Patterns and Mood Effects of Concomitant Polydrug Use of Ecstasy and Alcohol in Dutch and British Electronic Dance Event Visitors: An EMA Study

Introduction: Given the widespread prevalence of concomitant polydrug use of ecstasy and alcohol, it is important to better understand the nature and effects of concomitant use. The current study aimed to investigate patterns of concurrent ecstasy and alcohol use and their possible association with mood alterations. Methods: Nightlife attendees who reported having used ecstasy three times or more in the past year were recruited and participated in an ecological momentary assessment protocol as part of a larger study on substance use in the European nightlife context (ALAMA study). Substance use and mood states were assessed on four timepoints per day or night with 2-h intervals on Friday and Saturday over a 5-week period. Results: Analyses of the course of alcohol consumption during an “ecstasy and alcohol” night (i.e., with at least one time ecstasy use) showed that alcohol consumption decreased in the hours following the first night-time use of ecstasy. Alcohol consumption increased more over time on “no ecstasy” nights than on “ecstasy and alcohol” nights. There were stronger improvements in positive mood states and a stronger decline in negative mood states over the course of “ecstasy and alcohol” nights compared to “no ecstasy” nights. Conclusion: Concomitant ecstasy and alcohol use among nightlife attendees is common and is associated with specific use patterns and mood effects. These findings underscore the need for nightlife-specific harm-reduction approaches that consider the social context, patterns, and the reinforcing mood effects associated with combined ecstasy and alcohol use.