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Official websites use. Share sensitive information only on official, secure websites. Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. The COVID pandemic spread rapidly worldwide in the year , which was initially restrained by drastic mobility restrictions. The remaining substances were detected in all the investigated catchment areas. In general, no remarkable changes were found in population normalized loads compared to former years, except for cocaine i. Furthermore, two events of ecstasy 3,4-methylenedioxymethamphetamine, MDMA dumping in the sewage network were confirmed by enantiomeric analysis, one in Santiago de Compostela just prior the lockdown and the second one in the Bilbao and its metropolitan area in July after relieving the more stringent measures. The latter could also be associated with a police intervention. The comparison of WBE with web survey data, which do not provide information at a local level, points towards contradictory conclusions for some of the substances, thereby highlighting the need for stable WBE networks capable of near real-time monitoring drug use. Due to the rapid transmission of the virus in early , most countries imposed lockdowns and perimeter closures, affecting mobility, and limiting essential activities. Subsequently, the closure of bars, pubs, clubs, restaurants etc. The obliged self-isolation produced a change in our lifestyle that could have had a psychological impact on human health Brooks et al. As regards to illicit drugs, these restriction measures have had an important impact on the logistics of drugs trafficking European Monitoring Centre for Drugs and Drug Addiction, a. Despite this, access to them has not been totally affected since, new distribution strategies have been adopted to overcome the restrictions, such as the use of darknet markets European Monitoring Centre for Drugs and Drug Addiction, b. However, such methods are not, on their own, able to capture the real impact of the pandemic over drug use Palamar and Acosta, The analysis of wastewater can give an additional and representative estimation of human consumption of licit and illicit substances during the pandemic. This methodology, known as wastewater based epidemiology WBE , uses wastewater as an anonymized, integrated and diluted sample of urine of a particular location to obtain comprehensive results, which can be then completed with surveys results van Wel et al. WBE has been successfully used in studying spatial and temporal differences of illicit drug use Bijlsma et al. Nowadays, the scope of WBE has been extended to many applications, such as the estimation of alcohol and tobacco consumption Castiglioni et al. Due to the fast expansion on the subsequent weeks, the authorities declared the state of alarm on 15 March and imposed a lockdown, where only essential activities were permitted and movement was restricted to buy groceries and other essential goods, seek medical attendance, etc. During March, cases continued to rise with a peak on 31 March In the following weeks, cases and deaths followed a decreasing pattern until 11 May , when the quarantine ended. In Spain, wastewater sampling was performed in the period between 10 March to 14 July , depending on the particular location sampled. Further details are provided in Section 3. On 16 March , schools were closed and two days later, on 18 March , the Emergency State was declared, and Portugal was placed under a strict lockdown. During the consecutive weeks, new cases and deaths decreased until 2 May , when the quarantine ended. The so-called state of calamity Estado de Calamidade , divided in three phases started the same day, where gradually, recreative centers, activities etc. Wastewater samples were collected from 19 April to 24 July in Portugal. Sodium acetate and sodium chloride were obtained from Fluka Steinheim, Germany. Table S1 compiles sampling dates and flow rates of each individual sample, the characteristics of the WWTPs and sampling mode. A time-proportional sampling mode was employed in all cities. Further data from and and in the case of Porto were obtained from the literature Bijlsma et al. Besides, both laboratories participated and satisfactorily passed the interlab study organized by the SCORE Network in , which warrants good performance and comparability of the results van Nuijs et al. Concentrations of each particular biomarker compiled in Table S2 were used to determine population-normalized daily loads compiled in Table S3 of each compound in the 24 h composite wastewater samples, Eq. Human consumption rates presented in Table S4 were then estimated Eq. Although a recent study in Australia Thai et al. Besides, the use of the same CF as previously applied in former studies in Spain warrants a better comparability of data. These were used to derive the enantiomeric fraction EF , which was then employed to tentatively differentiate between licit prescription or illicit abuse consumption and direct dumping in the sewage network. Data were plotted with Microsoft Excel and R ggplot2 package. Moreover, a more detailed division according to the different de-escalation phases, as detailed in Section 2 and Fig. The horizontal line and blue dots and smaller black dots represent the median, mean and individual datapoints, respectively. Further detailed plots are presented in Fig. MAMP remained below the detection limits in all samples. This is consistent with former studies in Europe and Spain Bijlsma et al. In fact, in a former study where samples from 13 Spanish cities were collected during a week in Spring Bijlsma et al. These findings confirm our former studies in the area of Bilbao, where