The high prevalence of substance use disorders among recent MDMA users compared with other drug users: Implications for intervention.

Abstract

In light of the resurgence in MDMA use and its association with polysubstance use, we investigated the 12-month prevalence of substance use disorders (SUDs) among adult MDMA users to determine whether they are at risk of other drug-related problems that would call for targeted interventions.Data were drawn from the 2006 National Survey on Drug Use and Health. Past-year adult drug users were grouped into three mutually exclusive categories: 1) recent MDMA users, who had used the drug within the past year; 2) former MDMA users, who had a history of using this drug but had not done so within the past year; and 3) other drug users, who had never used MDMA. Logistic regression procedures were used to estimate the association between respondents' SUDs and MDMA use while adjusting for their socioeconomic status, mental health, age of first use, and history of polydrug use.Approximately 14% of adults reported drug use in the past year, and 24% of those past-year drug users reported a history of MDMA use. Recent MDMA users exhibited the highest prevalence of disorders related to alcohol (41%), marijuana (30%), cocaine (10%), pain reliever/opioid (8%), and tranquilizer (3%) use. Adjusted logistic regression analyses revealed that, relative to other drug users, those who had recently used MDMA were twice as likely to meet criteria for marijuana and pain reliever/opioid use disorders. They were also about twice as likely as former MDMA users to meet criteria for marijuana, cocaine, and tranquilizer use disorders.Seven out of ten recent MDMA users report experiencing an SUD in the past year. Adults who have recently used MDMA should be screened for possible SUDs to ensure early detection and treatment.

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Citation

Published Version (Please cite this version)

10.1016/j.addbeh.2009.03.029

Publication Info

Wu, Li-Tzy, Andy C Parrott, Christopher L Ringwalt, Ashwin A Patkar, Paolo Mannelli and Dan G Blazer (2009). The high prevalence of substance use disorders among recent MDMA users compared with other drug users: Implications for intervention. Addictive behaviors, 34(8). pp. 654–661. 10.1016/j.addbeh.2009.03.029 Retrieved from https://hdl.handle.net/10161/20004.

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Scholars@Duke

Wu

Li-Tzy Wu

Professor in Psychiatry and Behavioral Sciences

Education/Training: Pre- and post-doctoral training in mental health service research, psychiatric epidemiology (NIMH T32), and addiction epidemiology (NIDA T32) from Johns Hopkins University School of Public Health (Maryland); Fellow of the NIH Summer Institute on the Design and Conduct of Randomized Clinical Trials.

Director: Duke Community Based Substance Use Disorder Research Program.

Research interests: COVID-19, Opioid misuse, Opioid overdose, Opioid use disorder, Opioid addiction prevention and treatment, Pain and addiction, Chronic diseases and substance use disorders, diabetes, pharmacy-based care models and services, medication treatment for opioid use disorder (MOUD), Drug overdose, Polysubstance use and disorders, cannabis, alcohol, tobacco, hallucinogens, stimulants, e-cigarette, SBIRT (substance use Screening, Brief Intervention, Referral to Treatment), EHR-based research and intervention, data science, psychometric analysis (IRT), epidemiology of addictions and comorbidity, behavioral health care integration, health services research (mental health disorders, substance use disorders, chronic diseases), nosology, research design, HIV risk behavior. 

