F A Guide toOAIDSCResearch andU CounselingS Volume 15 Number 4 March 2000

by groups of individuals working with very Harm Reduction small budgets. While some of these have developed into huge parties called “mas- in the Rave Community sives” with attendance at more than Kirsten Henricksen 10,000, the best raves are still thrown by small, dedicated collectives. Admittance usually requires a ticket sold in advance, Over the past 10 to 15 years, a world- at any price between $10.00 and $150.00, wide community of people has come and the venue is sometimes unknown until together to share art, music, dance, and the day of the party. People usually arrive drugs in a new context: the rave party. at around 10:00 pm and stay all night. At their best, raves are elaborate private Because the rave scene encourages parties, decorated and thrown with a creative expression, a good party often reverence for free creative expression in includes ravers in bright day-glow outfits, any form—art, dance, spirituality, and glow sticks, and glitter make-up, and most importantly, music. For many people venues with elaborate decorations and attending these parties, the experience is complex lighting. There are layers of enhanced by the use of drugs. And techno music penetrating the space: any because chemicals are involved, raves can space will do, the only necessary element pose risks to some individuals. is excellent sound equipment. This techno In response to these risks, the rave com- music can take endless forms, and munity has fostered collectives of individu- depending on the form of the music, so als working to distribute information about can the crowds. Young suburban kids are harm reduction. Employing an unbiased drawn to a much different party than and nonjudgmental approach, groups such middle-aged tripping hippies. Inner-city as DanceSafe in the San Francisco Bay Area, kids are likely to be drawn to a very dif- Crew 2000 in Amsterdam, and the Toronto ferent type of gathering than the well- Raver Information Project (TRIP) in oiled circuit party boys. The movement Toronto, are taking harm reduction to has grown to include people from every raves and other underground parties background, age, and economic status. throughout the world. This article defines Most of the creative energy of a rave is the rave “scene” and what attracts people sensory, and often the goal is to create a to it, describes the development of a harm positive sensory response, which can be reduction approach in the rave community, heightened by drug use. Ravers seek envi- and explores how this approach might be ronments conducive to the use of a particu- applied to HIV-related risk. lar classification of drugs recently labeled by the National Institute on Drug Abuse An Introduction to Raving (NIDA) as “Club Drugs.” These drugs The rave scene grew out of several shift- include, but are not limited to, crystal ing elements over the past two decades. methamphetamine (speed, crystal meth, Significant growth in art, technology, crystal), gamma hydroxybutyrate (GHB, G, music, and drug chemistry have all helped Liquid X), ketamine (K, Special K), and most to create a thriving underground commu- commonly, methylenedioxymethampheta- nity. And, it is important to acknowledge mine (MDMA, ecstasy, E, X, XTC). While that it is a community. Most underground some people do come to parties having parties and raves started out being thrown already bought their drugs, most ravers people who would otherwise Editorial: Wonder and Caution throw it completely to the wind. Robert Marks, Editor The second article in this issue—by Robert Guzman—looks My history is almost devoid of disbelief. Whether it is the youth at another manifestation of the experience with controlled sub- culture or the drug culture or dance party, the circuit party. stances: the bottom line is that different racial or ethnic cultures, Both Guzman and Henricksen my body just does not react well I am bound by my own limited offer perspectives from the to drugs and alcohol. I’ve also experience, and when faced with inside, ethnographic snapshots been socialized to believe that an experience so different from of a world that has not received while taking drugs is not a moral my own, I should seek to dilute much attention in the United failing—and society should my skepticism with wonder. States. (You might notice that the continue along the path to The great thing about Henrick- Recent Reports section of this decriminalization—it is not the sen’s approach is that she has issue includes articles only from healthiest way of living. Despite achieved the converse, if not Europe and Australia; it was very an ever-growing embrace of embracing a skepticism of her difficult to find published stud- harm reduction as an HIV pre- own, at least acknowledging the ies of the U.S. situation.) vention strategy, this perception risks of raves and party drugs, There is no doubt that some of drug use seems to be shared mixing her wonder with caution. people prefer the clarity of absti- by many HIV providers. People like Henricksen and orga- nence to the complexity of harm So, it was a challenge to edit nizations like DanceSafe—or, for reduction, but human behavior is Kirsten Henricksen’s review of that matter, STOP AIDS or the usually messier than that. the rave scene. A little voice in needle exchange advocacy group Henricksen and Guzman offer at my head kept wondering: is the Prevention Point—take on the least the first step toward signifi- scene really as fabulous as crucial societal role of not only cant harm reduction in this area: Henricksen suggests? The answer identifying risk but also mediat- a catalog of behavior, motivation, I came to is that crossing cultures ing caution, making it compre- and risk at these increasingly requires a certain suspension of hensible and acceptable to popular gatherings.

