Summary of Ecstasy Craving Study #1:
Numerous questionnaires have been published to assess craving for a variety of drugs and behaviors, but no such instrument has been developed to assess craving for MDMA/ecstasy. Therefore, we designed this study to develop and evaluate the properties of such a questionnaire. First, to develop a pool of potential items for the ecstasy craving questionnaire, we selected items that appeared on published questionnaires developed to assess craving for other drugs (e.g., tobacco, marijuana, heroin, cocaine). Items on these measures most often reflected one of four main themes: (1) intense urge or desire for a drug; (2) anticipated loss of control over drug use; (3) intention to use the substance; and (4) expectations of positive outcomes or relief from negative states. Additionally, we wanted to include items reflecting a fifth theme – craving for the social context in which the drug is taken – that we considered especially relevant for ecstasy. For example, we speculated that ecstasy users may experience craving as an intense longing to be with friends and/or significant others and to be in locations, such as clubs and bars, in which they have used ecstasy. We modified the wording of 90 selected items to make them relevant to ecstasy. After removing duplicate items, we had a list of 19 items that comprised the ECQ-Draft.
Next, using a web-based recruitment and data collection procedure, we asked ecstasy users to rate their agreement with the 19 craving statements both immediately before and immediately after watching either an ecstasy-related (rave/club with interspersed images of ecstasy pills) or a control video (football half-time video interspersed with images of peanuts). Next, they completed questionnaires to assess their motivations for using ecstasy, their confidence that they could refuse ecstasy in a variety of situations, their obsessive/harmonious engagement in ecstasy use, drug/alcohol use and problems, and demographic information.
During the recruitment period (August, September, and October, 2011) we obtained useable data from 217 regular ecstasy users from around the world (approximately two-thirds from the United States). Both groups were predominantly Caucasian, male, and under 30 years of age. The cue exposure groups did not differ significantly in their endorsement of problems associated with drug use or their average alcohol consumption, and their scores on the AUDIT-C indicated that these participants were not hazardous drinkers. As further examination reveals, the cue exposure groups were also similar on a variety of ecstasy use history characteristics (e.g., frequency and amount of ecstasy use). Other drug and alcohol use was also prevalent in both samples. Specifically, participants reported having used a variety of other substances over the previous three months, including alcohol (Experimental = 80%; Control = 79% ), cannabis (Experimental = 65%; Control = 66% ), hallucinogens (Experimental = 55%; Control = 31% ), and prescription opioids (Experimental = 48%; Control = 27% ).
Based on statistical analyses, we found several interesting findings. Firstly, many participants endorsed levels of craving that are consistent with a significant emotional experience of need, want, and desire to consume this drug, anticipated loss of control over their use, and immediate intention to consume ecstasy. However, many participants also indicated that they were not experiencing any craving at all. We were not able to determine why there were differences, other than the assumption that different people have different experiences of craving for this drug. Secondly, we found that the more one endorsed craving for ecstasy the more they indicated using ecstasy for coping reasons. It might be that those who consume ecstasy to relieve themselves from negative emotional experiences also crave using the drug more because of this desire to feel better. Thirdly, we found that there was a strong relationship between craving for ecstasy and the confidence that one feels they could refuse to consume ecstasy in various situations. Meaning that participants who endorsed higher levels of craving also endorsed less confidence that they could refuse offers to take ecstasy. Finally, we found strong associations between craving and obsessive and harmonious passionate engagement in ecstasy use. Meaning that those individuals who endorsed high levels of craving also endorsed more obsessive engagement in their ecstasy use. Interestingly, for those individuals who indicated that their use is more harmonious with other areas of their life, they also indicated slightly more craving, but not high levels.
There is a more comprehensive manuscript that is available at the following link -
http://etd.ohiolink.edu/view.cgi?acc_num=bgsu1335999475 - if you wish to read more details about the study. I have taken every effort to consolidate this information for this forum in order to make the information more meaningful to the reader, and incorporated less scientific jargon. Also, there is a manuscript in the process of being peer-reviewed right now based on this study. Once it is published I will provide a link to that article as well.
Thanks so much for your help with this study. I am almost finished with data collection on Phase #2 and will present a summary of those results probably next spring.
All the best,
Alan Davis
