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Obsessive-compulsive disorder followed by psychotic episode in long-term ecstasy misuse
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Official websites use. Share sensitive information only on official, secure websites. This article presents selected findings from a qualitative study of Ecstasy sellers and their sales practices, knowledge of distribution networks, buyer-seller relationships, and self-reported drug use. In-depth interviews were conducted with 80 men and women who had sold five or more hits of Ecstasy five or more times in the six months prior to the interview. Study participants described their perceptions of the various types of Ecstasy they had distributed or used themselves. We demonstrate that considering Ecstasy branding increases our understanding of buyer and seller relationships. Ecstasy is the street nomenclature for MDMA 3,4-methylenedioxymethamphetamine. The marketing of Ecstasy has evolved to encompass a plethora of brand names and drugs manufactured in an assortment of shapes and colors with the choice of powder or pressed tablets with varying ingredients that are sold under the name Ecstasy. There is scant research in the area of Ecstasy branding, particularly from the perspective of the distributor. In this study, the authors explore the importance and role of pill brands and preferences for powder or pressed pills from the perspectives of a sample of San Francisco Bay Area Ecstasy sellers. While there is no physical hangover analogous to an alcohol hangover, some research has shown that users experience depressed mood in the days following use, although this effect seems to be reversible Morton According to Ecstasy users, the positive attributes far outweigh any of the adverse side effects Levy et al. Although Ecstasy became classified as a Schedule I drug in the US in , recreational Ecstasy use spread worldwide, beginning on the holiday island of Ibiza, Spain. Ecstasy use did not achieve mainstream status in the United States until a decade later, concurrent with the emergence of a domestic rave scene Sloan In these earlier times users would ingest the drug orally in the form of small, white or light-colored pressed tablets; various pill colors and types of Ecstasy had barely surfaced. In the late s and into the turn of this century, a wide variety of Ecstasy brands appeared with distinctive pressings, shapes and colors. What is Ecstasy? Ecstasy is distinctive as it refers to not necessarily one drug but possibly to several substances; and for the purposes of this article, we will use the term Ecstasy to denote a potentially multiple substance drug. Whether Ecstasy can be considered a designer drug or a concept drug, there appears to be marketing of Ecstasy through brand names. In order to discuss branding in the context of the Ecstasy market, it is necessary to look at the definition of brand. A drug distributor understandably might want to utilize branding to create and maintain a connection with his or her customers. According to Van de Wijngaart and colleagues , most Ecstasy users obtain their pills via friends or acquaintances and many are not sure of the composition of these pills. While the aforementioned research did not delve into the specifics of Ecstasy brands, it would appear that friendships between buyers and sellers yielded trust in the purity and quality of the Ecstasy exchanged regardless of brand. The present study will further explore the importance of Ecstasy brand reputation versus the social bonds between buyers and sellers of Ecstasy. Ecstasy is not the first illicit drug to be distinguished by brand names. Drugs like lysergic acid diethylamide LSD and heroin have been stamped with various symbols over time, often spawned by popular culture and recognizable icons. McCormick notes that LSD has the longest history of imagery in its marketing. The early designs used for LSD were reminiscent of childhood fantasies and inspired by popular cartoons of the time, including Mickey Mouse in Fantasia, Snoopy, Mr. Natural, and Alice in Wonderland. Oftentimes these images referenced the purported surreal, psychedelic experience produced by the drug also known as acid. As production techniques evolved along with technological advances over the years, blotter acid prints began to carry images of the prevailing culture as a sort of mockery, ranging from national monuments to the official FBI emblem McCormick Cell phones and beepers increased in popularity for dealers, diminishing the role of drug stamps. The researchers suggest that heroin stamps functioned as a chronicling, not only of the heroin market at the time, but also of inner city life and possibly subconscious responses to what distributors saw in the world around them. Ecstasy labeling can be viewed in a similar way to heroin stamps and acid blotter sheets; however, findings from analyses of our interview data and reviews of Ecstasy-related websites indicate that Ecstasy branding is somewhat distinctive compared to labeling in other drug markets. According to the United States Drug Enforcement Administration DEA , major distributors package Ecstasy with appealing logos in hopes of building brand loyalty, instilling confidence in the product, and ultimately promoting use of the drug as fun and harmless. Media and law enforcement reports have claimed that Ecstasy sellers market the drug to children by creating candy-colored pills with kid-friendly logos DenverDA. Although the majority of sellers interviewed for this study were not major distributors or manufacturers, we wanted to determine what our