Hallucinogen-related disorders in a national sample of adolescents: The influence of ecstasy/MDMA use

AimsTo present the prevalence and correlates of hallucinogen use disorders (HUDs: abuse or dependence) and subthreshold dependence.MethodsThe study sample included adolescents aged 12–17 years (N = 55,286) who participated in the National Survey on Drug Use and Health (2004–2006). Data were collected with a combination of computer-assisted personal interviewing and audio computer-assisted self-interviewing.ResultsThe overall prevalence of HUDs among adolescents was low (<1%). However, more than one in three (38.5%) MDMA users and nearly one in four (24.1%) users of other hallucinogens reported HUD symptoms. MDMA users were more likely than users of other hallucinogens to meet criteria for hallucinogen dependence: 11% (95% confidence interval [CI]: 8.24–14.81) vs. 3.5% (95% CI: 2.22–5.43). Compared with hallucinogen use only, subthreshold dependence was associated with being female (adjusted odds ratio [AOR] = 1.8 [95% CI: 1.08–2.89]), ages 12–13 years (AOR = 3.4 [1.64–7.09]), use of hallucinogens ≥52 days (AOR = 2.4 [1.66–6.92]), and alcohol use disorder (AOR = 1.8 [1.21–2.77]). Compared with subthreshold dependence, abuse was associated with mental health service use (AOR = 1.7 [1.00–3.00]) and opioid use disorder (AOR = 4.9 [1.99–12.12]); dependence was associated with MDMA use (AOR = 2.2 [1.05–4.77]), mental health service use (AOR = 2.9 [1.34–6.06]), and opioid use disorder (AOR = 2.6 [1.01–6.90]). MDMA users had a higher prevalence of most other substance use disorders than users of non-hallucinogen drugs.ConclusionsAdolescent MDMA users appear to be particularly at risk for exhibiting hallucinogen dependence and other substance use disorders.