Ecstasygroup drug consumption

Globally, ecstasy-group52 substances (primarily MDMA) are consumed by between 11.6-23.5 million people aged 15-64, or 0.3-0.5% of the population. As a proportion of the population, Oceania accounts for the highest annual prevalence of any region (3.6-4.0% of the general population), but has the fewest users in absolute numbers. The region with the highest number of users is Asia, with an estimated range between 3.6-13.6 million annual users, aged 15-64. Most are living in the East and South-East Asia subregion. Due to a lack of country-level prevalence estimates, subregional estimates cannot be calculated for South Asia, Central Asia, or the Near and Middle East.

Ecstasy-group use concentrated in Western Europe and North America

UNODC estimates that there are about 2.6 million ecstasy-group users in North America, with the majority living in the USA. North America's annual prevalence for the general population is about 0.9%, similar to that of West and Central Europe. There are between 3.8 and 4.0 million ecstasy-group users in Europe. Drug use in West and Central Europe appears largely stable but continues to increase in several East and South-East European countries, particularly among young people.

52 Reports show that unbeknown to many ecstasy users, what is sold to them as ecstasy (MDMA) is often a combination of many psychoac tive substances, such as methamphetamine and ketamine. Amphetamines and Ecstasy: 2008 Global ATS Assessment (United Nations publication, Sales No. E.08.XI.12).

Expert perceptions: Growth in ecstasy-group drug use in developing countries outpacing that of developed countries

The unweighted expert perception trends between 1998 and 2007 reflect continued increases in ecstasy-group use.53 Country experts in developed countries have perceived a stable or slightly declining trend since 2004, about the time when developing countries (particularly in Eastern Europe and Latin America) perceived more frequent and more significant increases in their use.54 In 2007, experts from 63 Member States responded, with 32 identifying a stable ecstasy-group trend over 2006, and 9 identifying a decrease.55 Decreases in developed countries were driven in part by North America and West and Central Europe.

The most recent student surveys in the USA (2008) and Canada (Ontario, 2007) show that little change in annual prevalence of ecstasy-group use has occurred since 2003. However, in the USA and Canada 'ecstasy' is sourced primarily from Canadian-based operations, which increasingly cut it with other psychoactive ingredients. (see special features section for further information)

53 Expert perception data is derived from the ARQ, and is unweighted. The following points are allocated if experts perceive: 'strong increase' 2; 'some increase': 1; stable: 0; 'some decline' -1; 'strong decline' -2. If all countries had reported 'some increase', the global trend line would have increased by one point each year and would have reached 109 by 2007.

54 The criteria to calculate subregional estimates include recent representative prevalence estimates (since 1998) from at least two Member States that combined account for at least 20% of the subregion's population aged 15-64.

55 Increases and decreases were coded from strong increase/decrease or some increase/decrease, and represent the unweighted number of Member States responding.

Table 25: Estimated number of people who used ecstasy at least once in the past year and

proporton of population aged 15-64, by region, 2007

Sources: Annual Reports Questionnaire data, various Government reports, reports of regional Bodies, UNODC estimates

Region/Subregion (Ecstasy-group)

Estimated number of users annually (lower)

Estimated number of users annually (upper)

Percent of population age 15-64 (lower)

Percent of population age 15-64 (upper)

Africa

340,000

1,870,000

0.1

West and Central Africa

Eastern Africa

Subregional estimate cannot be calculated Subregional estimate cannot be calculated Subregional estimate cannot be calculated

Southern Africa

210,000

400,000

0.2

0.4

Americas

3,130,000

3,220,000

0.5

0.5

North America

2,560,000

2,560,000

0.9

0.9

Central America

20,000

30,000

0.1

0.1

The Caribbean

30,000

130,000

0.1

0.5

South America

510,000

510,000

0.2

0.2

Asia

3,550,000

13,580,000

0.1

0.5

East/South East Asia

2,250,000

5,950,000

0.2

0.4

South Asia

Subregional estimate cannot be calculated

Central Asia

Subregional estimate cannot be calculated

Near and Middle East

Subregional estimate cannot be calculated

Europe

3,750,000

3,960,000

0.7

0.7

Western/Central Europe

2,110,000

2,120,000

0.8

0.8

East/South East Europe

1,640,000

1,830,000

0.6

0.6

Oceania

810,000

880,000

3.6

4.0

Global

11,580,000

23,510,000

0.3

0.5

Fig. 113: Ecstasy-group use trends as perceived by experts, by OECD and non-OECD countries, 1998-2007 (baseline: 1998 = 100)56

Note: Ecstasy-group trends were systematically collected only as of 2000, and thus pre-2000 data represent ATS data used as a proxy. Sources: UNODC, Annual Reports Questionnaire Data, UNODC Field Offices, UNODC's Drug Use Information Network for Asia and the Pacific (DAINAP).

