Recent-onset ecstasy use: Association with deviant behaviors and psychiatric comorbidity.

Background: Despite increases in ecstasy (MDMA) use in the United States, little is known about characteristics linked with recent-onset ecstasy use, especially psychiatric symptoms and deviant behaviors. Aims: To test whether individuals with high levels of other drug use are more likely to be recent-onset ecstasy users; to test whether psychiatric symptoms in adults are associated with recent-onset ecstasy use; to explore the association between recent-onset ecstasy use and concomitant deviant behaviors in adolescents and adults. Methods: Data from the 2001 National Survey on Drug Use and Health. Findings: Recent-onset ecstasy use was significantly more likely to occur among adolescents and adults (18-34 years old) who engaged in deviant behaviors during the past year as compared with those who did not engage in deviant behaviors during the past year. Higher levels of deviancy indicated a higher likelihood of being a recent-onset ecstasy user, and associations were strongest with nonviolent deviant behaviors such as selling illegal drugs and stealing. Associations between deviant behaviors and recent-onset ecstasy use were similar in strength to associations between deviant behaviors and recent-onset cocaine and marijuana use, respectively. Adults who had past-year psychiatric symptoms (both depressive and panic symptoms) were twice as likely to be recent-onset ecstasy users as compared with those without past-year psychiatric symptoms. Greater levels of drug involvement increased the odds of being a recent-onset ecstasy user. Conclusion: Recent-onset ecstasy use seems to be associated with a range of other behavioral problems and may reflect one aspect of a larger problem behavior syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Places and patterns of drug use in the Scottish dance scene

Interviews were conducted with 135 participants in the Glasgow dance (rave) scene. Drug use in this group was varied and not merely restricted to drugs associated with dance events, such as MDMA (Ecstasy). The setting in which each drug was used varied greatly. Amphetamine, nitrites and Ecstasy were the drugs most commonly used at dance events. Pharmaceuticals were least likely to be used in such settings. However, some drugs, such as Temazepam, were sometimes used prior to or after attending rave events. It is suggested that dance drug users are polydrug users who use drugs in a setting specific fashion. As such it would be wrong to classify such users solely on the grounds of their very visible behaviour in the public arena (at dance events). Other forms of substance use engaged in by this group may have a greater potential for harm than that seen at raves. The implications of these findings are discussed.     

Ecstasy (MDMA) does not have long-term effects on aggressive interpretative bias: A study comparing current and ex-ecstasy users with polydrug and drug-naive controls.

±3, 4-methylenedioxymethamphetamine (MDMA or ecstasy) remains a widely used recreational drug, which, in animals, can produce long-lasting changes to the brain's serotonergic system. As serotonin has been implicated in human aggression, it is possible that ecstasy users are at risk of increased aggression even after prolonged abstention from the drug. The objective of this study was to indirectly assess aggression in current and abstinent ecstasy users using an information-processing paradigm that measures cognitive bias toward material with aggressive content. The task employed has previously shown increased aggressive bias 3-4 days after ecstasy use. An interpretative bias task was administered to 105 male participants: 26 ex-ecstasy users, 25 current ecstasy users, 29 polydrug using controls, and 25 drug-naive controls. Accuracy and response times to process and recognize ambiguous sentences were tested. There were no group differences in aggressive interpretative bias. All 4 groups processed neutral sentences faster than aggressive sentences and were subsequently faster and more confident in recognizing neutral compared with aggressive sentences. Further, self-ratings of aggression also showed no group differences, even though self-rated impulsivity was significantly higher in current ecstasy users than in drug-naive controls. The findings that all groups were biased toward neutral and away from aggressive interpretations of ambiguous sentences add to the existing body of knowledge in suggesting that increased aggression found in ecstasy users a few days after taking the drug is a transient phenomenon and not a long-term, persisting effect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association between the negative effects attributed to ecstasy use and measures of cognition and mood among users.

