Aims 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/ 3,4‐methylenedioxymethamphetamine (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 2016–19 and via video conferencing or telephone in 2020. Data were collected via an interviewer‐administered structured questionnaire. Setting Australian capital cities. Participants Australians aged 16 years or older who used ecstasy/MDMA and other illicit stimulants on a monthly or more frequent basis and resided in a capital city, recruited via social media and word‐of‐mouth ( n ~ 800 each year). Measurements Key outcome measures were self‐reported illicit drug market indicators (price, purity and availability) and, in 2020 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), mainly due to reduced opportunities for socialization. While market indicators were largely stable across most drugs, the odds of perceiving MDMA capsules as ‘high’ in purity decreased compared with 2016–19 [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.53–0.99], as did perceiving them as ‘easy’ to obtain (aOR = 0.42, CI = 0.26–0.67). The odds of perceiving cocaine and methamphetamine crystal as ‘easy’ to obtain also decreased (aOR = 0.67, CI = 0.46–0.96 and aOR = 0.12, CI = 0.04–0.41, respectively). Conclusions After COVID‐19‐related restrictions were introduced in Australia, use of ecstasy/MDMA, related stimulants and other licit and illicit drugs mainly appeared to remain stable or decrease, primarily due to impediments to socialization.

Synthetic cathinones and cannabinoids appear to be largely motivated by 'opportunistic' reasons (i.e. availability, legality), while NBOMe, 2C-family substances and DMT appear to be motivated by particular desirable qualities of a substance (i.e. value for money, short effect duration). Providing a nuanced understanding of why individuals use particular NPS improves our ability to understand the NPS phenomenon and to tailor harm reduction messages to the appropriate target groups.

word count is 259 words.Main text word count is 3,448 words.There are 4 tables and 0 figure. infection with a range of DSM-IV anxiety and affective diagnoses, while also testing for gender interactions. Results:In multivariate analyses, self-reported symptoms of prenatal genital infection predicted post-traumatic stress disorders (OR = 2.38, 95% CI: 1.14, 4.95) and social phobias (OR = 1.93, 95% CI: 1.03, 3.61), in addition to evidence for a gender interaction by which males (OR = 6.04, 95% CI: 2.00, 18.30) but not females were at greater risk for PTSD.Further analyses among those with PTSD revealed the relationship to be stronger when excluding those not exposed to trauma (OR = 3.21, 95% CI; 1.53, 6.72). Limitations:We were unable to clinically or serologically verify the presence and the type of prenatal genital infection. Conclusion:This is the first study to show an association between self-reported symptoms of prenatal genital infections and two highly prevalent anxiety disorders. The relationship with PTSD was particularly strong and suggested that the exposure may primarily impact PTSD in males. Further research with the capacity to assess a fuller-range of specific prenatal infections is warranted to evaluate the potential of reducing the prevalence of these disorders.

Mental health disorders are more likely in young adults with polysubstance use disorders than those with alcohol/cannabis use disorders. Predictors of comorbid mental health/polysubstance use disorders differ from those for alcohol/cannabis use disorders, and are detectable during adolescence.