COLOMBIAN GDS SAMPLE : SAMPLE CHARACTERISTICS N = > 1400

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1 COLOMBIAN GDS SAMPLE : SAMPLE CHARACTERISTICS N = > 1400 PREPARED BY THE GDS CORE RESEARCH TEAM Prof. Adam R. Winstock, Dr. Monica J. Barratt, Dr. Larissa J. Maier, & Ass. Prof. Jason A. Ferris

2 THIS REPORT IS EMBARGOED UNTIL: MAY 9TH AM AUSTRALIAN CENTRAL TIME USING AND REPORTING THE DATA InallcopyrelatedtothedataprovidedthestudyshouldbereferredtoasGlobalDrugSurvey2018conductedinpartnershipwithglobalmedia partners including yours. No part of this report is to be shared with any other organization, including other news agencies, health services, or government departments. Please forward any request for further information including access to data reports to:

3 GLOBAL DRUG SURVEY 2018 MISSION Data from 130,00 people from over 40 countries was used in the preparation of this report. GDS is an independent research organisation that conducts university ethics approved, anonymous web surveys in collaboration with global media partners who act as hubs to promote our survey and our findings. GDS is comprised of experts from the fields of medicine, toxicology, public health, psychology, chemistry, policy, criminology, sociology, harm reduction, and addiction. We research key issues of relevance and importance to both people who use drugs and those who craft public health and drug policy. We aim to make drug use safer regardless of the legal status of the drugs by sharing information in a credible and meaningful way. Our last 4 surveys, run at the end of 2014, 2015, 2016 and 2017 have each received over 100,000 responses. To date over 550,000 people have taken part in our annual surveys. Over the last 7 years GDS has successfully supported the widespread dissemination of essential information both to people who use drugs -through our media partners, and to the medical profession through presentations at international conferences, expert advisory meetings and the online resources Over 50 academic papers have been generated using the data from our survey.

4 Overthelast5yearsmorethanhalfamillionpeoplehavetakenpartinoursurveys. GDS2018 was translated into 19 languages. GDS2019 launches in November 2018 and we hope to expand our reach and be available in over 20 languages. If you would like your country or organisation to be part of GDS2019 please contact us at We are especially keen to expand into Africa,SEAsiaandtheMiddleEast.

5 GDS METHODS & ACADEMIC CREDITS GDS uses encrypted anonymous online surveys to get to the truth about the use of drugs around the world. We are self-funded and free to explore positive aspects of drug use in addition to drug related harms. Our work aims to support crafting effective public health policy that optimises the health and well-being of people who use drugs and the wider community. Participation is voluntary. Our survey is not a general population survey and should not be used to determine the prevalence of drug use within a population. Recent work by GDS suggests that the age and sex distribution of those who volunteer to be surveyed is not vastly different between these non-probability and probability methods. We conclude that opt-in web surveys of hard-to-reach populations are an efficient way of gaining indepth understandings of stigmatized behaviours among hidden populations, and are appropriate, as long as they are not used to estimate drug use prevalence of the general population Barratt et al Our work is increasingly recognised as a legitimate data source to better understand drug use and its impact on health around the world. GDS is comprised of the Core Research Team and an international partnership with researchers and harm reduction organisations in over 30 countries. Probability based surveys tell you about the size of the drug use problem in your country; GDS tells you what to do about it. Prof. Adam Winstock

