Patterns of Drug Use Among Drug Misusers in Sweden. Gender Differences

The goal of the article is to provide information about polydrug abuse and drug misuse patterns in Sweden among women and men. The data has been taken from a 1998 national survey of “Heavy”/severe drug misuse in Sweden, project “MAX-98” (). The drug misusers were reported by various government agencies, including health services, social services, police, and correctional treatment facilities on a special form. One of the significant gender differences that emerged was that a greater percent of the women in the survey used and injected amphetamines, injected opiates, and used tranquilizers/sedatives, while a greater percent of the men smoked cannabis, smoked heroin, and misused alcohol. Furthermore, the most common combinations for both genders was amphetamines + cannabis, followed by amphetamines + heroin + cannabis. Alcohol played a large role for the narcotics users. Heroin as a primary drug has grown in the age groups under 35. The trends document that the use of ecstasy as well as chemical CNS-stimulating/hallucinogenic drugs has grown, that polydrug use has increased compared with earlier surveys, and that the methods of ingestion have changed. It is therefore more precise today to speak of different types of polydrug users than about users of exclusively one drug.     

Drug-abusing women in Sweden: marginalization, social exclusion and gender differences

A quantitative epidemiological prevalence study of problem drug abuse in Sweden is the basis for a study of differences between drug abuse among men and women. A significant difference between genders was that, of those who come to the attention of the authorities, fewer women than men abuse drugs. The women were younger than the men. A greater percent of women abused amphetamines and injected heroin, as well as abusing tranquilizers/soporifics. A larger proportion of women than men were unemployed. The men had a significantly longer history of drug abuse than the women, a greater percent of them were born outside Sweden, and more of them had smoked heroin and used cannabis. A greater percent of the men had used illegal means to finance their abuse. There was a group of women (17%, median age 32) at the margins of the society, i.e. who had no work or place of residence, socialized solely with other addicts and financed their habit by illegal activities. Abuse of amphetamines and heroin was the most common. The majority of the women were polydrug abusers. Sweden has historically had, and continues to have, a large number of amphetamine abusers, but has now also developed a distinct population of heroin addicts.     

Some Little-Known Hallucinogenic Plants of the Aztecs

Abstract

A quantitative epidemiological prevalence study of problem drug abuse in Sweden is the basis for a study of differences between drug abuse among men and women. A significant difference between genders was that, of those who come to the attention of the authorities, fewer women than men abuse drugs. The women were younger than the men. A greater percent of women abused amphetamines and injected heroin, as well as abusing tranquilizers/soporifics. A larger proportion of women than men were unemployed. The men had a significantly longer history of drug abuse than the women, a greater percent of them were born outside Sweden, and more of them had smoked heroin and used cannabis. A greater percent of the men had used illegal means to finance their abuse. There was a group of women (17%, median age 32) at the margins of the society, i.e. who had no work or place of residence, socialized solely with other addicts and financed their habit by illegal activities. Abuse of amphetamines and heroin was the most common. The majority of the women were polydrug abusers. Sweden has historically had, and continues to have, a large number of amphetamine abusers, but has now also developed a distinct population of heroin addicts.     

Polydrug Use Among Secondary School Students: combinations, prevalences and risk profiles

The aim is to describe polydrug use among secondary school students: combinations of substances, number of students per user type and corresponding risk profiles. The method employed was as follows. Data were derived from the 1999 sample of the Dutch National School Survey on Substance Use. The analysis was limited to secondary school students between 12 and 16 years, at which age it is still compulsory to attend school (N = 6236). Studied substances are alcohol, tobacco, cannabis, ecstasy, amphetamines, opiates and cocaine. Of the students, 56.7% used one or more substances. Among the users, 41.8% were polydrug users in the sense that they had used more than one substance during the previous 4 weeks. In the student population concerned of about 1 000 000, 243 000 were polydrug users of whom 146 000 use only alcohol and tobacco, 67 000 combine alcohol or tobacco with cannabis, and 21 000 combine alcohol, tobacco or cannabis with at least one hard drug such as ecstasy, cocaine, amphetamines or heroin. The risk of polydrug use increased with increasing age. Prevalence rates were highest among ethnic Dutch students, very low among Moroccan students and high at the lower educational levels. By comparison with girls, boys had a specific risk of becoming the type of polydrug user using soft or hard drugs. The high prevalence of polydrug use among young students makes this an important topic for research, monitoring and prevention.     

