Drug use changes at the individual level : Results from a longitudinal, multisite survey in young europeans frequenting the nightlife scene

Background: Monitoring emerging trends in the increasingly dynamic European drug market is vital; however, information on change at the individual level is scarce. In the current study, we investigated changes in drug use over 12 months in European nightlife attendees. Method: In this longitudinal online survey, changes in substances used, use frequency in continued users, and relative initiation of use at follow-up were assessed for 20 different substances. To take part, participants had to be aged 18–34 years; be from Belgium, Italy, the Netherlands, Sweden, or the UK; and have attended at least 6 electronic music events in the past 12 months at baseline. Of 8,045 volunteers at baseline, 2,897 completed the survey at both time points (36% follow-up rate), in 2017 and 2018. Results: The number of people using ketamine increased by 21% (p < 0.001), and logarithmized frequency of use in those continuing use increased by 15% (p < 0.001; 95% CI: 0.07–0.23). 4-Fluoroamphetamine use decreased by 27% (p < 0.001), and logarithmized frequency of use in continuing users decreased by 15% (p < 0.001, 95% CI: −0.48 to −0.23). The drugs with the greatest proportion of relative initiation at follow-up were synthetic cannabinoids (73%, N = 30), mephedrone (44%, N = 18), alkyl nitrites (42%, N = 147), synthetic dissociatives (41%, N = 15), and prescription opioids (40%, N = 48). Conclusions: In this European nightlife sample, ketamine was found to have the biggest increase in the past 12 months, which occurred alongside an increase in frequency of use in continuing users. The patterns of uptake and discontinuation of alkyl nitrates, novel psychoactive substances, and prescription opioids provide new information that has not been captured by existing cross-sectional surveys. These findings demonstrate the importance of longitudinal assessments of drug use and highlight the dynamic nature of the European drug landscape

A practice-based perspective on the new legislation by prevention workers and health promoters

Introduction How do professional actors working with the changed Belgian law on alcohol consider the influence of this framework on their work? A qualitative method was used to take into consideration the views and opinions of prevention and health promotion professionals and key persons concerning the 2009 law, which fixes the minimum age limit for the use of beers and wine on 16 and for liquor on 18 years old. Methodology Eight Nominal Groups were organized according to the Nominal Group Technique (NGT). This NGT consists of five phases and combines quantitative and qualitative data collection methods and also yields data that can be analysed quantitatively and qualitatively (Vander Laenen, 2015). Qualitatively, a content analysis of the individual items was carried out. This enables themes to be constructed out of the individual items. Moreover, the ‘discussion’ sections of the procedure were analysed with a focus on statements regarding policy recommendations. The quantitative analysis provides priority to the opinions on the new legislation. The central question was: In your profession, which advantages and disadvantages of the current Belgian alcohol legislation do you consider? Results The NGT provided practice based policy recommendations with regard to compliancy and enforcement, the legislative distinction between types of alcohol and age limits, communication, raising awareness, prevention and marketing and promotion. Conclusions The legal framework is insufficient to change moral standards towards alcohol, as it puts focus on younger age groups while the highest consumption is seen in older groups. The law is more stringent than societal attitudes. The focus must lie on attitude modification towards alcohol consumption

Substance Use and Attendance Motives of Electronic Dance Music (EDM) Event Attendees: A Survey Study

EDM event attendees are a high-risk population for substance use and associated adverse effects. The aim of this study was to examine substance use at EDM events, focusing on associations between attendance motives and substance use. Sociodemographic characteristics, event specifics, past-year use, and attendance motives were assessed through an online survey. Participants were 1345 Belgian EDM event attendees (69.44% male, Mage = 22.63, SDage = 4.03). Ecstasy/MDMA/Molly (52.28%), other synthetic hallucinogens (53.68%), ketamine (42.13%), amphetamines (40.45%), and alkyl nitrites (poppers) (32.76%) were most frequently used at festivals/outdoor parties/raves. In nightclubs, cocaine (32.29%) was shown to be prevalent as well, while other synthetic hallucinogens (15.79%) were less often consumed. At events with a more private character, cannabis (68.88%) and magic mushrooms (66.44%) were most frequently used. Aside from alcohol (47.76%), substance use in pubs/bars was negligible. Overall enjoyment was demonstrated to be the key attendance motive, which was succeeded by those relating to music and socialization. A wide range of motives proved to be more important to users (e.g., dance, exploration, escapism, excitement, alcohol, drugs) than non-users, while some were associated with the use of particular substances. The prevalence of substance use was shown to be dependent on the specifics of the setting. Moreover, the idea of a three-dimensional classification of the most principal motives for music event attendance was supported. Finally, correlations were estimated between attendance motives and substance use as well as specific substances. Results could enable more tailored approaches in prevention and harm reduction efforts as well as event management strategies