6 MORE INFORMATION ON OUR METHODS Our recruitment strategy is an example of non-purposive sampling. We acknowledge that this has significant limitations, most notably with respect to response bias. It is more likely that individuals will respond to surveys if they see topics or items that are of interest to them, and thus by definition will differ from those who do not participate. Don t look to GDS for national estimates. GDS is designed to answer comparison questions that are not dependent on probability samples. The GDS sample is thus most effectively used to compare population segments, young, old, males, females, gay, straight, clubbers, thin people, obese people, vegetarians, those with a current psychiatric diagnosis, students, etc.given that GDS recruits younger, more involved drug using populations we are able to spot emerging drug trends before they enter into the general population. GDS complements existing drug use information and provides essential, current data on the patterns of use, harms, health and well-being experienced by the drug users in your country. THE FOUNDER AND CEO OF GDS IS PROFESSOR ADAM R WINSTOCK MD Adam is a Consultant Addiction Psychiatrist and academic researcher based in London. The views presented here are entirely his own and have no relationship to those of his current employers or affiliate academic organizations. No government, regulatory authority, corporate organization or advocacy group has influenced the design of the survey or content of report. LIMITATIONS This is not a nationally representative sample, but it does represent one of the largest studies of drug use ever conducted. The findings can inform policy, health service development and most importantly provide people who drink, smoke and/or take other drugswith practical advise on how to keep healthy and minimize the harms associated with the use of psychoactive substances. Stories are based on preliminary findings and are subject to change on further analyses. LIMITATIONS WITH CROSS-COUNTRY COMPARISONS Throughout this report we provide some comparisons on some key areas that may be of interest to readers of your publications. Because the samples we have obtained from different countries vary considerably in the size, its representativeness, the precise demographics and other characteristics of respondents such as age, gender, involvement in clubbing and drug use, these comparisons have to be treated with some caution. The results do not necessary represent the wider drug using community. Saying that if you ask a 100 people in a country how much a drug costs or a group of 50,000 people who had used cannabis last year how often they sought emergency medical help you can t dismiss the findings as irrelevant and inconsistent with more representative samples. For countries with small numbers the findings need to be treated with more caution. For a full review and critique of or methods please see Barratt M, Ferris JA, ZadhowR, PalamarJ, Maier LJ, & Winstock AR. Moving on from representativeness: testing the utility of the Global Drug Survey. Substance Abuse: Research and Treatment; 11: Epub. Further detailed reports for each country are available on request for a small fee.

7 WHAT GDS WILL DO FOR YOU WHAT GDS WON T DO FOR YOU GDS is an efficient approach to gain content rich data that explores diverse health outcomes associated with the use of alcohol and other drugs across the population of your country. GDS helps you understand quantitative dynamics of personal decision-making about drug use, detects regional differences in patterns of drug use and related harm, and informs novel interventions. Provides current data on the patterns of use, harms, health and well-being experienced by the full spectrum of users. Provides data on new drug trends and crucial public health and policy issues Don t look to GDS for national estimates, GDS is designed to answer comparison questions that are not dependent on probability samples Be aware that GDS recruits young, well-educated, and more involved drug using populations The GDS database is huge but its non-probability sample means analyses are suited to highlight differences among user populations. We conclude that opt-in web surveys of hard-to-reach populations are an efficient way of gaining in-depth understanding of stigmatised behaviours and are appropriate, as long as they are not used to estimate drug use prevalence of the general population Barratt el al 2017

8 SHARING OUR FINDINGS WITH PEOPLE EVERYWHERE To ensure our findings are accessible and useful to people who use drugs we offer a range of free harm reduction resources such as : the GDS Highway Code the Safer Use Limits digital health apps to deliver brief screening and intervention: harm reduction and drug education videos available on our YouTube channel When reporting the results in print, online and on TV we ask all our media partners to place links to these free resources where suitable.

9 KEY FINDINGS DEMOGRAPHICS & RECENT DRUG USE EXPERIENCES OF GDS2018 þ Participation by country, age and gender þ Last 12 month experience legal & illegal drugs of entire global GDS2018 sample þ Age: mean age and % in different age categories of global GDS2018 sample þ Gender: male vs. female (1% who indicated they were transgender were removed for these analyses) þ Sexual orientation þ Ethnicity þ Educational attainment þ Employment/ studying þ Who they live with