sample thought about the purpose and effects of Ecstasy brands and how important they were in a business sense. Did buyers prefer one brand to another and, if so, why? Unlike heroin stamps, Ecstasy branding has occurred worldwide as Ecstasy use evolved from underground parties to mainstream use. And while LSD iconography was steeped in hippie-inspired emblems like peace signs and rainbows, the commercial logos of Ecstasy brands reveal a different ideology altogether McCormick While not every Ecstasy brand is based on corporate identifiers, the essence of consumer culture is apparent in the marketing of this drug with pill brands like Motorola and Mitsubishi. These labels also seem to reflect the current state of society in which Ecstasy pills could be seen as cultural artifacts of middle class, drug-using social worlds. We found the Internet to be a useful resource in discovering details about Ecstasy. From DEA operations to harm reduction guides, online Ecstasy information is plentiful. Schifano and colleagues assert that the scope of the MDMA market can be easily assessed in cyberspace. They found that nongovernment websites ranked second to friends in importance and perceived accuracy, followed by information obtained in drug treatment and from physicians. Falck et al. Evidently, young people today see the Internet as an important tool for gathering information on Ecstasy. An examination of Ecstasy-related websites reveals that Ecstasy users from all over the world access various websites and online bulletin boards to share information, particularly about specific brands. One such site is Pillreports. This daughter site of the Australian Bluelight. At the time of this writing, pills could only be rated above an eight if their purity had been tested using a kit available for purchase online; testing kits consist of a chemical reagent that reacts to the presence of specific drugs by changing colors. This site proved helpful in gathering information about various pill brands. Unfortunately, few of our participants were familiar with this website. The websites they accessed more often, such as DanceSafe. At the time of our research DanceSafe also provided a list of recent Ecstasy pill brand laboratory test results. The phenomenon of brands in Ecstasy markets necessitated further investigation into their significance to sellers and buyers. With minimal available information on this subject, it was unclear how important brands were to individuals who both sold and used Ecstasy. Past work in other drug markets, such as the aforementioned Wendel and Curtis study of heroin stamps, suggest that any sort of drug imagery may serve as subcultural text. We decided to study how the labeling of Ecstasy related to the social world of this drug from the perspective of those entrenched in these markets. In order to investigate a full range of sales practices, we extended the study to relatively low-level sellers in hopes of garnering information from both initiates and experienced distributors. Participants had to have sold five or more doses of Ecstasy five or more times in the six months preceding the interview. After acquainting the participant with the nature of the study and completing informed consent procedures, the interview proceeded with the tape-recorded, depth interview portion followed by the questionnaire. All of the study's instruments and protocols were subject to the approval and oversight of the Institute for Scientific Analysis Internal Review Board. Of those, 14 were attending full-time, and 15 were attending part-time. Of those, 50 were employed full-time and 20 were employed part-time. Study participants were predominantly White, male, middle to upper-middle class, and in their twenties. We analyzed findings from both our depth interview and questionnaire data. The depth interviews were transcribed and manually coded using a list of common themes that emerged from initial data analysis. Afterwards, codes were entered into Ethnograph 5. We then conducted searches for relevant coded segments. Questionnaire data were entered into SPSS We ran frequencies to find which brand names were most commonly reported by our interviewees, and conducted analyses of questions regarding to whom our participants sold as well as Ecstasy testing practices and perceptions regarding purity. In the early phases of our study, data emerged from depth interviews indicating the relevance of the branding phenomenon to our participants. The data collection process revealed that Ecstasy brands and labels could reveal a great deal about particular drug markets. Ecstasy brands and types may influence purchasing choices among customers, and suppliers may distribute specific brands to appeal to these customers. The choice of logos may reflect aspects of various Ecstasy-using social worlds. Interviews with study participants revealed the ways in which sellers chose to utilize or not utilize Ecstasy labels. After conducting searches of the aforementioned codes, we realized that we needed to gather more specific information on Ecstasy branding from the data. We surveyed the Internet to track the pill brands mentioned by our participants to observe images of specific pills, their contents if available , reviews of the pills given by users, and their ratings. Weekly checks were conducted of DanceSafe. At the time of our Internet research to , DanceSafe. While we checked this website weekly, updates on pill test results occurred less frequently, closer to monthly but not with any standard regularity. We made notes of brand names and descriptive characteristics of each pill that came from the