Harm reduction behaviours and harm experiences of people who use 3,4-methylenedioxymethamphetamine (MDMA) in Aotearoa New Zealand

Abstract

Background 3,4-Methylenedioxymethamphetamine (MDMA) is drug of high prevalence in Aotearoa New Zealand and is the primary drug analysed by legal drug checking services. We aimed to address the gap in literature pertaining to MDMA-related harm reduction behaviour and harm experiences within the country. Methods An online survey was used to assess the harm reduction behaviours (e.g., limiting consumption, planning use, seeking information) of people who use MDMA, in addition to their use of reagent testing and the major national drug checking and harm reduction service, KnowYourStuffNZ. Results In total, 915 people completed the survey (60.7% females, aged 18–65, median = 24, IQR = 20–28). Frequency of various MDMA-related harm reduction behaviours differed, although these were carried out relatively frequently by most participants. Those who reported experiencing harm (physical, psychological, spiritual, social) from MDMA, or another drug presumed to be MDMA, reported less frequent harm reduction behaviours than non-harmed consumers. Reagent testing of MDMA had been conducted by 42.3% of the sample. Approximately 27% of the sample had used KnowYourStuffNZ services. Of KnowYourStuffNZ clients, 95.9% reported learning about harm reduction, and 53.3% reported changing their behaviour because of the service. Reasons for not using the KnowYourStuffNZ service were primarily lack of availability in local area (32.8%) or at relevant events (51.8%), and lack of concern with substance quality (29.8%). MDMA harm was reported by 14.4% of the sample, whilst reported harm was more common from consumption of presumably non-MDMA substances, self-reported as being mistaken for MDMA. Harm was primarily physical or psychological. Potential MDMA dependence was apparent in 6.9% of the sample. Conclusions The findings highlight potential targets for harm reduction education and interventions and emphasize the need for greater availability of readily accessible drug checking services in Aotearoa New Zealand.

A thematic analysis of MDMA-related harm and harm reduction experiences and knowledge in Aotearoa New Zealand

“…Support for and acknowledgement of the benefits of drug checking services within Aotearoa was clear. However, many participants had not personally utilised the services, often due to lack of accessibility, a major reason also identified in a survey of MDMA consumers in Aotearoa [ 75 ]. Although drug checking service provision has continued to expand since legalisation [ 76 ], the number of MDMA (or other drug) samples checked across services is still low relative to the estimated population of drug consumers [ 33 ].…”

“…Although drug checking service provision has continued to expand since legalisation [ 76 ], the number of MDMA (or other drug) samples checked across services is still low relative to the estimated population of drug consumers [ 33 ]. Thus, further development of public promotion and expansion (e.g., hours of operation, location) of these services is warranted, particularly given the positive impact these services can have on harm reduction knowledge and behaviour within Aotearoa [ 31 , 75 ]. The lack of quantification technology currently available at client-facing drug checking services [ 77 ] also presents as a clear avenue for future development, particularly as high-dose MDMA pills are available globally [ 35 ], and in Aotearoa [ 78 ].…”