Aims To describe (i) self‐reported changes in drug use and (ii) trends in price, perceived availability, and perceived purity of illicit drugs, among people who regularly use ecstasy/ 3,4‐methylenedioxymethamphetamine (MDMA) and other illicit stimulants in Australia following COVID‐19 and associated restrictions. Design Annual interviews with cross‐sectional sentinel samples conducted face‐to‐face in 2016–19 and via video conferencing or telephone in 2020. Data were collected via an interviewer‐administered structured questionnaire. Setting Australian capital cities. Participants Australians aged 16 years or older who used ecstasy/MDMA and other illicit stimulants on a monthly or more frequent basis and resided in a capital city, recruited via social media and word‐of‐mouth ( n ~ 800 each year). Measurements Key outcome measures were self‐reported illicit drug market indicators (price, purity and availability) and, in 2020 only, perceived change in drug use (including alcohol and tobacco) since March 2020 and reasons for this change. Findings For most drugs, participants reported either no change or a reduction in their use since COVID‐19 restrictions were introduced. Ecstasy/MDMA was the drug most frequently cited as reduced in use ( n = 552, 70% of those reporting recent use), mainly due to reduced opportunities for socialization. While market indicators were largely stable across most drugs, the odds of perceiving MDMA capsules as ‘high’ in purity decreased compared with 2016–19 [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.53–0.99], as did perceiving them as ‘easy’ to obtain (aOR = 0.42, CI = 0.26–0.67). The odds of perceiving cocaine and methamphetamine crystal as ‘easy’ to obtain also decreased (aOR = 0.67, CI = 0.46–0.96 and aOR = 0.12, CI = 0.04–0.41, respectively). Conclusions After COVID‐19‐related restrictions were introduced in Australia, use of ecstasy/MDMA, related stimulants and other licit and illicit drugs mainly appeared to remain stable or decrease, primarily due to impediments to socialization.

Almost all festival-goers surveyed did not report being deterred from drug usage by the expected presence of drug dogs. Instead, a variety of alternative responses to avoid detection were reported, many of which could place festival-goers at greater risk of experiencing drug-related harms. In the face of mounting evidence of both ineffectiveness and iatrogenic effects, the use of drug detection dogs at Australian music festivals should be urgently reconsidered.

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Introduction and Aims. The term 'double dropping' refers to a person consuming two drugs simultaneously, typically two ecstasy pills. This practice has been reported in numerous countries, including Australia; however, the prevalence and correlates of double dropping among ecstasy users is unknown. Double dropping is particularly risky when adulteration of 'ecstasy' with novel substances and higher dosages of MDMA in pure ecstasy pills have both been increasingly reported. This paper investigates the prevalence and correlates of double dropping in a purposive sample of Australian festival-goers who used ecstasy at the last festival they attended. Design and Methods. A web survey was completed by almost 2000 Australian festivalgoers. The analytic sample (n = 777) was 59% male and had a median age of 20 years (interquartile range 19-23). Results. Almost half (48%) of respondents who used ecstasy pills reported double dropping in association with the last festival attended. Multivariable logistic regression found respondents who were younger, male, more frequent ecstasy users, more frequent festival-goers, had a preference for electronic dance music, attended a multi-day festival and used ecstasy in pill form were at greater odds of reporting double dropping at the last festival attended. Discussion and Conclusions. Double dropping was a commonly reported practice among festival-goers in this purposive sample. While this practice may reflect historically low-dose ecstasy pills in Australia, the changing contexts of novel drugs and increasing MDMA purity may warrant consideration of harm-reduction interventions and drug-checking services which could help festival-goers make more informed decisions about drug dosage. [Grigg J, Barratt MJ, Lenton S. Double dropping down under: Correlates of simultaneous consumption of two ecstasy pills in a sample of Australian outdoor music festival attendees. Drug Alcohol Rev 2018;37:851-855]

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