title: Hallucinogen-related disorders in a national sample of adolescents: the influence of ecstasy/MDMA use.
abstract: OBJECTIVE
  To present the prevalence and correlates of hallucinogen use disorders (HUDs: abuse or dependence) and subthreshold dependence.
  
  
  METHODS
  The 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.
  
  
  RESULTS
  The 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 > or = 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.
  
  
  CONCLUSIONS
  Adolescent MDMA users appear to be particularly at risk for exhibiting hallucinogen dependence and other substance use disorders.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA. litzy.wu@duke.edu
authors.forename: Li-Tzy
authors.initials: LT
authors.lastname: Wu
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Ringwalt
authors.forename: Roger D
authors.initials: RD
authors.lastname: Weiss
authors.forename: Dan G
authors.initials: DG
authors.lastname: Blazer
mesh_terms: D000293:Adolescent; D002648:Child; D003415:Crime; D005006:Ethnicity; D005260:Female; D006213:Hallucinogens; D006801:Humans; D008297:Male; D008603:Mental Health; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D013334:Students; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D014481:United States / Q000453:epidemiology
chemical_list: D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine