Plants - Drugs Mind - Spirit Freedom - Law Arts - Culture Library  
Prevalence of Ecstasy use in the UK
by Harry Sumnall, May 2002
HTML by Erowid
Recent community surveys of illicit drug use in the UK have estimated that approximately 4% of 16-59 year olds have ever taken ecstasy (Ramsey and Partridge, 1999; Ramsey et al., 2001). This figure represents over 2.5 million people. Use was most commonly reported in the 16-29 year old group (Figure 1). Within this age group, the most popular drugs were (based upon % of respondents reporting ‘use in last year’): cannabis (22%); non-MDMA amphetamines (5%); ecstasy (5%); cocaine (5%); LSD (2%); and psilocybin mushrooms (2%). Figures provided by monitoring systems in other European countries and the USA suggests that levels of use are similar elsewhere (Griffiths & Vingoe, 1997; Johnston et al., 2000; Tossmann et al., 2001). Whilst ecstasy use has remained stable in the UK over the previous 7 years, the proportion of 16-29 year olds reporting use of cocaine has risen sharply from 1% in 1994 to 5% in 2000 (King, 1997; Ramsey & Partridge, 1999; Sharp et al., 2001). This may be because of the consistently high purity or the reduction in price of cocaine (King, 1997), but also its perceived safety compared to ecstasy, which has received substantial negative media attention (Cole et al., in press; Hammersley et al., 2001). The public health consequences of increased cocaine use have been obscured in investigations of ecstasy.

General population studies such as the British Crime Survey (a national survey which includes data on self-reported drug use) have underestimated the prevalence of drug use within particular sub populations (Table 1). These studies have also failed to address the context of substance use and concomitant use with other compounds. Ecstasy is most commonly used, although not exclusively (Hansen et al., 2001), at raves. Whilst rave is a somewhat outmoded term in the UK, it may be considered generic. These events are defined by several unique characteristics which are important when assessing the acute toxic and long-term neurotoxic profile of MDMA and other drugs: (i) larger than average venues, (ii) loud, modern music with 120 or more beats per minute, (iii) high ambient temperatures, (iv) prolonged physical exertion in participants (energetic dancing), and (v) ubiquitous drug use (Henderson, 1993; Henry, 1992; Randall, 1992). Indeed, this latter aspect is perhaps the defining feature of UK raves (Merchant & McDonald, 1994; Weir, 2000).

Whilst ecstasy is the drug most often associated with dance music events, epidemiological evidence indicates that it is only one of several used. Initiates and inexperienced users tend to use ecstasy in isolation (with the exception of alcohol), but as they become more experienced they exhibit a pattern of use that includes the consumption of greater amounts of ecstasy and an increasing combination of other drugs (Hansen et al., 2001). Young people attending dance music events report use of a wide range of compounds and have considerably greater drug experience than the general population of corresponding age. Characteristically, rave attendees ingest a mixture of stimulants and hallucinogens with the vast majority being polydrug users (Boys, 1997; Boys et al., 1999; Cole et al., in press; Curran & Travill, 1997; Davison & Parrott, 1997; Forsyth, 1996; Hammersley et al., 1999; Lenton et al., 1997; Parrott & Stuart 1997; Pedersen & Skrondal, 1999; Riley et al., 2001; Solowij et al., 1992; Cole & Sumnall, submitted; Tossmann et al., 2001; van de Wijngaart et al., 1999; Winstock et al., 2001a). The variable nature of ecstasy tablet content partly underlies this (Cole et al., in press). This very specific polydrug use is termed ‘dance drug’ use because these drugs are used to aid all night dancing (Bean et al., 1997; Collins & Godfrey, 1998; Hammersley et al., 2001 Forsyth, 1996; Measham et al., 2001; Tossmann et al., 2001). Cannabis, alcohol, opiates and/or benzodiazepines are frequently used after the event to aid the ‘come down’ from dance drugs (Forsyth, 1996; McDermott, 1993; Riley et al., 2001; Solowij, 1992; Williams et al., 1998; Williamson et al., 1997; Winstock et al., 2001). Some reports indicate that users also co-administer selective serotonin reuptake inhibitors (SSRI) and/or dietary supplements before or after ecstasy in an attempt to protect themselves from neurotoxicity (McCann & Ricaurte, 1993). Identifying and studying human drug using populations based solely upon consumption of ecstasy has ignored the unique profile of dance drug consumption and has made the assessment of specific risks posed by ecstasy use per se very difficult.

Summary of Available British Data on Ecstasy & Related Psychoactive Drug Use
Percentage Reporting Use Ever used / Use in last year / Use in last month
Survey Type of Population Number Surveyed Age Range Ecstasy Non-MDMA Amphetamines
(mainly d-amphetamines sulphate)
Cocaine Cannabis LSD Mix Drugs
(% reporting)
2000 British Crime Survey General population survey 3015 16-29 12/5/3 22/5/2 10/5/2 44/22/14 11/2/<0.5% Not assessed Ramsay et al., 2001
Nottingham harm reduction Dance drug users 125 <= 30 95/-/- 98/-/- 81/-/- -/-/- 91/-/- ~75% Akram & Galt, 1999
Release drugs and dance survey Rave attendees 520 16-29 81/-/- 81/-/- 57/-/- 91/-/- 74/-/- - Bean et al., 1997
Glasgow dance scene Rave attendees 135 14-44 91/87/- 93/77/- 70/59/- 98/96/- 92/79/- >50% Forsyth, 1997
Edinburgh, UK dance events Rave attendees 122 18-29 -/82/74 -/81.1/68.7 -/38.5/18 -/48.4/- -/30/38 66% Riley et al., 2001
'Mixmag' survey Rave culture magazine readers 1151 mean=23.9 96/-/86 92/-/40 75/46/- 91/73/- 71/10/- ~75% Winstock et al., 2001
Table 1. Summary of UK community surveys of 'dance drug' use. Comparison of results obtained from members of the rave culture with the 2000 British Crime Survey. The British Crime Survey surveyed a total of 13,021 people with regards to use of all types of drug use and analyses data by particular age groups.1 '- ' indicates not assessed.

Percentage of English and Welsh population reporting use of Ecstasy in previous year
British Ecstasy Use Bar Chart
Figure 1. Data 1994-2000 taken from the British Crime Survey.

