Self-Reported Ecstasy/MDMA/“Molly” Use in a Sample of Nightclub and Dance Festival Attendees in New York City

Abstract

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).

Hair testing to assess both known and unknown use of drugs amongst ecstasy users in the electronic dance music scene

“…These results add to and corroborate a previous hair study which found higher levels of party attendance are related to a higher risk of testing positive for synthetic cathinones (Palamar, Salomone, et al, 2016). These results also corroborate multiple previous studies that have found higher levels of party attendance are related to robust increases in risk of using a variety of drugs including synthetic cathinones and other NPS (Palamar, Acosta, Ompad, et al, 2016; Palamar, Acosta, Sherman, et al, 2016; Palamar, Barratt, et al, 2016; Palamar et al, 2015). …”

“…A recent national survey of Australian dance festival-attending adults found that 78.1% of recent users reported using an illicit drug at their last-attended festival, and of users, 85.1% reported use of ecstasy (Hughes et al, 2017). A recent study of EDM party attendees in New York City (NYC) estimated lifetime use of ecstasy/MDMA or “Molly” amongst young adult (age 18-25) attendees to be 42.8% (95% CI: 32.8, 52.7) (Palamar, Acosta, Ompad, & Cleland, 2016). “Molly” is a common street name for powder or crystalline MDMA in the US; thus, since ecstasy and Molly are both street names for MDMA, some epidemiology surveys in the US now use these terms interchangeably or in combination (Palamar, 2017).…”

“…While use of more traditional drugs such as ecstasy in these environments is most common, hundreds of new psychoactive substances (NPS) such as methylone have emerged in recent years (European Monitoring Centre for Drugs and Drug Addiction, 2015; U.S. Drug Enforcement Administration, 2016) and many have been detected as adulterants in or replacements for traditional drugs such as ecstasy (Brunt et al, 2016; Caudevilla-Gálligo, Ventura, Indave Ruiz, & Fornís, 2013; Palamar et al, 2016a; Vidal Gine et al, 2016). Biological confirmation of self-reported use is informative as it helps validate prevalence, but research on unintentional or unknown use of drugs—particularly NPS—is important to further guide continued prevention, education, and harm reduction efforts within these high-risk scenes.…”

Shifting characteristics of ecstasy users ages 12–34 in the United States, 2007–2014

“…Adding to the literature on polydrug use among ecstasy users (Halkitis et al, 2007; Martins et al, 2007; Palamar et al, 2017b; Wu et al, 2006), 70% of ecstasy users in this sample reported using at least 2 other substances in the past year, and reporting use of 5–8 substances increased across time. The proportion of past-year use of marijuana, LSD, ketamine, and/or DMT/AMT/Foxy increased, with greatest relative increases in DMT/AMT/Foxy use (i.e., 314%) from 2007/08 to 2013/14.…”

“…While ecstasy use appears to be most prevalent in the electronic dance music scene (Hughes et al, 2017; Palamar et al, 2017b), examining recent shifts in demographic characteristics of users can inform potential needed changes to strategies for prevention efforts, public health messages, and harm reduction. User demographics may have shifted over time as the form of the drug has largely changed from pills to powder; individuals who continue to use ecstasy despite decreased prevalence could need focused efforts to reduce related harms.…”