Pautas y problemas derivados del consumo de fármacos entre los consumidores de éxtasis en Australia

Edmund Silins, Jan Copeland, Paul Dillon


Antecedentes: en el ambiente de las discotecas de todo el mundo existe un aumento significativo del uso de medicamentos con receta. El consumo conjunto de éxtasis y fármacos se asocia con daños potencialmente graves para la salud. Esto tiene ramificaciones en el caso de personas que combinan de forma deliberada los fármacos con el éxtasis para lograr un determinado efecto y en quienes toman legalmente fármacos por problemas de salud y de vez en cuando consumen éxtasis. Este estudio exploratorio se propone investigar los hábitos y daños del consumo concomitante de fármacos y éxtasis y explorar las experiencias de los participantes cuando visitan al médico de cabecera (MC). Método: se entrevistó a fondo a 30 consumidores de éxtasis/fármacos. Resultados: los consumidores admitieron la combinación deliberada de estimulantes (dexanfetamina, metilfenidato [p.e. Ritalín]), antidepresivos y sildenafil (p.e. Viagra®) con éxtasis por motivos no médicos. Se descubrió una amplia gama de efectos. Aparecieron claras relaciones entre el consumo de fármacos y éxtasis, y se analizaron las distinciones entre ellos en términos de motivaciones para el consumo y consecuencias del mismo. Las actitudes de los MC fueron profesionales y sin prejuicios, y los participantes mostraron escasa resistencia a reconocer el consumo de drogas ilegales. Se limitó el cribado de drogas ilegales. Consecuencias: Los resultados tienen importantes repercusiones para el público de las discotecas en lo referente a estrategias de reducción del daño y en el descubrimiento de una serie de ámbitos para futuras investigaciones.

Palabras clave

éxtasis; fármacos con receta; hábitos de consumo; clientes de discotecas; médicos de cabecera; reducción del daño

Texto completo:



United Nations Office on Drugs and Crime. World Drug Report 2005. Vienna: United Nations; 2005.

McCaughan J, Carlson R, Falck R, Siegal H. From “Candy Kids” to

“Chemi-kids”: a typology of young adults who attend raves in the midwestern United States. Subst Use Misuse 2005;40:1503-23.

Topp L, Hando J, Dillon P, Roche A, Solowij N. Ecstasy use in Australia: patterns of use and associated harm. Drug Alcohol Depend 1999;55:105-15.

Ter Bogt T, Engels R. ‘Partying’ hard: party style, motives for and effects of MDMA use at rave parties. Subst Use Misuse 2005;40:1479-502.

Scholey A, Parrott A, Buchanan T, Heffernan T, Ling J, Rodgers B.

Increased intensity of ecstasy and polydrug usage in the more experienced recreational ecstasy/MDMA users: A WWW study.Addict Behav 2004;29:743-52.

Tossmann P, Boldt S, Tensil M. The use of drugs within the techno party scene in European Metropolitan cities. Eur Addict Res 2001;7(1):2-23.

Winstock A, Griffiths P, Stewart D. Drugs and the dance music scene: A survey of current drug use patterns among a sample of dance music enthusiasts in the UK. Drug Alcohol Depend 2001;64:9-17.

Kurtz S, Inciardi J, Surratt H, Cottler L. Prescription drug abuse among ecstasy users in Miami. J Addict Dis 2005;24(4):1-16.

Black E, Dunn M, Degenhardt L, Campbell G, George J, Kinner S, et al. Australian trends in ecstasy and related drug markets 2007: Findings from the Ecstasy and Related Drugs Reporting System (EDRS). Australian Drug Trends Series No. 10. Sydney: National Drug and Alcohol Research Centre; University of New South Wales; 2008.

McCambridge J, Mitcheson L, Hunt N, Winstock A. The rise of Viagra among British illicit drug users: 5-year survey data. Drug Alcohol Rev 2006;25:111-3.

Inciardi J, Surratt H, Kurtz S, Cicero T. Mechanisms of prescription drug diversion among drug-involved club- and street-based populations. Pain Med 2007;8(2):171-83.

Zito J, Safer D, DosReis S, Gardner J, Madger L, Soeken K, et al. Psychotrophic practice patterns for youth: A 10-year perspective. Arch Pediatr Adol Med 2003;157:17-25.