Reference List
  • Boys A, Lenton S, Norcross K (1997) Polydrug use at raves by a Western Australian sample. Drug and Alcohol Review 16: 227-234
  • Boys A, Marsden J, Griffiths P, Fountain J, Stillwell G, Strang J (1999) Substance use amongst young people: the relationship between perceived functions and intentions. Addiction 94: 1043-1050
  • Cole JC, Bailey M, Sumnall HR, King LA (2002) An analysis of the content of Ecstasy tablets. Implications for the study of their long term effects. Addiction In Press
  • Cole JC, Sumnall HR, Grob CS (2002) Sorted: Ecstasy facts and fiction. Psychologist In Press
  • Collin M, Godfrey J (1997) Altered State: The story of Ecstasy culture and acid house. Serpent's Tail, London
  • Curran HV, Travill RA (1997) Mood and cognitive effects of + 3,4-methylenedioxymethamphetamine (MDMA. 'ecstasy'): week-end 'high' followed by mid-week low. Addiction 92: 821-831
  • Davison D, Parrott AC (1997) Ecstasy (MDMA) in recreational users: self-reported psychological and physiological effects. Human Psychopharmacology 12: 221-226
  • Forsyth AJ (1996) Places and patterns of drug use in the Scottish dance scene. Addiction 91: 511-521
  • Griffiths, P. and Vingoe, L. The use of amphetamines, ecstasy and LSD in the European Community: A review of data on consumption patterns and current epidemiological literature. 1997. London, The National Addiction Centre.
    Ref Type: Report
  • Hammersley R, Ditton J, Smith I, Short E (1999) Patterns of Ecstasy use by drug users. British Journal of Criminology 39: 625-647
  • Hammersley R, Khan F, Ditton J (2001) Ecstasy and the rise of the chemical generation. Routledge, New York
  • Hansen D, Maycock B, Lower T (2001) 'Weddings, parties, anything…', a qualitative analysis of ecstasy use in Perth, Western Australia. International Journal of Drug Policy 12: 181-199
  • Henry JA, Jeffreys KJ, Dawling S (1992) Toxicity and deaths from 3,4-methylenedioxymethamphetamine ("ecstasy"). Lancet 340: 384-387
  • Johnston, L. D., O'Malley, P. M., and Bachman, J. G. The Monitoring the Future national survey results on adolescent drug use: Overview of key findings, 1999. 00-4690NIH. 2000. Bethesda, MD, National Institute on Drug Abuse.
    Ref Type: Report
  • King LA (1997) Drug content of powders and other illicit preparations in the UK. Forensic Science International 85: 135-147
  • Lenton S, Boys A, Norcross K (1997) Raves, drugs and experience: drug use by a sample of people who attend raves in Western Australia. Addiction 92: 1327-1337
  • McCann UD, Ricaurte GA (1993) Reinforcing subjective effects of (+) 3,4-methylenedioxymethamphetamine ("ecstasy") may be separable from its neurotoxic actions: clinical evidence. Journal of Clinical Psychopharmacology 13: 214-217
  • McDermott P (1993) MDMA use in the north west of England. International Journal of Drug Policy 4: 210-221
  • Measham F, Parker H, Aldridge J (2001) Dancing on Drugs: Risk, Health, Hedonism in the British Club Scene. Free Association Books, London
  • Parrott AC, Stuart M (1997) Ecstasy (MDMA), amphetamine, and LSD: comparative mood profiles in recreational polydrug users. Human Psychopharmacology 12: 501-504
  • Pedersen W, Skrondal A (1999) Ecstasy and new patterns of drug use: A normal population study. Addiction 94: 1695-1706
  • Ramsey, M., Baker, P., Goulden, C., Sharp, C., and Sondhi, A. Drug misuse declared in 2000. 224, 1-104. 2001. London, Home Office. Home Office Research Study.
    Ref Type: Report
  • Ramsey M, Partridge B, Byron C (1999) Drug misuse declared in 1998: key results from the British Crime Survey. Research Findings 93: 1-4
  • Randall T (1992) Ecstasy-fueled 'rave' parties become dances of death for English youths. Journal of the American Medical Association 268: 1505-1506
  • Riley SC, James C, Gregory D, Dingle H, Cadger M (2001) Patterns of recreational drug use at dance events in Edinburgh, Scotland. Addiction 96: 1035-1047
  • Solowij N, Hall W, Lee N (1992) Recreational MDMA use in Sydney: a profile of 'ecstasy' users and their experiences with the drug. British Journal of Addiction 87: 1161-1172
  • Tossmann P, Boldt S, Tensil MD (2001) The use of drugs within the techno party scene in European metropolitan cities. European Addiction Research 7: 2-23
  • van de Wijngaart G, Braam R, de Bruin D, Fris M, Maalsté NJ, Verbraeck HT (1999) Ecstasy use at large-scale dance events in the Netherlands. Journal of Drug Issues 29: 679-702
  • Williams H, Dratcu L, Taylor R, Roberts M, Oyefeso A (1998) "Saturday night fever": ecstasy related problems in a London accident and emergency department. Journal of Accident and Emergency Medicine 15: 322-326
  • Williamson S, Gossop M, Powis B, Griffiths P, Fountain J, Strang J (1997) Adverse effects of stimulant drugs in a community sample of drug users. Drug and Alcohol Dependence 44: 87-94
  • Winstock A, Griffiths P, Stewart D (2001) Drugs and the dance music scene: a survey of current drug use patterns among a sample of dance music enthusiasts in the UK. Drug and Alcohol Dependence 64: 9-17