Bay Area. Typically, there were new pill ratings entered at least on a weekly basis. The majority of the popular pill brands mentioned by our participants were observable on both websites. Various batches were noted to be within each of the popular brands, and therefore testing results and ratings differed greatly. The majority of this sample characterized themselves as low- to mid-level sellers. They knew little about manufacturing Ecstasy and how the names of pills were chosen. Not one of them had chosen an insignia with which to stamp pills or had pressed tablets themselves. Still, their perceptions about the meaning and function of pill brands in Ecstasy markets were valuable since these participants were often both sellers and users. Probably just like quality assurance. An interviewee who distributed powder MDMA in capsules at the peak of her sales also felt that brand names referenced quality as a marketing strategy. All the other ones had names, and that was in relationship to whatever emblem or logo was stamped on the top of them. But even like the alligators, I think, are supposed to be Lacoste. You know what I mean? With a similar notion of designer appeal, a year-old White man who only sold powder or capsule Ecstasy understood the use of brand names for Ecstasy. After telling us that he would never distribute press tabs, he expressed his thoughts on the purpose of Ecstasy labels and the relevance of brand loyalty. Just for marketing. For marketing I think like if a certain pill is good and popular and people like that combination like cocktails, then people look for that name again and test that brand name. A number of participants spoke about not depending heavily on the brand names of Ecstasy pills. It was clear to them that multiple batches of a pill could be made with a specific stamp and that copies containing other substances could also be marketed. Research confirms this belief; for example, Sherlock and colleagues studied the makeup of Ecstasy tablets in the United Kingdom and found that the amount of active ingredients in pills with the same brand name often varied. Some of our interviewees were cognizant of this fact based on their own experiences. An interview with a year-old male who sold to pills per month provided an example of variations in batches:. They got websites that you could like go to. I mean but you might get like a blue one that, say, has a dolphin on it. You have that for about a month or, you know, you have yours till you sold out. And then you get something else, and it has like a crown on it. You know, who cares? They could call it whatever you want. He postulated that brands and logos helped distinguish the source of each batch but felt that it was unwise to rely solely on brand names. You gotta \[sic\] trust it through, um you know, the people that \[sell it to you\]. I—I actually have never been really into—into that. For the most part, interviewees viewed Ecstasy brands as identifiers that referenced quality as a marketing strategy. However, they saw reliance on brands as risky because 1 a brand name potentially could identify the source of the supply and 2 the same brand actually could be different configurations of various drugs, not necessarily including MDMA. Ultimately, some sellers believed that brand names gave Ecstasy a bad reputation because of the possibility of the brand named pill not containing any MDMA. From both our depth interviews and questionnaires, we found there were particular Ecstasy brands that were common for both personal use and sales. Interviewees reported selling a broad variety of Ecstasy pill brands, seventy different brands total. One interviewee talked about becoming exposed to various Ecstasy brand names when his use increased. This year-old African-American man learned which pills he preferred from his personal experience. I started, you know, really learning once I started finding the different names. Once I find a cool one, then I would ask for it by name. Do you have this, that, you know? Some participants also reported an increase in the assortment of pill brands over time. Those who had experience with Ecstasy in its earlier days described how pills had evolved over time. One male participant had been using and selling Ecstasy for several years at the time of the interview. He noted the changes he had witnessed:. No logos, none of that stuff. And this is my opinion but I believe that it—some of the chemicals were harder to make and so they had to do something to market these pills. So there were dollar signs and Polos and Rolls Royce logos and all the different logos and they started giving names to them too. And then I even knew a lot of dealers that would use food coloring to make maybe more of an impact of marketability on the product. For example, a year-old White male seller listed some of the names of what he perceived to be good Ecstasy. Yet, he also pointed out that what was thought to be good or bad was often subjective. Usually the bad ones are just white. I mean not my friends or people that I deal with now, but in general Ecstasy. They just want to escape. The majority of our participants were seasoned Ecstasy users and their sales experience gave them additional knowledge about brands. Several interviewees told us that they did not pay attention to which brands were popular, and sometimes their customers were not concerned with the names of pills either, as is evident in this quote from a year-old White woman:. I never really could remember the names. They trusted their suppliers and had formed social bonds with them as well. For many of the interviewees, the