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  • BBC News – Monday, 14 January, 2002, 15:04 GMT

    Clubbers who take ecstasy are 25% more likely to have a mental health disorder, compared to the general population, a survey has found.

    The survey by clubbers’ magazine Mixmag, for 18 to 24 year olds, found one in four who take ecstasy had a potentially serious psychiatric disorder.

    The UK average is one in five.

    Mixmag claim the annual survey, carried out in conjunction with Dr Adam Winstock of the National Addiction Centre at the University of Kent is “the most accurate snapshot of drug taking in young Britain today”.

    Its findings back up previous scientific concerns over a link between ecstasy and mental health problems.

    Ecstasy users are also twice as likely to have seen a doctor about a mental health problem compared to the rest of the population.

    Half of them asked about depression, which scientists believe could be linked to use of the Class A drug.

    But one in 10 users believed that taking ecstasy had made their lives worse overall.

    Both ecstasy and cocaine have been linked with mental health problems such as paranoia, panic attacks and depression.

    Widespread drug use

    The extent of drug use amongst clubbers is graphically illustrated by the fact 97% of 1,000 people surveyed said they had tried both E and cannabis at least once.

    Eleven per cent have tried heroin.

    Mixmag estimates 1.5m people take ecstasy every weekend.

    But it says consumption has dropped by 13% among regular users.

    Ecstasy use had resulted in unplanned sex for one in three, one in 100 of which resulted in pregnancies.

    Half said their performance at work had been affected because of the drug.

    But the survey also found clubbers had developed a novel way of ensuring Ecstasy got into their bloodstream as quickly as possible – by taking it as a suppository.

    The technique was seen in the 1996 cult movie Trainspotting where Ewan McGregor’s character used a heroin suppository.

    One in 15 surveyed by Mixmag admitted they had taken the drug in this way, a 200% increase compared to last year.

    Inserting it into the rectum allows the body to absorb it more quickly because of the large number of blood vessels in the anus. In the stomach where it has to be broken down by enzymes.

    Falling cost

    The cost of ecstasy has fallen to £4.12 per pill, compared with £8.83 in 1999, the survey showed.

    Cocaine use fell 4%, though 45% of those surveyed said they still took the drug on a regular basis.

    Almost a third of cocaine users reported suffering a nosebleed after snorting the drug.

    Drug use appeared to be linked closely with high levels of alcohol use.

    More than a third of men who responded to the survey spent more than four nights a week in the pub.

    All respondents were three-and-a-half times more likely to injure themselves on alcohol than on ecstasy.

    They were also two-and-a-half times more likely to end up in the local casualty department.

    The survey also showed one in three said they had been violent on alcohol, compared with one in 10 on ecstasy.

    Twice as many had driven on ecstasy than on alcohol but drink drivers had a higher accident rate.

    Viv Craske, senior editor of Mixmag, said: “Hopefully what our survey respondents have to say will reach all the right ears and open up the debate on drug taking even further, making clubbing safer.”

    He added that part of the fall in ecstasy use may have been due to the death of 19-year-old Lorna Spinks, the student who died last May after taking ecstasy while clubbing with friends in Cambridge.

    Harry Shapiro, of the drugs charity DrugScope, said the survey results could be affected by the fact people chose whether or not to respond.

    He said: “It is likely that those people who use recreational drugs on regular basis are also more likely to develop a mental health problem than those who do not use drugs.”


    This statement is being issued as a corrective to some of the regrettable, sensationalist and inaccurate coverage that has recently occurred regarding the Mixmag drug use data concerning clubbers’ drug use. A press release was issued that was not seen by any of the researchers and which contained some factual inaccuracies that were incorporated into the coverage of the study findings.

    See the following URL for an example.

    The study researchers are Adam Winstock, Luke Mitcheson and Neil Hunt. Contrary to what the press release says Adam Winstock does not work at the University of Kent and never has. Until recently he worked at the National Addiction Centre, Institute of Psychiatry and is in the process of moving to Australia to take up a post as a Clinical Director. Luke Mitcheson works at the South London and Maudsley NHS Trust. Neil Hunt works at the University of Kent.

    The Mixmag survey is a self completion questionnaire that readers elect to complete and send to a Freepost address. The provisional analyses on which the press release is based are drawn from responses from 988 clubbers from 2001. According to their press release, Mixmag has an estimated readership of 600,000 so on this basis only about 1 out of every 60 readers completed the questionnaire.

    It seems likely that people who take the trouble to complete and post a questionnaire may well be more drug-involved in some way: either more enthusiastic about their drugs or having had aversive experiences that they want to share with other people for altruistic reasons. For this reason we believe it is highly unlikely that the sample is representative of the average clubber. This is of great importance when interpreting data such as drug problem data and mental health data and means that the findings cannot be generalised to the general population of clubbers. This sample seems more likely to consist of a ‘hard core’ of clubbers.

    The Press release from Mixmag said:

    “Clubbers 25 per cent more likely to have mental disorder”

    “Mixmag asked survey respondents to complete a standard mental health questionnaire used by psychiatrists to diagnose psychological disorders.”

    “One in four of the survey respondents had the potentially to develop a serious psychiatric disorder, compared with the UK average of one in five.”

    “Mixmag respondents are also twice as likely to have seen a doctor about a mental health problem than the rest of the population. Half of those asked about depression. (Many scientists believe that ecstasy use can lead to depression).”

    In fact the tool that was used was the GHQ 12 which is not a diagnostic tool and the study does not provide any confirmation of whether respondents have a mental disorder. We are unable to say that any respondents have a mental disorder.

    32% of the sample scored more 4 or more on the GHQ 12 (a cut off point used to indicate poorer wellbeing) whereas the “Comparative Review and Assessment of Key Health State Measures of the General Population” (available from found an overall rate of 17% for 16-24 year olds in 1995 scoring this level.

    Mixmag may have derived the 25% figure from some preliminary codings that didn’t use the same cut-point as the ‘Comparative Review and Assessment of Key Health State Measures of the General Population’. However it was derived, the 25% figure appears to be wrong anyway. In fact the proportion of respondents with higher GHQ12 scores is almost double that of the nearest age-equivalent group in the general population.

    We don’t know where the quote about depression came from as there were no questions about what people talked to their doctor about so there is no data to substantiate this claim.

    We did get some striking responses to the following questions for the whole sample. However, they are all about lifetime experience and the first three questions do not allow any conclusions to be drawn about causation or the sequence of events.

    Ever seen a doctor about a mental health problem? 21.9%
    Ever been referred to a psychiatrist? 10.9%
    Ever deliberately harmed yourself? 12.1%
    Ever sought help from a drug service or some other type of expert? 13.0%
    Ever sought help from elsewhere? 17.6%

    The Press release from Mixmag also said:

    “an estimated one and a half million young people still take E every weekend”

    We don’t know where this figure comes from. It is certainly not the research and should not be attributed to this or us. This study design does not enable us to estimate population prevalence of ecstasy use.

    We hope this may be helpful to anyone who has seen the coverage and is surprised by it (as we were).

    There’s a lesson in here somewhere.

    Neil Hunt

    (on behalf of the Mixmag Research Group)

    Neil Hunt, Lecturer in Addictive Behaviours
    Kent Institute of Medicine and Health Sciences Research and Development Centre
    University of Kent at Canterbury Canterbury
    Kent CT2 7PD

    Tel/voicemail: +44 (0) 1227 824090
    Fax: +44 (0) 1227 824054
    Mob 07780 665830






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Forums Drugs Clubbers’ mental health risk