purchase drugs at the event.1 The most drugs or different drugs simply because popular drug is ecstasy, and it was the they have been offered. rediscovery of ecstasy and its derivatives in Because this environment is not risk- the late 1970s and early 1980s that helped free, that is, because it relies on illegal to propel forward the rave movement. substances that have physical and psycho- Raves are meant to be safe, drug-friendly logical effects, the rave community faces challenges of suppression by establish- environments. While the concept of “safe- ments that are pre-programmed against ty” is relative, the rave scene has sought to them. In response, rave collectives—such create a sense of safety by perpetuating an as DanceSafe—have begun to self-police internal code of ethics exemplified by the the underground economy within the acronym PLUR, which stands for Peace, community, monitor the behaviors and Love, Unity, Respect. The scene also seeks mores of the community, and fight exter- to evoke a certain hedonistic rapture, the nal stereotyping about the community. end result of which may be 15 or 20 sweaty people lying together on a floor that is The Attraction of User-Friendly Environments covered in mattresses, entwined in a peace- The chemical composition of MDMA ful, drug-induced euphoria. The environ- causes the brain to release large amounts ment creates a level field, on which anyone of serotonin, and this release creates an can play and be accepted. The impact of euphoric, multi-sensory experience for the the decorations, the music, the lighting, user. The impact of MDMA on the user is the people, and the drugs create a contain- both validating and potentially life-chang- er around the party where responsibilities ing. For the first time E user, there is a and commitments fall aside. new understanding of individuality and For the experienced raver, it is easy to interconnection, a level of self-awareness find a balance between the party and real that is often called “spiritual.” life, to remember that everyone will have Users of MDMA will often dance for long to get back to life in the real world in the periods of time without stopping (some- morning. The inexperienced raver, howev- times referred to as “trance-dancing” or er, may lose track of concrete details over “trancing out”). The drug allows the user to the course of the party and take more hear the music more completely, to feel the 2 FOCUS March 2000 music. MDMA heightens and enhances the sy to cause damage to the neurotransmit- experiences of touch and physical reaction. ters of regular users.2 In addition, MDMA leads to some hallucino- genic effects through the increased ocular DanceSafe and Harm Reduction nerve stimulation that accompanies pupil While there are potential drawbacks to dilation. Ecstasy is also sometimes referred club drugs and the research is unclear about to as an “empathogen”— long-term use, public concern about club meaning that it allows drugs is rarely rooted in fact-based informa- the user to feel empathy tion. It is instead the result of the propagan- Rave collectives for his or her environ- da of a highly political drug war. The rise of ment. As such, the collectives such as DanceSafe demonstrates themselves are MDMA high leads to a that people within the rave community are loss of ego and to a themselves concerned about safety. But they concerned about greater likelihood than are also concerned about the effects of this safety, but they with other drugs of anti-drug campaign: the adulteration of bonding deeply with substances that results from a black market approach this other people. and the barrage of fear-based misinforma- Heightened sensory tion. In response to all of these factors, rave challenge differently awareness, combined collectives throughout the world have with the internal peace adopted harm reduction as their goal and than do advocates created when using information as their strategy. For example, ecstasy, is also the foun- DanceSafe seeks: “To distribute non-biased, of a highly political dation from which risk- fact-based information to the rave and drug war. taking behaviors arise. nightclub community.” Collectives are usual- There is