In self reports, abstinent ecstasy/polydrug users claim that they experience certain ongoing affective and psychological changes including elevated anxiety, arousal, and depression. In addition, various aspects of cognition (e.g., everyday memory, reasoning, executive functioning) appear to be affected. The present paper investigated the link between these two psychological sequelae. Ninety-five ecstasy/polydrug users completed tests of reasoning, intelligence, information processing speed, executive functioning, and everyday memory. Affect was measured via a mood adjective checklist. Adverse effects attributed to ecstasy were measured via responses to adjectives reflecting changes in users since they started using the drug. In addition, indicators of sleep quality and daytime sleepiness were obtained. Users attributed a number of adverse effects to ecstasy, namely heightened irritability, depression, paranoia, and deteriorating health. Adverse effects were significantly and negatively correlated with aspects of intelligence, everyday memory, and sleep quality. Length of use of ecstasy use was positively correlated with adverse effects. While many users attribute a number of adverse affects to their use of ecstasy, it remains unclear whether these self-perceptions are a corollary of the psychopharmacological effects of the drug or reflect factors which in fact predate its use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of general identity disturbance on reports of lifetime substance use disorders and related outcomes among sexual minority adults with a history of substance use.

Previous research has shown that sexual minority (i.e., nonheterosexual) individuals report increased problematic substance use involvement, compared with their sexual majority counterparts. We hypothesize that feelings of an unstable sense of self (i.e., identity disturbance) may potentially drive problematic substance use. The purpose of the current study is to examine identity disturbance among sexual minorities as a potential explanatory mechanism of increased sexual minority lifetime rates of substance dependence. Measures of identity disturbance and three indicators of sexual orientation from lifetime female (n = 16,629) and male (n = 13,553) alcohol/illicit drug users in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were examined. Findings generally showed that the increased prevalence of alcohol dependence, illicit drug dependence, and combined alcohol/illicit drug dependence as well as a younger age of alcohol use initiation among sexual minority women was associated with elevated levels of identity disturbance. The results were consistent with a mediational role for identity disturbance in explaining the association between sexual minority status and substance dependence and were generally replicated among male sexual minority respondents. The current research suggests that identity disturbance, a predictor of substance use, may contribute to heightened risk for substance dependence among certain subgroups of sexual minority individuals. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

CD5 B cells and B-cell malignancies

Evidence from both animal, and human, studies suggests that repeated administration of 3,4-methylenedioxymethamphetamine (MDMA: "ecstasy") produces lasting decreases in serotonergic activity. Serotonin is believed to play a modulatory role in a variety of psychological processes, including learning and memory. There are recent reports that polydrug users, who have used ecstasy recreationally, exhibit selective impairments in memory. However, these studies did not compare ecstasy users with polydrug users who had not taken ecstasy, leaving open the possibility that the memory deficits may be associated with a history of use of other illicit drugs. The present study used the Rivermead Behavioural Memory test to investigate immediate and delayed recall in: 25 polydrug-users who had taken more than 20 tablets of ecstasy (MDMA group), 22 participants (polydrug controls) who had never taken ecstasy, but, otherwise has personal characteristics (e.g. age, gender, education, height, weight), and illicit drug use histories, that were generally not significantly different from those of the MDMA group, and 19 participants who had not used illicit drugs but who also had similar personal characteristics (non-drug controls). Participants in the MDMA group recalled significantly fewer ideas (approximately 75% of the number of ideas recalled by participants in either of the other two groups), in both immediate and delayed recall conditions. The two illicit drug-using groups did differ in their estimated IQ scores and their duration of use of LSD, but only the latter proved to be a statistically significant covariate, and the difference in recall performance between the MDMA and polydrug controls groups remained statistically significant when this variable was treated as a covariate. The present findings provide the first evidence that deficits in memory performance in recreational ecstasy users are primarily associated with past exposure to ecstasy, rather than with the other legal and illicit drugs consumed by these individuals, and are consistent with reduced serotonergic modulation of mnemonic function as a result of long-term neurotoxic effects of MDMA in humans.     