Wong I, Murray M, Camilleri-Novak D, Stephens P. Increased prescribing trends of paediatric psychotrophic medications. Arch Dis Child 2004;89:1131-2.

Wong I, Camilleri-Novak D, Stephens P. Rise in psychotrophic drug prescribing in children in the UK - an urgent public health issue. Drug Saf 2003;26:1117-8.

Mant A, Rendle V, Hall W, Mitchell P, Montgomery W, McManus P, et al. Making new choices about antidepressants in Australia: the long view 1975-2002. Med J Aust 2004;181(7):s21-s4.

Wu L, Pilowsky D, Schlenger W, Galvin D. Misuse of methamphetamine and prescription stimulants among youths and young adults in the community. Drug Alcohol Depend 2007;89:195-205.

Substance Abuse and Mental Health Services Administration. Overview of findings from the 2003 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies; 2004.

International Narcotics Control Board. Report of the International Narcotics Control Board for 2006. New York: United Nations; 2007.

Levine S, Coupey M. Nonmedical use of prescription medications: an emerging risk behaviour among rural adolescents. J Adol Health 2009;44:407-9.

Kelly B, Parsons J. Prescription drug misuse among club drugusing

young adults. Am J Drug Alcohol Abuse 2007;33(6):875-84.

Aldridge J, Measham F. Sildenafil (Viagra) is used as a recreational drug in England. Br Med J 1999;318:669.

Copeland J, Dillon P, Gascoigne M. Ecstasy and the concomitant use of pharmaceuticals. Addict Behav 2006;31:367-70.

Bleeker A, Silins E, Dillon P, Simpson M, Copeland J, Karina H. The feasibility of peer-led interventions to deliver health information to ecstasy and related drug users. NDARC Technical Report No. 299. Sydney: National Drug and Alcohol Research Centre; University of New South Wales; In press.

Gillman P. A review of serotonin toxicity data: Implications for the mechanisms of antidepressant drug action. Biol Psychiatry 2006;59:1046-51.

Silins E, Copeland J, Dillon P. A qualitative review of serotonin syndrome, ecstasy (MDMA) and the use of other serotonergic substances: hierarchy of risk. Aust N Z J Psychiatry 2007;41(8):649-55.

Swearingen S, Klausner J. Sildenafil use, sexual risk behaviour,

and risk for sexually transmitted diseases, including HIV infection. Am J Med 2005;118:571-7.

Romanelli F, Smith K. Recreational use of sildenafil by HIVpositive

and -negative homosexual/bisexual males. Annals Pharmacotherapy 2004;38:1024-30.

Deehan A, Marshall EStrang J. Tackling alcohol misuse: opportunities and obstacles in priamary care. Br J Gen Pract 1998;48:1779-82.

Roche A. Medical practitioners’ involvement in drug and alcohol

problems: progress and barriers. Subst Abuse 1993;14:106-16.

Sanson-Fisher R, Webb G, Reid A. The role of the medical practitioner as an agent for disease prevention. Better Health Commission: Looking forward to better health 1986;3:201-12.

Stafford J, Sindicich N, Burns L. Australian Drug Trends 2008: Findings from the Illicit Drug Reporting System (IDRS). Australian Drug Trends Series No. 19. Sydney: National Drug and Alcohol Research Centre; University of New South Wales; 2009.

Blum R, Beuhring T, Wunderlich M, Resnick M. Don’t ask, they won’t tell: the quality of adolescent health screening in five practice settings. Am J Public Health 1996;86(12):1767-72.

Friedman P, McCullough D, Saitz R. Screening and intervention for illicit drug abuse. A national survey of primary care physicians and psychiatrists. Arch Intern Med 2001;161:248-51.

Maheux B, Haley N, Rivard M, Gervais A. Do physicians asses lifestyle health risks during general medical examinations? A survey of general practitioners and obstetrician-gynecologists in Quebec. JAMC 1999;160(13):1830-4.

Beck A, Steer R. Beck Anxiety Inventory Manual. San Antonio: Psychological Corporation 1990.

Beck A, Steer R, Brown G. Beck Depression Inventory Manual

(2nd Edition). San Antonio: Psychological Corporation 1996. 37 Keyes K, Martin S, Hasin D. Past 12-month and lifetime comorbidity and polydrug use among young adults in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug Alcohol Depend 2008;97:139-49.