rarely an MDMA ly composed of MDMA users themselves. user who does not have DanceSafe began in 1998 in response to a story about how touch- a number of documented incidents of ing with friends rapidly progressed to deep- adulterated MDMA being sold at raves. er intimacy, a result that was completely Unknowing users, upon finding the adul- comfortable. Most ecstasy users do not terated MDMA inadequate, would ingest an “wake up” the next day with regrets about additional but unadulterated pill. In some their behavior or their interactions. In gen- cases, the chemical reaction caused by the eral, the “wake up” happens during the combination of the authentic drug and the MDMA experience; the days that follow have adulterated pill caused extreme adverse more to do with comprehending the growth reactions. For example, the introduction of that occurred during the high. However, dextramethorphin (DXM, DMX, Robo) into behaviors that are emotionally comfortable the scene in recent years has dramatically can still be risky; and risk increases with the increased the numbers of “ecstasy-related” number of substances ingested by the user. deaths. Misinformed users, thinking they Frequent MDMA use leads to tolerance, were taking ecstasy, were given DXM. Since which means that it takes more drug to DXM has different effects than ecstasy, get the same high. Instead of regulating users would often purchase another dose the amount of ecstasy ingested (and giv- of ecstasy. If the second pill were, in fact, ing the body time to recoup), a poorly ecstasy, the result could lead to a potential- informed raver might take up to five or ly lethal drug combination. six hits of ecstasy in a night, combining it DanceSafe’s response is based on a with GHB, possibly some speed or crystal References fundamental harm reduction philosophy. meth, or any number of other drug combi- It assumes that people will purchase and 1. Unofficial surveys nations. This irresponsible behavior trans- taken by DanceSafe use drugs regardless of any propaganda- volunteers place the lates primarily to the risk of overdose, based or actual threats to safety. It also numbers of people and secondarily, to risky sexual behavior. asserts that the best way to protect ravers purchasing drugs on Other potential risks emerge as well: as a from making irresponsible decisions site at over 65 per- result of the immense energy rush experi- begins with education from within the cent. This data is enced by the user, it is possible for the being compiled into community. Better-informed users are official statistics and person on ecstasy to go for long periods more responsible for their own well-being can be found at the of time dancing without recognizing the and for that of those around them. DanceSafe web site: body’s basic needs. This manifests most www.dancesafe.org. DanceSafe, with chapters in Vancouver, often in users who fail to rehydrate their Seattle, and Portland, Oregon, reaches out 2. Shoop SA, Rayl AJS. bodies. In addition, there is little informa- to the community by creating a presence at Ecstasy use rises tion about long-term use of MDMA and raves. It coordinates with party promoters despite brain danger. other club drugs in humans. Recent stud- USA Today. 7 January to set up booths from which staff and 2000. ies have suggested the potential for ecsta- volunteers distribute fact-based fliers—in 3 FOCUS March 2000 snappy, demographic-specific formats—to Finally, for some people, the first ecstasy the people attending the gatherings. These experience may evoke emotions that they fliers contain detailed information about a have never before experienced, and this specific drug, including chemical composi- may continue in the hours and days follow- tion, impact on the body, potential risks, ing the party. In response, DanceSafe is overdose symptoms, and referrals for more developing “peer-incorporation sessions,” detailed information. In response to the which will give first-time MDMA users a additional drug-related risks, including safe venue for asking questions, voicing possible HIV infection, DanceSafe also concerns, and integrating into the rave distributes thousands of condoms from community that exists