a high consumption of AMP was observed mean ca. The statistical analysis confirmed that there was no statistical difference Table S6 between the different periods of the study, including former years in the case of Bilbao and its metropolitan area. Furthermore, these findings also point to the fact that AMP use is not a local issue in Bilbao and its metropolitan area, but a regional behaviour, which will position the consumption of AMP in the Basque Country at levels close to those found in central Europe, e. Data from this region agree with general-population surveys GPS , as regards the fact that AMP consumption is higher in this region as compared to the rest of Spain, but WBE estimations indicate that such difference is larger to what GPS report, as already discussed in former studies Bijlsma et al. Other WBE studies Alygizakis et al. However, this trend was not observed in this study. MDMA was detected in the six studied cities. The excretion loads of MDMA in ranged from 0. Hence, these two together with other randomly selected samples were subjected to enantiomeric analysis. Given this observation, these two events were not considered for calculating average loads Table S3 nor for consumption back-calculation Table S4. In the case of the metropolitan area of Bilbao the finding was also consistent with media reports e. EUS, ; El Diario Vasco, from July reporting a police action taking place on the previous day where a drug trafficking organization was dismantled. Considering the loads on those two days related to disposal events and average loads in wastewater in Santiago de Compostela and Bilbao and its metropolitan area under normal circumstances Table S3 , we could calculate the disposed amount, which would translate into 39 and g of pure MDMA in the event in Santiago de Compostela and Bilbao and its metropolitan area, respectively. This would correspond to either tablets or These figures could be, however, underestimated, since they assume that all MDMA was dissolved in the transit from the disposal site to the WWTP where water was collected, but this may not be true. The extrapolated MDMA consumption after excluding the two direct disposal events is summarized in Fig. S2 and Table S4. S2 and Fig. Therefore, and considering the overall picture presented in Fig. Interestingly, these findings contrast both with on-line surveys and expert information Table 2 , which indicate an overall decrease in MDMA consumption during the lockdown. However, the conclusions from other WBE studies Table 1 differ from location to location, but the overall trend during the lockdown was also towards a decrease or no change in MDMA consumption as compared to former years in the studied areas. However, consumption seemed to recover in those places after lockdown relaxation in Europe European Monitoring Centre for Drugs and Drug Addiction, a. Both cocaine and its metabolite, benzoylecgonine were detected in all samples Table S2. The ratio of cocaine to benzoylecgonine was calculated as it may indicate a direct disposal event when above 1 Bijlsma et al. Altogether, this data points to the fact that no significant cocaine dumping occurred in The average calculated consumption of cocaine from benzoylecgonine, summarized in Fig. No statistical differences among the different time-periods considered were found in Vitoria-Gasteiz or Vila do Conde, where data from former years were not available, neither for Bilbao and its metropolitan area Table S6 , where data were available for one week in and The post-hoc test could not detect any statistical pairwise differences among periods in Santiago de Compostela, however, the data plotted in Figs. S3, Fig. S3 and Fig. Consumption levels were estimated with two different correction factors see Section 3. S4 , while calculations with CF Given that several uncertainties exit around this compound, as detailed elsewhere Bijlsma et al. In this context, the statistical analysis confirmed the existence of temporal statistically differences in all investigated locations, except Vila do Conde Table S6. In the case of Bilbao and its metropolitan area, the statistical difference is due to the higher loads of THC measured in respective subsequent periods Fig. S4, Table S6. Altogether, there is no clear trend on cannabis consumption Fig. Moreover, in this case, findings are in line with other WBE studies showing no change in cannabis consumption or even an increase Table 1 , which also agree with on-line surveys Table 2 where a remarkable change in cannabis consumption is not very clear. Nicotine consumption is presented in Fig. S5 as the average estimation from its two metabolites Montes et al. Although the presence of nicotine metabolites in wastewater may also be due to smoking cessation products or e-cigarettes, besides tobacco smoking, these other sources are expected to be rather small in the case of Spain, as discussed in Montes et al. The higher usage rate in this location may partially be due to the higher variability and should be confirmed in future studies. Considering 0. Charles et al. All locations showed statistical differences among periods, with the exception of Vila do Conde Table S6. In Santiago de Compostela, the differences were due to the low measured consumption during the 5 pre-lockdown days sampled as compared to Phases I and II of lockdown relaxation Table S6, Fig. The only two WBE studies considering tobacco Table 1 show contradictory conclusions Alygizakis et al. Thus, overall, the picture is not conclusive, but points towards a minor impact of COVID on tobacco. Although there was a significant decrease in tobacco sales in April and June respecting the same period of the former year Fig. In Bilbao