10 TOTAL NUMBER WITH 100+ RESPONDENTS NO OF COUNTRIES: 44

11 Germany Denmark Poland United States Switzerland Austria Slovakia England Netherlands Israel New Zealand Hungary Australia Balkans Italy Brazil Canada Colombia Finland Scotland Czech Republic Belgium France Sweden Russian Federation Ireland Mexico Spain Norway Portugal Turkey South Africa Ukraine 10K 5K 0K 7,353 5,756 5,683 3,881 3,726 3,675 3,423 3,345 3,223 2,674 2,549 2,089 2,078 1,916 1,535 1,439 1,339 1, K 15,008 20K No of Respondents 25K 30K 35K 40K 45K 48,543 50K GDS2018: WHO TOOK PART AND WHERE WERE THEY FROM? (N) Luxembourg 194 Argentina 127 Chile 110 Estonia 107 Georgia 106 Wales 96

12 Germany Denmark Poland United States Switzerland Austria Slovakia England Netherlands Israel New Zealand Hungary Australia Balkans Italy Brazil Canada Colombia Finland Scotland Czech Republic Belgium France Sweden Russian Federation Ireland Mexico Spain Norway Portugal Turkey South Africa Ukraine Luxembourg 5% 0% 5.8% 4.5% 4.5% 3.0% 2.9% 2.9% 2.7% 2.6% 2.5% 2.1% 2.0% 1.6% 1.6% 1.5% 1.2% 1.1% 1.0% 1.0% 0.8% 0.6% 0.5% 0.4% 0.4% 0.4% 0.3% 0.3% 0.3% 0.3% 0.2% 0.2% 0.2% 0.2% 10% 11.8% 15% % of Total No. of Respondents 30% 25% 20% 35% 40% 38.0% 45% 50% GDS2018: WHO TOOK PART AND WHERE WERE THEY FROM? (%) Argentina 0.1% Chile 0.1% Estonia 0.1% Georgia 0.1% Wales 0.1%

13 MEAN AGE OF SAMPLES BY COUNTRY

14 OVERALL BREAKDOWN BY AGE AND GENDER OF GDS2018 SAMPLE Norway Poland Portugal Russian Federation Scotland Slovakia South Africa Spain Argentina Australia Austria Balkans Belgium Brazil Canada Chile Colombia Czech Republic Denmark England Estonia Finland France Georgia Germany Global Hungary Ireland Israel Italy Luxembourg Mexico Netherlands New Zealand Sweden Switzerland Turkey Ukraine United States Wales Var1Factors Female 25 + Female <25 Male 25 + Male < % of Respondents

15 DEMOGRAPHICS (AGE & GENDER): ENTIRE GDS2018 SAMPLE VS COLOMBIAN SAMPLE GENDER (%) AGE RANGE (%) AGE & GENDER (%)

16 DEMOGRAPHICS (ETHNICITY EDUCATION EMPLOYMENT): ENTIRE GDS2018 SAMPLE VS COLOMBIAN SAMPLE ETHNICITY(%) EMPLOYMENT(%)

17 DEMOGRAPHICS (EDUCATIONAL ATTAINMENT & INVOLVEMENT) ENTIRE GDS2018 SAMPLE VS COLOMBIAN SAMPLE EDUCATIONAL STATUS (%) EDUCATIONAL ATTAINMENT (%)