outside of the party. its booths every month and is planning to develop fliers on sexual appropriateness. Conclusion The DanceSafe booth also functions as a Crucial to the type of grassroots harm focal point at raves: when people experience reduction model implemented by rave negative drug effects, and are intimidated collectives is the involvement of peers and about approaching an “authority” such as a the concept of acknowledgment. The vol- security officer or an emergency medical unteer acknowledges that the user would technician (who usually attend rave events), be using drugs regardless of the external DanceSafe offers an alternative. DanceSafe input of his or her peers. In this acknowl- volunteers are most often users, but they edgment, the volunteer communicates that are sober while at the booth. Volunteers are the user has nothing to lose by becoming trained to identify troubling symptoms and more informed, and that the volunteer take appropriate action. DanceSafe encour- does not threaten the user’s intention to ages a potential volunteer to attend several use. Likewise, the user acknowledges that parties as an observer. Volunteers also the volunteer is providing fact-based and attend at least two training meetings where nonjudgmental information. they learn peer counseling and crisis inter- This model of harm reduction integrates vention techniques, and may attend a HIV-related risk, and is being broadened. DanceSafe-sponsored American Red Cross For example, DanceSafe is distributing First Responder training. information about the sexual risk related to Most of the one-on-one peer counseling club drug use and about unprotected sex. at a rave entails spending time with ravers In response to the misconception that a and giving them the opportunity to inte- person on ecstasy always wants to be grate their feelings. This requires establish- touched, DanceSafe is creating a flyer ing a non-biased dialogue with them, aimed at reminding the community to maintaining contact with them throughout respect the personal space of fellow ravers. the party to ensure that everything is going The ecstasy experience is not always sexu- Authors well and that they are taking care of their al, and DanceSafe aims to create a dialogue basic bodily needs (water and fresh air), within the community about this issue. Kirsten Henricksen is a freelance writer and and seeking out the necessary authorities The main tool of harm reduction is infor- raver in San Francisco. if help is required. Some harm reduction mation, both for club drugs and HIV. The She volunteers for collectives in the rave scene call this the hope is that information will lead to respon- DanceSafe Bay Area “karma patrol” or “vibe monitors,” ensuring sible, fact-based decision making. As the and has been dedicat- ed to harm reduction that everybody has the supplies and infor- rave community continues to inform, and since 1997. mation they need to have a good time. police itself, perhaps it can also heal itself.

Journal of Health Psychology. 1998; Clearinghouse: Raves/Circuit Parties 3(part 4): 295-317. French R, Power R. A qualitative study of and Policy. 1999; 6(2): 215-225. the social contextual use of alkyl nitrites References (poppers) among targeted groups. Journal Adlaf EM, Smart RG. Party subculture Buxton J, Craig C, Daly P, et al. An of Drug Issues. 1998; 28(1): 57-76. or dens of doom? An epidemiological outbreak of mumps among young study of rave attendance and drug use Hammersley R, Ditton J, Smith I, et al. adults in Vancouver, British Columbia, patterns among adolescent students. Patterns of ecstasy use by drug users. Journal of Psychoactive Drugs. 1997; associated with “rave” parties. British Journal of Criminology. 1999; 29(2): 193-198. Canadian Journal of Public Health. 39(4): 625-647. 1999; 90(3): 160-163. Akram G, Galt M. A profile of harm- Lewis LA, Ross MW. The gay dance reduction practices and co-use of illicit Conner M, Sherlock K, Orbell S. party culture in Sydney: A qualitative and licit drugs amongst users of dance Psychosocial determinants of ecstasy analysis. Journal of Homosexuality. drugs. Drugs: Education, Prevention use in young people in the U.K. British 1995; 29(1): 41-70.