Parrott A, Milani R, Parmer R, Turner J. Recreational ecstasy/ MDMA and other drug users from the UK and Italy: psychiatric symptoms and psychobiological problems. Psychopharmacology 2001;159:77-82.

de Win M, Jager G, Vervaeke H, Schilt T, Reneman L, Booij J, et al. The Netherlands XTC Toxicity (NeXT) study: objectives and methods of study investigating causality, course and clinical relevance. Int J Methods Psychiatr Res 2005;14(4):167-85.

Mechan A, Esteban B, O’Shea E, Elliot J, Colado MGreen A. The

pharmacology of the acute hyperthermic response that follows administration of 3,4-methylenedioxymethamphetamine (MDMA, ‘ecstasy’) to rats. Br J Pharmacol 2002;135:170-80.

Gillman P. Monoamine oxidase inhibitors, opiod analgesics and

serotonin toxicity. Br J Anaesth 2005;95(4):434-41.

Eli Lilly and Company. Prescribing Information: Prozac, fluoxetine hydrochloride [cited 2009 June 14th]; Available from:

Gillman P. Serotonin syndrome: history and risk. Fundam Clin

Pharmacol 1998;12:482-91.

Liechti M, Bauman C, Gamma A, Vollenweider F. Acute psychological effects of 3,4-methylenedioxymethamphetamine (MDMA, ‘ecstasy’) are attenuated by the serotonin uptake inhibitor citalopram. Neuropsychopharmacology 2000;22(5):513-21.

Vuori E, Henry J, Ojanpera I, Nieminen R, Salovainen T, Wahlsten P, et al. Death following ingestion of MDMA (ecstasy) and moclobemide. Addiction 2003;98:365-8.

Nandwani R, Gourlay Y. Possible interaction between sildenafil and HIV combination therapy. Lancet 1999;353:840.

Goldmeier D, Lamba H. Prolonged erections produced by dihydrocodeine and sildenafil. Br Med J 2002;324:1555.

Smith K, Romanelli F. Recreational use and misuse of phosphodiesterase 5 inhibitors. J Am Pharm Assoc 2005;45(1):63-72.

Alpert J. Viagra: the risks of recreational use. Am J Med 2005;118(6):569-70.

Vollenweider F, Gamma A, Lietchi M, Huber T. Psychological and cardiovascular effects and short-term sequelea of MDMA (‘Ecstasy’) in MDMA-naive healthy volunteers. Neuropsychopharamcology 1998;19:241-51.

Parrott A, Lasky J. Ecstasy (MDMA) effects upon mood and cognition: before, during and after a Saturday night dance. Psychopharamcology 1998;139:261-8.

Parrott A. Is ecstasy MDMA? A review of the proportion of ecstasy tablets containing MDMA, their dosage levels, and the changing perceptions of purity. Psychopharamcology (Berl) 2004;173:234-41.

Tanner-Smith E. Pharmacological content of tablets sold as ‘ecstasy’: Results from an online testing service. Drug Alcohol Depend 2006;83:247-54.

Spruit I. Monitoring synthetic drug markets, trends, and public health. Subst Use Misuse 2001;36(1):23-47.

Green R, Moore D. ‘Kiddie drugs’ and controlled pleasure: Recreational use of dexamphetamine in a social network of young Australians. Int J Drug Policy. In press.

Cunningham J, Sobell L, Chow V. What’s in a label? The effects of substance types and labels on treatment considerations and stigma. J Stud Alcohol 1993;54:693-9.

Link B, Struening E, Rahav M, Phelan J, Nuttbrock L. On stigma and its consequences: evidence from a longitudinal study of men with dual diagnosis of mental illness and substance abuse. J Health Soc Behav 1997;38:177-90.

Kurtz S, Surratt H, Kiley M, Inciardi J. Barriers to health and social services for street-based sex workers. J Health Care Poor Underserved 2005;16:345-61.

Miller N, Sheppard L, Colenda C, Magen J. Why physicians are unprepared to treat patients who have alcohol- and drugrelated disorders. Acad Med 2001;76:410-8.

United Nations Office on Drugs and Crime. Amphetamines and ecstasy: 2008 global ATS assessment. Vienna: United Nations Office on Drugs and Crime; 2008.


Enlaces refback

  • No hay ningún enlace refback.