Congenital sodium diarrhoea in an Indian girl

BACKGROUND: Ecstasy is a synthetic amphetamine which causes a wide variety of adverse effects. Hepatic toxicity was only recently demonstrated but can be quite severe. CASE REPORT: A 27-year-old male with no past medical or surgical history developed jaundice without fever. He was a regular user of ecstasy and had recently increased the number of doses consumed. No evidence of a viral, alcoholic, metabolic or autoimmune mechanism was found which could explain the hepatitis. Complete cure was obtained by discontinuing ecstasy. DISCUSSION: Few cases of ecstasy hepatic toxicity have been reported. Ecstasy was undoubtedly the causal agent in this case since other known causes of acute hepatitis were excluded, confirming the hepatotoxicity of ecstasy reported in the literature. The liver disease has been reported to range form acute regressive hepatitis to fatal liver failure. Iterative exposure can lead to fibrosis. The pathophysiological mechanism of this toxic effect is not well elucidated. Ischemia alone cannot explain all the clinical forms described, particularly cases without hyperpyrexia. Ecstasy must be added to the list of potential causes of acute hepatitis. Exposure must always be searched for in cases of acute hepatitis in young subjects.     

Comparison of the effect of EMLA and semicircular subcutaneous anaesthesia in the prevention of tourniquet pain during plexus block anaesthesia of the arm

The present study examined resting heart rate variability (HRV; an index of parasympathetic tone) and heart rate response to the Valsalva maneuver (Valsalva ratio; an index of overall autonomic responsiveness) in 12 repeat users of 3.4-methylenedioxymethamphetamine (MDMA, "Ecstasy"), and a matched comparison group of presumed nonusers. HRV and Valsalva ratio were smaller in users than in controls. Three out of 12 MDMA users but no controls had Valsalva ratios below 1.50, the cut-off for autonomic dysfunction. In several users, there was a total absence of post-Valsalva release bradycardia. All MDMA users were polydrug users. Parasympathetic cardiovascular tone appears impaired in repeat MDMA users, although the ubiquitous problems in such epidemiologic designs (including lack of testing before the first use of the drug and confounding with use of other drugs) preclude definitive causal interpretations.     

M.D.M.A. ("Ecstasy"); a case of possible drug-induced psychosis

3, 4, Methylenedioxymetamphetamine (M.D.M.A., Ecstasy) is a modified amphetamine with stimulant and hallucinogenic properties. Ecstasy has been increasingly abused in Dublin in recent years. It is commonly perceived by users as a safe drug. We report a case of prolonged psychosis following brief recreational use of Ecstasy.     

Drugs on a medical campus. III. Drug use among nursing and paramedical personnel

Fifty nurses and 50 paramedical staff working in the Rajendra Hospital and Medical College, Patiala, were studied by means of a structured, self-report questionnaire. The life-time prevalence of drug use among nurses was comparatively low--55%, compared to 81% among the paramedical staff. Current use of drugs as shown by the 30-day prevalence rate was also very low among the nurses, a majority of whom restricted themselves to using tranquillizers and sedatives for the specific purpose of relaxation or inducing sleep; only a few had experimented with alcohol, cannabis, and tobacco. On the other hand, the most commonly used drug among the paramedical personnel was alcohol, followed by sedatives, tranquillizers, cannabis and tobacco, most of them taking the drug for social reasons or for the thrills from the effects of the drug. This is also reflected in the comparatively higher number of paramedicals who felt that they would probably continue to use these drugs in the future, as also the fact that there were a few dependent users of opium and narcotics in this group.     

Prevalence and a drug use development model for the study of adolescent drug use in Japan

The purposes of this study were to estimate the prevalence of drug use, to examine the correlation between drug use and drinking/smoking in Japan, and to test a developmental model of adolescents' drug use based on three basic theories of deviance: Strain, Social control, and Differential association. The survey was conducted from April to May, 1996, in 14 public high schools in Tokyo, using anonymous self-reporting. A total of 4,171 (99.45%) students responded to our questionnaire. It included central concept items in the three deviant theories, beliefs about the ill effects of drugs, sex, grades, etc. The following findings were obtained: 1) Among the subjects, 255 students (6.1%) reported drug use within the past year. Of these drug users, 73.3% used drugs soon after being "tempted" by friends. Responding to "When was it.", as a first year junior high school was the most common first experience, and the next most common was during the sixth year of elementary school. 2) Drinking and smoking appeared to be gateway drugs for adolescents in Japan as has been shown in the United States. 3) Multiple regression and logistic multiple regression analyses suggested that differential association variables were far more powerful predictors of adolescent drinking, smoking and drug use than either the control or strain variables. Results provided modest support for the Differential Association Theory as an explanation of drug use. 4) LISREL's goodness-of-fit statistic indicated a much better fit between the model and the data. (CN: 282, GFI: 0.967, AGFI: 0.941). These findings show two processes by which adolescents become involved in drug use. Strain and Social Control do not directly affect drug use. However, Social Control is important because it works indirectly, through Differential Association resulting in drug use. Second, though weaker, Differential Association appears to lead to dangerous beliefs in drug use followed by actual drug use.     