4 FOCUS March 2000 dance parties with prevalent club drug Circuit Parties use, but differ from raves in several ways. Robert Guzman Circuit parties are attended overwhelm- ingly by gay and bisexual men, whereas Across the United States, but increas- raves attract primarily, but not exclusive- ingly around the world, a subpopulation ly, heterosexuals. While circuit parties of gay men gather at “circuit parties,” have evolved from a set path from city to city, raves are often less planned and large-scale dance events with fast-paced, follow no path; and there may be any high-energy music, and a proliferation of number of raves going on simultaneously “club” drugs other than alcohol. So named in a given metropolitan area. Raves attract because these annual events initially a much younger crowd, including many seemed to followa circuit from one city under 21 years old, while circuit parties to another every few weeks, circuit parties attract a broader range of ages with more seem to have evolved out of the large men in their thirties and forties. References AIDS benefit parties of the 1980s and a Circuit parties recently gained national 1. Woody GE, Donnell reemergence of the gay dance party cul- attention through the Gay Men’s Health D, Seage GR, et al. ture of the 1970s. Whatever their origin, Non-injection sub- Crisis (GMHC) Morning Party, which was stance use correlates these events present specific opportuni- held annually since 1983 on Fire Island. In with risky sex among ties for HIV risk behavior. 1996, two men had to be airlifted from the men having sex with party after overdosing on drugs; in 1998, men: Data from The Circuit Party Defined HIVNET. Drug and another man overdosed on GHB and died Alcohol Dependence. Circuit parties typically run from one during the party weekend. Critics of the 1999; 53(3): 197-205. day to one week or longer. Although dance party said that holding an AIDS fundraiser parties are typically the main events of 2. Stone E, Heagerty P, where drug use was so prevalent was Vittinghoff E, et al. circuit party celebrations, parties may counter to GMHC’s overall goal, particular- Correlates of condom also involve activities such as “gay day” at ly in light of research that suggests that failure in a sexually amusement parks, pool parties, and in one active cohort of men self-reported drug use predicts high risk who have sex with case a river rafting trip. These events may sex,1 condom breakage,2 and seroconver- men. Journal of draw up to 20,000 or more gay men from sion.3 While some within the gay commu- Acquired Immune around the world. Some weekends there nity have criticized parties and their Deficiency Syndromes are circuit parties in more than one city 4 and Human Retroviro- attendees, others have cautioned against logy. 1999; 20(5): 495- and even competing events within a city. scapegoating and have emphasized the 501. Currently, there is little published data positive aspects of circuit parties, that on these events. The stereotypical circuit 3. Ostrow DG, Beltran is, the ways in which these events fulfill ED, Joseph JG, et al. party goer is the muscular, upper-middle emotional, recreational, and spiritual Recreational drugs class, gay white man in his mid-thirties— needs for attendees.5 and sexual behavior the image seen on promotional fliers and The reasons men attend circuit parties in the Chicago MACS/ web sites and in magazines—but party are probably as diverse as the men who CCS cohort of homo- sexually active men. goers range in age, ethnicity, or socioeco- attend them. They range from dancing to a Chicago Multicenter nomic class. While some participants may certain type of music or hearing a famous AIDS Cohort Study focus much of their lives on their party disc jockey, to hanging out with friends (MACS)/Coping and going, other party goers may only attend and meeting new ones, experiencing a Change Study. Journal of Substance Abuse. occasionally. sense of community, using drugs, and 1993; 5(4): 311-325. Circuit parties are similar to “raves,” seeking new sex partners. It is these last

Measham F, Parker H, Aldridge J. The Morgan MJ. Recreational use of “ecstasy” Contacts teenage transition: From adolescent (MDMA) is associated with elevated Robert Guzman, San Francisco recreational drug use to the young impulsivity. Neuropsychopharmacology. Department of Public Health, HIV adult dance culture in Britain in the 1998; 19(4): 252-264. Research Section, 25 Van Ness, Suite mid-1990s. Journal of Drug Issues. 1998; 28(1): 9-32. Pederson W, Skrondal A. Ecstasy and 500, San Francisco, CA 94102, 415-554- new patterns of drug use: A normal 9342, 415-621-0641 (fax), robert_guz- Millman RB, Beeder AB. The new population study. Addiction. 1999; [email protected] (email). psychedelic culture: LSD, ecstasy, “rave” parties and the Grateful Dead. Psychia- 94(11): 1695-1706. DanceSafe, PO Box 12462, Berkeley, tric Annals. 1994; 24(3): 148-150. Van de Wijngaart GF, Braam R, de Bruin CA 94712, 510-834-4654, dsusa@ dancesafe.org (email), http//www. D, et al. Ecstasy use at large-scale Morgan MJ. Memory deficits associated dancesafe.org (web site). with recreational use of “ecstasy” dance events in the Netherlands. (MDMA). Psychopharmacology. 1999; Journal of Drug Issues. 1999; 29(3): 141(1): 30-36. 679-702. See also references cited in articles in this issue.

5 FOCUS March 2000 two reasons that have caused the most intervention. Health promotion strategies concern among health professionals, crit- for circuit party attendees should capital- ics, party attendees, and party producers. ize on the positive and community- centered aspects of circuit parties. Moti- HIV Prevention and Circuit Parties vations for healthy behavior can be to Circuit parties present specific potential take care of “the tribe” or one’s friends, HIV-related risks, but since there is little to party safely in order to keep the party data on the parties, prevention providers going, to avoid drug overuse so one does currently rely on hunch- not miss one of the parties, or to make es and anecdotal obtaining condoms part of preparing for reports. Chief among the party events. Since strongly these risks is the use What may be less productive as inter- of drugs such as ventions are punitive or abstinence-based negative information methylenedioxymetham- measures. Many party attendees are likely phetamine (MDMA, to be well-informed about the substances may run counter ecstasy), gamma-hydrox- they use, how much they can take, and in ybutyrate (GHB), what order to use different drugs to to the experiences methamphetamine (crys- diminish the risk of overdose. Many atten- tal, speed), and ketamine dees may also be knowledgeable about of individuals (K). But while drug use their own sexual choices in a variety of may have an impact on settings and while on different and their friends, risk for some, engaging substances. Since strongly negative infor- in unsafe sex may sim- mation may run counter to the experi- these messages ply be a conscious deci- ences of individuals and their friends, sion ahead of time. these messages may be rejected out of may be rejected Circuit party weekends, hand as ill-informed or biased. Further, because they are cele- they may contribute to the stigma around out of hand as ill- brations and, in some drug use and lead to silence at crucial cases, out-of-town vaca- times. For instance, there is anecdotal informed or biased. tions, may be times evidence that the man who died during when men allow them- the 1998 GMHC Morning Party weekend selves to let go in terms did not disclose his use of GHB to some- of drug and sexual safe- one who tried to take care of him because ty as a reward for having been so respon- the man was too embarrassed to admit he sible at other times. For others, sexual and had used the drug.6 drug risk taking during circuit parties 4. Signorile M. Life weekends may be part of their regular Conclusion Outside. New York: behavior patterns. The impact of new HIV As with all HIV prevention efforts, it is Harper Collins, 1997. treatment advances may also play a role important for providers to include circuit 5. Rofes E. Dry Bones in risk taking, reducing fears about the party attendees as active participants in Breathe. Binghamton, consequences of HIV infection. However, the process of designing and implementing N.Y.: Haworth Press, 1998. even if a small proportion of circuit party effective interventions. It is also important goers engage in risky behaviors during to gather and rely on quantitative and 6. Meers E. Frank these events, the potential for large num- qualitative scientific information about Giordano’s last hours. bers of sexual partners increases the Electric Dreams. circuit parties as it becomes available. September, 1998. (To potential for HIV transmission. subscribe to this email Until current research results in a clear- newsletter, send an er understanding of risk at circuit parties, email to: edreams- HIV prevention workers should collabo- subscribe@egroups. Comments and Submissions rate with party producers to implement com.) We invite readers to send letters traditional HIV educational approaches, responding to articles published in including condom, lubricant, and informa- Authors FOCUS or dealing with current AIDS tion distribution. At the same time, coun- Robert Guzman is the research and counseling issues. We selors can assist their clients by Coordinator of the also encourage readers to submit arti- recently completed encouraging them to explore the meaning cle proposals, including a summary of Circuit Party Men’s of circuit parties in their lives and of risky Health Survey of the the idea and a detailed outline of the behaviors during circuit party and non- San Francisco article. Send correspondence to: Department of Public party weekends. Health, HIV Research Since much of the press attention Editor, FOCUS Section. Results from towards circuit parties has been strongly UCSF AIDS Health Project, Box 0884 this study will be available in Spring critical, those for whom circuit parties are San Francisco, CA 94143-0884 2000. important may be wary of any outside 6 FOCUS March 2000 point in their lives, and 37 percent of Recent Reports these reported having injected in the previous month. None of these, however, Drug Use at Raves reported sharing needles during this time. Lenton S, Boys A, Norcross K. Raves, drugs and Musical Preference and Drug Use experience: Drug use by a sample of people who attend raves in Western Australia. Addiction. 