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Official websites use. Share sensitive information only on official, secure websites. Corresponding author at: Department of Population Health, E. A quarter Half Racial minorities were more likely to test positive for butylone or test positive for NPS after reporting no lifetime use. Keywords: ecstasy, novel psychoactive substances, nightclubs, dance festivals, synthetic cathinones. Ecstasy —a common street name for 3,4-methylenedioxymethamphetamine MDMA —is one of the most prevalent party drugs in the US. About one out of ten young adults in the US are estimated to have used ecstasy in their lifetime. Specifically, in , However, targeted samples of nightclub attendees suggest that rates of use are much higher among those who attend nightclubs or raves where electronic dance music EDM events are held Kelly et al. Ecstasy use can place users at risk for acute and long-term adverse health outcomes Hall and Henry, ; Parrott, , and between and , emergency department ED visits related to ecstasy use increased in the US from 4, to 10, among those age 21 and under SAMHSA, a. Older studies conducted in the US Baggott et al. In another study, researchers conducted a retrospective analysis of hair samples that previously tested positive for MDMA or amphetamine and many hair samples also contained piperazines and some samples contained mephedrone a synthetic cathinone; Rust et al. However, it is not known whether individuals used these NPS unknowingly, thinking it was ecstasy. Synthetic cathinones a. While effects of some synthetic cathinones are reportedly similar to effects of ecstasy or other stimulants Brunt et al. Poisonings and deaths at dance festivals in the US have also recently occurred related to methylone use—taken alone or in combination with MDMA Ridpath et al. The nightclub and dance festival scene is at particularly high risk for unintentional use of synthetic cathinones and other NPS so research is needed to examine the extent to which ecstasy users are unknowingly using these substances. We surveyed nightclub and festival attendees in New York City NYC from July through early September of using a variation of time-space sampling. Eligible participants were those who 1 identified as ages 18—25, and 2 were about to attend the randomly selected party. After providing informed consent, participants completed the computer-assisted personal interview on tablet computers. Some males expressed interest in providing a sample, but their hair was too short, which often prevented us from being able to obtain an adequate analyzable sample. In some cases, male participants volunteered to have the recruiter to clip or buzz with an electronic buzzer body hair from the arm, chest, or leg. In this study, we evaluated a cohort composed of 48 participants who reported lifetime ecstasy use and had a hair sample compatible with the quantity needed for the analysis see Section 2. Answers were recoded into: 1 attend less than once a week and 2 attend at least once a week. We also created a variable indicating whether the participant was surveyed outside of a nightclub or a dance festival. Specifically, participants were provided with lists of drugs along with common street names when available belonging to specific NPS classes and asked whether they had ever knowingly used. Participants were also able to type in names of other drugs they used that we did not ask about. Hair samples collected from heads, as well as samples collected from other body parts, were analyzed in their full length. The average length was 9. Assuming normal hair growth rate Kintz, , the corresponding mean time frame is 1 cm per month. A minimum quantity of 20 mg was needed to perform the analysis. The second method Salomone et al. The new designer drug mCPP can be detected in biological fluids as a metabolite of trazodone Lendoiro et al. We also tested for the presence of bupropion as its recreational use has been reported McCormick, Deuterated internal standards were constantly used, whenever commercially available. We first examined descriptive statistics and determined the extent of overlap between self-reported drug use and positive hair results. We also examined whether any covariates were related to reporting no lifetime use of synthetic cathinones or other stimulant NPS or unknown pills or powder and having a positive test result for one of these drugs. However, we did not consider reports discrepant if a participant reported use of other drugs such as NBOMe, ketamine, cocaine, or methamphetamine. Of the 48 participants that reported lifetime ecstasy use and provided a hair sample that was analyzable, the majority Seven participants No participants reported use of other stimulant NPS, and 8 participants A tenth Two-thirds With exception of MXE, none of the other analytes considered in the analytical method were identified in any of the analyzed samples. Although beyond the scope of our analyses, it should be noted that four participants who also tested positive for butylone tested positive for MXE a common ketamine replacement ; however, all four of these cases reported ketamine use, three of which also reported use of 2-MeO-ketamine and one specifically reported using MXE. Table 2 presents percentages of drug report discrepancies and positive test results according to sample characteristics. Due to small sample size we were not able to implement a statistical correction for multiple testing. Ecstasy is among the most popular party drugs in the nightclub and dance festival scenes. Rates of poisonings related to use have increased in the US, and this may be due, in part, to users unknowingly using NPS such as synthetic cathinones in their ecstasy. While we cannot completely rule out dishonest responses e. Surely, the time frame represented by hair testing cannot adequately test for overall lifetime use. We could not confirm that these drugs were in