVE SUMMARY

Demographic characteristics of regular ecstasy users
One hundred regular ecstasy users (REU) participated in the Queensland EDRS in 2006. The mean age of participants was 22 years, which is younger than in recent years. Almost two thirds of the sample was male, the majority identified as heterosexual and only one identified as Indigenous. As in previous years, most participants had completed high school and around a third had completed a university degree. Most were either studying or employed full-time and very few had a
history of imprisonment. Only one REU was currently receiving any form of drug treatment. Overall, as in previous years, there was little evidence of significant disadvantage in the sample.

Patterns of drug use among REU
Polydrug use continues to be the norm among REU and as in previous years, the other drugs most commonly used by regular ecstasy users were alcohol, tobacco and cannabis. The proportion of REU reporting lifetime drug injection has been declining in recent years and in 2006 only 14% of REU reported a lifetime history of injection. There was some evidence of an increase in use of LSD and MDA (albeit from a very low base), and a decline in use of ketamine.

Ecstasy
REU in 2006 first tried ecstasy on average at 18 years of age, younger than in previous years. Consistent with previous years, regular use typically started about one and a half years after first use. The median frequency of ecstasy use was just over once a fortnight, although 29% of REU used weekly or more often. Nearly all REU (97%) report mainly swallowing ecstasy, although 11% reported having injected ecstasy at some time in their life.

The average quantity of ecstasy used in a session has increased from 1 tablet in 2000 and 2001 to 2 tablets since 2004; in 2006 sixty-three percent of REU reported typically using more than 1 tablet.
Polydrug use is normative with 95% of REU reporting use of other drugs with ecstasy and 85% reporting use of other drugs coming down from ecstasy.

In 2006, thirty-eight percent of REU reported bingeing on ecstasy recently – this figure has declined since 2000. The most common location for ecstasy use in 2006 was nightclubs, although a considerable number also reported using ecstasy in private locations such as their own home, a friend’s home or a private party.

Price, purity and availability of ecstasy
The price of ecstasy appears to be falling, from an average of $40 in 2000 and 2001, and $32 in 2005, to $30 in 2006; most REU reported that the price had been stable in the preceding six months. There was little agreement among REU with respect to ecstasy purity, with roughly equal proportions reporting that it is of medium purity, high purity or fluctuating. As in previous years, almost all REU reported that ecstasy was either ‘easy’ or ‘very easy’ to obtain, and the majority
reported that availability was ‘stable’ or ‘easier’.

The most common source of ecstasy continues to be ‘friends’, with only a minority reporting obtaining ecstasy in public places such as nightclubs or pubs. It is normative for REU to obtain ecstasy for themselves and others, with REU in 2006 reporting typically purchasing ecstasy for three people on any given occasion, and they typically purchased 4 tablets at once. Roughly equal proportions reported purchasing 1-6 times, 7-12 times and 13-24 times in the last six months. Most were able to obtain other drugs from their main ecstasy dealer, typically cannabis and ice/crystal. Arrests for ecstasy use/possession in Queensland are subsumed under the broad amphetamine type stimulants (ATS) category, and are therefore of little use in monitoring the ecstasy market. The number of ecstasy border detections by Australian Customs Service (ACS) has fallen in recent years, although the overall weight of seizures continues to fluctuate.

Methamphetamine
More than half of REU reported recent methamphetamine powder use, typically using less than once a month and using half a gram in a session. Just over a third reported recent base use, typically using once every two months and using 2 points at a time. One in two reported recent use of ice/crystal, on an average of 4 times in the last 6 months, and typically used 2 points in a session.

Although many REU use methamphetamine in nightclubs and at raves, the most common locations for use in 2006 were private homes, either the user’s own home or a friend’s home. This was particularly true with respect to use of ice/crystal.

The price of methamphetamine forms varied only slightly between 2005 and 2006, with ice/crystal continuing to cost about twice as much for a point ($50) and a gram ($325) as powder (point $25, gram $150) and base (point $25, gram $190). The majority of REU reported that the price of powder and base had been stable; one-third reported the price of ice/crystal as stable and one in four reported that it had increased.

There was poor agreement among REU with respect to purity, however, as in previous years, REU were more likely to report that ice/crystal was of high purity, compared to other forms of the drug. The majority of REU reported that powder and ice/crystal were either ‘easy’ or ‘very easy’ to obtain, however, 44% reported that base was ‘difficult’ to obtain. The availability of all forms was typically reported to be ‘stable’ and the most common source for all forms was ‘friends’ at a
‘friend’s home’, although an equal proportion reported obtaining ice/crystal from a dealer at a dealer’s home.

The number of arrests for ATS use/possession in Queensland has continued to increase, however, this trend may reflect an increasing law enforcement focus on ATS, as well as, or rather than increased market activity. The number of clandestine methamphetamine laboratories has declined in recent years, presumably in response to legislative and policing changes which have created a greater deterrent for less determined, less organised manufacturers.

Cocaine
As in previous years, in 2006 about half of REU reported lifetime cocaine use and around a third reported recent cocaine use, although on average only twice in the last six months. The most common locations for cocaine use were nightclubs and private homes, and cocaine was usually obtained from friends in private homes.

