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Use of Crystal Methamphetamine and Other Club Drugs Among High School Students in Vancouver and Victoria

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Use of Crystal Methamphetamine and Other Club Drugs Among High School Students in Vancouver and Victoria Thomas M. Lampinen, PhD, Doug McGhee, MD, Ian Martin, MD, CCFP Use of crystal methamphetamine and other club drugs among high school students in Vancouver and Victoria A recent survey suggests that students who identify themselves as gay or bisexual are at increased risk of using club drugs. ABSTRACT Background Background: The prevalence and cor- Results: Among 607 students sur- Crystal methamphetamine (MA) is a relates of British Columbian adoles- veyed (mean age 15.9 years), 81 stu- powerfully addictive central nervous cents’ use of four “club” drugs— dents (13.6%) reported previous use stimulant that is typically inhaled crystal methamphetamine (MA), of MA (5%), ecstasy (12%), ketamine (snorted), smoked, eaten, or injected. MDMA (“ecstasy”), ketamine, and (4%), or GHB (4%). Most of this use Heavy MAuse can lead to serious con- gamma-hydroxybutyrate (GHB)— appeared to be experimental or oc- sequences, including paranoia, psy- remain poorly defined. This is partly casional within a context of mul- chosis, depression, violence, and death.1 because past surveys have mea- tidrug use; every MA user but one In recent years, there have been wide- sured drug use in aggregate cate- reported also using alcohol and mar- spread reports of substantial increases gories rather than by specific drug. ijuana. In multivariate analyses ad- in MAuse and increasing attention has In addition, little research has been justed for age, a twofold greater risk been paid to its health effects on youth done regarding anecdotal evidence for use of ecstasy was observed and young adults in BC. Use of MA suggesting increased risk of drug among girls. The 2.5% of students represents a shift from organic stimu- use among gay and bisexual youth. who identified themselves as gay or lants (for example, cocaine) to those The purpose of our study was to con- bisexual had significantly elevated easily synthesized in makeshift home sider this and to assess the preva- risk of previous year use of MA (odds laboratories. Crystal methampheta- lence, characteristics, and corre- ratio [OR] 26.28), ecstasy (OR 3.29), mine has a higher dependence liabili- lates of use of each of these four and ketamine (OR 8.26). ty: the single-isomer MAis more potent club drugs separately among grade 9 to 12 students. Conclusions: School-based initia- Dr Lampinen is a senior post-doctoral fel- tives may fail to reach many regular low at the BC Centre for Excellence in Methods: In 2003 we conducted a MA users. Interventions and clinical HIV/AIDS in Vancouver, BC, and is a clinical pilot-project survey of a convenience assessments involving youths at- assistant professor in the Department of sample in six schools in Vancouver tending high school should address Health Care and Epidemiology at the Uni- and Victoria using a confidential the individual’s use of multiple drugs versity of British Columbia. Dr McGhee is self-administered questionnaire to rather than MA or any other club medical co-director of the Victoria Youth assess students’ demographic char- drug specifically. Targeted substance Clinic, Victoria, BC. Dr Martin is a clinical acteristics, sexual orientation, and abuse research and intervention ini- instructor in the Department of Family Prac- substance use. tiatives appear warranted for stu- tice, UBC, and a physician at Three Bridges dents who identify themselves as Community Health Centre. gay or bisexual. 22 BC MEDICAL JOURNAL VOL. 48 NO. 1, JANUARY/ FEBRUARY 2006 Use of crystal methamphetamine and other club drugs among high school students in Vancouver and Victoria 80 70 Used ever 60 Used in previous year Used in previous month 50 40 30 20 Percentage of students 10 0 Alcohol Marijuana Tobacco* Mush- Ecstasy Cocaine LSD Ketamine MA GHB Heroin Peyote rooms (crystal meth) Figure. Prevalence of substance use reported by Vancouver and Victoria grade 9 to 12 school survey participants, by drug and timing of use. *Called cigarettes on the questionnaire. than the mixed-isomer amphetamines since 1999, increasing proportions Methods previously in circulation and MA contain ketamine.5 Between March and June 2003, grade users typically ingest larger doses. The determination of the preva- 9 to 12 students in Victoria and Van- The recreational use of other club lence and correlates of adolescents’ couver voluntarily completed an anon- drugs, so named because of their fre- use of MA, ecstasy, ketamine, and ymous and confidential pilot-project quent use at adolescents’dance events GHB individually is important but has questionnaire. The study protocol was (called “raves”) and other dance venues, been hindered by past surveys that approved by the UBC Behavioural particularly gay clubs, has increased have tended to measure drug use in Ethics Board and school boards