The law of 2009 concerning the selling and serving of alcohol to youths: from state of the art to assessment

Alcohol consumption is a widely discussed topic in the field of health issues in the world. Delaying the onset of drinking should be a key issue in alcohol prevention (WHO, 2014b) . Although age limits on the use of alcohol exist throughout Europe, alcohol use by youngsters of 15 and 16 years of age is common (Mulder & De Greeff, 2013a). Also in Belgium, where the minimum age limit for the use of alcohol is 16, it is clear that the majority of less than 16 year olds already drank alcohol in their life (Melis, Rosiers, & Geirnaert, 2014). Indeed, a recent study related to alcohol use among adolescents in Europe (Steketee, Jonkman, Berten, & Vettenburg, 2013) showed, from a sample size of 33.566 students from 25 countries (from 11 to 18 years old, x age= 13,90), that overall lifetime prevalence rate for beer, wine and breezers was 60,1% and 34,2% for spirits. Similar data were found in Belgium by the CRIOC study (2010) including 2.519 youths (from 10 to 17 years olds) where 65% of them had already drunk alcohol and 28% drank at least one glass of alcohol every week. Many factors may contribute to these high figures of underage alcohol consumption, but easy access to alcohol is generally assumed to play a significant role (Gosselt et al., 2007). Availability can be influenced by national policies that restrict supply and availability; such seems to be a proven effective policy (Babor et al., 2010). One of the possible measures taken by a government to reduce availability is establishing a minimum legal drinking age which has been a proven effective national health policy measure (Achterberg, 2011). Therefore, the legislation in Belgium was adapted in 2009. However, a newly introduced alcohol policy relies on retailers’ willingness to refuse to sell alcohol to underage customers. Before they are willing to comply, their knowledge of the new legislation is key. Indeed, another study of CRIOC (2009) including 160 sellers and shops showed that underage youths, using the mystery shopping method, obtained alcohol in 8 out of 10 selling points. Some possible reasons of non-compliance have been suggested but have not been clearly examined (e.g. motivational, psychological, economic, educational reasons) (Centre de Recherche et d'Information des, 2010; Kuendig et al., 2008). Finally, legal age restrictions without enforcement at different levels (federal, regional and local) are not sufficient (Gosselt, van Hoof, de Jong, & Prinsen, 2007) and so different levels (federal, regional and local) should pay attention to enforcement. The effect of enforcement is considered to be twofold: it influences the direct availability of alcohol and it influences the societal norms, attitudes and beliefs in society (Mulder & De Greeff, 2013a)(Wagenaar, 2011 in Mulder & de Greef, 2013). So far, the Belgian alcohol law from 2009, has not been evaluated. Therefore, the aim of this project is sixfold. WP 1. A critical analysis of relevant indicators of the new law of 2009 on drinking age limits which influence the behaviour of young people. Views on enforcement. WP 2. Evaluate empirically the impact of the alcohol law from 2009 on alcohol availability and consumption. WP 3. Evaluate the knowledge of sellers and young people regarding the 2009 law. WP 4. Feasibility study on test purchasing research (“mystery shopping”) WP 5. A practice-based perspective on the 2009 legislation by prevention workers and health promoters WP6: General conclusions and policy recommendation

How do online and offline sampling compare in a multinational study of drug use and nightlife behaviour?

Background: Online sampling is widely used to recruit hard to reach samples such as drug users at nightlife events. We conducted the first study comparing differences in demographics, drug use and nightlife behaviour between an online sample of young adults engaging with the European nightlife scene, and an offline sample recruited at nightclubs and festivals in Europe. Methods: Online participants who attended at least six nightlife events in the past 12 months were recruited using social media advertising (May-November 2017). Offline participants were recruited at nightclubs and festivals using a random intercept method (May-November 2017). Samples were compared with respect to age, gender, past year use of alcohol, cannabis, cocaine, ecstasy/MDMA and amphetamines, and past year attendance at nightclubs, licensed festivals, illegal festivals, pubs and house-parties. Results: 6153 online and 3529 offline participants were recruited. When adjusting for differences in age and gender, online participants were less likely to have used each drug and to have attended illegal festivals, pubs and house-parties in the past 12 months. The online sample also used each drug and attended each venue, with the exception of nightclubs, less frequently on average than offline participants. Adjusted odds ratios (range 0.37 to 1.39) and regression coefficients (range-0.84 to 0.07) indicate that the majority of observed differences between the samples were of a small effect size. Conclusions: Estimates of drug use and nightlife engagement are more conservative when using online sampling compared to venue based sampling. Observed differences were generally small in effect, indicating good overall representativeness when using online sampling in the European nightlife scene