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Commonly known as ecstasy, MDMA has been central to the British acid house, rave and dance club scene over the last 20 years. Figures from the annual national British Crime Survey suggest that ecstasy use has declined since 2001. This apparent decline is considered here alongside the concurrent emergence of a ‘new’ form of ecstasy ‐ MDMA powder or crystal ‐ and the extent to which this can be seen as a successful rebranding of MDMA as a ‘premium’ product in the wake of user disenchantment with cheap and easily available but poor quality pills. These changes have occurred within a policy context, which in the last decade has increasingly prioritised the drugs‐crime relationship through coercive treatment of problem drug users within criminal justice‐based interventions, alongside a focus on binge drinking and alcohol‐related harm. This has resulted in a significant reduction in the information, support and treatment available to ecstasy users since the height of dance drug harm reduction service provision pioneered by the Safer Dancing model in the mid‐1990s.

The purpose of this paper is to evaluate the changing use of language concerning the drug Ecstasy and their potential consequences over the last ten years.

The research used metadata analysis of different resource types to assess the changing frequency with which the terms Ecstasy and MDMA occur.

Since 2011 there has been an increase in the use of the term “MDMA” relative to “Ecstasy”. The prevalence of the term MDMA is higher than that of Ecstasy in both academic literature and web based information resources. This is also found in the public's own use of the terms. The shift from one term to the other highlights the lack of uniformity in the way Ecstasy and MDMA are reported. This underlines the need for clarity and consistency in reporting this substance so that correct information is disseminated for use by the general public, law enforcement agencies and healthcare professionals.

This paper establishes a time line for when the term MDMA began to be used which has not yet been reported on. It compares the relative frequency of the use of the terms Ecstasy and MDMA over time illustrating a change in use and language and whether Ecstasy is still an appropriate term to use.

The purpose of this paper is to present the results and context of the drug checking service (DCS) performed by the harm reduction project Échele Cabeza (EC) in Colombia.

Data from several years are presented with a focus on data from 2021. In 2021, data were derived from 2,339 questionnaires filled out by DCS users and a total of 2,868 drug checking test results from samples collected at the fixed-site service in Bogotá and 30 music festivals in 8 cities nationwide.

The tusi phenomenon is gaining strength in Colombia revealing a problem associated with the changing makeup of tusi and, thus, polydrug use. MDMA adulteration and misrepresentations have increased in comparison to 2019. There is an increasing number of people who want to use the DCS in Colombia, which is encouraging but also exposes the limitations of the drug checking methods available to EC.

This paper offers the first publication of the pioneering drug checking organization EC in Latin America.

In this fourth paper in a series on emergent drug trends in the UK (2006 ketamine, 2009 MDMA powder/crystal, 2010 mephedrone), the authors consider how the pharmacological landscape has changed since substituted cathinones (including mephedrone) were controlled in April 2010 and in particular assess the prevalence of mephedrone in the general night time economy (NTE) and its relationship to the use of established illegal drugs.

Surveys were conducted with a convenience sample of 207 adults stopped at random in four town and city centres on Friday nights in Lancashire in November 2010.

Of the adults surveyed, one in ten reported having taken mephedrone within the past year and one in 20 within the past month. Those who used mephedrone were also significantly more likely to report using ecstasy pills, cocaine and amphetamines. Regarding the next generation of “legal highs”, no clear substitute for mephedrone had emerged; instead, there was uncertainty, confusion and a degree of disinterest. In this vacuum, “Bubble” has emerged and evolved as a generic term in the north west of England to refer to any unidentified white powders which are synthetic stimulants.

Despite an emotional investment by advocates and opponents alike in mephedrone being an ecstasy‐type substitute, research now points towards more amphetamine‐type characteristics at a time when national prevalence of amphetamines is at an historic low. The emergence of unidentified white powders sold as “Bubble” in the North West of England is a graphic illustration of the unknown content, effect and risk of current (by contrast with previous) “legal highs”, and the resultant challenges for health service providers and criminal justice agencies. Bubble may be indicative of the enduring popularity but increasingly indiscriminate use of cheap stimulants.

For this cohort of NTE customers, the paper's analyses indicate that mephedrone was added to existing polydrug repertoires, rather than significantly displacing use of established illegal drugs or acting as a gateway for initiation into drug use.