18 DEMOGRAPHICS (CLUBBING INVOLVEMENT) ENTIRE GDS2018 SAMPLE VS COLOMBIAN SAMPLE FREQUENCY OF CLUBBING(% )

19 OVERALL EXPERIENCE : LEGAL DRUGS, ILLEGAL DRUGS & INJECTING ENTIRE GLOBAL GDS2018 VS COLOMBIAN SAMPLE

20 LIFETIME DRUG USE AMONG THE COLOMBIAN GDS2018 SAMPLE n = > 1400

21 12 MONTH DRUG USE AMONG THE COLOMBIAN GDS2018 SAMPLE n = > 1400

22 COUNTRY COMPARISON: % OF PARTICIPANTS REPORTING USE OF LEGAL & ILLEGAL DRUGS LAST 12 MONTHS n= Finland United States Australia 20.5% 70 Wales Canada Czech Republic Scotland Italy Ireland Estonia the times where Drug contained the drug I suspected plus at least one other (psychoactive) 7.8% Drug contained only a different substance to what I suspected 3.0% Drug contained only a non-psychoactive substance 2.4% Results were not conclusive % of people who have consumed illegal drugs Argentina Georgia Colombia Brazil Mexico Israel Sweden Belgium Norway Chile Spain Ukraine France Portugal Slovakia Balkans Average Hungary Russian Federation Switzerland Denmark 45 Germany 40 Luxembourg 35 New Zealand Turkey % of people who have consumed legal drugs

23 GLOBAL GDS2018 SAMPLE SEEKING EMERGENCY MEDICAL TREATMENT

24 WHY LOOK AT RATES OF SEEKING EMERGENCY MEDICAL TREATMENT? Seeking emergency medical treatment can be taken as a proxy measure for the acute harms experienced following the use of alcohol and other drugs Emergency medical attendance and admission also represent significant economic burden upon acute medical services While the press often highlights attendance at A+E departments as a frequent occurrence among those who drink and take drugs there is little date on the actual prevalence of such treatment seeking among people in the general population This year we asked last year users of the most commonly taken substances whether they had sought emergency medical treatment What this section covers Whether participants had needed to seek emergency medical treatment in the last 12 months as a result of using a number of drugs This section compares the percentages of those last year users of different drugs using the entire GDS2018 sample. This is the first time we have included rates for GHB and ketamine GDS ADVICE ON TAKING A NEW DRUG FOR THE FIRST TIME The biggest risk is starting off taking lots of an unknown drug before you know how long it takes to come on, peak and starting coming down so easy does it. Test drive it before putting your foot down. Wait for at least minutes before re-dosing Choose your time don t be coming down or experiment on the back of a bender Don t have anything else on board/including prescribed medications Don t be on your own Plan ahead before you re too off your head Make sure others know what you have taken and that at least one of them is not intoxicated If you feel unwell let someone you know and seek help Be in a safe place familiar First dose should be at least a quarter of what you think a tiny dose is (or a maximum quarter of a pill) Avoid taking other drugs/alcohol after dosing Don t drive/bath/play with knives Accept many drugs wont be very good/effective or nice

25 COMPARISON BY DRUG : SEEKING EMERGENCY MEDICAL TREATMENT (EMT) BY LAST YEAR USERS (GLOBAL SAMPLE) Female Male All % of Respondents % of Respondents % of Respondents % 2.9% 3.1% 4.8% 1.8% 2.7% 3.9% 2.0% 2.5% nps ghb methamp hetam 1.3% 2.3% 2.0% synthetic cannabis 3.2% 1.5% 1.9% ampheta m 3.5% 0.9% 1.5% mephedr one 1.2% 1.2% 1.3% 1.3% 0.8% 0.9% 1.0% 1.2% 0.8% 1.0% 0.9% 0.9% 0.7% 0.5% 0.6% 0.5% 0.4% 0.5% 0.3% 0.3% 0.3% alcohol lsd coca mdma ketam cannabis mushroo ms For the second year running, magic mushrooms seem to carry the lowest acute risk of harm of any drug. The ranking of 13 drugs looked at in GDS2018 were as follows 1. Novel Drugs 2. GHB 3. Methamphetamine 4. SCRAs 5. Amphetamine 6. Mephedrone 7. Alcohol 8. LSD 9. Cocaine 10. MDMA 11. Ketamine 12. Cannabis 13. Magic mushrooms

