The Emergence of ATS

UNODC has sounded the alarm on amphetamine-type stimulants (ATS) (e.g., methamphetamine, ecstasy). UNODC Executive Director Antonio Costa recently said that, "in the period ahead, the use of synthetic drugs may become the most serious problem ever faced".

In light of this warning, it may be worth briefly reviewing what we know about ATS. ATS are a form of synthetic drug that, among other possible effects, act as a stimulant. A synthetic drug is one that is manufactured in a lab and does not rely on plant-based components. Another term applied to ATS is "designer drugs" because many were originally designed to get around drug laws by shifting the molecular structure of a banned drug. Other common synthetic drugs include LSD, GHB and ketamine.

ATS have emerged over the past 15-20 years and have become readily available because they are so easy and cheap to produce, and the production labs can be quickly established or moved. A particular climate or special growing conditions are not needed, so labs can be found in most parts of the world. A major worldwide concern with these substances is the possibility that unknown chemicals could be added during manufacture, resulting in unexpected effects and possibly fatal consequences.

Over the past decade, rates of ATS use have increased more than any other drug group worldwide. ATS are the next most commonly used illicit substance after cannabis among high school students in every place where information is available. Most users are mainstream adolescents and young adults. Through the '90s, ATS were most associated with nightclubs, dance scenes and resort activity, but there now appears to be a trend by mainstream youth toward use in other settings. Athletes may use these stimulants in the belief that they delay fatigue and improve performance. In developing countries, labourers (including children and youth), sometimes use stimulants to help them work longer hours.

ATS of particular concern are methamphetamine. Methamphetamine can be taken orally, smoked, inhaled or injected (with injection being the most risky). Like cocaine, use of the drug results in feelings of increased energy and grandiosity. Users are susceptible to accidents, violence, HIV, hepatitis C (from dirty needles) and risky sexual activity as a result of impulsiveness and impaired judgment.

Because of the intensity of the effects and the depression experienced after coming off the drug, it is relatively easy to become dependent. Treatment for methamphetamine dependence is reported to take longer than with many other substances because of the depression that can linger for a number of months after stopping use.

Methamphetamine use has been a concern in parts of the US for a number of years. It is currently the leading substance of concern in South-east Asia, replacing heroin. A study in Thailand found that 29% of vocational students had used methamphetamines (39% of males and 18% of females). The following are percentages from 1999 of 15-year-olds who have used amphetamines in different areas of the world where comparable statistics are collected:

	Europe - lowest country 0%
	Europe - highest country 8%
	USA 16%
	Australia 9%
	Ontario, Canada 11%

Patterns of use for another type of ATS, ecstasy, appear to be converging in several parts of the world. Early rates of relatively high prevalence in several Western European countries in the mid-'90s have stabilized, whereas rates in Eastern Europe, the US and Canada have recently increased and, in some cases, surpassed Western European rates. Prevalence rates of ecstasy use in other parts of the world are low, however, the number of times it is mentioned in country and media reports is increasing. The following are percentages from 1999 date of 15-year-olds who have used ecstasy in different areas of the world where comparable statistics are collected:

	Europe - lowest country 0%
	Europe - highest country 6%
	USA 6%
	Australia 5%
	Ontario, Canada 5%

Users of ecstasy report a pleasant experience that includes a sense of increased empathy for others. Aside from questions about the actual ingredients of an ecstasy pill, the most common immediate problem linked to ecstasy is dehydration resulting from use of the drug while dancing over long periods. As with all substances, use with other drugs increases risks. While most do not continue to use ecstasy beyond early adulthood, some are heavy continuous users who are more likely to also use other substances and more likely to experience problems as a result. There are indications that ecstasy may cause long-term damage to the brain, however, this is controversial with some critics questioning the quality of the research.

A common intervention addressing ecstasy risks in Europe (less so in North America) is on-site pill testing operations. These programmes aim to provide information and support to those attending techno dance parties or raves. These operations vary between prevention and harm reduction in their approach and messages, however, they all share the goal of providing accurate, timely information on the chemical make-up of pills being presented as ecstasy. Many also use the contact with dancers to provide "safer dancing" messages, counselling and other supports. With the exception of the Netherlands, where they are supported by the national drug strategy, these services generally operate through informal agreements among local governments, police and dance sponsors.

	Johnson, C. "UN sees synthetic pills as next big drug problem", Reuter Health Information (2002-11-29).
	Swedish Council for Information on Alcohol and Other Drugs, The 1999 ESPAD Report, Stockholm, 2000.
	Johnston, L.D., O'Malley, P., Bachman, J.G. "Monitoring the Future: National Survey Results on Adolescent Drug Use: Overview Of Key Findings", 1999, Rockville, MD: U.S. Department of Health and Human Services, 2000.
	Lynskey, M., et al. "Prevalence of Illicit Drug Use Among Youth: Results From the Australian School Students' Alcohol and Drug Survey", Australian and New Zealand Journal of Public Health, Vol. 23(5) 1999.
	Adlaf, EM., Paglia, A. "Drug Use Among Ontario Students: Findings from the OSDUS", Centre for Addiction and Mental Health, 1999.
	Bellis, MA., et al. "Ibiza Uncovered: Changes in Substance Use and Sexual Behaviour Amongst Young People Visiting an International Night Life Resort", Drug Policy, Vol. 11: 235-244, 2000.

Gary Roberts, Senior Associate
Canadian Centre on Substance Abuse
Phone: 613-235-4048-225 // 613-829-3152 (home)
Fax: 613-235-8101/613-829-3307 (home)