in substantially since the mid-1990s.2,3 aggregate categories (“methampheta- Vancouver and Victoria. Passive con- In the present study, we include the mine, speed, or ecstasy”) or have em- sent was obtained from parents and no following club drugs: 3,4-methylene- ployed broad and relatively technical incentives were provided (passive dioxymethamphetamine (MDMA, wording (“amphetamines”).2,6,7 Before consent=parents were notified by commonly known as “ecstasy”), an we undertook our survey in 2003, newsletter that the study was being amphetamine analog with sympath- information from BC youth drug treat- conducted and were instructed to con- omimetic properties; ketamine, a de- ment facilities, early psychosis pro- tact the school if they opposed their rivative of phencyclidine hydrochlo- grams, and our clinical experience child’s participation.) ride used clinically as a dissociative suggested an elevated prevalence of In Victoria, a team that included anesthetic; and gamma-hydroxybu- MA use among gay and bisexual school district officials, board mem- tyrate (GHB), a gamma-aminobutyric youth, but relevant data were unavail- bers, principals, and a study investi- acid (GABA) analog with sedative able. We therefore decided to conduct gator (D.M.) selected two Victoria properties.3,4 The Internet has facilitat- a pilot-project cross-sectional survey high schools to best represent a cross- ed dissemination of recipes for home using youths’ own language and in- section of the district’s school-attend- synthesis of some of these drugs and cluding questions about sexual orien- ing population. Within each school, so they are likely to continue to be tation to measure the respective preva- the team selected a sample of students readily available. Importantly, health lence, patterns, and correlates of use in each of grades 9 to 12 from among care providers need to be aware that of MA, ecstasy, ketamine, and GHB those students randomly assigned to approximately half the tablets and among high school students in Van- attend compulsory Career and Per- capsules presently sold in BC as ecsta- couver and Victoria, BC. sonal Planning classes that semester. sy contain methamphetamine; and In Vancouver, a study investigator VOL. 48 NO. 1, JANUARY/ FEBRUARY 2006 BC MEDICAL JOURNAL 23 Use of crystal methamphetamine and other club drugs among high school students in Vancouver and Victoria Table 1. Characteristics of crystal methamphetamine (MA) use among 27 students reporting Five percent of students reported any previous use. previous use of MA, half during the previous year. Only 0.8% reported Age of first use, mean years 14.7 (1.3) using MA during the previous month (standard deviation) (Table 1 ). Most users had smoked or Most recent use, n (%) During previous month 5 (18.5) snorted the drug; none reported inject- During previous year 14 (55.6) ing it. Half of the 27 students reported More than one year ago 12 (44.4) their peak frequency of MA use to be Mode of use, n (%) Smoke 19 (70.4) less than once per month. The median Inhale 14 (51.9) peak number of days awake on the Eat 8 (29.6) Inject 0 drug was 3, but ranged from 1 to 12. Other 3 (11.1) Five users (19%), all of whom used MA during the previous year, report- Maximum frequency during previous use, n (%) Daily 4 (15.4) Weekly 2 (7.7) ed previous treatment for alcohol or Monthly 7 (26.9) substance use. Less than monthly 13 (50.0) Although 12% of students had pre- vious experience with ecstasy, includ- Maximum days awake during previous use, 3 (2, 4) median (IQR) ing 9% during the previous year, only 4% reported its use during the previ- History of alcohol or substance abuse 5 (18.5) treatment, n (%) ous month. In contrast, among the smaller number of students reporting any previous use of ketamine (4%) or (I.M.) selected four schools to ensure We compared groups using Pear- GHB (4%) most reported its use dur- participant heterogeneity with respect son’s chi-square or Fisher’s exact test ing the previous month (3% and 3%). to geographic location and family for categorical variables and Wilcox- Previous use of any of these four income. Within each school, the in- on rank sum tests for continuous vari- drugs—MA, ecstasy, GHB, or keta- vestigator and principal selected one ables. We evaluated potential corre- mine—was reported by 13.6% of stu- homeroom class in each of grades 9 to lates of substance use (age, gender, dents. Of these students, 10.7% report- 12 and administered the survey to all and sexual orientation) using adjusted ed use in the previous year and 4.5% four classes in a single day. After each odds ratios and 95% confidence inter- reported use during the previous survey, a brief information session vals, computed with multivariate lo- month; these students exhibited a dis- about MAwas provided. In both school gistic regression models. tinct pattern of use of many of the 12 districts, a standard protocol for ad- licit and illicit substances included in ministration of the survey ensured stu- Results theFigure .
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