and its metropolitan area consumption of ethanol in and remained stable Kruskal-Wallis p -value: 0. Other WBE studies Table 1 either point towards a stable alcohol consumption or decrease, which may also recovered after the strict lockdown period European Monitoring Centre for Drugs and Drug Addiction, a. As regards to global and Spanish survey reports, divergent results were shown Table 2 , pointing towards an increase or decrease at Global or Spanish level, respectively. Other publications considering surveys at Spanish level also point towards an overall decline in alcohol consumption Kilian et al. Yet, the data from the panel survey of domestic consumption of foods in Spain which includes alcoholic drinks show a dramatic increase of alcoholic drinks being sold in supermarkets and similar shops Fig. This increase in alcohol being taken home does, however, not necessary translate in an increased consumption, since alcohol consumption at bars, restaurants, etc. In this work, we have studied the use of illicit drugs, alcohol and tobacco by WBE during the initial months March—July of the pandemic in six locations in Spain and Portugal. The overall picture obtained points towards low impact of the COVID mobility restrictions, particularly after relieving the more stringent measures. Other WBE published studies showed very inconsistent conclusions, highly dependent on the locations under study. Yet, the Spanish statistics on mortality related to poisoning due to drugs of abuse, registered vs. Although the results of this study need to be interpreted with caution, they stress the importance and need for a stable WBE network for drug use monitoring that can provide rapid near real-time data to inform policy interventions in a pandemic context, as it has become a common practice for COVID monitoring itself. All relevant data generated or analyzed during this study are included in the supplementary information. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Sci Total Environ. Find articles by Lubertus Bijlsma. Find articles by Ricardo Capela. Find articles by Rafael Cela. Find articles by Alberto Celma. Find articles by Unax Lertxundi. Find articles by Rosa Montes. Find articles by Gorka Orive. Find articles by Ailette Prieto. Find articles by Miguel M Santos. Find articles by Rosario Rodil. Open in a new tab. Reference Reinstadler et al. Web survey of ca. 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. Reinstadler et al. Been et al. Alygizakis et al. Di Marcantonio et al. Bade et al. Did not change 2 locations Increase 1 location Decrease 4 locations. Global Drug Survey, Spanish OEDA telephonic survey with responders. Only the responders in the 15—64 years range are considered here b.

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Delgado buying MDMA pills

Official websites use. Share sensitive information only on official, secure websites. Address correspondence to Kevin E. O'Grady, Ph. This study examined ecstasy use in 30 college students who participated in one of four minute focus groups with other participants who also had a history of ecstasy use. Ten topics emerged in the sessions: 1 pill ingredients, 2 mechanism of MDMA effects, 3 reasons for initiating ecstasy use, 4 risky behaviors and ecstasy use, 5 sexual activity and ecstasy, 6 positive effects from ecstasy use, 7 negative effects related to ecstasy use, 8 ecstasy and polysubstance use, 9 perceived risks of ecstasy use, and 10 motivational factors related to quitting ecstasy use. Most participants had a basic understanding of the contents of ecstasy pills, and the effects that ecstasy has on the brain and bodily functions. Participants reported positive effects on mood, social pressure, curiosity, availability, boredom, desire for an altered state of mind, desire to escape, self-medication, desire to have fun, and the ease of use of ecstasy in comparison to other drugs as reasons for initiating ecstasy use. They were divided regarding whether ecstasy increased the likelihood of engaging in risky behaviors, including risky sexual behavior. Participants described their experiences of both the positive and negative effects physical and psychological that they attributed to their use of ecstasy. All participants were polysubstance users, consuming a number of other substances simultaneously and concurrently with ecstasy. The majority was unaware of specific types of problems ecstasy could potentially cause and discounted its potential harm. Implications for prevention and intervention are discussed. Substance abuse a among young adults continues to be an area of concern for public health research, as well as among medical and mental health professionals. During the past 10 years, the use of club drugs—a class of synthetic compounds that have various stimulant and hallucinogenic properties—has become more prominent among the spectrum of drugs used by youth and young adults in the United States Rivas-Vazquez and Delgado, The aim of the present study was to conduct an in-depth examination of six important and inadequately understood topic areas relating to ecstasy use in college students, a group that appears to be at high risk for club drug use. In addition to providing useful information in regard to these six topic areas, it was anticipated that data gathered from the focus groups would provide guidance in generating specific hypotheses that could be tested in larger samples using quantitative methods. Beck and Rosenbaum interviewed ecstasy users and detailed the common stages of the ecstasy high. When an average dose of ecstasy — mg was ingested orally on an empty stomach, its effects were usually experienced after 20 to 60 minutes, and were often described