Polydrug Use Among Secondary School Students: combinations,prevalences and risk profiles

The aim is to describe polydrug use among secondary school students: combinations of substances, number of students per user type and corresponding risk profiles. The method employed was as follows. Data were derived from the 1999 sample of the Dutch National School Survey on Substance Use. The analysis was limited to secondary school students between 12 and 16 years, at which age it is still compulsory to attend school (N = 6236). Studied substances are alcohol, tobacco, cannabis, ecstasy, amphetamines, opiates and cocaine. Of the students, 56.7% used one or more substances. Among the users, 41.8% were polydrug users in the sense that they had used more than one substance during the previous 4 weeks. In the student population concerned of about 1 000 000, 243 000 were polydrug users of whom 146 000 use only alcohol and tobacco, 67 000 combine alcohol or tobacco with cannabis, and 21 000 combine alcohol, tobacco or cannabis with at least one hard drug such as ecstasy, cocaine, amphetamines or heroin. The risk of polydrug use increased with increasing age. Prevalence rates were highest among ethnic Dutch students, very low among Moroccan students and high at the lower educational levels. By comparison with girls, boys had a specific risk of becoming the type of polydrug user using soft or hard drugs. The high prevalence of polydrug use among young students makes this an important topic for research, monitoring and prevention.     

The epidemiology of illicit drug use in Spain

On the basis of a review of the available information, this article summarizes the situation, patterns and trends in respect of the use of cannabis, heroin and other opiates, cocaine, amphetamines, hallucinogens and inhalants, as well as multiple drug use. The review clearly shows that since the early 1980s there has been an increasing trend in the use of drugs, particularly heroin and cannabis. Drug use predominantly affects young people. The use of two or more drugs simultaneously or successively, often involving alcohol, is reported as the most common pattern of drug use among youth. Drug use has become incorporated into the current youth culture, with all the individual, social and economic implications this engenders. The average age of users at first use of inhalants was 16.3 years, cannabis 17.5 years, hallucinogens 18.8 years, cocaine 20.6 years and amphetamines 23.5 years.     

Illicit drug use by young people in sydney: results of a street intercept survey

To complement existing institution-based drug use surveys, a street intercept survey of 581 young illicit drug users was conducted in Sydney, Australia. Patterns of use, reasons for use and awareness of the health risks associated with use were investigated. The most commonly used illicit drug type, after marijuana, was amphetamines. The least popular illicit drug was heroin. Most of the sample used occasionally, exhibiting a controlled pattern of use with a low prevalence of problems associated with use. Heroin users, in contrast, were often frequent users and reported a higher prevalence of associated problems. The majority of the sample reported excessive drinking patterns, indicating that the current policy of emphasis on alcohol misuse rather than illicit drug use amongst youth is appropriate.     

Impulsivity, risk taking and recreational 'ecstasy' (MDMA) use

The present study investigated characteristics of recreational drug users, especially 'ecstasy' (MDMA) users, in 254 undergraduates. All participants completed a drug history questionnaire (DHQ), the impulsiveness venturesomeness and empathy questionnaire, a novel risk-taking task (Bets16), and 59 also completed the tri-dimensional personality questionnaire (TPQ). DHQ responses allocated participants to five groups: non-drug controls, cannabis users, polydrug (no ecstasy) users, low (<20 occasions) ecstasy users and high (>20 occasions) ecstasy users. Eighteen percent of the sample had used ecstasy and of the ecstasy users, only one had not used other substances. A larger proportion of high ecstasy users had also used amphetamines, cocaine and LSD in comparison to the low ecstasy and non-ecstasy polydrug users. High ecstasy users typically took significantly more ecstasy tablets compared with low ecstasy users. Impulsiveness, venturesomeness and novelty seeking behaviour increased from the non-drug users to high ecstasy users. Ecstasy users (low and high) and polydrug (non-ecstasy) users had higher levels of impulsivity, venturesomeness and novelty seeking behaviour compared with non-drug users. Furthermore, high ecstasy users scored higher on the Bets16 risk-taking measure than non-drug users, cannabis users and low ecstasy users. The findings are discussed in relation to: (i) the possibility that increased impulsivity pre-dated drug use; and (ii) the possible link between impulsivity and the putative serotonergic neurotoxicity of ecstasy.     

