Pathways into ecstasy use: The role of prior cannabis use and ecstasy availability

Max Planck Institute of Psychiatry, Clinical Psychology and Epidemiology, Kraepelinstrasse 2, 80804 Munich, Germany.
Drug and Alcohol Dependence (Impact Factor: 3.42). 10/2005; 79(3):331-41. DOI: 10.1016/j.drugalcdep.2005.02.008
Source: PubMed

ABSTRACT To explore the role of cannabis use for the availability of ecstasy as a potential pathway to subsequent first ecstasy use.
Baseline and 4-year follow-up data from a prospective-longitudinal community study of originally 3021 adolescents and young adults aged 14-24 years at baseline were assessed using the standardized M-CIDI and DSM-IV criteria.
Baseline cannabis users reported at follow-up more frequent access to ecstasy than cannabis non-users. Higher cannabis use frequencies were associated with increased ecstasy availability reports. Logistic regression analyses revealed that cannabis use and availability of ecstasy at baseline are predictors for incident ecstasy use during the follow-up period. Testing simultaneously the impact of prior cannabis use and ecstasy availability including potential confounders, the association with cannabis use and later ecstasy use was confirmed (OR=6.3; 95%CI=3.6-10.9). However, the association with ecstasy availability was no longer significant (OR=1.2; 95%CI=0.3-3.9).
Results suggest that cannabis use is a powerful risk factor for subsequent first onset of ecstasy use and this relation cannot be sufficiently explained by availability of ecstasy in the observation period.

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Available from: Petra Zimmermann, Mar 18, 2014
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    • "Previous studies' findings with regard to gender have been inconsistent, with some reporting more ecstasy use in young males (Singer et al., 2004; Zimmermann et al., 2005), and others reporting more use in young females (Martins and Alexandre, 2009). Our finding of no racial/ethnic difference in ecstasy use is consistent with those of Singer (Singer et al., 2004) and Zimmermann (Zimmermann et al., 2005), but inconsistent with some other studies where whites were found to be more likely to be ecstasy users compared to youth from other racial/ethnic groups, especially African Americans (Martins and Alexandre, 2009; Martins et al., 2007). "
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    ABSTRACT: To investigate adolescent pathways to ecstasy use by (1) examining how early onsets of smoking, drinking, and marijuana use are related to a child's risk of initiation of ecstasy use and (2) assessing the influence of other individual and parental factors on ecstasy use initiation. Data on 6426 adolescents (12-17 years old at baseline) from the National Survey of Parents and Youth (NSPY), a longitudinal, nationally representative household survey of youth and their parents, were used in the analyses. Information on youth substance use, including ecstasy use, as well as familial and parental characteristics, was available. Initiation of ecstasy use is predicted by an adolescent's early initiation of smoking, drinking, or marijuana use. In particular, early initiation either of marijuana use, or of both smoking and drinking, increases a child's risk for ecstasy use initiation. Among the familial and parental variables, parent drug use emerged as significantly predictive of child initiation of ecstasy use; living with both parents and close parental monitoring, on the other hand, are negatively associated with ecstasy use initiation, and may be protective against it. At the individual level, sensation seeking tendencies and positive attitudes towards substance use, as well as close associations with deviant peers, are predictive of adolescent initiation of ecstasy use. Our findings on the risk and protective factors for initiation of ecstasy use, especially with regard to factors that are modifiable, will be useful for prevention programs targeting youth use not only of ecstasy, but also of other drugs.
    Drug and alcohol dependence 09/2009; 106(2-3):193-8. DOI:10.1016/j.drugalcdep.2009.08.020 · 3.42 Impact Factor
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    • "Perhaps, other factors that we did not include in our study could better predict future ecstasy use. Some studies point at cannabis use as a risk factor for later ecstasy use (de Win et al. 2006; Martins et al. 2007; Pedersen and Skrondal 1999; Zimmermann et al. 2005). However, in the current study, cannabis and cocaine use did not significantly predict future ecstasy use. "
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    ABSTRACT: Ecstasy (+/-3,4-methylenedioxymethamphetamine) is a widely used recreational drug that may damage the serotonin system and may entail neuropsychological dysfunctions. Few studies investigated predictors for ecstasy use. Self-reported impulsivity does not predict the initiation of ecstasy use; the question is if neuropsychological indicators of impulsivity can predict first ecstasy use. This study tested the hypothesis that a neuropsychological indicator of impulsivity predicts initiation of ecstasy use. Decision-making strategy and decision-making reaction times were examined with the Iowa Gambling Task in 149 ecstasy-naive subjects. The performance of 59 subjects who initiated ecstasy use during a mean follow-up period of 18 months (range, 11-26) was compared with the performance of 90 subjects that remained ecstasy-naive. Significant differences in decision-making strategy between female future ecstasy users and female persistent ecstasy-naive subjects were found. In addition, the gap between decision-making reaction time after advantageous choices and reaction time after disadvantageous choices was smaller in future ecstasy users than in persistent ecstasy-naives. Decision-making strategy on a gambling task was predictive for future use of ecstasy in female subjects. Differences in decision-making time between future ecstasy users and persistent ecstasy-naives may point to lower punishment sensitivity or higher impulsivity in future ecstasy users. Because differences were small, the clinical relevance is questionable.
    Psychopharmacology 12/2008; 203(3):519-27. DOI:10.1007/s00213-008-1398-y · 3.88 Impact Factor
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    ABSTRACT: Drug law enforcement does not have the deterrent effects on the use of ecstasy that are intended by international anti-drugs agreements or national legislation. In addition, prevention programs generally fail to reduce substance use. With regard to drug use, Dutch policy can be characterised as harm reduction oriented. The findings presented in this thesis support a harm reduction approach. Drug education targeted at party drug users should translate sound scientific findings into easy to grasp harm reduction strategies. A holistic educational approach covering life style, substance use, friends and behavioural aspects (such as sleep and nutrition) may yield the best results in promoting safer ecstasy use. Since ecstasy users are generally poly drug users, focus on drug interactions is necessary. Furthermore, a positive tone of voice and respect for a dance/ecstasy life-style are vital. As substance use behaviour and knowledge travel through friend networks in a dynamic way, social networks and peer education are cornerstones in the educational process.
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