Adolescent drug use: Findings of national and local surveys.

Adolescent drug use increased until about 1981, but since then it has steadily declined. Current data show some drug use in the 4th and 5th grades and considerable increases from the 6th to the 9th grades. For drugs such as marijuana, cocaine, and stimulants, lifetime prevalence continues to increase through high school; for drugs such as inhalants and heroin, lifetime prevalence may decline for Grades 10, 11, and 12, suggesting that students who use these drugs early may drop out. Drug use of rural youth is similar to that of other youth. Barrio, ghetto, and Native-American reservation youth may have high rates of use, but use of Black and Hispanic seniors may be equivalent to or less than that of White seniors. National data and broadly defined ethnic data, however, may cover up important subgroup differences. For example, Western Mexican-American girls have lower use than Western Spanish-American girls, possibly because of the greater influence of "marianisma." Different locations may also have very different patterns of adolescent drug use, calling for different types of local intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Huba, Wingard, and Bentler.

Reports an error in the article "Beginning Adolescent Drug Use and Peer and Adult Interaction Patterns" by G. J. Huba, Joseph A. Wingard, and P. M. Bentler (Journal of Consulting and Clinical Psychology, 1979, 47, 265-276). On page 269 all the coefficients in Table 3 should be positive (with the indicated numerical value). On page 270-271 the loading in Table 4 for the variable "are liked by parents" on Dimension II' should read .00 instead of -.60. Interpretation of the results does not change. (The following abstract of this article originally appeared in record 1979-28564-001). Interaction patterns among drug users, their peers, and significant adults have been implicated as causal factors of later drug abuse. Data were collected from 1,634 adolescents about their current use of 13 substances and about their interactions with peers and significant adults. Five canonical dimensions were necessary to explain the significant covariation in each of 2 comparable samples. The replicated pattern of rotated canonical loadings indicated that users of various classes of substances associated with other individuals who used the same substances. Other indicators of interaction patterns did not suggest that the drug users had friends who were particularly deviant. Adolescent drug users do not appear to form subcultures delineated from nonuser subcultures along interaction dimensions other than that of drug use. The results are consistent with an interactionist-socialization viewpoint of the development of drug use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Students' estimates of the prevalence of drug use: Evidence for a false consensus effect.

False consensus, or the tendency to overestimate the extent to which others share one's own attitudes and behaviors, was investigated in a study of 348 university students classified as non-drug users, cannabis-only users, or amphetamine+cannabis users. Participants estimated the prevalence of cannabis and amphetamine use among students. Cannabis and amphetamine users made significantly higher estimates of cannabis use among students than did nonusers, whereas amphetamine users gave significantly higher estimates of amphetamine use than nonusers and cannabis-only users. Correlations between estimates of use among friends and other students were significantly positive for both drugs. The results suggest that students are motivated to overestimate the commonality of their own position on drug use and that their estimates may also be influenced by selective exposure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beginning adolescent drug use and peer and adult interaction patterns.

Interaction patterns among drug users, their peers, and significant adults have been implicated as causal factors of later drug abuse. Data were collected from 1,634 adolescents about their current use of 13 substances and about their interactions with peers and significant adults. Five canonical dimensions were necessary to explain the significant covariation in each of 2 comparable samples. The replicated pattern of rotated canonical loadings indicated that users of various classes of substances associated with other individuals who used the same substances. Other indicators of interaction patterns did not suggest that the drug users had friends who were particularly deviant. Adolescent drug users do not appear to form subcultures delineated from nonuser subcultures along interaction dimensions other than that of drug use. The results are consistent with an interactionist-socialization viewpoint of the development of drug use. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid spread of HIV among injecting drug users in north-eastern states of India

Manipur, a north-eastern state of India bordering Myanmar, has experienced very rapid transmission of the human immunodeficiency virus (HIV) among its vast drug-injecting population. Seroprevalence among intravenous drug users increased from 0 per cent in September 1989 to 50 per cent within six months. With a minimum injecting population of 15,000 and seropositivity of over 50 per cent, the infection quickly spread to the population at large. One per cent of antenatal mothers tested seropositive by 1991. Forming part of the area of South-East Asia known as the Golden Triangle, and producing opium and its derivatives, Myanmar shares a long international border with four States of the region, and populations with a common language and culture move freely across borders. Two other north-eastern states of India bordering Myanmar have faced a similar epidemic within a short period of time. As a result of serosurveillance for HIV since 1986, the epidemic could be detected at an early stage. The present paper provides an account of the results of ongoing comprehensive studies conducted in the north-eastern states of India on drug-related HIV infection, already a serious problem, but possibly still restricted to that region of the country. The prevalence of intravenous drug users, their HIV serological status, the demographic profile, risk behaviour, the spread of the infection to other groups and the problems of harm minimization are also covered.     

Personality factors in student drug use.

Interviewed a random sample of 160 male and female undergraduates concerning illicit psychotropic drug use and administered the Personality Research Form. Univariate and multivariate analyses strongly supported the hypothesis that nonusers, moderate users, and heavy users of illicit drugs differ in personality characteristics. Dramatic sex differences were observed in the personality characteristics associated with illicit drug use, suggesting that sex and personality interact in a crucial way to influence drug use. The relationships between illicit drug use and GPA, satisfaction with academic performance, aptitude, and other relevant variables were also investigated. The data are interpreted as suggesting that both male and female heavy users may have rejected their stereotypic sex roles. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A 12-year study (1975-1986) of mortality in methadone-maintenance patients: selected demographic characteristics and drug-use patterns of AIDS and non-AIDS-related deaths

This paper describes changes in demographic characteristics and drug use patterns of persons who died while enrolled in a New York City methadone-maintenance program during the years preceding and subsequent to the AIDS epidemic. Persons dying from AIDS were more likely to be younger, Hispanic, and male than those dying from other causes. Drug use increased during the 12-year study period, and the spread of the HIV infection among drug users may be reflected in an increased use of injectable drugs.     

Positron emission tomographic evidence of toxic effect of MDMA ("Ecstasy") on brain serotonin neurons in human beings

BACKGROUND: (+/-)3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") is a popular recreational drug that selectively damages brain serotonin (5-HT) neurons in animals at doses that closely approach those used by humans. We investigated the status of brain 5-HT neurons in MDMA users. METHODS: We enrolled 14 previous users of MDMA who were currently abstaining from use and 15 controls who had never used MDMA. We used positron emission tomography (PET) with the radioligand carbon-11-labelled McN-5652, which selectively labels the 5-HT transporter. We analysed whether there were differences in 5-HT transporter binding between abstinent MDMA users and participants in the control group. Blood and urine samples were taken and tested to check for abstinence. FINDINGS: MDMA users showed decreased global and regional brain 5-HT transporter binding compared with controls. Decreases in 5-HT transporter binding positively correlated with the extent of previous MDMA use. INTERPRETATION: Quantitative PET studies with a ligand selective for 5-HT transporters can be used to assess the status of 5-HT neurons in the living human brain. We show direct evidence of a decrease in a structural component of brain 5-HT neurons in human MDMA users.     

Heroin craving and drug use in opioid-maintained volunteers: Effects of methadone dose variations.

Recent data indicate that opioid agonist and antagonist challenges decrease and increase (respectively) heroin craving in physically dependent individuals. This study investigated effects of methadone dose variations on craving and new drug use in 18 outpatients who were given money contingencies. In Phase 1, volunteers were told in different test sessions that methadone dose would increase, decrease, or stay the same; drug-abstinence contingencies were suspended for 24 hr. Craving significantly increased and new heroin use marginally increased (relative to maintenance dose) only when a dose reduction was paired with a dose decrease instruction. In Phase 2 (detoxification), craving and heroin use significantly increased as methadone dose decreased. Thus, loss of μ-receptor agonist effect increased craving and risk of relapse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)