label on the pill was secondary to the source of the pill. A smaller but substantial number of our participants sold powder Ecstasy or Ecstasy in capsules. This moniker for powder Ecstasy was novel, yet we heard different definitions for sassafras from two participants. A year-old White male interviewee was the first to reveal this name to us. Another interviewee, a year-old White male, who was one of our highest level dealers also talked about sassafras. He gave us a different definition and an in depth explanation. He seemed to have more knowledge about the manufacturing processes for Ecstasy than most of the sample. R: They called it Molly. Molly was the only name because it was supposedly from molecule. It was created molecule by molecule or whatever the process is. Looking back on it I highly doubt it was Molly. My bet was that it was sassafras, that it came from sass-sassafras oil, that method of making Ecstasy was my bet. Um, from my limited understanding, you can make Ecstasy by putting all the chemicals together and making Ecstasy or sassafras is two or three molecule, sassafras oil is two or three molecules off of what Ecstasy is the, the compound. And by removing and adding chemicals you can change sassafras oil into Ecstasy. Um, and was a lot cheaper and it—the chemicals were easier to purchase in the United States um, so. INT: And what do you think the differences are like, feeling—like use wise between Molly and the sassafras? Whereas like Molly and um, molecule is more upbeat, dance-y \[sic\], club, keep energy boost, grind your teeth all night type high. Both of these sellers dealt with hippie-type subcultures in which the customers seemed interested in the possible natural roots of Ecstasy. While these participants had distinct explanations for sassafras, both definitions seemed tailored to the market in which they were selling. Further research should explore the socioeconomic aspects of labeling in which, for example, corporate and high status brands may appeal to those in the upscale club scene. In general participants did not feel brand names were of primary importance in their Ecstasy sales. A year-old Filipina seller reported picking up Ecstasy brands she was familiar with, both for her own consumption and to sell to buyers accordingly. This practice exemplified that of the majority; they were users as well as sellers who often put aside pills for their own use from a batch they sold. This participant tailored her sales of particular brands to the customer. Like, I know I like Blue Dolphins. And I know that the White Fins are very, very mild. INT: And so, when you do hook other people up, you try and hook them up with the kind that they like? R: When I try to hook—well, yeah. Another participant also spoke about purchasing batches to sell that he and his selling partner preferred to use themselves. While the particular Ecstasy he described did not have a brand name per se, he believed this specific type contained heroin. We love that stuff. Give it to us. And that was the only one we recognized was the brown dots. Interviewees and their customers varied in their preferences for powder Ecstasy versus pressed pills. Just from selling it, people always want the capsules, it seems to me. A year-old, white interviewee talked about his concern for his customers and their preference for powder or capsule Ecstasy. He chose to distribute powder Ecstasy primarily because he disliked the brand market. I never got into the brand names, but I just knew that that was generally, you know, a pretty backwards market to go into. Alternatively, some felt that pressed pills were higher quality and more likely to be pure since it seemed easier to adulterate powder. A year-old White man believed that labeled pills sold better than capsule Ecstasy. In the following he describes what his customers preferred:. Anyone could make those capsules, where pills are definitely manufactured. So I definitely think it makes a difference. It should be noted that the majority of the sample did not test their Ecstasy regularly. These were only estimations as available kits did not test for purity levels. The Ecstasy sellers in this sample often relied on their own judgment and trust in their suppliers to obtain and distribute what they believed to be quality Ecstasy. Our online tracking of Ecstasy pill brands uncovered some crossover between what we heard from interviewees and what we saw on the websites. While a small number of participants talked about checking specific pills online, the common mentions of brand names from both our interviews and from online research revealed the widespread nature of this branding phenomenon. The most visited website was Dancesafe. Other websites mentioned were Bluelight. We were not able to fully review the exhaustive amount of information on even one website Pillreports. We found there were different batches of the same brand with various ratings. It should be noted that the ratings on Pillreports. As previously mentioned, 24 of our participants accessed the Internet to look at images of particular pills. Most interviewees went online to find information about the purity and quality of specific pills, but many times interviewees could not recall the name of the website they had looked at because they had conducted a search on major search engines e. When asked about researching pills on the Internet, this year-old White man said his friend first told him about the pill websites:. R: I had a friend that did it actually. Or someone has a pill like that they found or something, you know, we can just look it up. Go on the Internet and see