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Self-reported prevalence of dependence of MDMA compared to cocaine, mephedrone and ketamine among a sample of recreational poly-drug users

Hanna Uosukainen, Ulrich Tacke, Adam Winstock

International Journal of Drug Policy July 15, 2014 DOI: 10.1016/j.drugpo.2014.07.004 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional survey Peer reviewed
Population Global non-treatment-seeking sample of last year users of MDMA, cocaine, mephedrone, and ketamine
Topics Ketamine MDMA Addiction Esketamine
Keywords Mephedrone Confidence interval Logistic regression Harm reduction Odds ratio Drug Adulterant Clinical psychology
Citations 55
Key findings MDMA users were more likely to report three or more DSM-IV dependence symptoms compared to users of cocaine, mephedrone, and ketamine, but less likely to desire to use less or get help.

Abstract

BackgroundEvidence regarding MDMA (ecstasy) dependence and the most suitable criteria for its assessment are controversial. This study aimed to assess the prevalence of last year symptoms of dependence upon MDMA compared to cocaine, mephedrone and ketamine among a large global non-treatment seeking sample.MethodsA cross-sectional anonymous online survey was promoted by a UK-based dance music website between 15 November 2010 and 1 January 2011. Endorsement of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) dependence criteria was sought from all last year users of MDMA, cocaine, mephedrone and ketamine. Reporting ≥3 dependence symptoms was indicative of dependence. Logistic regression models with Generalized Estimating Equations were used to compare dependence symptoms between groups.ResultsMDMA users were more likely to report ≥3 DSM-IV dependence symptoms compared to users of cocaine (odds ratio OR 0.81, 95% confidence interval CI 0.71-0.93), mephedrone (OR 0.91, 95%CI 0.78-1.06) and ketamine (OR 0.52, 95%CI 0.44-0.62) (p<0.001). MDMA users were less likely to report desire to use less or get help compared to users of other substances (p<0.001). MDMA got the highest rating of pleasurable high (mean 8.2±1.7) and lowest rating for risk of harm (mean 2.7±2.4).ConclusionsOur results highlight the self-reported dependence potential of MDMA but low desire to use less or get help. MDMA's pleasurable effects may compensate for drug-related problems and, therefore, DSM-IV criteria may not be suitable for assessing MDMA dependence. Further research is needed on the ability of DSM-V to assess MDMA dependence.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

  • MDMA users were more likely to report three or more DSM-IV dependence symptoms than users of cocaine, mephedrone, or ketamine, but less likely to desire to use less or seek help.

    Synthesized

Comparable studies

Other cross-sectional and survey studies on MDMA for addiction, most cited first.

Study Year Design Participants
Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey Online survey respondents 2020 Cross-sectional survey
User perceptions of the benefits and harms of hallucinogenic drug use: A web-based questionnaire study Users of hallucinogenic drugs who completed a web-based questionnaire 2010 Cross-sectional survey n = 600
Neural Correlates of the Severity of Cocaine, Heroin, Alcohol, MDMA and Cannabis Use in Polysubstance Abusers: A Resting-PET Brain Metabolism Study Polysubstance users enrolled in residential treatment 2012 Cross-sectional n = 49
Mental disorders in current and former heavy ecstasy (MDMA) users Current ecstasy users, former ecstasy users, polydrug controls, and drug-naive controls 2005 Cross-sectional study n = 118
MDMA Use by Paris Medical Students: Prevalence and Characteristics Paris VII medical students 2020 Cross-sectional study n = 592

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