26 APPROXIMATE NUMBERs OF LAST YEAR USERS OF EACH DRUG THAT THE RATES OF SEEKING EMT WERE DRAWN FROM (GLOBAL SAMPLE) Approximate N of last year users All Male Female Alcohol >110,000 70,000 40,000 Cannabis >52,000 40,000 13,000 MDMA >21,000 15, Cocaine >15,000 10, LSD >10, Magic mushrooms > Amphetamine >10, Ketamine > GHB > Methamphetamine > NPS (new drugs) > Mephedrone > SCRAs (synthetic can) >

27 ALCOHOL GDS2018 SAMPLE : COLOMBIA 98.7% of the GDS2018 participants reported the use of alcohol lifetime 94.5% of the GDS2018 participants reported the use of alcohol last 12 months n= > 123,500 99% of COLOMBIANGDS2018 participants reported the use of alcohol, with 94.7% reporting drinking in the last 12 months Data from over >100,000 people was used to compile this report including >1400 from COLOMBIA

28 BACKGROUND GDS2018 has continued to map global drinking patterns using the Alcohol Use Disorders Identification Test (AUDIT),a World Health Organisation questionnaire to ascertain a score for harmful drinking levels and dependence. All AUDIT scores of 8 or higher indicate hazardous and harmful alcohol use. AUDIT scores ranging from 8-15 represent risky use causing some problems whereas scores of 16 and above represent harmful use causing lots of problems. AUDIT scores of 20 or above warrant further diagnostic evaluation for alcohol dependence. The higher the score, the larger not only the problems but also the need for treatment. Each year, about 1 in 3 GDS participants express a desire to drink less alcohol in the next 12 months. Digital health applications, media and lifestyle blogs help to raise awareness of the health harms associated with excessive drinking. The results of the GDS are, for example, also used to inform the online and smart phone app Drinks Meter This year, we were explored the potential influence of health warnings on alcohol labels on raising awareness and changing drinking behaviours.

29 KEY RESULTS IN THIS SECTION Drinking harms and adverse experiences þ The % in each AUDIT score category for each country total & by gender & by age (16-24y and 25y +) þ The % who reported feelings of regret or guilt at least monthly because of their drinking total & by gender & by age (16-24y and 25y +) þ The % who reported being unable to remember what happened the night before because of their drinking total & by gender & by age (16-24y and 25y +) Awareness of alcohol related health harms, personal relevance and potential to reduce drinking þ The % of last year drinkers for whom alcohol health label information was new to them total& by gender þ The % of last year drinkers who believed the health warning total& by gender þ The % of last year drinkers who perceived the health warning as personally relevant -total& by gender þ The % of all last year drinkers who reported that each message would get them to consider drinking less -total& by gender Who wants to drink less, who wants help and who sought emergency medical treatment? þ The % of last year drinkers who would like to drink less in the next 12 months þ The % of last year drinkers who would like help to reduce drinking þ The % of last year drinkers who sought emergency medical treatment total& by gender & by age

30 CATEGORICAL AUDIT (RISK OF HARM ALCOHOL SCORES) 70% Low Risk Increasing Risk Higher Risk Possible Dependence 70% Low Risk Increasing Risk Higher Risk Possible Dependence 60% 50% 49.0% 54.0% 60% 50% 56.6% 53.3% 54.5% 45.6% % of Respondents 40% 30% 40.0% 35.7% % of Respondents 40% 30% 41.7% 36.5% 34.3% 35.0% 20% 20% 10% 10% 6.7% 5.1% 5.5% 5.8% 6.1% 4.0% 4.7% 4.7% 5.9% 5.7% 5.1% 4.7% 0% 0% Female Male Female Male Female Male Female Male Female <25 Female 25 + Male <25 Male 25 + Female <25 Female 25 + Male <25 Male 25 + Female <25 Female 25 + Male <25 Male 25 + Female <25 Female 25 + Male <25 Male 25 +

