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5 Ecstasy, amphetamine and related substances The official name for Ecstasy is 3,4-methylenedioxymethamphetamine (MDMA). Other substances that are chemically similar to MDMA – or indeed substances that bear no resemblance to it - are also sold as Ecstasy without the user being aware of the difference. These include MDA, MDEA, MBDB and amphetamines. In this chapter, unless otherwise indicated, ‘Ecstasy’ is understood to mean substances that are experienced or passed off as Ecstasy. By amphetamines we mean both ‘ordinary’ amphetamine - and methamphetamine, the stronger variant - unless otherwise indicated. Ecstasy has a stimulating and entactogenic effect. An entactogenic effect means that people feel drawn to each other and make contact more easily. This combination of qualities has contributed to Ecstasy’s reputation as a party or dance drug. The addictive effect is thought to be low. Ecstasy is generally swallowed in the form of tablets. Sometimes it is dissolved as a powder in a drink and then taken. User names for Ecstasy tablets are often derived from the logo stamped on the pills, such as “mitsubishi”, “lover boy” or “superman’. High dose pills are sometimes called “Super X” or “triple stacks”. Other street names include “E”, “Rolls”, “Adam”, “Hug Drug”, “Disco biscuits”, “White Doves” “New Yorkers”, “sweeties” and “wafers” (Nabben et al., 2008). Amphetamine likewise has a stimulating effect, stronger than Ecstasy, but has no entactogenic effect. Amphetamine is used socially, but also by opiate or polydrug addicts. Frequent use can lead to dependence. This risk is greater for methamphetamine than for ordinary amphetamine. The user name for amphetamine is “speed”. User names for methamphetamine are “crystal”, “ice”, “tina”, “yaba” and “meth” (Nabben et al., 2008). In the Netherlands, amphetamines are generally swallowed or snorted, and sometimes injected. Methamphetamine is sometimes smoked. Among rural youth, amphetamine is sometimes used as a cheaper alternative to cocaine. Used in this way, amphetamine is known in Dutch as ‘farmer’s coke’ (Schaafsma 2008). 5.1 Recent facts and trends The most important facts and trends about Ecstasy and amphetamines in this chapter are: • The use of Ecstasy and amphetamine among pupils of secondary schools shows a declining trend between 1996 and 2007. The sharpest decline took place between 1996 and 1999 (§ 5.3). 5 Ecstasy, amphetamine and related substances 105
• Pupils attending REC-4 schools have considerably more experience of both Ecstasy and amphetamine, compared to their peers in mainstream and other forms of special education (§ 5.3). • Compared to a number of other EU member states, the percentage of recent Ecstasy users in the Netherlands is on the high side (§ 5.5). • The number of people with a primary or secondary Ecstasy problem seeking treatment from (outpatient) addiction care is relatively small, and has been declining gradually since 2005 (§ 5.6). • The rise in the number of clients with a primary or secondary amphetamine problem between 2002 and 2007 did not continue in 2008 (§ 5.6). • The number of admissions to general hospitals with a primary diagnosis of misuse of or dependence on amphetamine(-like substances) is low, but showed an increase between 2006 and 2008 (§ 5.6). • The percentage of Ecstasy pills containing (only) a high dose of MDMA or an MDMAlike substance declined in 2008 and the first half of 2009. The percentage of Ecstasy tablets containing other substances (mCPP, mephedrone) has increased (§ 5.8). • Methamphetamine, an extra strong variant of amphetamine, has found little popularity in the Netherlands (§ 5.8). 5.2 Usage: general population • The number of people in the Dutch population aged between 15 and 64 that had ever used Ecstasy increased between 2001 and 2005 (table 5.1). The percentage of recent and current users remained stable during this period (Rodenburg et al., 2007). • Considerably fewer people have ever or recently used amphetamines. Their numbers remained stable between 2001 and 2005. • The percentage of current users for both Ecstasy and amphetamine remained well below one percent. • In absolute terms, the number of current Ecstasy users in 2005 amounted to 40,000, while there were 21,000 current amphetamine users. These estimates are probably on the low side, because problem users of hard drugs were under-represented in the survey in question. • The annual increase in new Ecstasy users remained stable between 2001 and 2005. For amphetamines, the drop between 2001 and 2005 is significant. This may be an indication of a slight loss of popularity of this substance. 106 Netherlands National Drug Monitor - NDM Annual Report 2009
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Netherlands National Drug Monitor N
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Colophon Project Manager Dr. M.W. v
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Preface This is already the tenth A
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5.4 Problem Use 113 5.5 Usage: Inte
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List of abreviations and acronyms 2
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NEMESIS NFU NIGZ NMG NPO NRI NVIC N
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Summary Below is an outline of the
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The number of hospital admissions c
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GHB. In 2008/2009 4.6 percent of fr
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Deaths In the Netherlands, smoking
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Offences by drug users Drug users c
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Opiates Ecstasy Amphetamine Alcohol
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1 Introduction The National Drug Mo
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use, particularly cannabis, under-r
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information is available, this is b
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2 Cannabis Cannabis (Cannabis Sativ
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Figure 2.1 Cannabis users in the Ne
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Figure 2.2 Cannabis use among secon
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Cannabis and problem behaviour •
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Table 2.4 Cannabis use among pupils
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Table 2.5 Current cannabis use in s
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• The sharp increase in treatment
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Trends It is difficult to determine
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• The role of cannabis in all req
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- misuse or dependence on alcohol a
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At the Ambulance Transport Centre (
Page 56 and 57: • So far, epidemiological studies
Page 58 and 59: Quality and price The Trimbos Insti
Page 60 and 61: 3 Cocaine Cocaine works as a stimul
Page 62 and 63: Age, gender and urbanisation level
Page 64 and 65: Special groups In certain groups of
Page 66 and 67: Table 3.3 Cocaine use in special gr
Page 68 and 69: and 7.7% in the U.K (England and Wa
Page 70 and 71: Table 3.5 Cocaine use among school-
Page 72 and 73: Figure 3.2 Number of (outpatient) a
Page 74 and 75: Figure 3.4 Admissions to general ho
Page 76 and 77: The Netherlands Cause-of-Death stat
Page 78: • Little is known as yet about a
Page 81 and 82: 4.2 Usage: general population Heroi
Page 83 and 84: • In the province of Gelderland,
Page 85 and 86: Figure 4.1 Estimates of the number
Page 87 and 88: and syringes exchanged has been reg
Page 89 and 90: • Between 2001 and 2004 the numbe
Page 91 and 92: - misuse of or dependence on alcoho
Page 93 and 94: same time it should be noted that t
Page 95 and 96: International comparison The Europe
Page 97 and 98: The total number of chronic hepatit
Page 99 and 100: • It is thought that risk behavio
Page 101 and 102: the ICD-9 classification. Drug deat
Page 103 and 104: Amsterdam GGD Amsterdam reports the
Page 105: Figure 4.9 Number of drug-induced d
Page 109 and 110: 5.3 Usage: juveniles and young adul
Page 111 and 112: • In 2008, key observers in Amste
Page 113 and 114: Table 5.3 Use of Ecstasy and amphet
Page 115 and 116: Table 5.4a Use of amphetamines and
Page 117 and 118: Table 5.5a Ecstasy use among school
Page 119 and 120: Ecstasy • The number of (outpatie
Page 121 and 122: Figure 5.3 Numbers registered with
Page 123 and 124: • The same person may be admitted
Page 125 and 126: • The number of requests for info
Page 127 and 128: According to the EMCDDA, in other E
Page 129 and 130: Figure 5.6 Concentration of MDMA in
Page 131 and 132: Table 5.9 Number of samples contain
Page 133 and 134: • Consumers who had drug samples
Page 135 and 136: 6.2 Usage: general population The r
Page 137 and 138: GHB use is more common among juveni
Page 139 and 140: • GHB use among school-goers is l
Page 141 and 142: Table 6.4 GHB incidents registered
Page 143 and 144: • Of the liquid samples sold as G
Page 145 and 146: • Total deaths from alcohol-relat
Page 147 and 148: Figure 7.1 Alcohol consumption amon
Page 149 and 150: Ethnic background • Among seconda
Page 151 and 152: Table 7.3 Percentage of current dri
Page 153 and 154: Table 7.4 Alcohol use in the social
Page 155 and 156: Holiday-makers • Research conduct
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Figure 7.3 Heavy drinkers by gender
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The countries with the lowest perce
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• In France it is more likely tha
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Figure 7.6 Age distribution of prim
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• In 2008, 337 day-care admission
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• In approximately 1,200 admissio
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Table 7.9 Estimated number of injur
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• On the basis of current researc
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Figure 7.10 Deaths from alcohol use
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• EU member states have different
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• Surveys by the Continuous Surve
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Figure 8.1 Percentage of smokers in
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8.3 Usage: juveniles and young adul
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Special education Table 8.3 shows t
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Table 8.4 Smokers in the EU-15 plus
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medication, Champix ® , which was
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among passive smoking men, the elev
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Table 8.6 Deaths from lung cancer a
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Since 1 January 2003 it is no longe
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Table 8.8 Cigarette prices and taxe
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eported. These refer to 2007 in the
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Table 9.1 Criminal investigations i
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Table 9.2 Number of dismantled prod
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Table 9.3 Characteristics of suspec
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Figure 9.2 Number of Opium Act case
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Table 9.5 Opium Act cases as a perc
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Disposals by the courts (in the fir
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• Financial orders (Public Prosec
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Table 9.9 Prevalence of new crimina
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10.2 Drug use among offenders Drug-
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• In some two-thirds of cases opi
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I, II Table 10.2 Number of times th
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• The ISD has a capacity of 1,000
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• Although there are some female
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Clinical admission Admission to a h
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Mellow Type of music at raves that
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Secondary diagnosis A secondary or
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Dismissal on policy grounds Decisio
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eintegration and rehabilitation of
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I. Use and problem use Source Targe
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II. Treatment demand and treatment
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IV. Market information Source Targe
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Source Target group/subject Sources
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Appendix C Explanation of ICD-9 and
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Appendix D Websites in the area of
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Ministry for Health, Welfare and Sp
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Appendix E Drug use in a number of
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References Adlaf, E.M., Korf, D.J.,
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Coumans, A.M. (2005). Survival on t
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Ganpat, S., Wits, E., Schoenmakers,
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Knibbe, R.A., Joosten, J., Derickx,
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Monshouwer, K., Smit, F., De Graaf,
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Rigter, H., Van Laar, M. (2002). Ep
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Tweede Kamer der Staten-Generaal (2
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Van Leeuwen, F.E. (1999). Epidemiol
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In the Netherlands various monitori
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