3,4-Methylenedioxymethamphetamine (MDMA; Ecstasy) Use and Transitions to Injection Drug Use Among Street-Involved Youth

Peer reviewed: 
Yes, item is peer reviewed.
Scholarly level: 
Graduate student (PhD)
Final version published as: 

Stephanie Lake, Andrew Gaddis, Kenneth W. Tupper, Ekaterina Nosova & Kora DeBeck (2018): 3,4-Methylenedioxymethamphetamine (MDMA; ecstasy) use and transitions to injection drug use among street-involved youth , Substance Abuse, DOI: 10.1080/08897077.2018.1528493

Date created: 
2018-11-20
Keywords: 
N-Methyl-3,4-methylenedioxyamphetamine
MDMA
Ecstasy
Injection
Drug use
Youth
Adolescent
Abstract: 

Background: Despite the popularity of MDMA (ecstasy) among young people across North America and Europe, MDMA is rarely explored in studies of young people at highrisk of injecting drugs. We conducted a study among street-involved youth who use illicit drugs in Vancouver, Canada to understand if use of MDMA is associated with initiation of injection drugs. 

Methods: We followed injection-naïve participants in the At-Risk Youth Study (ARYS), an ongoing prospective cohort of street-involved youth who use illicit drugs aged 14-26. Bivariate and multivariate extended Cox models with time-updated variables were used to examine the association between MDMA use and initiation of injection drug use between September 2005 to May 2015. 

Results: Among 483 youth, 306 (63.4%) had a history of MDMA use and 218 (45.1%) had used MDMA in the previous six months at baseline. A total of 105 (21.7%) youth initiated injection drug use over the 10-year period, yielding an incidence density of 8.51 (95% Confidence Interval [CI]: 6.96 – 10.30) per 100 person-years. MDMA use was not significantly associated with initiating injection drugs at the bivariate- (Hazard Ratio: 0.93; 95% CI: 0.61 – 1.42) or multivariate- (Adjusted Hazard Ratio: 0.88; 95% CI: 0.57- 1.35) level after adjusting for unemployment, homelessness, and crystal methamphetamine use. 

Conclusions: Amid ongoing frequent use of MDMA among some young people in North America, we did not observe an elevated risk of injection initiation among those who used MDMA in this cohort of street-involved youth.

Description: 

The full text of this paper will be available in November 20, 2019 due to the embargo policies of Substance Abuse. Contact summit@sfu.ca to enquire if the full text of the accepted manuscript can be made available to you.

Language: 
English
Document type: 
Article
Rights: 
Rights remain with the authors.
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