31 GUILT, REGRET & MEMORY LOSS FOLLOWING ALCOHOL USE LAST 12 MONTHS 100% Do not feel guilt or regret at least monthly Do not report memory loss at least monthly Feel guilt or regret at least monthly Memory loss at least monthly 90% 90.3% 92.0% 91.5% 88.0% 84.3% 86.5% 83.9% 80% 79.4% 70% 60% 50% 40% 30% 20% 10% 0% Female <25 Female 25 + Male <25 Male 25 + Female <25 Female 25 + Male <25 Male 25 + Female <25 Female 25 + Male <25 Male 25 + Female <25 Female 25 + Male <25 Male 25 + % of Respondents 20.6% 15.7% 16.1% 13.5% 12.0% 9.7% 8.0% 8.5%

32 HEALTH WARNINGS ON ALCOHOL LABELS Alcohol is responsible for 4% of the world s global burden of diseases and is implicated in at least 60 health conditions, including those that kill us most often -cancer and heart disease. The alcohol industry is rather powerful and quite protective of things that might show alcohol in a poor light and dent profits. They don't like people to think of alcohol as a drug, though of course it is. Given the success of tobacco health warning labels in recent years GDS2018 was interested to see how they might work for alcohol. GDS2018 thus conducted the biggest study ever undertaken into exploring the potential impact of product health warning labels on people s awareness of alcohol health harms and the potential for them to influence peoples attitude and drinking behaviour. In collaboration with a group of public health and alcohol experts we created 7 different health warnings each addressing a different aspect of alcohol and health. The messages focused on harms to self and others and used a combination of positive and negative messaging to address the risks of excessive drinking as well as the benefits of drinking less. The 7 messages were provided in text form only with no supporting graphic. GDS HEALTH MESSAGES 1Heart disease is a major cause of death among people with heavy alcohol use. ALCOHOL = HEART 2 Even people with heavy alcohol use can reduce their risk of liver disease by cutting down by even a small amount. ALCOHOL = LIVER 3 Drinking less reduces your risk of 7 different sorts of cancer. ALCOHOL = CANCER 4A bottle of wine or 6 bottles of beer contain as many calories as a burger and fries. ALCOHOL = CALORIES 5 Experts recommend having at least 2 alcohol free days per week. This can help you reduce and control your drinking. ALCOHOL = 2 DAYS OFF 6 Most people get little or no health benefit from alcohol use, even at low levels of drinking. ALCOHOL = HEALTH MYTH 7 Alcohol use increases the risk of violence and abuse. ALCOHOL = VIOLENCE

33 ALCOHOL LABEL HEALTH WARNINGS COMPARED INFORMATION NEW TO THEM (by age and gender) 53.5% Female < % Male days off Calories Cancer Heart Liver Myth Violence Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female % Male < % Female % Female < % Male % Male <25 8.2% Female % Female < % Male % Male <25 100% 90% % of Respondents 80% 70% 60% 50% 40% 74.8% 69.4% 74.3% 69.8% 61.9% 63.2% 66.2% 69.4% 64.6% 68.1% 65.4% 70.5% 44.9% 39.6% 41.9% 45.3% 49.0% 30% 20% 10% 0%

34 ALCOHOL LABEL HEALTH WARNINGS COMPARED BELIEVE THE HEALTH WARNING INFORMATION (M+F combined) 13.0% No 50.4% Yes 21.4% Unsure 28.1% No Yes 1.6% 2 days off Calories Cancer Heart Liver Myth Violence Yes Unsure No Yes Unsure No Yes Unsure No Yes Unsure No Yes Unsure Unsure 4.0% No 100% 90% 94.3% 80% 70% 65.4% 66.5% 66.5% 69.5% 65.4% % of Respondents 60% 50% 40% 30% 20% 10% 19.4% 15.2% 20.9% 12.7% 21.5% 12.0% 23.1% 7.4% 21.6% 0%