what it is. Another participant, a year-old White man, talked about using Ecstasy websites not only to research pills he planned to sell but also to educate himself on the health risks of using Ecstasy. He liked Bluelight. I look at various sites. I like Bluelight. That just talks about the pills and rates the quality. I just did it out of curiosity. Understanding the branding of Ecstasy has the power to relay messages not only about this particular drug market and its subculture but also about our consumer-conscious society as a whole. Clearly more research is needed in this area. We were not able to interview any sellers who had branded Ecstasy themselves. San Francisco Bay Area Ecstasy distributors seem to be in a unique position. According to many of these participants who had lived in other parts of the country, San Francisco has a reputation for high quality, less expensive drugs, particularly Ecstasy. Perhaps they assumed the available drugs in San Francisco would be enjoyable regardless of brand name. These participants were less trusting of colorful pressed tablets because they were mass-produced in unknown locations and allegedly less organic than powdered Ecstasy. There were also interviewees who felt that powder would be easiest to adulterate, and therefore they preferred to sell pressed pills. The majority of the sample sold pressed tablets at the time of interview either due to availability or preference. After comparing our findings to what we researched on websites such as Pillreports. Generally, this sample appeared to have passed their peak usage of Ecstasy, while those who posted on these websites seemed to be either initiates or individuals fully immersed in an Ecstasy-using social world. The majority of our sellers did not utilize these websites on a consistent basis. Study participants had less faith in brand names observed online and relied more on trusting their sources for Ecstasy. The difference between the present sample and those who post on Ecstasy-related websites could be a function of age or membership in a specific subculture, but it is difficult to disentangle since there is not much information about the people posting on these websites aside from the region where they reside. A major limitation of this study is that we were not able to ask enough questions about Ecstasy pill brands and their function in the market. Since the study was exploratory in nature with the hopes of obtaining data about all aspects of Ecstasy sales practices, we did not originally include questions regarding this emergent theme. We probed for information on Ecstasy branding once the theme emerged, but we did not obtain as much data on this phenomenon as we would have liked. Unlike the in depth investigation conducted by Wendel and Curtis on the similar topic of heroin stamps, we have simply skimmed the surface of Ecstasy brands research. The way branding is employed in the Ecstasy market seemingly distinguishes it from other drug markets. There is much to be discovered in this area. While the emergent theme of Ecstasy pill brands is just one fraction of the larger study, this piece revealed important information linked to our main research aims. At the same time, pill brands became less meaningful for many participants when there was an established bond between buyer and seller. Most interviewees guessed the number of hands that the Ecstasy went through before it reached them, making it a challenge for them to assess how and why labels were chosen for particular pills. It is notable that some interviewees had very little knowledge of the origins of the Ecstasy they were selling. Future research should compare individuals who sell Ecstasy in private settings to those who sell Ecstasy on the street and in public venues to ascertain the role of pill brands in various Ecstasy markets. Furthering an understanding of how Ecstasy sellers utilize brands may help in better understanding how Ecstasy in general is sold. For most participants brand names were, at best, a tool for giving their customers a positive experience with a minimum of health risks. The majority of sellers in this sample distributed to friends and sometimes used with them, which also explains, in part, their concern for customers. Although some study participants felt that certain types of Ecstasy were reputable, they trusted their relationships with suppliers more than they trusted a particular brand name or type. This faith in their suppliers to distribute high-quality Ecstasy often outweighed any need to test the drug. While more extensive research is required, it appears that Ecstasy labels hold complex functions in a drug market that greatly depends on a moral contract between buyer and seller. The authors are grateful to the study participants for their time and candor; without them, this research project would not be possible. As a library, NLM provides access to scientific literature. J Psychoactive Drugs. Published in final edited form as: J Psychoactive Drugs. Find articles by Micheline Duterte. Camille Jacinto , B. Find articles by Camille Jacinto. Paloma Sales , Ph. Find articles by Paloma Sales. Sheigla Murphy , Ph. Find articles by Sheigla Murphy. Micheline Duterte : B. Camille Jacinto : B. Paloma Sales : Ph. Sheigla Murphy : Ph. PMC Copyright notice. The publisher's version of this article is available at J Psychoactive Drugs. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.
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Obsessive-compulsive disorder followed by psychotic episode in long-term ecstasy misuse
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