The average reported price of cocaine was $300 per gram, and the majority reported that this price was stable. Relatively few REU were able to comment on purity but the majority of these considered it medium. REU typically reported that cocaine was difficult to obtain.

The number of arrests for cocaine use/possession in Queensland has increased in recent years, however, the overall number of arrests is still very low, compared to arrests for other drugs. Both the number and weight of cocaine seizures at the Australian border continue to fluctuate. The number of inpatient hospital admissions with cocaine as the primary diagnosis has increased in recent years, however, the number of calls to telephone help-lines in relation to cocaine remains small.

Ketamine
The proportion of REU reporting recent ketamine use fell from 2005 (20%) to 2006 (12%), with those reporting recent use in 2006 typically reporting use only once in six months, and using on average 1.25 ‘bumps’. Few REU reported on locations of recent ketamine use, however, the most common locations for use was a friend’s home and the most common source was a friend, with the transaction occurring at a friend’s home.

Only one REU reported a price for ketamine, at $180 a gram, and the most common response was that price had been stable recently. There was little agreement with respect to purity however, most of those responding indicated that ketamine was difficult to obtain.

GHB
As in previous years, only a minority of REU (9%) reported recent GHB use, typically using once in the last six months and using on average 3.5mLs. The most common source for GHB was a ‘friend’ and the most common location for both purchase and use was a friend’s home. The average price of GHB was $5 per ml, and few REU were able to comment on purity or availability.

LSD
Consistent with the reports of some KE, and anecdotal reports from some REU, there was evidence of an increase in LSD use among REU in 2006, with more than a third reporting recent use. As in previous years, however, use was typically infrequent (on average 1.5 days in 6 months) and the median quantity used was 1.25 tabs. The most common location for use was a private home, although some REU also reported use at live music events and raves. The most common
sources for LSD were friends and known dealers, and most purchases occurred in a private home.

As in previous years, the median price of LSD was $20 per tab, and most REU considered the price stable. Most REU reported that the purity of LSD was high and stable, however, there was little agreement with respect to availability, with roughly equal proportions reporting current availability as ‘easy’ and ‘difficult’.

MDA

Only a minority of REU in 2006 (12%) reported recent MDA use, and among those who had used recently, the median frequency of use (1.5 days in 6 months) was lower than in previous years. The typical quantity used in a session was 2 caps. Among the few who were able to comment, the most common location for MDA use was a private party, and the most common sources of MDA were friends and known dealers.

Few REU were able to comment on the price of MDA, and prices ranged from $30 to $40 for a cap. Similarly, few REU were able to comment on purity or availability, and there was little agreement in these reports.

Patterns of other drug use
As in previous years, almost all REU reported recent alcohol consumption, with the frequency of consumption in this group considerably higher than that in the general population. The majority of REU also reported typically consuming alcohol with ecstasy and coming down from ecstasy, with many consuming at least 5 standard drinks on these occasions. Based on responses to the Alcohol Use Disorders Identification Test (AUDIT), a well-validated measure of usual alcohol use, the vast majority of REU reported typically drinking at hazardous or harmful levels, with no difference between males and females. The proportion of REU reporting recent cannabis use has increased in recent years and in 2006, ninety-two percent (92%) reported use in the last 6 months. One in five reported daily use and just over half reported use at least weekly. About half reported using cannabis with ecstasy and around three quarters reported using cannabis coming down from ecstasy. Data from telephone help-lines and hospital admissions suggest an increase in cannabis related problems, however, this increase
may also reflect increasing awareness of the harms associated with cannabis use.

Throughout Queensland around 23% of the population were current smokers in 2004; by comparison, 77% of REU in 2006 reported being current (typically daily) smokers. Around half of the sample reported using tobacco both with ecstasy, and when coming down.

Just over a third of REU reported recent benzodiazepine use. Nearly one in four (23%) reported lifetime use of antidepressants, however, only 6% reported recent use of antidepressants.

One in four REU (26%) reported lifetime use of amyl nitrate and about half (55%) reported lifetime use of nitrous oxide (‘bulbs’). A third (32%) reported recent use of nitrous oxide, however, only 6% reported recent use of amyl nitrate. Thirteen percent of REU reported recent use of mushrooms.

Few REU reported lifetime use of heroin (12%) or methadone (5%), with only one respondent reporting recent use of both opiates. One in ten REU reported recent use of ‘other opiates’, typically over-the-counter painkillers.

Drug information-seeking behaviour
Almost a third of REU (30%) reported never attempting to find out the content or purity of the ecstasy tablets they purchased, before consuming the drug; this figure rose to 56% for other drugs. The main sources of information about the content and purity of ecstasy were friends, websites and dealers, although 23% of those who responded reported using pill testing kits at least sometimes.

Risk behaviour
Most REU in 2006 (86%) had never injected drugs. Among those who had injected recently (9%), the mean numbers of drugs injected recently was two, and 5% reported first injecting under the influence of another drug. The most commonly injected substances were methamphetamine (primarily powder) and ecstasy tablets. Only one REU reported sharing a needle with others: a ‘regular sex partner’, and a ‘close friend’. The most common location for injection was a private
home and REU reported obtaining needles primarily from needle syringe programmes (NSP) and pharmacies.

