At second follow-up in a longitudinal study, 9.1% (approximately 223) out of a representative sample of 2446 adolescents and young adults residing in Munich (Germany) reported ever having used ecstasy. Younger respondents (14-17) were sampled more heavily than older respondents (22-25), (researchers intentionally contacted a greater number of younger individuals). Men were more likely than women to use ecstasy overall, but women were more likely to report an earlier age of onset for ecstasy use than men. First use of ecstasy rarely occurred before age 14, and it was most prevalent between ages 15-17. However, people continued to report onset of ecstasy use as age increased, up until age 24 for women and 26 for men. People in the younger cohort (born 1977-1981) had a higher likelihood of using ecstasy and related drugs compared to the older cohort (born 1970-1976). At follow-up, rates of diagnosed ecstasy abuse had increased from 0.5% to 1% and dependence had risen from 0.4% to 0.6%. Men were at greater risk of developing abuse and dependence at follow-up than women, though men were not more likely to be ecstasy-dependent at baseline. There was a general tendency for cessation of ecstasy and related drug use at follow-up after reporting use at baseline; 99.7% of respondents reporting no ecstasy use at baseline had not taken ecstasy at follow-up, 87.7% 1-5 time users were abstinent 12 mo prior to second follow-up, 64.6% of "considerable" ecstasy users (no more than weekly use, usually approximately 50 uses overall) were abstinent at second follow-up, and 72.5% "heavy" users (more than twice a week, usually 100 or more uses) were abstinent at second follow-up. The tendency to cease using ecstasy over time was true in both age cohorts and for both men and women. 79.8% of the ecstasy users not diagnosed with abuse or dependency at baseline had ceased using ecstasy in the 12 months prior to second follow-up. 88% of respondents diagnosed with ecstasy abuse at baseline became non-users at follow-up, (67.2%) or became users without abuse or dependence (14.9%), whereas 17.9% remained ecstasy abusers but did not develop dependence. 50% of respondents diagnosed with ecstasy dependence at baseline were totally remitted at second follow-up, and 35.8% showed partial improvement, while 6.7% remained dependent at second follow-up and 7.5% were diagnosed as showing ecstasy abuse, but not dependence, at second follow-up. While former ecstasy users did report consuming more nicotine (cigarettes), cannabis, cocaine, sedatives, hallucinogens and opiates than those never reporting ecstasy use, former users did not replace their ecstasy use with use of other drugs after cessation of ecstasy use. Former ecstasy users reported consuming fewer drugs at second follow-up than people reporting continued ecstasy use. The same team has already published a study reporting the initial findings, representing the baseline figures (Schuster et al. 1998). The authors conclude that the use of ecstasy and related drugs is probably a transient "youth-limited" phenomenon, and that ecstasy does not produce particularly high rates of abuse or dependence. Rather, incidence of dependence generally declines over time. The findings of this paper seem to contradict findings drawn from a sample of American adolescents and young adults (Cottler et al. 2001), where incidence of ecstasy abuse and dependence were high. However, sampling methods and criteria for study inclusion differed across these studies. Von Sydow and colleagues examined a representative sampling of people selected from a government registry, whereas Cottler and colleagues recruited participants through flyers, advertisements and snowball sampling. Study participants in Cottler et al. (2001) were required to have used ecstasy at least 5 times, whereas no such restriction was applied to the ecstasy users studied by Von Sydow and colleagues.