Background Synthetic cannabinoids are marketed as “legal highs” and have similar effects to cannabis (marijuana). Although prevalence of synthetic cannabinoid use is now declining in the US, use has been associated with tens of thousands of poisonings and hospitalizations, particularly among teens. It is important to examine which teens are at highest risk for use of these new, potentially deleterious drugs as they are understudied and continue to emerge. Methods Data were analyzed from a nationally representative sample of high school seniors in the Monitoring the Future study (2011–2013; Weighted N = 11,863; modal age: 18). Bivariable and multivariable models were used to delineate correlates of recent (12-month) synthetic cannabinoid use. Results Ten percent reported any recent use and 3% reported more frequent use (used ≥6 times). Females were at low odds for use and going out 4–7 evenings per week for fun consistently increased odds of use. Black and religious students were at low odds until controlling for other drug use, and higher income increased odds of use until controlling for other drug use. Lifetime use of alcohol, cigarettes and other illicit drugs all robustly increased odds of use, but frequency of lifetime marijuana use was the strongest correlate with more frequent use further increasing odds of synthetic cannabinoid use. Only 0.5% of non-marijuana users reported use of synthetic cannabinoids. Conclusions This is among the first national studies to delineate correlates of synthetic cannabinoid use. Results can inform national and local efforts to prevent use and adverse consequences resulting from use.

Background Novel psychoactive substances (NPSs) continue to emerge in the United States and worldwide. Few epidemiological studies have examined the prevalence and correlates of use. Objective We examined the extent of NPS use in a high-risk population—attendees of electronic dance music (EDM) parties at nightclubs and festivals. Methods We surveyed 682 adults (age 18–25) entering EDM events at nightclubs and festivals in New York City (NYC) in 2015. A variation of time–space sampling was used. We examined the prevalence of self-reported use of 196 NPS and correlates of any NPS use. Results Over a third (35.1%) of participants reported lifetime use of any NPS. Self-reported use of synthetic cannabinoids was most prevalent (16.3%), followed by psychedelic phenethylamines (14.7%; 2C series: 10.3%, 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine [NBOMe] series: 9.0%, Dox series: 3.5%), synthetic cathinones (“bath salts”, 6.9%), other psychedelics (6.6%), tryptamines (5.1%), and dissociatives (4.3%). 2C-I was the most prevalent 2C series drug (5.1%); methylone was the most prevalent synthetic cathinone (3.3%), 2-MeO-ketamine was the most prevalent dissociative (3.7%), and 1P-lysergic acid diethylamide (LSD) (2.9%) was the most prevalent non-phenethylamine psychedelic. Risk factors for NPS use included Ecstasy/MDMA/ Molly, LSD, and ketamine use; identifying as bisexual (compared to heterosexual), reporting higher frequency of nightclub/festival attendance, and being surveyed outside of a festival (compared to those surveyed outside of nightclubs). Discussion NPS use is prevalent in the nightclub and festival scenes in NYC. Since individuals in these scenes—especially frequent attendees—are at high risk for use, prevention and harm reduction services need to be geared toward this population.

Background Ecstasy (MDMA) use has regained popularity in the United States, particularly in the form of “Molly,” which is often marketed as pure MDMA. Surveys have generally not included “Molly” in the definition of ecstasy, so rates of use may be underestimated. As popularity of ecstasy increases, research is needed to examine use among those at highest risk for use—nightlife attendees. Methods We surveyed 679 young adults (age 18–25) entering nightclubs and festivals holding electronic dance music (EDM) parties in New York City in 2015. A variation of time-space sampling was utilized. We examined prevalence and correlates of self-reported lifetime ecstasy use. Results Self-reported lifetime ecstasy use was common (42.8%, 95% CI: 32.8, 52.7). Use was most common among older participants, frequent party attendees, and those reporting higher levels of exposure to users. Those surveyed outside of festivals were less likely to report use compared to those surveyed outside of nightclubs (AOR=0.37, p = .015). Over a third of ecstasy users (36.8%) reported use in pill, powder, and crystal form. Ecstasy users were also more likely to report use of other drugs, including novel psychoactive substances (e.g., 2C series drugs, synthetic cathinones [“bath salts”]). Half (50.4%) reported suspecting (21.9%) or finding out (28.5%) that their ecstasy had ever contained a drug other than MDMA. Conclusion A large percentage of nightlife attendees in NYC report lifetime ecstasy use. Findings should inform prevention and harm reduction programming. Further research is needed as ecstasy continues to change (e.g., in form, purity, and name).