FUNDED Research projects (Principal Investigator [PI], Site PI, or Sub-award PI): 
R03: Substance use/dependence (PI).
R21: Treatment use for alcohol use disorders (PI).
R21: Inhalant use & disorders (PI).
R01: MDMA/hallucinogen use/disorders (PI).
R01: Prescription pain reliever (opioids) misuse and use disorders (PI).
R01: Substance use disorders in adolescents (PI).
R21: CTN Substance use diagnoses & treatment (PI).
R33: CTN Substance use diagnoses & treatment (PI).
R01: Evolution of Psychopathology in the Population (ECA Duke site PI).
R01: Substance use disorders and treatment use among Asian Americans and Pacific Islanders (PI).
UG1: SBIRT in Primary Care (NIDA, PI).
UG1: TAPS Tool, Substance use screening tool validation in primary care (NIDA, PI).
UG1: NIDA CTN Mid-Southern Node (Clinical Trials Network, PI).
UG1: EHR Data Element Study (NIDA, PI).
UG1: Buprenorphine Physician-Pharmacist Collaboration in the Management of Patients With Opioid Use Disorder (NIDA, PI).
PCORI: INSPIRE-Integrated Health Services to Reduce Opioid Use While Managing Chronic Pain (Site PI).
CDC R01: Evaluation of state-mandated acute and post-surgical pain-specific CDC opioid prescribing (Site PI).
Pilot: Measuring Opioid Use Disorders in Secondary Electronic Health Records Data (Carolinas Collaborative Grant: Duke PI).
R21: Developing a prevention model of alcohol use disorder for Pacific Islander young adults (Subaward PI, Investigator).
UG1: Subthreshold Opioid Use Disorder Prevention Trial (NIH HEAL Initiative) (NIDA supplement, CTN-0101, Investigator).
NIDA: A Pilot Study to Permit Opioid Treatment Program Physicians to Prescribe Methadone through Community Pharmacies for their Stable Methadone Patients (NIDA/FRI: Study PI).
UG1: Integrating pharmacy-based prevention and treatment of opioid and other substance use disorders: A survey of pharmacists and stakeholder (NIH HEAL Initiative, NIDA, PI).
UG1: NorthStar Node of the Clinical Trials Network (NIDA, Site PI).
R34: Intervention Development and Pilot Study to Reduce Untreated Native Hawaiian and Pacific Islander Opioid Use Disorders (Subaward PI, Investigator).
UG1: Optimal Policies to Improve Methadone Maintenance Adherence Longterm (OPTIMMAL Study) (NIDA, Site PI).
R01: Increasing access to opioid use disorder treatment by opening pharmacy-based medication units of opioid treatment programs (NIDA, PI)

Mannelli

Paolo Mannelli

Professor of Psychiatry and Behavioral Sciences
Blazer

Daniel German Blazer

Professor Emeritus of Psychiatry and Behavioral Sciences

I am currently semi-retired. Most of my recent work has been focused on roles with the National Academy of Medicine (former Institute of Medicine). I have chaired three committees during the past four years, one on the mental health and substance use workforce, one on cognitive aging, and one on hearing loss in adults. I currently also chair the Board on the Health of Select Populations for the National Academies. 

In the past I have been PI on a number of research projects, including the Epidemiologic Catchment Area Study, and  the Clinical Research Center for Late Life Depression.  More recently I have been involved with five  research projects. The first, the Established Populations for Epidemiologic Study of the Elderly (EPESE), included a study demonstrating that sleep complaints are more frequent in white compared to blacks, even when relevant demographic variables are controlled. In a second study, day-time napping was a significant predictor of mortality. A third study in the Piedmont of North Carolina revealed no difference in utilization or satisfaction with health services when urban elders were compared with rural elders. In a fourth study, self-rated health was not as strong a predictor of mortality, as has been found in previous studies, especially when controlling for important covariates.

A second research endeavor has been with the National Comorbidity Study. I led investigators who demonstrated that the prevalence of major depression is higher than previously estimated in national samples of persons between the ages of eighteen and fifty-five in the community and discussed the methodological issues that may contribute to this differing estimate. The risk-factor profile of pure major depression was compared with comorbid major depression. I will continue in this research during 1994/95 to look at Seasonal Affective Disorders (SAD).

I have also worked with my colleague Litzy Wu ScD in the study of substance use disorders and have published a number of papers related to substance use in the elderly. I also work closely with my colleague Celia Hybels, PhD looking at trajectories of depressive symptoms in older adults over time.

I spent considerable time during 1994/97 working on four books. I co-edited the second edition of Geriatric Psychiatry, to be published in the late winter of 1994 or early spring of 1995. I am working on a single author book, Freud vs. God: The End of the Debate/How Psychiatry Lost Its Soul and Christianity Lost Its Mind and on a research methods textbook for clinical psychiatry research. I have produced a second edition of Emotional Problems in Later Life. Since then our Textbook of Geriatric Psychiatry has gone through three additional editions and I published (based on my work during a sabbatical at the Center for Advanced Studies of Behavioral Sciences at Stanford) The Age of Melancholy (for which I received the Oscar Pfister Award from the American Psychiatric Association).


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