The overall aim of the available epidemiological research in charting drug use and the dance scene has been to assess the prevalence of drug use and “risk factors for addiction, psychological problems which might be treated, or a general and dangerous propensity for antisocial behaviour” (Glassner and Loughlin 1987: 3). More specifically, the extant research has emphasized the problems of using ecstasy and other club drugs, the extent of drug-using behaviors connected with the scene, and the characteristics of the users.
The problems of using ecstasy and other club drugs
First, researchers have examined the potential problems of using ecstasy (MDMA) and other club drugs. For example, in the case of ecstasy, a number of physical and psychological problems have been associated with its use. MDMA can cause psychological problems such as depression, sleep problems, anxiety, and paranoia, and the stimulant effects of MDMA may lead to a significant increase in heart rate and blood pressure, dehydration, hyperthermia, or possible seizures and heart or kidney failure (Dowling 1990; Milroy 1999; National Institute on Drug Abuse 1999). Possible long-term brain damage has also been identified (Asghar and DeSouza 1989; McCann et al. 1998; National Institute on Drug Abuse 1999; Peroutka 1990). Although MDMA is said to be physically non-addictive, users may become psychologically dependent and may subconsciously use the drug as a form of self-medication for underlying disorders (Jansen 1999). Other serious reactions include “hyperthermia, rhabdomyoysis, disseminated intravascular coagulation, renal failure, cardiac complications, intracranial hemorrhage and hepatotoxicity” (Maxwell 2005: 1212; see also Goss 2001; K. M. Smith et al. 2002).
The extent of drug-using behaviors connected with the scene
As many researchers in Australia, Canada, Germany, and the UK have documented, a strong association exists between the dance scene and specific types of drugs, especially ecstasy and methamphetamines (Adlaf and Smart 1997; Boys et al. 1997; Deehan and Saville 2003; Forsyth 1996; Lenton et al. 1997; Measham et al. 2001; Soellner 2005). As Measham and her colleagues note, “the key conclusion to be drawn … is that clubbers are extremely drug-experienced” (2001: 96). Not only did researchers discover that the majority of attendees use drugs at raves and clubs (Akram and Galt 1999; Boys et al. 1997; Ward and Fitch 1998), but also that attendees had a much higher rate of using drugs than non-attendees (Tossmann et al. 2001: 12. See also Adlaf and Smart 1997; Measham et al. 2001). Overall, these studies suggest a strong association between dance events and drug use, and most researchers have argued that increases in the use of club drugs by young adults reflect their increasing involvement in dance events.
Epidemiologists have identified ecstasy as the quintessential drug of the international rave and club scenes. Lenton and colleagues (1997) in Australia discovered that ecstasy was the only drug which was used by more respondents in association with a rave than in any other setting (for similar findings in Britain see Pearson et al. 1991 and Ward and Fitch 1998) and ecstasy rates among ravers and clubgoers are much higher than among youth in the general population (Tossmann et al. 2001: 12). It is not solely ecstasy, though, that epidemiologists have found prevalent in the dance scenes. Research suggests that marijuana may be used more extensively than ecstasy (see for example Tossmann et al. 2001), especially in the stages before and after the event, and high rates of amphetamine and hallucinogen use have also been documented (Van de Wijngaart et al. 1999; Ward and Fitch 1998).
Characteristics of the users: age, gender, ethnicity, sexuality
The age of the users is the first striking and somewhat obvious characteristic. The majority of attendees at dance events are teenagers and young adults, both male and female. From the available research this trend appears generally consistent in different countries, and ecstasy users who attend raves and clubs have some similar characteristics. For example, according to Measham and her colleagues, ravers in the north of England are predominantly young adults between the ages of 16 and 25 (Measham et al. 1998). A number of other studies show that the age range is generally similar, although there may be slight variations in attendees’ average age; studies range from a mean age of attendees of 18.9 in Australia to 24.8 in Berlin (Boys et al. 1997; Calafat et al. 2001).
The gender ratio of the users is the second striking feature to emerge from the research literature. Although no representative surveys have been completed on the gender ratio of attendees at clubs, raves, and parties, researchers have argued that, while men are in the majority in the scene, women are a significant presence. Most studies suggest that the ratio of young men to young women is never greater than 60–40.3 For example, the SONAR project (Calafat et al. 2001) showed an overall dominance of men (approximately 60 percent) but they also discovered that the precise gender ratios varied both from one city to another as well as within different scenes (see also Solowij et al. 1992).
The presence of women within the scene is also reflected in their drug-using behaviors. The fact that attendees at clubs and parties are “drug-experienced” is true for both young women and men. Researchers still tend to find greater male involvement in club drugs among adults (Measham et al. 2001: 101) but young women’s use appears to be increasing, and “the once distinctive difference in the figures between boys and girls is disappearing, with young women being almost as likely to take drugs as young men” (H. Parker et al. 1998: 14). (For more on gender and club drugs see Chapter 9.)
In terms of ethnic characteristics, the research evidence from the national studies suggest that ecstasy users are primarily white. This predominance of white users and attendees has been noted both in the UK and in the US. For example, in the UK Measham and her colleagues (2001), in their sample of over 2,000 clubgoers in Manchester, found that only 5 percent were either Afro-Caribbean or Asian. In the US, Johnston and colleagues (2003), using data from the Monitoring the Future study, found that white high-school seniors were nearly six times as likely to report ecstasy use in the past year as their African American counterparts, and Yacoubian and Urbach, analyzing data from the US NHSDA survey between 1990 and 2001, found that “the use of ecstasy has remained primarily a white phenomenon” (2004: 75). However, there exists some local research that suggests that the ethnic composition of ecstasy users may either be altering or may be determined by geographical location. For example, Schensul and colleagues (2005b) have highlighted the extent to which ecstasy has begun to diffuse to African American and Latino youth in inner urban areas, and in some regions Asian Americans have become a significant presence within the rave and club scenes (as we will examine in Chapter 11).
Another body of research has developed in recent years focusing on sexuality and club drug use, centered particularly on analyses of drug use among men who have sex with men (MSM) in the gay club/party scenes. For example, studies have highlighted higher rates of marijuana, cocaine, and popper use (McKirnan and Peterson 1989), and higher rates of methamphetamine and ketamine among homosexual versus heterosexual drug users in the dance/club scenes (Degenhardt 2005). A particular focus of this research has centered on analysis of the connections between club-drug use (particularly methamphetamine use) and high-risk sexual practices that can lead to HIV transmission. For example, Colfax et al. (2005) found higher rates of unprotected anal intercourse (UAI) when MSM were using methamphetamine, poppers, or cocaine; Operario et al. (2006) found significant increases in risky sexual practices associated with frequent substance use, club-drug use, and polydrug use among young MSM; and Celentano et al. (2005) found significant associations between incidents of UAI and being under the influence of alcohol, cocaine, amphetamines, and marijuana. The research on MSM drug use, which continues to grow, remains somewhat isolated from other club-drug research, with relatively little cross-citation.