as a sudden and intense high, a perfect euphoria. Following this initial period, users generally reported a relatively stable and enjoyable period that tended to last between 2 and 3 hours. Ecstasy users reported using other substances such as alcohol, tranquilizers, or marijuana to ease the comedown. The ecstasy experience is often associated with varying undesirable effects. Physical effects can include loss of appetite, nausea, vomiting, blurred vision, increased heart rate and blood pressure, muscle tension, faintness, chills, sweating, tremor, insomnia, convulsions, and a loss of control of voluntary body movements Beck and Rosenbaum, ; Kalant, Because ecstasy is typically produced in clandestine laboratories, pills can often contain various adulterants, such as methamphetamine, caffeine, cough suppressants with PCP-like effects, and cocaine Hansen, Riddle, and Sandoval, ; Drug Enforcement Administration, Research evidence indicates that ecstasy use frequently includes the use of other illicit substances. According to a report by the Drug Enforcement Administration , ecstasy is often used in combination with alcohol, other club drugs GHB and ketamine , marijuana, methamphetamine, psilocybin mushrooms, and LSD. Arria et al. Yacoubian et al. One factor that has been consistently cited in the literature as a predictor of future substance use among adolescents and young adults is prior substance use. Boys and Marsden examined the use of alcohol, cannabis, ecstasy, amphetamine, and cocaine hydrochloride in a nontreatment sample of 16—year-old polysubstance users. Initiating use at a younger age was significantly associated with more intensive use of ecstasy, cannabis, and cocaine. Dating back to , Kandel found that associating with drug-using peers was a significant risk factor for initiating illicit drug use. Consistent with this prior research, according to Hussong and supported by numerous studies e. Involvement in a substance-using group tends to be associated with various forms of licit and illicit substance use Chassin et al. Boys and Marsden found that participants' perception of substance use by their peers was a significant predictor of their own intensity of use for five substances alcohol, cannabis, ecstasy, amphetamine, and cocaine hydrochloride. The use of several different psychoactive substances has become very common among young adult drug users Boys, Lenton, and Norcross, ; Boys, Marsden, and Strang, Prior research has found that the concurrent use of drugs is commonplace among young adults, mainly to improve the effects of other drugs or to help manage negative effects Boys and Marsden, ; Boys, Marsden, and Strang, Furthermore, students who used ecstasy in the past year were more likely to use marijuana, engage in binge drinking, smoke cigarettes, have more sexual partners, rate parties as important, rate religion as less important, spend more time socializing with friends, and spend less time studying than nonusers. The variable with the strongest correlation with ecstasy use was marijuana use in the past year In trying to understand adolescents and young adults' motivations for using drugs, it is important to examine how motivations may differ depending on the type of substance Newcomb, Chou, and Bentler, For example, if the desired effect is increased nervous system arousal, stimulants such as amphetamines, ecstasy, or cocaine may be used. In a recent study of substance use by 16—year-old polydrug users in the United Kingdom, Boys, Marsden, and Strang found that the most popular functions for substance use among six substances cannabis, amphetamine, ecstasy, LSD, cocaine hydrochloride, and alcohol were: to relax Seven of the 17 reasons were endorsed by over half of those who had used ecstasy in the past year. The most common reasons for using ecstasy were: to keep going One of the significant trends in illicit club drug use in the United States has been the increased use of ecstasy among college students. A nationally representative survey of more than 14, college students from 4-year colleges in the United States found that the prevalence of past year ecstasy use had risen from 2. Results of a follow-up study of the same sample showed that the trend of increased ecstasy use continued through Strote, Lee, and Wechsler, The Monitoring the Future Study found that the lifetime and annual prevalence of ecstasy use among college students in was According to the National Household Survey on Drug Abuse, young adults between the ages of 18 and 25 represented the majority of the past year ecstasy users 2—3 million. The most recent results from the Monitoring the Future Study show a leveling off or slight decline in ecstasy use Johnston, O'Malley, and Bachman, The current study sought to provide a clearer understanding about several critical aspects of ecstasy use among young adults, particularly college students. Six main topic areas were introduced in the focus groups sessions: 1 history and course of all drug use, 2 general knowledge about ecstasy, 3 motivations for using ecstasy, 4 positive and negative effects—both psychological and physical—of using ecstasy, 5 the role of ecstasy in engaging in risky behaviors, and 6 reasons for quitting ecstasy. Results from this line of research have important implications both for understanding the antecedents and correlates of ecstasy use, as well as for designing universal and targeted prevention and intervention programs. We targeted college students with a history of ecstasy use as our population of interest, given that ecstasy has become increasingly popular on many college campuses. In , fliers were posted on a large 35,student campus, inviting individuals who had used ecstasy