Perceived risk and risk reduction among ecstasy users: the role of drug, set, and setting

In order to provide information on, and to identify factors associated with, risk-taking behaviours and adverse experience among ecstasy users, data were collected by way of focus groups involving 42 participants, all of whom had used ecstasy. While participants described a range of adverse experiences resulting from ecstasy use, they reported few major harmful outcomes from these experiences. Participants described a range of coping strategies for dealing with such experiences, which partly derived from an appreciation of the relative importance of drug, set, and setting, and the interaction between these factors. Social support networks were described as being particularly important in this respect. These strategies were applied not only during an unpleasant drug-taking episode, but also when preparing for using ecstasy, and also for ‘winding down' after taking ecstasy. Participants' awareness of harm reduction principles in relation to ecstasy use was encouraging, but more worrying was the limited impact of possible long-term neurological damage on the group’s behaviour and perceptions of risk. The risk reduction strategies of this group are discussed in the more general context of risk discourse, specifically to highlight participants’ different subjective assessments of short- and long-term risk.