Adolescents Club Drugs and the Rave Scene

A recent review of the literature revealed that club drug use [MDMA (3,4-methylenedioxymethamphetamine), ketamine, and GHB (gamma-hydroxy-butyric acid)] has reached epidemic proportions and is particularly problematic among adolescents with psychiatric illness, including mood and anxiety disor ders, as well as attention-deficit/hyperactivity disorder. Although club drugs originally got their name from nightclubs and raves, adolescents and young adults now use club drugs in both club and nonclub settings (Rosenthal & Solhkhah, in press). Overall, studies of typical MDMA users reveal high rates of multiple drug use (Parrott, Milani, Parmar, & Turner, 2001; Parrott, Sisk, & Turner, 2000; Rodgers, 2000; Schifano, Di Furia, Forza, Minicuci, & Bricolo, 1998). Among treatment seekers, heavy MDMA use is associated with increased psychopathology (Parrott et al., 2000; Schifano et al., 1998). In addition to use of alcohol and cannabis, the heavier the MDMA use, the more likely is the co-use of stimulants and hallucinogens (Scholey et al., 2004). MDMA as a sole drug of abuse is an uncommon phenomenon; thus, it is a reasonable proxy for abuse of multiple substances (Rodgers, 2000).

Raves are large, all-night dance parties, where people come together to use club drugs and "feel like a closely knit family" in what is sometimes called "marching to the beat of Ecstasy." Raves started in England in the early 1980s and have since spread throughout the United States, Europe, South America, and Australia in major urban centers and on college campuses. Adolescents and young adults are particularly drawn to raves, where they feel free to hug, laugh, talk, scream, and dance to "techno" or "house" music under laser lights and the effects of drugs, primarily MDMA (Cohen, 1998). Rave participants often describe looking for a "trance-induced" state or "euphoric transcendence," while smiling, touching, and loving each other in a completely nonviolent setting (Tyler, 1995). Interestingly, a recent study from the Netherlands found a negative association between substance dependence and violent offending (but not criminal recidivism) among a sample of incarcerated male Dutch adolescents (Vreugdenhil, Van Den Brink, Wouters, & Doreleijers, 2003).

Heroin use has been rising among adolescents and young adults, possibly because heroin is now so pure that people can easily sniff or smoke it. An extensive review of descriptive studies of young heroin users revealed, in a pattern similar to that of adult heroin users, substantial multiple substance use and psychiatric comorbidity (Hopfer, Khuri, Crowley, & Hooks, 2002). The same authors also reviewed different treatments of adolescents who use heroin, including therapeutic communities and methadone maintenance, and found that length of time in treatment, regardless of modality, was the best predictor of patient outcome (Hopfer et al., 2002).

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