Drug use among university students in the state of S?o Paulo, Brazil

A survey of drug use carried out from April 1984 to May 1985 at the University of S?o Paulo, Brazil, showed that of 2,475 undergraduate students surveyed, 588 respondents, or 23.8 per cent, abused drugs at some time in their lives. Drug use was somewhat more common among males (25.3 per cent) than among females (21.5 per cent). Among the drug users, the use of cannabis ranked first (41.2 per cent), followed by amphetamines (27.4 per cent), cocaine (12.2 per cent), tranquillizers (12.2 per cent), barbiturates (5.6 per cent), morphine and heroin (0.8 per cent) and lysergic acid diethylamide (0.5 per cent). Of the total number of respondents, 10 per cent were current habitual drug users, while 13.8 per cent had at some time been drug users but were no longer using drugs at the time of the survey. Of 23 postgraduate students surveyed, 10 respondents, or 43.5 per cent, used either cannabis, amphetamines or tranquillizers.     

Perceived Treatment Need and Latent Transitions in Heroin and Methamphetamine Polydrug Use among People who Inject Drugs in Tijuana,Mexico

People who inject drugs (PWID) in Tijuana, Mexico, use heroin and/or methamphetamine. While polydrug use is associated with HIV risk behavior, less is known about the stability of polydrug use patterns over time and how polydrug use is related to perceived treatment need. Within a cohort of PWID in Tijuana (N = 735) we sought to (1) characterize subgroups of polydrug and polyroute use from baseline to six months; (2) determine the probabilities of transitioning between subgroups; and (3) examine whether self-reported need for help for drug use modified these transition probabilities. Latent transition analysis (LTA) identified four latent statuses: heroin-only injection (38% at both baseline and follow-up); co-injection of heroin with methamphetamine (3% baseline, 15% follow-up); injection of heroin and methamphetamine (37% baseline, 32% follow-up); and polydrug and polyroute users who injected heroin and both smoked and injected methamphetamine (22% baseline, 14% follow-up). Heroin-only injectors had the highest probability of remaining in the same latent status at follow-up. The majority reported great or urgent need for treatment (51%) and these PWID had greater odds of transitioning to a higher-risk status at follow-up, emphasizing the need for evidence-based drug treatment options for PWID.     

Polydrug misuse patterns in Sweden. Gender differences

The main purpose of this study was to draw up literature about polydrug misuse and to study the patterns and gender differences of polydrug misuse in a sample (N = 1,268) of narcotics users in Sweden. They were interviewed personally when entering treatment about their drug misuse from debut to established misuse. A nationwide case-finding study was used to verify the results. First, results indicate that those studied were primarily polydrug misusers and that alcohol consumption was very high. Second, gender differences were found. Third, a basic characteristic of multiple substance use was formulated. The findings are discussed in relation to new knowledge of consumption patterns.     

Gender differences in adolescents attending a drug and alcohol withdrawal service

Introduction and Aims . Gender differences have been reported in adult substance users, but little research has examined gender differences in adolescents presenting to treatment services. This study aimed to explore gender differences in adolescents presenting to a withdrawal service. Design and Methods. All presentations to a withdrawal service between March 2000 and September 2004 were identified. For each presentation, the following information was extracted from clinical databases: sociodemographics, drug use, risk‐taking behaviour, mental health symptoms, reasons and context of drug use. Significant gender differences identified at bivariate analysis were then incorporated into multivariate models exploring predictors of heroin use, cannabis use and sharing injecting equipment. Results. A total of 262 young people were admitted during the study period (53% male, mean age 16.8 years; SD 1.13). Bivariate analysis indicated that girls were more likely to report: being homeless, using a greater number of substances, using heroin and amphetamines, higher rates of injecting, sharing injecting equipment and using with a partner. Multivariate analysis identified that being female was an independent predictor of heroin use and that being male was an independent predictor of cannabis use. Significant predictors of sharing injecting equipment were using with a partner and current use of heroin; the effect of gender was not significant after controlling for other factors. Discussion and Conclusions. Our findings indicate that male and female adolescents presenting to a withdrawal treatment service exhibit differences in substance use characteristics. Future research should examine the role of gender in determining optimal treatment approaches in substance‐using adolescents.[Dean AJ, McBride M, Macdonald EM, Connolly Y, McDermott BM. Gender differences in adolescents attending a drug and alcohol withdrawal service. Drug Alcohol Rev 2010]     

Cocaine--profiles, drug histories, and patterns of use of patients from Brazil.

We studied profiles and drug histories of 294 cocaine users from 15 treatment services in S?o Paulo, Brazil during 1996-1997. Mean age of subjects was 27 years, and 90% were male. Over 50% had used five different substances apart from cocaine, usually tobacco, alcohol, cannabis, tranquilizers, and solvents. Mean age at first cocaine use was 18.9 years by which time 87% had snorted the drug. Thirty-two percent had injected cocaine, 82% had smoked crack, and 74% reported a full route transition. Sixty-three percent reported daily cocaine use. Median duration of cocaine use was 6.3 years. Acts of acquisitive crime were common, and 56% had been arrested. Our finding are discussed in terms of implications for prevention and treatment.     