J 101

Table 26: Expert perception of changing ecstasy-group use, by region: 2007

Sources: UNODC, Annual Reports Questionnaire Data

Region

Member States responding

Use problem increased*

Percent use problem increased

Use problem stable

Percent use problem stable

Use problem decreased*

Percent use problem decreased

Europe

30

11

37%

15

50%

4

13%

Americas

13

3

23%

10

77%

0

0%

Asia

15

6

40%

5

33%

4

27%

Oceania

0

0

0

0

Africa

5

2

40%

2

40%

1

20%

Global

63

22

35%

32

51%

9

14%

* Identifies increases/decreases ranging from either some to strong, unweighted by population.

* Identifies increases/decreases ranging from either some to strong, unweighted by population.

Note: Ecstasy-group trends were systematically collected only as of 2000, and thus pre-2000 data represent ATS data used as a proxy. Sources: UNODC, Annual Reports Questionnaire Data, UNODC Field Offices, UNODC's Drug Use Information Network for Asia and the Pacific (DAINAP).

Increases still reported in South American countries

In Latin America, only Colombia has annual prevalence rates of ecstasy-group use similar to North America. The rate among urban secondary students in Colombia was 3.0% in 2004/05.57 This is nearly double the rate (1.6%) from surveys of secondary school students conducted just three years earlier.58 Prior to 2001, there were no indications of measurable ecstasy-group drug use among students.

Stabilization in large parts of Europe, with possible shifts detected

Data continue to suggest stabilization in Europe, due in large part to stable use in West and Central Europe. Most notable are the trends from the UK, for many years Europe's largest ecstasy market, and Spain. Beginning around 2001, annual prevalence trends showed decreases in the general population in England and Wales (aged 16-59) and Spain (aged 15-64).

Between 1999 and 2007, European students (aged 15-16) reported increased lifetime use of ecstasy-group substances. However, there were diverging trends by subregion. Students in West and Central Europe59 have reported relatively stable unweighted lifetime use since 2003. In contrast, students from Eastern Europe60 reported nearly 1.5% higher lifetime prevalence rates than their West and Central European counterparts. (see Special Features section for further information)

Consistent with these data, expert perception in 2007 showed 11 experts reporting increasing ecstasy-group use, of which nearly two thirds were from East and South-East European countries.

56 Ecstasy-group trends were systematically collected only as of 2000. There are indications from several countries that late 1990s ATS and ecstasy-group trends followed similar patterns, and thus pre-2000 data represent ATS data used as a proxy.

57 Oficina de las Naciones Unidas contra la Droga y el Delito (ONUDD) y la Comisión Interamericana para el Control del Abuso de Drogas (CICAD/OEA) (2006). Jóvenes y drogas en países sudamericanos: Un desafio para ¡as políticas públicas: Primer estudio comparativo sobre uso de drogas en población escolar secundaria de Argentina, Bolivia, Brasil, Colombia, Chile, Ecuador, Paraguay, Perú y Uruguay (Lima, September 2006).

58 The Inter-American Drug Abuse Control Commission. Multilateral Evaluation Mechanism (MEM): Colombia country report 2001-2002. (Organization of American States (OAS), 2008).

59 Students of West and Central Europe include: Austria, Belgium (Flanders), Cyprus, Denmark, Faroe Islands, Finland, France, Germany (6 states), Greece, Greenland, Iceland, Ireland, Isle of Man, Italy, Malta, Netherlands, Norway, Portugal, Sweden, Switzerland and the United Kingdom.

60 Students of Eastern Europe include: Bulgaria, Croatia, Czech Repub lic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Russian Federation, (Moscow), Slovakia, Slovenia, and the Ukraine.

Worsening ecstasy situation in parts of Asia may reflect other drugs

For 2007, 40% of experts perceived a growing ecstasy-group use problem in Asia. Of these, most were situated in East and South-East Asia, including China, Indonesia, Thailand and Viet Nam. However, like other regions, a lack of forensic capacity means that it is not known whether ecstasy-group substances actually contain MDMA or other psychoactive ingredients. "Club drugs" are increasingly being replaced by other substances, such as ketamine.61 For example, in Hong Kong, China, the market has changed rapidly and dramatically since 2000, as ketamine—nearly unheard of in 1998—has supplanted ecstasy use. The number of reported drug registry cases for ketamine doubled between 2005 and 2007, and now accounts for 29% of all newly reported cases in Hong Kong, China. Ketamine use has been noted in neighbouring areas and follows reports of significant illicit manufacturing operations and seizures throughout the subregion.