1997; Forsyth AJM, Barnard M, McKeganey NP. Musical 92(10): 1327-1337. (National Centre for Research preference as an indicator of adolescent drug use. into the Prevention of Drug Abuse, Perth, Australia.) Addiction. 1997; 92(10): 1317-1325. (University of Glasgow, Scotland.) An Australian study investigating drug Fans of rave music are more likely to use among people attending raves found use substances than those who prefer that those with less drug-using experience other types of music, according to a large may have less drug-related knowledge and Scottish study of early adolescents. may therefore be at increased risk of Further, rave music is significantly corre- harm. lated with the use of all substances, both The study included 83 participants who legal and illegal, and this correlation is had been to a rave in the last six months, not limited only to “dance drugs” such as and who had been recruited through fly- amphetamines, LSD, and ecstasy. ers in cafes, clothing and music stores, Study participants were secondary school and word of mouth. The average age of students between the ages of 12 and 15. the participants was 19 years, and 53 Two separate groups from five schools were percent were male. Interviews consisted studied, including 758 students from the of questions about drug use history, HIV city of Dundee in 1994 and 765 students risk behavior, knowledge of drug-related from the rural area of Perth and Kinross harm, and side-effects of drug use. District in 1996. The study sample repre- Ninety percent of participants had used sented approximately 10 percent of all LSD at least once in their lives, 76 percent children in the areas surveyed, and ques- had used ecstasy, and 69 percent had tionnaires were randomly administered. used amphetamines. The last time they Thirty-one percent of Dundee students had attended a rave, 52 and 25 percent of Perth and Kinross stu- percent of participants dents reported ever having used an illegal had used marijuana, 35 substance. Of these, 64 percent of Dundee Rave music percent had used students and 53 percent of Perth and remained strongly amphetamines or LSD, and Kinross students preferred rave music to 28 percent had used ecsta- all other styles. The level of use of “rave associated with sy. Many participants drugs”—including psylocibin, LSD, began using “dance drugs” amphetamine, cocaine, and ecstasy—was substance-using while they were in high 16 percent among Dundee students and 12 school. percent among Perth and Kinross students. students despite Sixty-five percent of Although it is widely considered to be the participants who had ever archetypal rave drug, ecstasy had been used the fact that "indie" used ecstasy did so for the by only 3 percent of Dundee students and music has replaced first time at a rave. 2 percent of Perth and Kinross students. Participants who had used Rave music remained strongly associat- it as the most drugs only a few times ed with substance-using students despite were less knowledgeable the fact that "indie" music has replaced it fashionable music about drug effects and as the most fashionable music among laws, suggesting that peo- young people in the United Kingdom. This among young ple new to the rave “scene” indicates that the relationship between may be at particular risk rave music and drug use is robust and not people in Britain. for harm because they merely an accident of time and geography, often have inaccurate limited to a specific group of young people information about the who follow whatever happens to be trendy. drugs they use. During the The relationship between musical pref- 12 months prior to the study, ecstasy was erence and substance use held true across the only drug that was used by more a range of drugs used, across two differ- respondents in association with a rave (86 ent types of geographical areas, over time, percent) than in settings not related to and controlling for age, gender, and raves (67 percent). parental social class. Despite the findings, Nearly one-third of respondents report- the researchers noted that a preference ed that they had injected a drug at some for rave music does not necessarily imply 7 FOCUS March 2000 that a person will use ecstasy or other users who had taken the drug on fewer drugs, or that using a specific substance than 10 occasions; and 15 control-group makes one prefer a certain style of music. members who had never used the drug. Each participant took part in a cognitive Social Functions of Substance Use test and mood assessment on four occa- F Boys A, Marsden J, Griffiths P, et al. Substance use sions: while not under the influence of A Guide toOCUAIDS Research and CounselingS among young people: The relationship between any drugs; at a Saturday night dance club; perceived functions and intentions. Addiction. Executive Editor; Director, two days after the club night; and finally, AIDS Health Project 