In the 1980s, MDMA appeared on the Dutch market. The popular use of MDMA and MDMA-analogs (commonly known as ecstasy) spread quickly in the second half of the 1980s, especially at large-scale dance events. After prohibition in 1988, the ecstasy market became 'polluted', adding an extra risk factor to its use. The Dutch government showed concern, and the Health Department initiated a research program. The Utrecht University Addiction Research Institute (CVO) conducted a socio-epidemiological study into the nature and extent of, and the risks involved in, ecstasy use at dance events. More than one thousand respondents participated in the study. This article focuses on the methodology and results of the study. Applied methods included observations, written questionnaires, in-depth interviews, and urine sampling.
In the 1980s, MDMA first appeared on the Dutch drug market. The early users of this substance primarily consumed it in their homes (Adelaars, 1991; Korf et al., 1991). During the second half of the 1980s, the drug turned up in the entertainment circuit when a few trendy night spots in the Randstad, an urban agglomeration in the Western part of the Netherlands, started to play a new type of dance music called house.
In comparison with neighboring countries, the Netherlands was late in placing MDMA on the list of prohibited substances. It was not until the end of 1988 that this substance was placed on List I (drugs with unacceptable risks) of the Dutch Opium Act. Along with MDMA, a number of related substances were declared illegal at the time. In subsequent years, analogs such as MDEA (1993) were also placed on List I of the Opium Act. The primary consideration in listing MDMA and MDMA analogs under the Opium Act was not so much to limit the health risks they pose for consumers, however, as would be expected from the general aims of Dutch drug policy (van de Wijngaart, 1988, 1990). Rather, the listing was in response to critical comments from abroad suggesting that the Netherlands was becoming a center for the production and transport of these drugs (Ossebaard and van de Wijngaart, 1998).
Despite being declared illegal, the acculturation of MDMA and MDMAanalogs continued at a remarkable rate. In addition to the trend setters in the Randstad conurbation, these drugs appealed to a rather mixed public, including not only old hippies and "wheeler-dealers," but also New Agers and Yuppies, disco regulars, football supporters and fringe youth groups. A number of social changes influenced these new drug consumption patterns. Public attention became focused on the new dance music with which the use of MDMA and MDMAanalogs is associated.
The popular use of MDMA and MDMA-analogs occurred in the second half of the 1980s when the first large-scale dance events (called house parties in the Netherlands and raves in Great Britain) were organized. As a result of this increase in scale, the new dance music became both more accessible and more commercial. We may now say with confidence that this group of users may be called a true youth (sub)culture, with its own unique magazines, rituals, symbols, gestures, (designer or brand) clothing and hair styles. MDMA and MDMA analogs became known universally by the popular generic name ecstasy, and the supply of these substances grew rapidly following the 1988 prohibition (Korf et al., 1991; Korf and Verbraeck,1993).
House culture centers around house parties that attract many thousands of young people. The first large-scale dance events organized in the first half of the 1990s took place in factories and warehouses, some of which had not been used for years. Understandably, elementary conveniences such as electricity, cloakrooms, air conditioning, ventilation and toilets were not what they should have been to accommodate large crowds. Supportive facilities such as security services and First Aid posts were sometimes completely lacking. Incidents and accidents at these large-scale parties, some involving fatalities, were sources of sensational media reports. This led to questions being raised in Parliament and to confusion and concern on the part of local authorities, social workers and parents.
In April 1995, the Ministry of Health, Welfare and Sport presented the City Hall and House Memorandum (1995), a document setting out practical suggestions for formulating municipal policies regarding large-scale dance events and the recreational use of drugs at them. The Memorandum acknowledges that drug use cannot be eliminated, considers strict prohibition on an individual level to be undesirable, and recommends measures to limit the possible health risks and allow for the maintenance of public order at such events.
Over time, house culture became an established phenomenon in the Netherlands. Every week, tens of thousands of young people gathered to party. By the mid- 1990s, it had become difficult to imagine contemporary nightlife without house parties. Young people apparently had developed a need for a place where they could be free to party and experiment.
The conditions under which these large-scale house parties take place have improved steadily over the years. The City Hall and House Memorandum (1995), drawn up in close cooperation with those who were active in the party circuit, forms a basis for the relatively safe administration of these large-scale dance events. Virtually all large-scale house parties now have service facilities, such as security and First Aid. Insofar as local authorities will allow, the Safe House Campaign - a national organization financed by both national and local governments that aims at risk reduction related to drug use - is present at these events.
Despite these noted improvements in the house party scene, not enough was, or is, yet known about the nature of the health risks involved in these extravagant events. In order to fill this gap, the Minister of Health, Welfare and Sport (VWS) requested that an empirical study be funded to answer these important questions. Utrecht University's Addiction Research Institute (CVO), one of the institutions that participated in the research, conducted the socio-epidemiological study into the nature and extent of ecstasy use and other "recreational" drugs in places of leisure in the Netherlands, as well assessing the risks involved. The problem definition for the study was: What is the nature and extent of the use of MDMA and MDMA-analogs (known by the popular name ecstasy) by people going to large-scale events, and what is the influence of exogenous factors on the effects of these substances? A second problem statement was identified as well: how do the different elements of drugs, set and setting contribute to more or less hazardous use of MDMA and MDMA-analogs?
This paper focuses on the methodology and results of the study of visitors to large-scale dance events in the Netherlands. The following section describes the structure and execution of the study. We begin by identifying the various study methods that were used. After that, we consider the survey procedures utilized to select the parties to be observed (setting) and the informants (set) for the study. We then look at the response rate, representativeness of the samples and validity issues. In the next section we provide field descriptions of the events of the study itself. Finally, we close with a description of a night of fieldwork at a large-scale house party.
The study was both exploratory and evaluative. It was exploratory in the sense that little was known about house parties and the use of ecstasy. It was evaluative, in that certain assumptions that gave rise to the investigation were ultimately verified.
The following study methods were used to answer the questions addressed:
Preliminary research consisted of literature studies, observations on location, open interviews with informants and ecstasy users, and two pilot studies.
Completion of a face-to-face survey among partygoers at the beginning and at the end of 10 large-scale "house parties." Six of these house events took place in the Randstad conurbation (the area encompassing Amsterdam, The Hague, Rotterdam, and Utrecht), and four were completed in other parts of the country. The Safe House Campaign (SHC) was present at seven of the 10 parties. Sampled partygoers were asked to complete the main questionnaire at the beginning of the event (N=I 121) and a follow-up/second questionnaire at its conclusion (N=769).
Observations were completed at 28 large-scale "house parties" and 24 venues in the regular club and discotheque circuit throughout the Netherlands. Urine samples were collected at the beginning and at the end (N=509) of three of the large-scale "house parties" where the questionnaires had been distributed.
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