Cannabis use among youth in the Netherlands

A nation-wide survey of cannabis use, based on a representative sample of 1,306 young people in the 15-to-24 age group, carried out in the Netherlands in 1983, showed that cannabis had been used or tried by 12.2 per cent of the respondents (13 per cent males and 11 per cent females). These results, compared with the results of a study carried out by the Central Bureau of Statistics in 1979 and 1980, showed an increase in cannabis use. In the three largest cities, the percentage of cannabis users (25 per cent) was double that of the country as a whole. The percentage of cannabis use was higher among the older age groups of respondents; the study also showed that the lower the age at first cannabis use the higher the risk of continuing and becoming involved with more dangerous drugs such as cocaine, heroin and amphetamines. The rates of alcohol drinking, tobacco smoking and the use of heroin, amphetamines, cocaine, sleeping pills and tranquillizers were significantly higher among cannabis users than among respondents who were not using cannabis. The rate of cannabis use was significantly higher among the unemployed respondents than among those who had a job. The authors suggest that these findings should be taken into account in designing preventive measures and other forms of intervention programmes to deal with cannabis-related problems among young people.     

Behavioral economic analysis of drug preference using multiple choice procedure data

The multiple choice procedure has been used to evaluate preference for psychoactive drugs, relative to money amounts (price), in human subjects. The present re-analysis shows that MCP data are compatible with behavioral economic analysis of drug choices. Demand curves were constructed from studies with intravenous fentanyl, intramuscular hydromorphone and oral methadone in opioid-dependent individuals; oral d-amphetamine, oral MDMA alone and during fluoxetine treatment, and smoked marijuana alone or following naltrexone pretreatment in recreational drug users. For each participant and dose, the MCP crossover point was converted into unit price (UP) by dividing the money value ($) by the drug dose (mg/70kg). At the crossover value, the dose ceases to function as a reinforcer, so "0" was entered for this and higher UPs to reflect lack of drug choice. At lower UPs, the dose functions as a reinforcer and "1" was entered to reflect drug choice. Data for UP vs. average percent choice were plotted in log-log space to generate demand functions. Rank of order of opioid inelasticity (slope of non-linear regression) was: fentanyl>hydromorphone (continuing heroin users)>methadone>hydromorphone (heroin abstainers). Rank order of psychostimulant inelasticity was d-amphetamine>MDMA>MDMA+fluoxetine. Smoked marijuana was more inelastic with high-dose naltrexone. These findings show this method translates individuals' drug preferences into estimates of population demand, which has the potential to yield insights into pharmacotherapy efficacy, abuse liability assessment, and individual differences in susceptibility to drug abuse.     

Benzodiazepine use and HIV risk-taking behaviour among injecting drug users.

This paper examines the prevalence of benzodiazepine use, and its relationship to other drug use and HIV risk-taking among a sample of 1245 injecting drug users (IDU). Approximately a third (36.6%) of the sample had used benzodiazepines during their last typical month of injecting. Benzodiazepine users had injected more frequently, injected more heroin and amphetamines, and had more poly-drug use than other IDU. They also had higher levels of HIV risk-taking, having shared injecting equipment more frequently and with more people. There were no differences between groups in number of sexual partners or condom use, although benzodiazepine users were more likely to have been paid for sex. The demographic and drug use variables indicate that benzodiazepine users are a more dysfunctional subgroup of IDU who require particular attention in HIV interventions.     