or sold as the ecstasy these participants reported taking, but results do suggest that ecstasy users are at high risk for unknowingly using such drugs—whether or not this unintentional use was directly associated with ecstasy use. Specifically, results from that study suggest that 3. Frequent attendance was also linked to ecstasy users not knowing they have used synthetic cathinones. Since racial minority status and level of education are often indicators of socioeconomic status, more research is needed to determine whether use is dependent on price or availability of unadulterated MDMA. While ecstasy users are at high risk for using synthetic cathinones and other NPS Bruno et al. This is among the first studies to compare self-reported ecstasy and NPS use to test results of biological hair samples. More studies are needed to adequately determine the extent to which ecstasy users are unknowingly using synthetic cathinones or other NPS. We were only able to obtain hair samples from a quarter of participants who took the survey. For many participants, the collected amount of hair was too small to be analyzed because it was difficult for trained recruiters to collect adequate samples in dark areas outside of nightclubs at night. However, we confirmed that there were no systematic differences by any covariate regarding who provided a hair sample, so we believe there was little to no bias. We do recommend that similar studies allow for collection of body hair as a potential alternative for participants primarily males who have little to no hair on their heads. Results from this study were derived from a relatively small analytic sample; however, the subsample was selected from a larger epidemiology study that utilized time-space sampling a form of probability-based sampling. Despite low power due to a relatively small cohort, we were still able to detect multiple significant differences along covariates. We only assessed self-reported lifetime use of drugs, which limited our ability to determine recency or frequency of use, and we were only able to test for select NPS. Therefore, it is possible that some participants knowingly or unknowingly used synthetic cathinones or other NPS that we were not able to test for. Thus, the percentage of discordant responses While we were unable to determine whether positive NPS tests results are due to ecstasy use, we did find that ecstasy users are at risk for unintentional use of NPS. Basic drugs, including most amphetamines and cathinones, are expected to bind to eumelanin via hydrogen bonds and charge-transfer interactions, possibly resulting in partly biased quantitative results that depend on the hair color of the donors Cooper, This alleged effect has been frequently addressed to justify differences observed among ethnic groups. However, the experimental studies have been somehow contradictory and the overlapping of other influencing factors prevented any definite conclusion on this point Vincenti and Kintz, Prevention and harm reduction education is needed for this population—especially among frequent attendees. All authors are responsible for this reported research. Palamar conceptualized and designed the study, and conducted the statistical analyses. Cleland mentored and assisted J. Palamar with regard to study design, time-space sampling, and statistical analysis. Salomone and M. All authors drafted the initial manuscript, interpreted results, and approved the final manuscript as submitted. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. As a library, NLM provides access to scientific literature. Drug Alcohol Depend. Published in final edited form as: Drug Alcohol Depend. Find articles by Joseph J Palamar. Find articles by Alberto Salomone. Find articles by Marco Vincenti. Find articles by Charles M Cleland. Issue date Apr 1. PMC Copyright notice. The publisher's version of this article is available at Drug Alcohol Depend. Open in a new tab. Contributors All authors are responsible for this reported research. Conflict of Interest No conflict declared. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. 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Words: Simon Doherty 22nd July Three ways in which MDMA could be sold if it was legal are presented and guests are invited to consider which one might be best. So what happens when you visit The Ecstasy Shop? So we can all agree that would be a really irresponsible way. The second retail model explored is located in a mini pop-up nightclub in the basement. The second the vending machine spits out your pills, a tune drops and a nightclub lighting show kicks in — like someone had just won the biggest ever jackpot at a bingo hall. A user would have to disclose their weight and experience with MDMA so a safer dose could be established. The medical professional will make sure the user understands the risks involved and they would signpost drug and mental health services when appropriate. There would be no promotional marketing. The case for legalising MDMA is strong: no drug is totally safe to use, but ecstasy is one of the safer recreational drugs. And, actually, a lot of the harms associated with MDMA are caused by the substance being illegal. Harms to society from the drug, like criminal gangs involved in the supply using violence and environmental issues caused by manufacturers dumping toxic waste, would also be eliminated if it was legal. And get rid of all the commercialised marketing side of it. Are you struggling with drugs? Click here to see a list of organisations that can help and click here for information about how the NHS can help. If you think there might be a drug-related emergency do not hesitate to ring — you will never be in trouble for doing this. Straight to your inbox. Society Words: Simon Doherty 22nd July The Face Newsletter My inbox doesn't receive enough newsletters. More like this. Sign me up.

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