Searching the Internet for drug related websites; analysis of onlineavailable information on ecstasy (MDMA)
Paolo Deluca1, PhD; Fabrizio Schifano1, MD, MRCPsych; and the Psychonaut research group2
1St. George’s, University of London, London (UK), 1 Division of Mental Health – Section of Addictive Behaviour,2Agosti Lisa (UK), Baldacchino Alex (UK), Bonan Caterina (I), Bothas Heikki (SF), Brigada Raffaella (I), Comacchio Anna (I), Di Furia Lucia (I),Eastwood Dorte (I), Farre Magi (E), Ferreira Susana (P), Flores Irene (P), Gastpar Markus (D), Ghodse Hamid (UK), Guionnet Claude (F), HarderLisbet (DK), Stokholm Jensen Lene (DK), Leoni Mauro (I), Littlejohn Christopher (UK), Majava Aino (SF), Peltoniemi Teuvo (SF), Pizza Milena (I),Prandin Cristian (I), Rawaf Salman (UK), Robert Damien (F), Rossi Maria Angela (I), Rota Deborah (I), Rovetto Francesco (I), Scherbaum Norbert(D), Siemann Holger (D), Tarrago Josep (E), Torrens Marta (E), Zambello Francesco (I)
Paolo Deluca, PhD
St George’s, University of London
Senior Researcher Fellow
Division of Mental Health – Section of Addictive Behaviour
London, SW17 0RE
Phone: +44 20 8266 6426
Fax: +44 20 8725 2914
The emergence of the Internet as an unregulated source of controlled substances is an important development
that may have significant public health implications. Although the Internet is an essential source of information on MDMA, no
studies have addressed the issue of what is available to the average web user in terms of information on MDMA.
Our study aimed at identifying, developing and evaluating a reliable methodology for sampling the Internet for
relevant information related to MDMA and to provide a description of the type of information available.
This study investigated 280 web pages generated by two search engines in running queries for MDMA (ecstasy).
Such queries were carried out in English using a single generic keyword (MDMA) on a week in June 2003 to overcome the
problem of the ever changing and expanding nature of the Internet. The Google™ and AltaVista™ search for MDMA (ecstasy)
related websites respectively provided a list of 71400 and 48747 web pages. The first 100 websites identified by both search
engines, together with a further random sample of 5% of the remaining sites (101 to 1000) were fully assessed. Since Google™
displayed less than 1000 web pages, the snapshot overall counted 280 web pages.
Of the 280 web pages' links (i.e., 145 from AltaVista™ and 135 from Google™), 23 (i.e., 17 identified by Google™
and 6 by AltaVista™) were offline or with restricted access at the time of their assessment, thus reducing the sample to 257.
Overall, we identified 49 (19.1%) irrelevant websites (25 with Google™ and 24 with AltaVista™). Only Google™ showed a
statistically significant difference between relevant and irrelevant websites’ ranking, having the former an average value of 80.69
and the latter a value of 142.32 (t
116 = -2.55, P
< .02). In considering the first 100 results within each search engine, both Google™
and AltaVista™ produced 18 duplicate links. Moreover, thirty-three out of 164 websites were quoted by each search engine and
49 websites were unique to each search engine. The ranking of these 66 (33 per search engine) websites, in comparison to those
98 (49 per search engine) unique websites was significantly different (t
162 = -6.315, P
< .001), having the common websites a
lower ranking level (37.3) compared to the others (63.3). Regarding websites’ position towards drug use, 50.4% were anti drug,
16.2% harm reduction and 24.8% pro drug. The MDMA pro drug websites showed a lower ranking (mean = 40.34; SD = 32.5),
hence appearing significantly earlier in the results’ list, than both the anti drug (mean = 55.0; SD = 26.6) and the harm reduction
(mean = 54.25; SD = 22.9) websites (F (3; 159) = 3.288; P
This study represents the first systematic analysis of the information available online on ecstasy. Health professionals
may need to be aware of the web being a new drug resource for information where pro drug use messages are more likely to be
encountered by web users.
