Polydrug use among 15- to 16-year olds: Similarities and differences in Europe

Abstract

Aims: We describe types of polydrug use among school students across Europe and explore differences between high, medium and low drug prevalence countries.

Method: Analysis is based on survey data from over 70,000 15- to 16-year-old school students in 22 European countries. Polydrug use (defined as the use of two or more listed substances during the last 30 days) is compared across three country clusters based on drug prevalences by hierarchical cluster analysis. Affinity between substances is measured by pairwise associations and regression analysis was used to assess the differences in rate ratio across the country clusters.

Results: A third of all school students had consumed two or more substances. The most common combinations were: alcohol and cigarettes, followed by alcohol or cigarettes combined with cannabis, followed by alcohol or cigarettes, cannabis and at least one other illegal drug. Pairwise associations show that cannabis and cocaine users are more likely to use illegal drugs than the general student populations but least likely to do so in countries with high prevalence levels (p < 0.0005).

Conclusion: Consideration of country differences and objective measures for the concept of normalization could help to inform more holistic prevention initiatives that respond to country-specific contexts.

Notes

Notes

[1] Illegal drugs refer to psychoactive substances, which are subject to special drug legislation to control their use, possession or trade.

[2] Parker et al. (1998, p. 151) describe normalization of drug use as a situation in which ‘mainstream youth culture assimilated and legitimated recreational drug use’.

[3] Turkey is a candidate for EU membership. In Turkey, figures are based on one major city in each of six different regions (Adana, Ankara, Diyarbakir, Istanbul, Izmir and Samsun).

[4] Croatia is a candidate for EU membership.

[5] ESPAD 2003 figures for Germany are based in six regions only (Bavaria, Brandenburg, Berlin, Hesse, Mecklenburg-Western Pomerania and Thuringia).

[6] The ESPAD question is: How often does the statement ‘My parents know where I am in the evenings’ apply to you? Always, Often, Sometimes, Usually not.

[7] The ESPAD question is: How well off is your family compared to other families in your country? Very much better off, Much better off, Better off, About the same, Less well off, Much less well off, Very much less well off.

[8] The ESPAD question is: During the LAST 30 DAYS how many whole days of school have you missed because you skipped or ‘cut’? None, 1 day, 2 days, 3–4 days, 5–6 days 7 or more days.

[9] Referred to in the ESPAD questionnaire as ‘inhalants’, which includes products such as butane gas lighter refills and contact adhesives.

[10] Referred to in the ESPAD questionnaire as ‘tranquillisers or sedatives’ with or without a doctor's prescription.