Fig. 114: Annual prevalence of ecstasy-group use among secondary students in select South American countries (rank ordered), 2004/05

Source: Oficina de las Naciones Unidas contra la Droga y el Delito (ONUDD) y la Comisión Interamericana para el Control del Abuso de Drogas (CICAD/OEA) (2006). Jóvenes y drogas en países sudamericanos: Un desafio para las políticas públicas: Primer estudio comparativo sobre uso de drogas en población escolar secundaria de Argentina, Bolivia, Brasil, Colombia, Chile, Ecuador, Paraguay, Perú y Uruguay. (Lima, 2006).

Colombia

Chile

B 1.6%

Ecuador

1

.1%

Peru

0.6%

Bolivia

0.5%

Paraguay

0.4%

61 Ketamine is a licit pharmaceutical illicitly used as a hallucinogen most often found in powder or liquid form that is increasingly encountered on ATS markets, either in connection with the "club-drug" scene, or found as an active ingredient in what is sold on illicit markets as 'ecstasy'. Ketamine is not currently under international control.

Fig. 115: England and Wales (UK) and Spain: Annual prevalence of ecstasy-group use among the general population, 1998-2007/08

Source: Kershaw, C., Nicholas, S., & Walker, A. (2008). Crime in England and Wales 2007/08: Findings from the British Crime Survey and police recorded crime. Home Office Statistical Bulletin (ISBN 978-1-84726-753-5) (London, 2008); Informe de la encuesta domiciliaria sobre alcohol y dogas en España (EDADES) 2007/08. Delegación del gobierno para el plan nacional sobre drogas. (Madrid, 2008).

o England & Wales (age 16-59) —Spain (age 15-64)

High use levels in Oceania, but the ecstasy used may vary

Given that the Australian population comprises the majority of population in Oceania, what occurs in Australia de facto "drives" trends in Oceania. Both Australia and New Zealand have reported increased annual prevalence of ecstasy-group among the general population since 1998, and the most recent studies find that their

Fig. 116: Hong Kong, China ecstasy-group and ketamine drug registry cases, 1998-2007

Source: Central Registry of Drug Abuse. Narcotics Division (ND), Security Bureau, the Hong Kong Special Administrative Region, China.

3,982

4,000

3,000

2,000

1,000

Source: Central Registry of Drug Abuse. Narcotics Division (ND), Security Bureau, the Hong Kong Special Administrative Region, China.

3,982

3,000

Ketamine Substance Abuse Trend Canada

Ketamine

Ecstasy-group

Ketamine

Ecstasy-group rates reflect some of the highest reported annual prevalence of use. Annual use in Australia remained stable since 2004, contrary to increases in New Zealand.

However, due to some of New Zealand's apparent increase may not be of MDMA-containing pills. Until 2008, New Zealand had a substantial legal "party-pills" market which sold, inter alia, benzylpiperazine (BZP), a drug with effects similar to MDMA (ecstasy). A 2006 household survey found that 15.3% of New Zealanders (aged 13-45) had used "party-pills" in the past year. In some cases these "party-pills" were sold as "ecstasy".

Fig. 117: Australia and New Zealand: Annual prevalence of ecstasy use, 1998-2007

Source: Australian Institute of Health and Welfare 2008. 2007 National Drug Strategy Household Survey: detailed findings. Drug statistics series no. 22. Cat. no. PHE 107. Canberra: AIHW. Wilkins C. & Sweetsur P. (2008) Trends in population drug use in New Zealand: Findings from national household surveying of drug use in 1998, 2001, 2003 and 2006. New Zealand Medical Journal, 121, 61-71. A216

Source: Australian Institute of Health and Welfare 2008. 2007 National Drug Strategy Household Survey: detailed findings. Drug statistics series no. 22. Cat. no. PHE 107. Canberra: AIHW. Wilkins C. & Sweetsur P. (2008) Trends in population drug use in New Zealand: Findings from national household surveying of drug use in 1998, 2001, 2003 and 2006. New Zealand Medical Journal, 121, 61-71. A216

What States Ecstasy Legal

Map 25: Changes in the use of ecstasy (MDA, MDMA), 2007 (or latest year available)

| Large increase ] Some increase Stable □ Some decline 1 Strong decline J Data not available

* Primary source: UNODC Annual Reports Questionnaires. For a few countries, UNODC has based its perception on supplementary drug trend information derived from or reported in national household surveys, United States Department of State (Bureau for International Narcotics and Law Enforcement Affairs), International Narcotics Control Strategy Report, Law Enforcement Reports, Meetins of Heads of Law Enforcement Agencies (HONLEA), UNODC Illicit Drug Trends publications for various countries, Drug Abuse Information Network for Asia and the Pacific (DAINAP), UNODC Global Assessment Programme on Drug Abuse (GAP), UNODC Data for Africa Project.

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