title: Incidence and patterns of polydrug use and craving for ecstasy in regular ecstasy users: an ecological momentary assessment study.
abstract: BACKGROUND
  Previous studies employing retrospective assessments methods found that regular ecstasy users frequently use alcohol, marihuana and other drugs in combination with ecstasy.
  
  
  METHODS
  Twenty-two participants (13 males, 9 females) wore a wrist actigraph/data recorder to record real-time drug use and ecstasy craving for 6 weeks. Rates of alcohol and drug use on ecstasy use versus non-use nights, and before, during, and after ecstasy use were analyzed with generalized estimation equations (GEE). Craving was modeled with GEE and linear mixed models.
  
  
  RESULTS
  Approximately 70% of ecstasy uses occurred on Friday or Saturday nights. No drug was significantly more likely to be used on ecstasy use nights than comparison Friday and Saturday nights. On nights ecstasy was used, in general across all drugs assessed, use was more likely before and during than after ecstasy intoxication, while alcohol use was also more likely before than during ecstasy intoxication. Though low overall, craving for ecstasy increased over 24 h before use and was higher on Friday nights of weeks ecstasy was used on weekends than weeks it was not used.
  
  
  CONCLUSIONS
  Use of ecstasy on a particular night may not be associated with any greater likelihood of using any other intoxicating drug, and use of other drugs on nights involving ecstasy use may simply reflect a "natural history" of drug-use nights that begins with alcohol, progresses to more intoxicating drugs, and ends with little drug use. Confirmation of these findings awaits further advances in the application of ecological momentary assessment methodologies.
authors.affiliation: Behavioral Psychopharmacology Research Laboratory, Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA 02478, USA. jhopper@mclean.harvard.edu
authors.forename: James W
authors.initials: JW
authors.lastname: Hopper
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Su
authors.forename: Alison R
authors.initials: AR
authors.lastname: Looby
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Ryan
authors.forename: David M
authors.initials: DM
authors.lastname: Penetar
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Palmer
authors.forename: Scott E
authors.initials: SE
authors.lastname: Lukas
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006213:Hallucinogens; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology*; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D015995:Prevalence; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine