In 2015, just over half (53%) of people starting treatment for primary MDMA use were under 20 years old, but in 2018, 75% of those starting treatment were in this age group. The most commonly used drugs have not changed over time. Cannabis is the most prevalent, followed by powder cocaine, MDMA, ketamine and amphetamine. Campbell N, Perkins A, Hui S, Khan B, Boustani M. Association between prescribing of anticholinergic medications and incident delirium: a cohort study. J Am Geriatr Soc. 2011;59 Suppl 2:S277–81.

A citation analysis was performed to identify and compare the clinical utility of individual anticholinergic rating scales to quantify anticholinergic burden and to evaluate its association with adverse outcomes (cognitive, functional, mortality) in older people. Studies that used the rating scales for assessing the adverse outcomes in older people are reported in this review. Use of MDMA by children and young adults has increased in recent years. Prevalence among 16 to 19 year olds in England and Wales was 4.5% in 2018 to 2019, the highest since 2001 to 2002. The proportion of 15 year olds who had used MDMA at some time in their lives was 3.9% in England and 6% in Scotland in 2018. Estimates within this publication are based on data from the CSEW self-completion module. The upper age limit for respondents eligible for the self-completion module was removed from 2019 to 2020, but remains in place for questions on drug use because of the low prevalence of drug use in those aged 60 years and over. New psychoactive substances Han L, Agostini JV, Allore HG. Cumulative anticholinergic exposure is associated with poor memory and executive function in older men. J Am Geriatr Soc. 2008;56(12):2203–10. The drug-related mortality rate per million population in Great Britain using the EMCDDA definition was the highest on record, at 76 per million. The mortality rate in Scotland was 229 per million in 2017, the highest rate reported in Europe in that year.Lowry E, Woodman RJ, Soiza RL, Mangoni AA. Clinical and demographic factors associated with antimuscarinic medication use in older hospitalized patients. Hosp Pract (1995). 2011;39(1):30–6.

Fox C, Livingston G, Maidment ID, Coulton S, Smithard DG, Boustani M, et al. The impact of anticholinergic burden in Alzheimer's dementia-the LASER-AD study. Age Ageing. 2011;40(6):730–5.Drug misuse data included in this release are sourced from the Crime Survey for England and Wales (CSEW). Our User guide to crime statistics for England and Wales provides detailed information about the crime survey. This systematic review aimed to synthesise data from published studies regarding the association between anticholinergic burden and mobility. The studies were critically appraised for the strength of their evidence. Methods Koshoedo S, Soiza RL, Purkayastha R, Mangoni AA. Anticholinergic drugs and functional outcomes in older patients undergoing orthopaedic rehabilitation. Am J Geriatr Pharmacother. 2012;10(4):251–7.