The vast majority of REU reported being sexually active in the preceding six months, with most of these reporting having between 2 and 5 sexual partners in this time. A minority reported always using a protective barrier when having penetrative sex with a regular partner, however, the vast majority reported using protection every time with a casual partner. Four out of five REU reported having sex under the influence of drugs (usually ecstasy) recently and of these, almost half reported not using a protective barrier every time they had penetrative sex under the influence with a casual partner.

Four out of five REU reported driving soon after taking a drug in the last six months. The drugs most commonly involved were cannabis, ecstasy and alcohol.

Health-related issues
Five percent of REU reported overdosing on a party drug in the last six months: three using ecstasy, one using methamphetamine base and one using gamma hydroxybutyrate (GHB).

The majority of REU reported no symptoms of methamphetamine dependence, however, 9% received a score of 4 or more on the Severity of Dependence Scale (SDS), indicating possible methamphetamine dependence. The most commonly reported sign of dependence was worrying about methamphetamine use. Eighteen percent of REU reported seeking help for their drug use in the last six months; typically health and/or medical assistance.

A significant proportion of REU reported other problems associated with their drug use including relationship/social problems (42%), financial problems (33%) and work/study problems (29%). Fifteen percent reported legal or police problems. The drug most commonly associated with these problems was ecstasy.

Criminal activity, policing and market changes
Almost a third of REU (29%) reported engaging in criminal activity in the last six months, mainly drug dealing (24%). The proportion reporting that police activity had increased recently rose to 82% in 2006, however, 73% of REU indicated that police activity had not impacted on their ability to obtain ecstasy.

Over half of REU reported having seen sniffer dogs in public places recently, and around one in five reported seeing sniffer dogs while in possession of drugs. The most common response to the presence of sniffer dogs was to consume drugs before attending an event, rather than at the event, and some suggested that if they were at risk of being detected carrying drugs, they would consume all the drugs in their possession. There is a clear need for further research into the impacts of sniffer dog presence on both drug using behaviour and risk behaviour among REU.

Conclusions and Implications

Recruitment and Interviewing
Recruiting REU into the EDRS has been more challenging in recent years, and in response greater efforts and resources are required in order to recruit REU to participate. Some REU informally indicated concerns that the EDRS was affiliated with law enforcement organisations, however, it is worth noting that these comments were made by respondents who volunteered to participate in the study. Interviewers also observed an increase in the participation of less experienced ecstasy users. This observation was in the context of anecdotal reports of a growing cohort of more mature ecstasy users who may be less likely to be recruited into the EDRS through existing recruitment methods. This underscores the importance of snow-balling recruitment methods to access this group of users.

Locations of Drug Use
Each year a proportion of REU interviewed for the EDRS report usually using ecstasy and other drugs in private homes (i.e., their own home, a friend’s home, a dealer’s home) as well as, or instead of, public venues such as nightclubs, pubs and raves. There is some evidence that this proportion is increasing, perhaps in response to a perception among REU of increasing law enforcement activity. Although the risk of apprehension by law enforcement may be lower in private venues, drug use in these locations may also increase the risk of drug-related harm. Most of the REU interviewed for the EDRS also report obtaining their drugs in private homes, for the obvious reason that the risk of apprehension is significantly greater in public locations. Policing of ‘open markets’ for ecstasy (e.g. at nightclubs) is therefore likely to have a limited impact on many of these consumers.

Cocaine
Cocaine may be becoming increasingly available in south-east Queensland, with more REU reporting recent cocaine use in 2005 and 2006 and KE reporting increased availability and higher purity cocaine on the market. Nevertheless, most REU reported using cocaine only very infrequently, presumably reflecting unstable supply and high price. There may well be a ‘niche market’ for cocaine, with higher levels of use among market participants, however, at present it appears that this market overlaps only slightly with the markets monitored by the EDRS.

Alcohol and Tobacco Use
REU consistently report alcohol and tobacco use at much higher levels than the general population. Consistent with previous EDRS samples, almost all respondents reported recent use of alcohol, usually at risky levels, and three-quarters reported recent use of tobacco. While it is important to focus on the risks associated with illegal drug use, the high levels of legal drug use in this group indicate an on-going need for harm reduction and health-related messages to be
targeted at these drugs as well.

Health Related Behaviours and Risks
Relatively few REU report seeking assistance for their drug use in 2006 and fewer than one in ten reported symptoms consistent with methamphetamine dependence. However, this does not mean that REU are not experiencing acute or chronic problems associated with their use. Over forty percent of the sample reported negative social and personal consequences due to their drug use. Four out of five reported driving within one hour of taking a drug, with two thirds reporting driving after use of ecstasy. Two-thirds also reported having penetrative sex while under the influence of ecstasy, with a proportion of these failing to use a protective barrier, even with a casual partner. Further, with increasing reports of REU consumption of alcohol in combination with ecstasy, there is clearly an ongoing need to provide harm reduction interventions focused specifically upon these potentially risky behaviours.