Although we have achieved a greater understanding of cryptomarket specifics, evidence on the consumer side of cryptomarkets is still needed – not only regarding the role of cryptomarkets on individual drug-using careers but also on the motives for buying illicit drugs from cryptomarkets. Moreover, research has indicated that national differences exist regarding different variables relating to cryptomarket use and prevalence, as well as to why users are drawn to these markets. In this chapter, the author presents the results of a Belgian case study focusing on drug cryptomarket buyers. Using an online quantitative survey (N = 99) and semi-structured interviews (N = 10), we gain exploratory insight into the motives of Belgian buyers sourcing illicit drugs from cryptomarkets and how they believe these cryptomarkets affect their drug-using careers. Results indicate that most of the respondents had bought drugs offline before buying them from cryptomarkets and that the frequency of their drug use did not change once cryptomarkets were accessed. Almost 60% of our respondents, however, consumed different drugs or a wider range of drugs following their cryptomarket use. Furthermore, most of the respondents purchased from cryptomarkets for their personal consumption, and some of them also shared their supply with friends, that is, social supply. The alternative drug offer was the principal reason why they were using cryptomarkets, followed by curiosity and the price and the quality of the drugs. Although the respondents in this study were well aware of different risks related to market vendors, market administrators, and law enforcement, these risks were considered to be minimal and part of the cryptomarket environment. The results of this case study are informative and highlight areas requiring further research.

This study aims to assess service user characteristics, uptake and outcomes for drug checking services offered to over 250,000 English festival-goers in summer 2018 and to compare findings with earlier years, wider festival-goers and the general population.

A total of 2,672 substances of concern were submitted by the public and tested by chemists in mobile laboratories on 24 show days at seven festivals. Results were embedded in 2,043 individually tailored brief interventions (BI) delivered by health professionals to 4,240 service users. Comparative data were collected through anonymous self-report surveys with 1,291 respondents at five of the same festivals.

Three percent of drug-using festival-goers received BI, 95% of whom had not previously accessed health services regarding their alcohol or other drug use. Drug checking service users were significantly more likely to be younger, male and past month polydrug users with a wider range of drugs consumed in the last month compared with the general festival population. For samples matching purchase intent, nearly half intended to reduce dosage, with younger and female service users significantly more likely to reduce dosage. For substances identified as other than expected, nearly two thirds disposed of them.

Festivals are potential sites to deliver innovative health interventions and to monitor their outcomes, reduce the risk of poisoning and overdose, and facilitate access to follow-up support services.

This study suggests that there is value in event-based services that provide risk reduction communications directly to young adults engaged in higher risk drug use compared with wider event and general populations.

Drug cryptomarkets increase information available to market actors, which should reduce information asymmetry and increase market efficiency. This study aims to determine whether cryptomarket listings accurately represent the advertised substance, weight or number and purity, and whether there are differences in products purchased from the same listing multiple times.

Law enforcement drug purchases – predominantly cocaine, methamphetamine, MDMA and heroin – from Australian cryptomarket vendors (n = 38 in 2016/2017) were chemically analysed and matched with cryptomarket listings (n = 23). Descriptive and comparative analyses were conducted.

Almost all samples contained the advertised substance. In most of these cases, drugs were either supplied as-advertised-weight or number, or overweight or number. All listings that quantified purity overestimated the actual purity. There was no consistent relationship between advertised purity terms and actual purity. Across the six listings purchased from multiple times, repeat purchases from the same listing varied in purity, sometimes drastically, with wide variation detected on listings purchased from only one month apart.

In this data set, cryptomarket listings were mostly accurate, but the system was far from perfect, with purity overestimated. A newer, larger, globally representative sample should be obtained to test the applicability of these findings to currently operating cryptomarkets.

This paper reports on the largest data set of forensic analysis of drug samples obtained from cryptomarkets, where data about advertised drug strength/dose were obtained.

Significant changes in British recreational drug use were seen throughout 2009, with the emergence and rapid growth in the availability and use of substituted cathinones or ‘M‐Cats’ (most notably mephedrone and methylone), a group of psychoactive drugs not currently controlled under the Misuse of Drugs Act 1971 (HM Government, 1971), with similar effects to ecstasy, cocaine and amphetamines. The reasons for the appearance and appeal of this group of so‐called ‘legal highs’ are explored here in relation to availability, purity, legality and convenience. The authors argue that a reduction in the availability (and thus purity) of illegal drugs such as ecstasy and cocaine and resultant disillusionment among users was a key motivation for displacement to substituted cathinones, conveniently and legally purchased online. Finally, we explore policy considerations around the likely criminalisation of substituted cathinones and the challenge of providing rapid yet considered harm reduction responses to emergent drug trends in the face of a minimal scientific evidence base and eager press demonisation.

Research suggests that student drug use is substantially higher than that of the general population and while the UK Government’s current Drug Strategy emphasises the importance of PSHE in preventing young people from becoming drug users, there is a lack of research investigating the longer-term effectiveness of drug prevention education, and students’ views using qualitative methods. The purpose of this paper is to gain a holistic understanding into university students’ lived experiences of recreational class A drug taking and the drug education taught in English secondary schools.

Five interviews with university students were undertaken and thematically analysed using an ideographic case study approach alongside a qualitative content analysis of publicly available drug education resources and policy documents.

The normalisation of drug taking at university and social micro-pressures to assimilate group norms were key contributing factors to participants’ drug use. While the content of drug education in PSHE is grounded in theory, its implementation is not.

This study extends upon existing theories of normalisation of drug use at university through the concept of micro-pressures to offer an explanation of the process by which students assimilate group norms through the implicit threat of not fitting in.