title: Pills and pints: risky drinking and alcohol-related harms among regular ecstasy users in Australia.
abstract: OBJECTIVE
  A significant proportion of young Australians engage in risky alcohol consumption, and an increasing minority are regular ecstasy (3,4-methylenedioxymethamphetamine) users. Risky alcohol use, alone or in combination with ecstasy, is associated with a range of acute and chronic health risks. The aim of this study was to document the incidence and some health-related correlates of alcohol use, and concurrent alcohol and ecstasy use, among a large, national sample of regular ecstasy users (REU) in Australia.
  
  
  METHODS
  National, cross-sectional surveys of REU in Australia 2003-2008. Among REU in 2008 (n=678) usual alcohol use, psychological distress and health-related quality of life were measured using the Alcohol Use Disorders Identification Test, Kessler Psychological Distress Scale and Short Form-8 Survey respectively.
  
  
  RESULTS
  Among REU in 2008, 36% reported high-risk patterns of usual alcohol consumption, 62% reported usually consuming more than five standard drinks with ecstasy, and 24% reported currently experiencing high or very high levels of psychological distress. Controlling for age and education, high-risk drinking among REU was associated with higher levels of psychological distress and poorer health-related functioning; however, the associations between concurrent alcohol and ecstasy use, and health outcomes, were not significant (P>0.05).
  
  
  CONCLUSIONS
  A large and increasing proportion of REU in Australia engage in high-risk patterns of alcohol consumption, including in combination with ecstasy. High-risk alcohol consumption among this group is associated with adverse health-related outcomes. Prevention and harm reduction interventions for REU should incorporate messages about the risks associated with alcohol use. There is an ongoing need for youth-specific, coordinated alcohol and other drug and mental health services.
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia. kinner@burnet.edu.au
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Kinner
authors.forename: Jessica
authors.initials: J
authors.lastname: George
authors.forename: Jennifer
authors.initials: J
authors.lastname: Johnston
authors.forename: Matthew
authors.initials: M
authors.lastname: Dunn
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000639:trends*; D000437:Alcoholism / Q000150:complications* / Q000453:epidemiology; D019969:Amphetamine-Related Disorders / Q000150:complications* / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D040261:Harm Reduction; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D011788:Quality of Life; D012309:Risk-Taking
chemical_list: D018817:N-Methyl-3,4-methylenedioxyamphetamine