Club Drugs and Ecstasy: A Review of the Literature

Introduction: Club Drugs and the Research Gap

"Though some researchers have indicated club drug users are more likely to be poly-drug users, there remains little known about the prevalence and specific combinations of the substances they use…" (Grov, et al., 2009, p. 848).

The use of club drugs in the United States has been a problem for healthcare agencies and law enforcement for many years. The focus of research on the use of club drugs — notably ecstasy — in most articles is on "rave" events, where loud music and drug use are typical. This paper reviews and critiques the literature related to the use and abuse of club drugs.

Club Drug Use in Chicago: Prevalence and Context

How extreme is club drug use in Chicago? A profile of adult club drug use was measured by Michael Fendrich and colleagues and published in the peer-reviewed journal Addiction (Fendrich, et al., 2003, p. 1693). What this team found, by surveying 627 randomly selected adult participants, is that use of Methylenedioxymethamphetamine (MDMA) — also known as ecstasy — was combined with "multiple illicit substances" (Fendrich, 1693). About twice as many of the 627 participants had used ecstasy combined with other drugs as those who were taking ecstasy alone.

This survey was conducted because the use of club drugs has not been fully explored and, moreover, there have not been studies of "local trends," the authors explain (1694). The study was also important because most research on club drugs tends to focus only on "MDMA and LSD, virtually ignoring other drugs" that are part of the club scene — such as ketamine and GHB (Fendrich, 1694). A third reason for this article is that large national surveys on the topic have not examined "the details and context of club drug use," offering little information about the "frequency of ingestion of these substances" (Fendrich, 1694).

The area that should receive more research attention, Fendrich continues, is the relationship between club drug use and "high-risk sexual behavior." The results of this survey show that the most commonly used club drug among Chicago participants was LSD (16.7%); next was MDMA/ecstasy (9.6%); and methamphetamine was the third most used club drug (6.7%) (Fendrich, 1696). About 36% of the 627 respondents reported using ecstasy at least ten times (Fendrich, 1697), and about half of the individuals reported having used a club drug at a rave.

Health Consequences: Ecstasy Overdoses at Raves

How dangerous is the use of ecstasy at a rave? A rave is an all-night dance party featuring electronic music and an elaborate laser light show; when thousands of people are expected, promoters position ambulances nearby because it is known that people use club drugs in unsafe ways. The Centers for Disease Control and Prevention (CDC) publish a "Morbidity and Mortality Weekly Report," and on June 11, 2010, the report showed that as a result of a New Year's Eve rave in Los Angeles, 18 individuals were taken to emergency departments in Los Angeles hospitals. Of those 18 — aged between 16 and 34 years, nine of whom were female — all were treated for "MDMA-related illness within 12 hours of the rave" (CDC). Five of the 18 had used ecstasy along with other drugs; 10 had used alcohol and club drugs; and one participant (age 24) died at home on January 1st (CDC). The cause of death was "multiple drug intoxication"; friends reported that the individual had been using cocaine and ecstasy at the rave and, once home, apparently also injected heroin.

A second CDC report on the Los Angeles incident notes that 45,000 people had attended the rave, with three stages playing electronic music from 6 p.m. on December 31st until 4 a.m. on January 1st. In addition to the 18 individuals mentioned in the first CDC report, further investigation found that 30 attendees were taken to area hospitals — one for trauma and 29 for "various drug and/or alcohol intoxications" (CDC). Many of those hospitalized showed symptoms consistent with MDMA overuse: "agitation, hypertension, mydriasis, and tachycardia" (CDC, p. 2). One patient among the 30 was admitted to the ICU with "seizure, rhabdomyolysis, renal failure requiring hemodialysis, and hepatic failure" and remained hospitalized for 28 days.