The Global Drug Survey What s next in drug use?

Transcription

1 The Global Drug Survey What s next in drug use? Dr. Larissa J. Maier & Dr. Adam R. Winstock KABS VIDEN STOFMISBRUG 2017, March 14 th 15 th, Vejle

2 OVERVIEW Part I Part II What is Global Drug Survey (GDS) and why do hundreds of thousands people bother helping us? What have we learned from GDS about substance use behavior across the world and specifically in Denmark?

3 One of the things our grandchildren will find quaintest about us is that we distinguish the digital from the real, the virtual from the real. William Gibson 3

4 GDS aims to make drug use safer regardless of the legal status of the drugs by sharing information with individuals, communities, health and policy organisations and government.

5 BACKGROUND Global Drug Survey languages 22 media partners and > 40 countries Drug Screen > 150 substances Frequency of use & usual amount used Price, source of supply, emergency visits Intention to reduce use +/- help NEW: Psychedelics, cannabis regulation, medical cannabis use, vaping, cognitive enhancement, encountering police 5

6 PREVIEW GDS2017 DENMARK > 14,000

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10 BACKGROUND Peer-reviewed publications 1. Winstock A, Lynskey M, Borschmann R, Waldron J Risk of seeking emergency medical treatment following consumption of cannabis or synthetic cannabinoids in a large global sample. J Psychopharmacology Freeman TP, Winstock Examining the profile of high potency cannabis and its associations with severity of dependence Psychol Medicine Shiner M, Winstock A. Drug use and social control: The negotiation of moral ambivalence. Soc Sci Med Uosukainen, Hanna, Ulrich Tacke, and Adam R. Winstock. "Self-reported prevalence of dependence of MDMA compared to cocaine, mephedrone and ketamine among a sample of recreational poly-drug users." International Journal of Drug Policy Winstock, Adam. "Cannabis regulation: the need to develop guidelines on use. British Medical Journal 348 (2014). 6. Lawn W, Borschmann R, Williams M, Winstock AR The NBOMe hallucinogenic drug series: patterns of use, characteristics of users and self reported effects from large international sample. J Psychopharmacology Winstock AR, Borschmann R, Bell, J. The non-medical use of tramadol in the UK: findings from a large community sample International Journal of Clinical Practice Winstock AR, Kaar S, Borschmann R Dimethyltryptamine (DMT): prevalence, user characteristics and abuse liability. J Psychopharmacology Barratt MJ, Ferris JA, Winstock AR The use of the Silk road, the online drug market place, in the UK, Australia and the USA. Addiction Winstock AR, Barratt MJ Synthetic cannabis comparison of patterns of use an effect profiles with natural cannabis Drug and Alcohol Dependence

11 BACKGROUND GDS data are used to create health apps 11

12 BACKGROUND Drinksmeter.com 12

13 BACKGROUND We run the world s largest drug survey GDS ,500 GDS ,000 GDS ,000 GDS ,000 GDS ,000 GDS ,

14 BACKGROUND GDS Core Team + Senior Academic Mentor Group + Scientific Advisory Group + International Network 14

15 BACKGROUND Strengths and limitations of the GDS Acceptance among recreational drug users ( HH surveys) Data triangulation (e.g., seizures, wastewater, drug checking) Profile new drugs quickly (e.g., Mephedrone, DMT, 1P-LSD) Identify regional differences Real time research Independent Not representative Mostly well-educated young adults 15

16 GDS2014/2015/2016 Danish GDS participants GDS2014 = % 88.5% 52.8% GDS2015 = % 84.6% 57.6% GDS2016 = % 77.4% 58.3% < 8% without any exercise 3% 1% < 13% clubbing at least 1x/week Ca. 27% daily tobacco users 7% 10% 5% Bornholm Fyn Hovedstaden Midtjylland < 8% daily cannabis users 17% 57% Nordjylland Sjaelland < 4% daily alcohol Syddanmark Ca. 20% no illegal drugs last year 16

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19 GDS2016 MDMA (ecstasy) & cocaine Return of high-quality MDMA since % of Danish people who use pills take 1-2x/year 22.5% of Danish people who use pills take 1x/2months MDMA powder is more prevalent < 6% weekly cocaine use 13 lines per gram cocaine 36.0% would like to use less next year Only 2 people (6.3%) aim to seek help 19

20 GDS2014/2015/ month illegal drug use Denmark % GDS2014 GDS2016 GDS2017 Cannabis MDMA pills MDMA powder Cocaine Amphetamine Psilocybin LSD Ketamine 20

21 GDS2016 Synthetic cannabinoids last 12 months 3.6% 3.2% 2.5% 2.3% 2.1% 70% joint with tobacco 24% bong/water pipe 3% vaporiser 2% vape pen 1% orally 1.7% 1.6% 1.5% 1.4% 1.3% 1.3% 1.3% 1.1% 1.1% 1.0% DK 0,7% 0.9% 0.8% 0.6% 0.6% 0.5% 0.5% 0.4% 21

22 GDS2015/2016 NPS use in the last 12 months Impact NPS ban? , GDS2016 % last 12 months GDS2015 % last 12 months DK 4,5% , ,3 1,0 >10% 22

23 3% Cannabis synth. cannabis 10% Cocaine synth. stimulant 11% Psilocybin synth. hallucinogen 16% MDMA synth. variant 23

24 GDS2016 Have you bought drugs off the darknet? In 2015, 6.7% reported darknet use (+2.7% longer ago) Yes (not within last 12 months) Yes (in last 12 months) 24

25 GDS2014/2015/2016 Darknet market use last 12 months Portugal Denmark Sweden 25

26 GDS2015/2016 Drugs bought on the darknet [N=7,310] In 2016, 63% reported accessing more than one drug type

27 Streetwork Zurich & DIB Bern (2017)

28 GDS2016 Emergency medical treatment 6 Global Male Female EMT with any substance 2,1% Synthetic cannabinoids n = 1.5K Any NPS Cannabis Alcohol MDMA/Ecstacy Cocaine Ketamine n = 4K n = 47K n = 90K n = 30K n = 20K n = 6K 28

29 GDS & DENMARK DK summary GDS Danish GDS participants use more MDMA powder than pills and snort it. Polydrug use is common among young recreational drug users. Psilocybin is the psychedelic of choice 1/10 used the darknet, mainly to buy MDMA, cannabis and NPS. Global Drug Survey findings support the risk assessment of new drugs. 29

30 CONCLUSIONS Triangulation: data from multiple sources 30

31 Jani Leinonen, ARoS Art Museum, Aarhus

32 Identity development during adolescence is a big challenge for youth Knuthenborg Safaripark, Maribo

33 throughout the lifespan, most people learn how to cope with stress, how to get a thick skin Knuthenborg Safaripark, Maribo

34 and well, sometimes people feel blue what can be one of many reasons for substance use Your Rainbow Panorama, ARoS Art Museum, Aarhus

35 but there is always light at the end of the path; problems disappear and new insights are gained Your Rainbow Panorama, ARoS Art Museum, Aarhus

36 however, everyone needs to relax without being afraid of the time recovery might take Moens Klint, Insel Moen

37 so, we just always need to know and be honest about where our home is to find peace Slot Egeskov

38 Copenhagen and even when living in a lively city with no time to rest, we should take a little time to reflect

39 to improve our (health) behavior as well as our understanding of local markets and policies

40 Insel Mandø, Jütland to finally be aware that we have to stand together to provide support for those in need.

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