on at least one occasion to anonymously contact the researcher via telephone or e-mail using a fictitious first name if they were interested in participating in a focus group about ecstasy. All potential participants engaged in a brief telephone screening in which they were asked their age, gender, student status, and whether or not they had used ecstasy. Only individuals between the ages of 18 and 25 who had used ecstasy at least once in their life were accepted. This restriction was implemented because the goal of the study was to increase understanding of ecstasy use among college students by gathering data directly from users. A total of 43 callers responded to the fliers, 40 of whom met the study criteria, and 30 of whom participated in the study. Seven callers had a schedule conflict with the group meeting times and three callers failed to attend their scheduled groups. Four focus groups of six to 10 individuals were held in a private room on campus one male-only, one female-only, and two mixed-gender. Upon entering the room for the focus group, each participant was instructed to write the fictitious first name they had used during the telephone screening on a nametag. Participants were instructed to only use their fictitious first name during the session to protect their identity. Prior to beginning the study, the facilitator reviewed the informed consent form with the participants who then signed and returned this form to the facilitator. Participants were free to ask any questions and were provided a copy of the consent form for their records. Approval to conduct this study was obtained from the University Institutional Review Board. After completion of a brief survey, the guidelines for the hour-long group discussion were reviewed, including a reminder on confidentiality. Participants were told that they could speak about their personal experiences or what they knew about other substance users, without disclosing anyone's identity. Participants then engaged in a group discussion led by a facilitator. The facilitator, a graduate student in clinical psychology, moderated the discussion by asking specific questions and permitting group members to respond to the experimenter and to each other. The amount of time allotted to each topic varied based on group feedback and the judgment of the facilitator. The facilitator introduced each of the six main topic areas outlined in Objectives of the Current Study above , but discussion was not limited to these topics. Participants were instructed that they were free to either respond or not respond to each topic. Responses were written down by the facilitator and a trained research assistant. At the conclusion of the group discussion, the moderator provided participants with a list of mental health resources and an informational handout about ecstasy containing a list of websites pertaining to substance use. Although researchers often conduct private interviews or surveys when gathering data that are sensitive in nature i. Although there are trade-offs in the selection of any methodology, we felt that this approach, in the current circumstances, allowed the opportunity for participants to respond to others' contributions through either commentary or questions, and such benefit outweighed any potential problems with candor. We felt that having participants in the groups who had both similar and diverse experiences would create a dynamic environment in which the participants would develop both a level of interest and a degree of trust that would simply not occur in one-on-one sessions. Finally, we believed that feedback among participants within the groups would foster the sharing of information that they may not have recalled or felt comfortable sharing individually with a researcher. Based on the information gathered in the brief written survey, some basic background information about the participants is available. Table 1 presents the demographic characteristics of the 30 participants. Their average age was Although the original goal of the study was to examine the six main topic areas outlined in Objectives of the Current Study above , based on a review of the written record of the four focus group sessions, a more appropriate breakdown of the session topics emerged: 1 pill ingredients, 2 mechanism of MDMA effects, 3 reasons for initiating ecstasy use, 4 risky behaviors and ecstasy use, 5 sexual activity and ecstasy, 6 positive effects from ecstasy use, 7 negative effects related to ecstasy use, 8 ecstasy and polysubstance use, 9 perceived risks of ecstasy use, and 10 motivational factors related to quitting ecstasy use. The presentation below summarizes the discussions in each of these topic areas. When participants were asked about the composition of ecstasy pills, most knew that the pills were supposed to contain MDMA and that sometimes other substances some undesirable were also in the pills MDA, caffeine, speed, cocaine, heroin. For this reason, most stated that they only took pills from friends. Interestingly, many commented that the highs were not the same every time. The high depended on the type of pill they took and the environment in which they used it. Many participants stated that they read articles and searched the Internet for information regarding ecstasy. Most had heard of ways to test pills for specific substances but few actually tested their pills. Instead, they relied on their friends or others who had already taken pills from the same batch of pills. They reasoned that pills from a particular batch should be the same. They explained that the test only tells you if the drug you are specifically testing for is in the pills rather than all of the substances that