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MDMA; Ecstasy; Internet; Psychonaut 2002 project; drug abuse; Google™; AltaVista™; search engine
amphetamines, cannabis, cocaine and crack cocaine, dancedrugs (i.e., ketamine, LSD, GHB), ecstasy, herbs and plants,
The Internet with all its web pages, databases, libraries, forums,
heroin and opiates, inhalants and solvents, precursors to illicit
blogs and online shops, has become an enormous resource where
drugs, prescription drugs, and tobacco. Search queries were
most of the knowledge is stored and accessible. Accessibility,
The present study focused exclusively on the findings generated
information is always a problem. Searching for relevant
by a search carried out in English on ecstasy (MDMA).
information on the World Wide Web is often a laborious and
On the week starting on June 23rd, 2003, a “snapshot” of the
frustrating task for casual and experienced users alike. Word of
available websites with contents related to MDMA (ecstasy)
mouth might be a way of identifying the right direction towards
was carried out, to overcome the problem of the ever changing
the right website/resource. However, search engines are both
and expanding nature of the Internet. Search engine queries
the quickest and most popular way for finding information
were carried out using a single generic keyword (ie, MDMA).
online . Indeed, new algorithms and technologies are
It is important to note here that different keywords or
constantly under development to improve their reliability in
combination of words would have inevitably generated different
retrieving relevant information and this will be a major
outputs. However, it was felt that the choice of a single generic
contribution on the development of Internet in the coming years
keyword was less biased than for instance searching for ‘buying
or manufacturing MDMA’. Moreover, MDMA was preferred
to the term ‘ecstasy’ because during pilot testing on various
legal and illicit drugs are no exceptions. In the last 5 years there
keywords it emerged that the term MDMA generated more
has been a growing interest on the availability of both drug
Data was collected and stored in an online, password-protected,
database. Searches for MDMA (ecstasy) related websites
provided a list of 71400 and 48747 web pages respectively with
search engines, both are however designed for displaying only
Among these substances, ecstasy has received limited attention
up to the first 1000 pages found . The sampled websites,
, notwithstanding that it is now a very popular drug after
therefore, were selected using a purposeful sampling technique.
a global escalating trend in the second half of the 1990s and
The first 100 websites identified by Google™ and AltaVista™
that currently around 2.6 million adults in the European Union
with the chosen keyword were fully assessed, together with a
(0.8% of all adults) are estimated to have used ecstasy recently
] sample of 5% of the remaining sites (101
to 1000). Since Google™ displayed less than 1000 web pages
and essential source of information on how to use/consume
listed, the snapshot overall counted 280 web pages.
. However, if the information about a drug contribute to], monitoring the information available to the
Although Google™ and AltaVista™ results would point to a
average web user becomes crucial. To the best of our knowledge
single webpage, we mapped and evaluated the whole website
nothing has yet been published on the content of what is
by accessing all its sections. Survey data of sampled websites
available to the average web user in terms of MDMA
included 64 variables, including: website relevance, ranking,
information on the Internet. Moreover, none of previous studies
country of origin, website position towards drug use, and
have addressed comprehensively the methodology they have
used for finding and evaluating identified websites.
Relevance referred to the content of the information offered bythe website, which was not always pertinent to the aims of the
search; ranking referred to the link’s numerical order ofpresentation in the engine results’ page. The country of origin
This study aimed at identifying, developing and evaluating a
of a website was not routinely identified through the URL
reliable methodology for both sampling and assessing the
domain extension (i.e., .uk, .com, .it, etc) but with the help of
Internet for relevant information related to MDMA and to
] and other information available (i.e., postal
provide a description of the type of information available. This
address, telephone numbers etc). The categorization of the
exercise was part of a larger European Collaborative Study, the
website position towards drug use included four main groups:
Psychonaut 2002 project that investigated the availability of
anti drug, pro drug, harm reduction approach, and not stated.
Anti drug websites typically advocated against the use of any
The Psychonaut 2002 project investigated thousands of web
drug; most usually, they offered either prevention and/or
pages generated by two search engines in querying for 11
treatment information. Conversely, pro drug websites were
psychoactive substances, or groups of substances, including:
actively promoting or facilitating the use of psychoactive drugs.
