{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T13:08:35Z","timestamp":1780492115013,"version":"3.54.1"},"reference-count":43,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["U01DA038886"],"award-info":[{"award-number":["U01DA038886"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite the popularity of 3,4-methylenedioxymethamphetamine (MDMA; ecstasy) among young people across North America and Europe, MDMA is rarely explored in studies of young people at high risk of injecting drugs. We conducted a study among street-involved youth who use illicit drugs in Vancouver, Canada, to understand if use of MDMA is associated with initiation of injection drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We followed injection-na\u00efve participants in the At-Risk Youth Study (ARYS), an ongoing prospective cohort of street-involved youth aged 14\u201326 who use illicit drugs. Bivariate and multivariate extended Cox models with time-updated variables were used to examine the association between MDMA use and initiation of injection drug use between September 2005 and May 2015.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 483 youth, 306 (63.4%) had a history of MDMA use and 218 (45.1%) had used MDMA in the previous 6 months at baseline. A total of 105 (21.7%) youth initiated injection drug use over the 10-year period, yielding an incidence density of 8.51 (95% confidence interval [CI]: 6.96\u201310.30) per 100 person-years. MDMA use was not significantly associated with initiating injection drugs at the bivariate (hazard ratio: 0.93, 95% CI: 0.61\u20131.42) or multivariate (adjusted hazard ratio: 0.88, 95% CI: 0.57\u20131.35) level, after adjusting for socio-demographic and substance use confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Amid ongoing frequent use of MDMA among some young people in North America, we did not observe an elevated risk of injection initiation among those who used MDMA in this cohort of street-involved youth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1080\/08897077.2018.1528493","type":"journal-article","created":{"date-parts":[[2018,11,20]],"date-time":"2018-11-20T13:56:37Z","timestamp":1542722197000},"page":"350-355","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["3,4-Methylenedioxymethamphetamine (Mdma; Ecstasy) Use and Transitions to Injection Drug Use among Street-Involved Youth"],"prefix":"10.1177","volume":"40","author":[{"given":"Stephanie","family":"Lake","sequence":"first","affiliation":[{"name":"School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada;"},{"name":"British Columbia Centre on Substance Use (BCCSU), Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Gaddis","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use (BCCSU), Vancouver, British Columbia, Canada;"},{"name":"Virginia Tech Carilion School of Medicine, Virginia Polytechnic Institute and State University, Roanoke, Virginia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth W.","family":"Tupper","sequence":"additional","affiliation":[{"name":"School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada;"},{"name":"British Columbia Centre on Substance Use (BCCSU), Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ekaterina","family":"Nosova","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use (BCCSU), Vancouver, British Columbia, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kora","family":"DeBeck","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use (BCCSU), Vancouver, British Columbia, Canada;"},{"name":"School of Public Policy, Simon Fraser University, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,7,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2017.1310219"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2014.926933"},{"key":"e_1_3_3_4_2","unstructured":"European Monitoring Centre for Drugs and Drug Addiction. 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