are in the pill. A few individuals reported that they had researched ways to reduce the risk of brain damage and mentioned that they often take selective serotonin reuptake inhibitors SSRIs for this purpose. Notably, they commented that it was easy to obtain antidepressant medication from friends. In general, most participants had a basic understanding of the effects of MDMA on the brain. They explained that MDMA results in a release of excess serotonin that causes feelings of euphoria. Some participants also mentioned dopamine and norepinephrine, but did not know how these neurotransmitters were affected or how they affected functioning. When questioned about the role of serotonin in bodily functions, some participants demonstrated an understanding of the link between taking ecstasy and effects on bodily functions such as sleep, appetite, sex drive, and mood. Nothing bothers you. Participants were asked if they thought people were more likely to engage in risky behaviors while using ecstasy. Responses indicated a lack of consensus. One participant who was a heavy user reported doing things he wouldn't normally do. Third, men expressed a fear of sexual dysfunction including difficulty or inability to obtain an erection or to orgasm. They gave the example that ecstasy makes people want to have a massage more than sex. Participants were asked about what positive effects they had experienced while using ecstasy and their responses were grouped into five main effects:. Enhances senses. Participants explained that ecstasy enhances every sense, particularly smell and touch. Perception of intimacy with others. Participants stated they felt connected with others and able to emotionally bond while using ecstasy. Reduced social inhibitions. Many participants stated that while using ecstasy they were better able to express themselves and felt more confident. Release of stress and energy. Participants mentioned the following negative psychological effects that they attributed to their use of ecstasy: depressed mood next day and mid-week , loss of appetite, difficulty concentrating, loss of interest in previously pleasurable activities, social withdrawal, insomnia, paranoia during use , anxiety during use , confusion, and memory loss. It makes you forget everything and lose your sense of time. All participants reported using other drugs in conjunction with ecstasy. All participants agreed that using ecstasy was harmful but many did not know exactly what kinds of problems it could cause. It's still first generation. Participants were asked to provide reasons of why people quit using ecstasy described from either their own personal experience or experiences of their friends. Their answers were grouped into seven main categories:. Negative personal experiences. These experiences included having a bad experience while using ecstasy, losing too much weight, and psychological effects emotionally unstable. The majority of participants stated that they felt that ecstasy was psychologically addictive but not chemically addictive. Yet many participants reported experiencing tolerance and that they took more ecstasy each time they used in an attempt to achieve their previous high. Some participants quit because they didn't have enough money to keep buying ecstasy. Others quit because they felt ecstasy wasn't worth the money. They felt they could have better drug experiences for a cheaper price. Loss of interest. Some participants didn't like ecstasy as much as other drugs. Others described quitting as a form of maturation. It's just a stage of my life where it's not me. I already knew how it felt, and the potential risks were too great for me to keep using. Observation of others using ecstasy. Others commented that it was scary to see the personality changes in their friends, which they attributed to taking ecstasy. The following sections highlight the interesting and potentially important findings of this study, and are organized according to topic areas in a manner similar to the Results. Most participants were knowledgeable about the contents of ecstasy pills and had a basic understanding of ecstasy's systemic effects. They reported reading articles and searching the Internet for information regarding ecstasy. They knew that the pills were supposed to contain MDMA and that sometimes they contained other substances, some of which were undesirable. However, this knowledge did not deter these individuals from using ecstasy. This finding is consistent with prior research, which suggests that providing only information about drugs is not necessarily an effective tool for fostering behavioral change in substance users Wish et al. Future research on the role of Internet-based information in both initiating and discontinuing illicit drug use is clearly needed. Participants reported a variety of motivations for experimenting with ecstasy, including the following motives: positive effects on mood, social pressure, curiosity, availability, boredom, desire for an altered state of mind, desire to escape, self-medication, desire to have fun, and the ease of use of ecstasy in comparison to other drugs. However, participants in the current study also emphasized the role of social pressure in their experimentation with and use of ecstasy. You can feel everything. It opens the serotonin gates. Participants were divided regarding whether ecstasy increased the likelihood of engaging in risky behaviors, including risky sexual behavior. Moreover, regarding sexual behavior, it is interesting to note that participants were divided in their views about whether ecstasy use increased the likelihood of promiscuity and risky sexual activities. Exploration of the role that ecstasy might