The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence

Background: The existence of an ecstasy-dependence syndrome is controversial. We examined whether the acute after-effects of ecstasy use (i.e. the 'come-down') falsely lead to the identification of ecstasy withdrawal and the subsequent diagnosis of ecstasy dependence. Methods: The Structur...

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Main Authors: McKetin, Rebecca, Copeland, J., Norberg, M., Bruno, R., Hides, L., Khawar, L.
Format: Journal Article
Published: Elsevier Ireland Ltd 2014
Online Access:http://hdl.handle.net/20.500.11937/57031
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author McKetin, Rebecca
Copeland, J.
Norberg, M.
Bruno, R.
Hides, L.
Khawar, L.
author_facet McKetin, Rebecca
Copeland, J.
Norberg, M.
Bruno, R.
Hides, L.
Khawar, L.
author_sort McKetin, Rebecca
building Curtin Institutional Repository
collection Online Access
description Background: The existence of an ecstasy-dependence syndrome is controversial. We examined whether the acute after-effects of ecstasy use (i.e. the 'come-down') falsely lead to the identification of ecstasy withdrawal and the subsequent diagnosis of ecstasy dependence. Methods: The Structured Clinical Interview for DSM-IV-TR Disorders: Research Version (SCID-RV) was administered to 214 Australian ecstasy users. Ecstasy withdrawal was operationalised in three contrasting ways: (i) as per DSM-IV criteria; (ii) as the expected after-effects of ecstasy (a regular come-down); or (iii) as a substantially greater or longer come-down than on first use (intense come-down). These definitions were validated against frequency of ecstasy use, readiness to change and ability to resist the urge to use ecstasy. Confirmatory factor analyses were used to see how they aligned with the overall dependence syndrome. Results: Come-down symptoms increased the prevalence of withdrawal from 1% (DSM-IV criterion) to 11% (intense come-downs) and 75% (regular come-downs). Past year ecstasy dependence remained at 31% when including the DSM-IV withdrawal criteria and was 32% with intense come-downs, but increased to 45% with regular come-downs. Intense come-downs were associated with lower ability to resist ecstasy use and loaded positively on the dependence syndrome. Regular come-downs did not load positively on the ecstasy-dependence syndrome and were not related to other indices of dependence.
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spelling curtin-20.500.11937-570312018-01-17T03:43:18Z The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence McKetin, Rebecca Copeland, J. Norberg, M. Bruno, R. Hides, L. Khawar, L. Background: The existence of an ecstasy-dependence syndrome is controversial. We examined whether the acute after-effects of ecstasy use (i.e. the 'come-down') falsely lead to the identification of ecstasy withdrawal and the subsequent diagnosis of ecstasy dependence. Methods: The Structured Clinical Interview for DSM-IV-TR Disorders: Research Version (SCID-RV) was administered to 214 Australian ecstasy users. Ecstasy withdrawal was operationalised in three contrasting ways: (i) as per DSM-IV criteria; (ii) as the expected after-effects of ecstasy (a regular come-down); or (iii) as a substantially greater or longer come-down than on first use (intense come-down). These definitions were validated against frequency of ecstasy use, readiness to change and ability to resist the urge to use ecstasy. Confirmatory factor analyses were used to see how they aligned with the overall dependence syndrome. Results: Come-down symptoms increased the prevalence of withdrawal from 1% (DSM-IV criterion) to 11% (intense come-downs) and 75% (regular come-downs). Past year ecstasy dependence remained at 31% when including the DSM-IV withdrawal criteria and was 32% with intense come-downs, but increased to 45% with regular come-downs. Intense come-downs were associated with lower ability to resist ecstasy use and loaded positively on the dependence syndrome. Regular come-downs did not load positively on the ecstasy-dependence syndrome and were not related to other indices of dependence. 2014 Journal Article http://hdl.handle.net/20.500.11937/57031 10.1016/j.drugalcdep.2014.02.697 Elsevier Ireland Ltd restricted
spellingShingle McKetin, Rebecca
Copeland, J.
Norberg, M.
Bruno, R.
Hides, L.
Khawar, L.
The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence
title The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence
title_full The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence
title_fullStr The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence
title_full_unstemmed The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence
title_short The effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence
title_sort effect of the ecstasy 'come-down' on the diagnosis of ecstasy dependence
url http://hdl.handle.net/20.500.11937/57031