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Typically, they provided information on how to synthesize,
how to synthesize MDMA were also providing information on
purchase or consume a variety of substances. Harm reduction
websites neither condemned nor promoted the use of drugs;
Interestingly, the websites’ ranking levels did significantly differ
they aimed instead at presenting evidence and facts, giving the
as a function of the website position towards drug use in both
visitors the possibility to draw their own conclusions. In those
search engines (analysis here was limited to the first 100 links
cases in which no statement was found and/or when the website
in both search engines, F
(3; 159) = 3.288; P
= .022). Pro drug
aims were unclear, the website was given a not stated position.
websites showed a lower ranking level (mean = 40.34; SD =
32.5), hence appearing significantly earlier in the results’ list,
Descriptive statistics were used to assess a number of
than both the anti drug (mean = 55.0; SD = 26.6) and the harm
parameters, including: information on country of origin,
reduction (mean = 54.25; SD = 22.9) websites. The Tukey’s
relevance of findings, type of information, and position towards
HSD post-hoc test confirmed that MDMA pro drug websites
drug use. Chi-square analyses were carried out to test association
had a lower (P
< .05) ranking than MDMA anti drug websites.
between different types of information provided and websites
Distribution of relevant websites between and within
position towards drug. Differences in terms of findings between
the two search engines
two search engines were tested for statistical significance by
The second set of analyses focused on the quality of results
generated by both search engines. We analyzed the distribution
To check for websites’ ranking number as a possible function
of irrelevant websites (i.e., those not referring to drugs but for
of their position towards drug use, the one-way ANOVA and
example to music, computer viruses etc.) within and between
the Tukey’s HSD post-hoc tests were both applied. The
the search engines. Overall, we identified 49 (19.1%) irrelevant
St.George’s, University of London, Local Research Ethics
websites. Irrelevant websites were almost equally distributed
Committee granted the ethical approval of the project.
between the two search engines (25 in Google™, and 24 inAltavista™). By means of t
-test analysis we investigated where
these websites were more likely to appear. It emerged thatGoogle™ had a statistical significant difference between
Of the 280 web pages links, 145 were from AltaVista™ and
Relevant and Irrelevant websites, having the former a ranking
135 from Google™, 23 (ie, 17 identified by Google™ and 6 by
mean of 80.69 and the latter a ranking mean of 142.32 (t
AltaVista™) were either not available online (offline) or access
< .02). On the other hand, AltaVista™ did not show
was password protected at the time of their assessment. An
additional 49 (19.1%) websites were not relevant for MDMA
137 = 0.475, P
> .05), although the
Irrelevant websites showed a ranking mean of 185.79 and the
content, thus reducing the sample to 208, 115 and 93 for
relevant ones a ranking mean of 216.89.
Google™ and AltaVista™ respectively.
Repetitions and overlapping between the two search
Although for 21 (10.1%) websites it was not possible to identifytheir country of origin, 133 (63.9%) were from the United States,
followed by 23 (11.1%) from the United Kingdom. With respect
The third and final set of analyses focused on the type of
to the websites’ position towards drug use, it emerged that 98
findings reported by AltaVista™ and Google™. In considering
(47.3%) of them showed a clear anti-drug position, 20 (9.7%)
the first 100 results within each search engine, in AltaVista™
did not state clearly their view, 34 (16.4%) websites showed a
we identified 18 duplicate links, resulting in 82 unique websites.
harm reduction approach and 55 (26.6%) a pro-drug stand.
Similar results were found in Google™, where 18 links were
Moreover, twenty (9.6%) websites provided detailed information
duplicates. In comparing those 164 unique websites, it was
on how to manufacture/synthesize MDMA (18 Pro drug and 2
found that 33 were quoted in both search engines databases
leaving the other 49 websites as unique to each search engine.