苯丙胺类兴奋剂在德国和欧洲的应用和治疗

背景和目的:概述苯丙胺类兴奋剂(ATS)如苯丙胺、甲基苯丙胺、摇头丸等在欧洲和德国的流行、消费模式和防治措施。在德国使用的非法物质中,大麻至今仍然是消费最广泛的非法药物。值得一提的数据是持续使用12月可卡因的为0.6%,苯丙胺为0.4%,摇头丸和迷幻蘑菇均为0.4%。海洛因、LSD、快克和可卡因的消费仍然限于在特定和更小范围的人群。2007年欧洲校园成瘾药物和其他药物调查项目的结果(the European School Survey Project on Addiction and other Drugs,ESPAD)显示,28%被调查的学生曾经尝试过某种非法药物(大麻、苯丙胺类、摇头丸、LSD、可卡因、快克或海洛因)(Krausetal.2008)。非法药物终生消费率(除了大麻)自2003年以来仍然几乎没有变化(10.0%vs.10.2%).在非法药物中(不包括大麻),苯丙胺类(6%)是最常被尝试的药物(一生中至少一次)。但是,与其它物质比较,苯丙胺类在德国的流行仍然不是非常广泛。闲暇和夜生活等中的药物滥用的预防措施仍然很缺乏。在一些城市(大多数是大城市),青少年中心,药物咨询机构或当地政府的团体项目已经制定了预防措施。他们通过网站或者传单宣传娱乐场所物质滥用的危害。在节日、聚会、夜总会或迪斯科舞厅的这些行动旨在提供药物滥用预防的信息。苯丙胺、甲基苯丙胺和摇头丸是欧洲最常用的非法药物。可卡因使用者的绝对数量可能更高,但就地理分布而言在许多国家一些合成药物仍然是继大麻后最常用的非法物质。而且,在一些国家苯丙胺的使用仍旧是药物滥用问题的重要部分,在治疗需求中占相当大的比例。最近的人群调查提示,欧洲各国家苯丙胺终生使用率(成年人,15-64a)在0到11.7%之间变化。平均3.5%的欧洲成年人报告曾经使用过至少一次苯丙胺。去年药物使用大大降低,欧洲人加权平均数为0.5%。据估计大约1千2百万欧洲人尝试过苯丙胺,大约2百万人在过去的一年使用过药物。要求对苯丙胺类为主的药物使用进行治疗的报道在大多数欧洲国家相对较少,主要在瑞典(34%),芬兰(23%),拉脱维亚(16%)和葡萄牙(11%)占相当大的比例。另四个国家(比利时,丹麦,德国,荷兰)的比例在6%和10%之间,其他国家的比例小于3%。在娱乐场所的药物滥用可提供一个研究使用苯丙胺类和摇头丸等行为的窗口。在这些场所药物滥用的估计数据特别高,多数药物使用发生在周末和假日。安全俱乐部指南旨在减少药物相关问题的发生机会,包括免费提供冷水、快速急救和宣传预防措施。国家专家提供了在夜总会这些措施的实施情况。总的说来,欧洲夜生活场所仅采用有限的预防和减少健康风险和药物使用的简单措施。宣传预防工作在19个国家中的少数夜总会开展。苯丙胺类的使用者通常在门诊药物服务机构获得治疗。在苯丙胺使用历史较为严重的国家中这样的门诊药物服务专门治疗这种类型的药物问题。大多数问题苯丙胺使用者可以在精神诊所或医院接受住院治疗。本文将介绍预防和治疗的方案。     

The effects of perceived parenting style on the propensity for illicit drug use: the importance of parental warmth and control

Introduction and Aims . Research in adolescents has shown that parental warmth and control are important factors in drug use. The present study focused upon investigating perceived parental warmth and control in a sample of post‐adolescent ecstasy/polydrug users, and investigating their relationship to severity of drug use. Design and Methods . A total of 128 (65 male) ecstasy/polydrug users, 51 (17 male), cannabis‐only users and 54 (13 male) non‐users were recruited from a university population. All participants completed the parenting styles and drug use questionnaires. Results . Compared to non‐users, a greater proportion of ecstasy/polydrug users characterised their parents' style as neglectful. The modal style endorsed by non‐users was authoritative. Those who rated their parents' style as authoritative had significantly lower lifetime consumption and average dose of ecstasy relative to those describing their parents as neglectful. Again, relative to those describing their parents as neglectful, participants from authoritarian backgrounds had significantly smaller lifetime consumption of ecstasy and cocaine and significantly smaller average doses of cannabis, ecstasy and cocaine. Contrary to expectation, there was no significant association between perceived parental warmth and the severity of ecstasy use. Discussion and Conclusions . The present study is, to our knowledge, the first to quantify drug use, and relate it to perceived parental practices in a post‐adolescent sample of ecstasy/polydrug users. The results provide further support for the relationship between perceived parental control and drug use.     

The use of buprenorphine and temazepam by drug injectors

There has been concern over the growing misuse of buprenorphine and temazepam in Scotland. In interviews with 78 clients of Glasgow drug agencies during 1989-1990, it was found that buprenorphine and temazepam are now more widely and frequently misused than heroin or other opiates. Fifty-eight percent of buprenorphine users used six to seven days weekly. Fewer users of other drugs used as frequently. Heroin, other opiates and temazepam were associated with criminality. Buprenorphine, perhaps because it is relatively inexpensive, was not associated with criminality. Implications for drug policy and treatment are discussed.