Alcohol and marijuana are two of the most prevalent psychoactive substances and each may result in distinct psychosocial and physical sexual experiences and different sexual risk behaviors. With marijuana becoming more accepted in the US along with more liberal state-level policies, it is important to examine and compare users’ psychosocial and physical sexual experiences and sexual risk behavior associated with these drugs. In this study, we interviewed 24 adults who recently used marijuana before sex. Participants were 50 % female and all self-identified as heterosexual and HIV-negative. Using thematic analysis, we compared self-reported psychosocial and physical sexual experiences of alcohol and marijuana. Participants described differences between drugs with regard to psychosocial (e.g., partner interactions and contexts before sex, partner choice, perceived attractiveness of self and others, disinhibition, and feelings of regret after sex) and physical sexual experiences (e.g., sexual dysfunction, dose effects, sensations of body/sex organs, length and intensity of sex, and orgasm). Alcohol use was commonly associated with social outgoingness and use facilitated connections with potential sexual partners; however, alcohol was more likely than marijuana to lead to atypical partner choice or post-sex regret. Both alcohol and marijuana had a variety of negative sexual effects, and the illegality of marijuana reportedly facilitated intimate encounters. While sexual experiences tended to be similar across males and females, we did find some variation by gender. Results can inform prevention and harm reduction programming that will allow us to design more realistic programs and to craft interventions, which guide potential users to make safer choices.

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Background The popularity of virtual raves and happy hours has increased during the COVID-19 pandemic. While nightlife settings are often associated with drug use, it is unknown whether virtual events are associated with use. Methods Electronic dance music (EDM) partygoers who live in New York and reported recent drug use were recruited online and screened for eligibility throughout April and May 2020. Eligible adults ( n = 128) were asked about virtual rave and happy hour attendance during the COVID-19 crisis. We examined prevalence and correlates of drug use during such events. Results 55.5% of participants attended virtual raves and 69.5% attended virtual happy hours. 40.9% used illegal drugs during virtual raves and the most frequently used drugs were cannabis (29.6%), ecstasy/MDMA/Molly (8.5%), LSD (7.0%), and cocaine (4.2%). 33.7% used illegal drugs during virtual happy hours and the most frequently used drugs were cannabis (29.2%), cocaine (3.4%), and ketamine (3.4%). Older participants were more likely to use illegal drugs during virtual raves, and those reporting past-year use of more drugs were more likely to use drugs during virtual raves and/or happy hours ( p s<0.05). Conclusions EDM partygoers are at risk for using drugs during virtual events. Results can inform prevention and harm reduction efforts.

Objective: The number of novel psychedelic phenethylamines and tryptamines has continued to increase, but little academic research has focused on the effects of these substances. We sought to determine and compare the subjective effects of various substances. Methods:We conducted in-depth interviews with 39 adults (75.4% male and 87.2% White) who reported experience using psychedelic phenethylamines and/or tryptamines. Participants described the effects of compounds they have used. We examined the subjective drug effects in a qualitative descriptive manner.Results: Participants reported on the use of 36 compounds. The majority (64.1%) reported the use of 2C series drugs, with 2C-B use being most prevalent; 38.5% reported the use of NBOMe, and 25.6% reported the use of DOx. With regard to tryptamines, 46.2% reported use, and 4-AcO-DMT was the most prevalent drug used in this class. 2C-B was often described as being more favorable than other 2C series compounds with the effects described as being comparable with MDMA and LSD. NBOMe effects were generally described in an unfavorable manner, and the effects of DOx were often described as lasting too long (12-36 hr). The effects of 4-AcO-DMT were often described as mimicking psilocybin.Conclusion: Knowing the effects of various compounds can inform education, prevention, and harm reduction efforts regarding the use of these drugs. K E Y W O R D Sdrug effects, new psychoactive substances, phenethylamines, psychedelics, tryptamines