play in increasing risky behavior, particularly in a college-age population that tends to discount the risks associated with many behaviors known to be risky e. Regarding participants' perceived risks of ecstasy use, all agreed that using ecstasy was harmful; however, many did not know the specific types of problems ecstasy could potentially cause and discounted the potential harm. The current study provided new information about why people quit using ecstasy described from either participants' own personal experience or the experiences of their friends. These results suggest that the reasons to quit using ecstasy are quite varied, and that perhaps one single factor is neither necessary nor sufficient to motivate quitting ecstasy use. Intervention programs that target ecstasy users should be diverse and contain multiple foci, if they are to be successful. Moreover, participants also provided information that might prove potentially valuable in the development and format of both prevention and intervention programs. Consistent with prior research in the area of social psychology McAlister et al. In this context, it would be helpful to further explore what type of educational materials would be most effective in preventing or intervening in the use of ecstasy among young adults. Results from this sample suggest that education about the risks associated with ecstasy use may be important, but certainly is not sufficient to deter its use. A potential limitation of this study is that the data are based on self-reports provided in a group discussion format, a potential threat to the validity of our findings. However, the methodology of the study attempted to address this potential concern in several ways. First, participants wore fictitious name tags during the focus groups, allowing for anonymity. Second, participants were not questioned individually and were free to either respond or not respond to any question. Third, participants were free to challenge statements made by others. Finally, behavior of the participants during the group sessions suggested they were uniformly forthright and forthcoming. Our study shows that it was feasible to recruit college student ecstasy users from campus advertisements. The resulting convenience sample appeared to contain a diverse group of persons with a range of drug use and behavior problems. However, we know little about how our results might vary by type of school, its size, or its rural or urban location. Replication of the methodology in a diverse sample of schools is clearly needed. The biggest limitations to this study were the small size of the sample and its self-selected nature. We know little of how representative the persons who respond to a public advertisement for ecstasy users are to the general population of college student users. Moreover, all participants came from a single large mid-Atlantic university. We also do not know to what extent our findings generalize beyond college students. College students are likely to have more academic achievement, financial resources, and an educated peer group that could greatly affect the consequences of their ecstasy use. A future study that compares young adult ecstasy users who attend college to a matched group of youths who do not attend a college might help us to better understand how the unique college environment affects ecstasy use and its associated consequences. Department of Justice. Points of view or opinions contained within this document are those of the authors and do not necessarily represent the official position or policies of USDOJ. Slang term used by ecstasy users to describe other ecstasy users who have used ecstasy excessively, and have a limited range of affect and little social interest. Her research interests focus on recreational drug use in adolescents and young adults. Kevin E. His research interests have focused on: 1 the etiology of substance abuse, particularly those individual, familial, and social factors that place an individual at increased risk for the development of a drug-abusing lifestyle; 2 the development of intervention programs that seek to impact at-risk individuals, where these programs are guided by the risk-factor information available from participants; and, 3 the development of conceptual models that explain differential responsiveness to substance abuse treatment. Eric Wish , Ph. Wish has conducted research and published reports on a variety of topics related to substance abuse, including drug use in Vietnam veterans, assessment of treatment services for marijuana users, the relationship of drug use at arrest to subsequent criminal behavior, and methods for identifying users. Amelia M. Arria , Ph. She is the Principal Investigator of a NIDA-funded longitudinal study of substance use among college students and a Robert Wood Johnson Foundation study on predictors of treatment entry and recidivism among drunk drivers. She is an epidemiologist with special interests in the area of physical and mental health consequences of alcohol and drug use, effective methods of drug prevention, and the intersection between drug use and violence. Substances can be and are used or misused. Living organisms are and can be abused. Editor's note. The copyright in an individual article may be maintained by the author in certain cases. Content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. As a library, NLM provides access to scientific literature. Subst Use Misuse. Published in final edited form as: Subst Use Misuse. The publisher's version of this article is available at Subst Use Misuse. Open in a new tab. 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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