3 = 47.6, P
< .001). Further, thirty-five
(17.2%) websites informed their visitors on how to use MDMA
In comparing the ranking of these 66 (33 per search engine)websites with that of those 98 (49 per search engine) unique
(32 Pro drug, 11 Harm reduction, and 1 Anti drug, x23 = 52.6,
websites, we found a significant difference between them (t
< .001) and just 57 (27.7%) had clear warnings on the
= -6.315, P
< .001), having the common websites a lower mean
consequences of using MDMA (19 Pro drug, 8 Harm reduction,
(37.3) compared to unique websites (63.3). Therefore popular
26 Anti drug, and 4 Not stated, x
23 = 2.24, P
> .05). However,
websites, which were quoted in both search engines, were also
warnings were slightly more likely to appear on websites
appearing on top of the ranking compared to those websites that
providing information on how to use MDMA. Indeed, 51.4%
were instead unique for each search engine.
of these websites provided health warnings (x21 = 12.52, P
<.001). Similarly, 80% of websites providing instructions on how
to manufacture/synthesize MDMA did also provide their
The results showed that even though anti drug web sites were
customers with warnings/disclaimers (x21 = 31.21, P
almost double in number compared to those promoting the use
Information on how to use and how to make MDMA were also
of MDMA, anti drug websites were statistically more likely to
more likely to appear together on the same website (x21 = 83.71,
appear after pro drug websites in the results’ list of both search
< .001). In addition, ninety percent of websites informing on
engines. In other words, information at risk related to MDMA
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seemed to be available significantly earlier to the average user.
probability of identifying irrelevant sites significantly increases
This finding, together with what has already emerged from other
in the 101-1000 list. Google™ seemed here to perform better
studies on the quality of the information available online, which
than AltaVista™, at least with respect of identifying earlier
is often a mis-information, may contribute to the growing
relevant MDMA-related websites. Popular websites, quoted by
evidence of Internet being an unregulated source on controlled
both search engines, were appearing on top of the ranking
substances and this may have significant public health
compared to those websites that were instead unique to each
search engine. In other words, if a site is popular it is likely bepicked up by all the search engines and will be offered at the
Since search engines are the main gateways to the information
top of their ranking. However, it was surprising that 49% of the
available online, one might think that they should be accountable
websites were unique to each search engine. This might confirm
for the information they provide. Alternatively, they might want
the underlying assumption that search engines crawl, index and
to filter out those websites that have a clear pro drug stance
rank the web in different ways and may also be following quite
and/or sell drugs online. Deliberate, localized, search results’
different criteria when reporting links related to the same query.
exclusions are already occurring for sensitive or illegal
This would support the need of using multiple search engines
items/topics (eg, Nazi memorabilia in France and Germany) to
is not apparently the case for online drug shops selling illicit
In conclusion, it is important to note that only one fixed keyword
and licit drugs thus apparently breaching the law in most nations.
was used in this study therefore statistical data about the
One might argue that these websites should not be listed in
underlying nature of each website (ie, pro drug vs. anti drug,
search engines, so that it would become less and less profitable
ranking positions etc) may be merely a reflection of the bias of
setting up websites to promote and sell illicit drugs.
the keyword used in the search. Percentages reported are whollydependent on what was searched. However, we aimed here at
Apart from being used for searching for relevant terms, search
exploring what a generic drug name would generate from those
engines are also a valuable source for discovering and analyzing
search engines. Finally, due to the rapidly changing nature of
search patterns, trends and sudden events that occur around the
the web any report on Internet issues, including the present one,
globe. This could be a valuable source of information for
might be considered somewhat out of date. Further studies
identifying the emergence of new drugs or new trends in drug
should be carried out to shed more light on what information
use. This information could be used in setting up an Early
is available online and how it might change overtime and by
using different keywords or combination of words.
It also appeared from this study that searching relevant datawithin the first 100 websites may be informative enough, as the
This paper has been supported by the grant number SPC 2002 306 (2002-2004) of the EU DG – Public Health and Risk Assessment.
The conclusion and interpretation of the findings of this study reflects the authors’ views and the Commission is not liable forany use that may be made of the information contained in this publication.
PD collected the data and wrote the manuscript, FS is the grant holder and contributed to and commented early drafts of themanuscript.
Conflicts of Interest
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GeneDx 207 Perry Parkway Gaithersburg, MD 20877 Phone: 301-519-2100 Fax: 301-519-2892 E-mail: [email protected] www.genedx.com Genetic testing of the SCN9A Gene in Inherited Pain Syndromes Includes: Inherited erythromelalgia (IEM); Paroxysmal extreme pain disorder (PEPD); Small fiber neuropathy (SFN); Congenital indifference to pain (CIP) Mend
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