1999; 94(7): 1043-1050. (National Addiction seven days after attending the dance club. Centre, London.) James W. Dilley, MD On the observed Saturday night at the Editor A British study exploring young peo- dance club, regular ecstasy users took an Robert Marks ple’s use of psychoactive substances average of 1.8 ecstasy tablets, novice Assistant Editors found that current consumption patterns users took an average of 1.45 tablets, and Alex Chase did not correlate with life-time experience John Tighe, MSW controls mostly drank alcohol. All three of substance-related negative effects. groups reported enthusiastic moods at Founding Editor; Advisor Michael Helquist Researchers interviewed 100 partici- the dance club. Cognitive performance on pants between the ages of 16 and 21, who both the verbal recall and visual scanning Medical Advisor Stephen Follansbee, MD were recruited by word of mouth. Forty- tests was significantly reduced while five percent were female, and 74 percent Design participants were on ecstasy compared to Saul Rosenfield described themselves as White European, the test when they were sober. A memory 17 percent as African-Caribbean or Black Production test at the Saturday night dance club Carrel Crawford British, 6 percent as Asian, and 3 percent revealed that regular ecstasy users Saul Rosenfield as mixed race. recalled only 60 percent to 70 percent of Marsha Stevens Ninety-three percent of participants had the test words remembered by controls. Circulation used alcohol in the previous 90 days, 67 Two days later, ecstasy users reported Carrel Crawford Cassia Stepak percent had used marijuana, 23 percent feeling significantly more depressed, had used amphetamines, and 22 percent Interns abnormal, unsociable, unpleasant, and Pegoh Pajouhi had used ecstasy. Past negative experiences bad tempered than the controls. Matthew Simons with substance use had little impact on Participants who used ecstasy had sig- current rates of use, suggesting that pro- nificantly impaired memory recall, with FOCUS is a monthly pub- grams that emphasize negative effects may lication of the AIDS regular ecstasy users showing the worst Health Project, affiliated be less effective. Many participants cited memory scores at every test session. with the University of both personal and social reasons for alco- Memory deficits may be due to damage in California San Francisco. hol and marijuana use such as enhanced various areas of the brain as a result of Twelve issues of FOCUS are $36 for U.S. residents, mood while alone, better social functioning, the toxicity of ecstasy. $24 for those with limited and increased peer involvement. incomes, $48 for individu- Understanding the “positive” functions of als in other countries, $90 for U.S. institutions, and substance use could help to indicate future $110 for institutions in patterns of use. For example, in contrast to Next Month other countries. Make alcohol and marijuana, amphetamines and checks payable to “UC Over the past few years, both psy- ecstasy are usually used in a social context, Regents.” Address sub- chotherapists and “philosophical prac- scription requests and cor- such as at a rave, and are less likely to be respondence to: FOCUS, titioners” have more consciously used alone or outside of a social “scene.” UCSF AIDS Health injected philosophy into the therapeu- Project, Box 0884, San Francisco, CA 94143- The Effects of Ecstasy Use tic context. In the April issue of FOCUS, 0884. Back issues are $3 Lou Marinoff, PhD, Associate Parrott AC, Lasky J. Ecstasy (MDMA) effects upon each: for a list, write to the Professor of Philosophy at the City above address or call mood and cognition: Before, during and after a (415) 476-6430. Saturday night dance. Psychopharmacology. 1998; University of New York, describes To ensure uninterrupted 139(3): 261-268. (University of East London.) philosophical practice and its rele- delivery, send your new vance to HIV-related therapy and ther- Regular use of ecstasy significantly address four weeks before apeutic issues. you move. impairs cognitive functioning and memo- Also in the April issue, Eric Printed on recycled paper. ry and may lead to feelings of depression, Glassgold, MD, Assistant Clinical ©2000 UC Regents: unpleasantness, and unsociable behavior Professor of Psychiatry at the All rights reserved. for several days after taking the drug, ISSN 1047-0719 University of California San Francisco according to a small British study of the and James W. Dilley, MD, Clinical mood states and cognitive skills of recre- Professor of Psychiatry at UCSF, dis- ational ecstasy users. cuss some of the thornier issues thera- Study participants were between the pists and their clients face and which ages of 19 and 30. The study sample was may be most amenable to philophical divided into three groups: 15 regular practice. ecstasy users who had taken the drug on 10 or more occasions; 15 novice ecstasy 8 FOCUS March 2000 searchable archive FREE DID YOU KNOW?

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