Aims: We aimed to describe i) self-reported changes in drug use and ii) trends in price, perceived availability, and perceived purity of illicit drugs, among people who regularly use ecstasy/MDMA and other illicit stimulants in Australia following COVID-19 and associated restrictions.
Design: Annual interviews with cross-sectional sentinel samples conducted face-to-face in 2016-2019, and via video conferencing or phone in 2020.
Setting: Australian capital cities.
Participants: Australians aged 16 years or older, who use ecstasy/MDMA and other illicit stimulants on a monthly or more frequent basis, and reside in a capital city recruited via social media and word-of-mouth (n~=800 each year).
Measurements: Data were collected via an interviewer-administered structured questionnaire. Key outcome measures were self-reported illicit drug market indicators (price, purity and availability), and in the 2020 survey only, perceived change in drug use (including alcohol and tobacco) since March 2020 and reasons for this change.
Findings: For most drugs, participants reported either no change or a reduction in their use since COVID-19 restrictions were introduced. Ecstasy/MDMA was the drug most frequently cited as reduced in use (n=552, 70% of those reporting recent use), mostly due to reduced opportunities for socialisation. While market indicators were largely stable across most drugs, the odds of perceiving MDMA capsules as ‘high’ in purity decreased compared to 2016-2019 (adjusted odds ratio [AOR] 0.72, 95% confidence interval [CI95]: 0.53-0.99), as did perceiving them as ‘easy’ to obtain (AOR 0.42, CI95: 0.26-0.67). The odds of perceiving cocaine and methamphetamine crystal as ‘easy’ to obtain also decreased (AOR 0.67, CI95: 0.46-0.96 and AOR 0.12, CI95: 0.04-0.41, respectively).
Conclusions: We observed changes in drug use indicative of reduced demand for certain drugs, and evidence for potential supply disruption to illicit drug markets predominantly for illicit stimulants. Ongoing monitoring is critical to capture evolving trends in drug use, markets and harms during and following the COVID-19 pandemic and associated restrictions.