This study identified five different subgroups of ecstasy users based on their perceptions of health problems they associated with their ecstasy use. It is notable that one-third of the ecstasy users did not perceive much health-risk in using ecstasy, and that one fourth of them mainly perceived problems on sexual related items. Researchers have suggested that prevention programs that target ecstasy use should focus on the more common acute and sub-acute side-effects of ecstasy use in order to increase perceived risk of ecstasy use (Baggott, 2002
; Carlson et al., 2004b
). Our findings are in line with those of Murphy and colleagues (2006)
that examined ecstasy risk perceptions among 328 young adult ecstasy users in the UK, and found that less than 30% of males and 40% of females saw any risk (either psychiatric, neuroanatomical, neurochemical, functional dementia or physical) in ecstasy consumption. Moreover, Leung and colleagues (2010)
have shown that ecstasy users who perceive health-related risks associated with ecstasy are more likely to diminish their frequency and quantity of ecstasy consumption.
Blacks were more likely than Whites to “perceive ecstasy-related problems in all areas”, suggesting that Whites may be more at risk to use ecstasy on more occasions and to persist using ecstasy. Higher levels of education were associated with the classes in which participants perceived more health-related problems due to ecstasy use. As such, those with lower levels of education have a greater likelihood of not perceiving problems related to their ecstasy use which may influence their use of the drug.
Those who had used ecstasy on more occasions were the ones more likely to “perceive problems in all areas.” One explanation for this finding might be that most ecstasy users in the other classes who had used ecstasy on fewer occasions had not had the opportunity to experience health-related problems due to ecstasy use. Only analyses of longitudinal data from this sample will clarify if the respondents that “perceived problems in all areas” were the ones more likely to diminish or quit ecstasy use during follow-up. On the other hand, there was a subgroup of respondents that perceived at least some memory and cognitive problems (Class 5) even though they used ecstasy on fewer occasions.
Respondents who “perceived problems in all areas” were more likely to have experienced depressive symptoms as compared to those with “low levels of perceived problems.” Notably, participants in this Class were also more likely to have used ecstasy more than 50 times prior to the interview. This is consistent with prior research showing that ecstasy users who have used ecstasy 50 or more times have higher depressive symptom scores compared to people who have used on fewer occasions (Falck, Wang, & Carlson; 2008
This study has several limitations. First, participants were recruited in one large metropolitan area in the Midwest United States, and the overwhelming majority is of white ethnicity. Secondly, findings are based on self-reported data. However, there is little reason to believe respondents were not providing the most accurate estimates of drug use possible (Carlson et al., 2005
). Findings by Stuerenburg et al. (2002
, p. 260) found a 91.3% concordance between self-reported use of ecstasy and levels of MDMA found in hair analysis. In addition, self-reported use of ecstasy does not necessarily mean that MDMA was ingested, because tablets sold as ecstasy may actually contain a wide range of other drugs, (Cole, Bailey, Sumnall, Wagstaff, & King et al., 2002
; Hayner, 2002
). Notwithstanding these limitations, this study is a valid attempt to identify subgroups of ecstasy users based on their perceptions of perceived risks associated with use of the drug.
In conclusion, this study identified five different subgroups of ecstasy users based on their risk perception. A large proportion of ecstasy users perceive either low or moderate risk associated with their ecstasy use. It is important to further investigate whether lower levels of risk perception are associated with persistence of ecstasy use.