35 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 0% 10% % of Respondents 100% 90% 80% 70% 60% 50% 40% 30% 20% 67.3% 66.0% 63.6% 64.7% 17.7% 20.1% 20.4% 19.4% 15.0% 13.9% 16.0% 15.8% 70.1% 65.3% 68.6% 61.9% 18.4% 18.8% 20.4% 25.9% 11.6% 16.0% 11.0% 12.2% 66.7% 61.8% 19.7% 23.6% 13.6% 14.6% 71.5% 19.1% 9.4% 66.2% 23.4% 10.4% 68.0% 21.1% 10.9% 68.1% 27.1% 72.0% 69.8% 20.9% 23.4% 7.1% 6.8% 72.8% 61.1% 15.6% 25.7% 11.6% 13.2% 68.6% 21.5% 9.9% 59.0% 23.7% 17.3% 57.1% 49.3% 48.2% 47.1% 19.0% 22.9% 21.5% 22.3% 23.8% 27.8% 30.4% 30.6% 96.6% 93.1% 95.5% 92.1% Yes Unsure No 2 days off Calories Cancer Heart Liver Myth Violence Answer ALCOHOL LABEL HEALTH WARNINGS COMPARED BELIEVE THE HEALTH WARNING INFORMATION (by age and gender)

36 Totally irrelevant Not very relevant Unsure A bit relevant Very relevant Totally irrelevant Not very relevant Unsure A bit relevant Very relevant Totally irrelevant Not very relevant Unsure A bit relevant Very relevant Totally irrelevant Not very relevant Unsure A bit relevant Very relevant Totally irrelevant Not very relevant Unsure A bit relevant Very relevant Totally irrelevant Not very relevant Unsure A bit relevant Very relevant Totally irrelevant Not very relevant Unsure A bit relevant Very relevant 0% % of Respondents 35% 30% 25% 20% 15% 10% 5% 18.4% 25.5% 13.5% 25.5% 17.1% 16.6% 24.9% 9.4% 29.2% 20.1% 5.5% 19.1% 13.1% 30.3% 32.0% 6.1% 27.6% 14.0% 32.1% 20.3% 8.6% 20.9% 15.1% 32.6% 22.8% 21.1% 26.5% 18.5% 21.4% 12.5% 6.6% 12.6% 5.9% 25.2% 40% 2 days off Calories Cancer Heart Liver Myth Violence 50% 45% 49.8% THE INFORMATION PRESENTED WAS PERCEIVED AS PERSONALLY RELEVANT (M+F combined)

37 0% 0% 0% 10% 10% 10% Yes Yes Yes Maybe Maybe Maybe Unsure 4.6% 4.6% Unsure 4.6% No No No Yes Yes Yes Maybe Maybe Maybe Unsure Unsure 3.6% 3.6% Unsure 3.6% No No No Yes Yes Yes Maybe Maybe Maybe Unsure Unsure 3.6% Unsure 3.6% 3.6% No No No Yes Yes Yes Maybe Maybe Maybe Unsure Unsure Unsure No No No Yes Yes Yes Maybe Maybe Maybe Unsure 5.2% Unsure Unsure 5.2% 5.2% No No No Yes Yes Yes Maybe Maybe Maybe Unsure 5.7% Unsure Unsure 5.7% 5.7% No No No Yes Yes Yes Maybe Maybe Maybe Unsure 1.4% Unsure Unsure 1.4% No 1.4% No No 20% 20% 20% 20.6% 20.6% 19.9% 19.9% %% of of Respondents % of Respondents 30% 30% 30% 40% 40% 40% 50% 50% 50% 21.4% 21.4% 20.0% 20.0% 34.1% 34.1% 34.1% 26.0% 26.0% 26.0% 36.3% 36.3% 36.3% 26.6% 26.6% 26.6% 14.7% 14.7% 14.7% 25.4% 25.4% 26.3% 26.3% 43.1% 43.1% 14.7% 14.7% 16.5% 16.5% 41.7% 41.7% 18.6% 18.6% 18.6% 38.2% 38.2% 38.2% 60% 60% 54.9% 54.9% 55.0% 55.0% 58.7% 58.7% 63.2% 63.2% 2 days 2 days off off Calories Cancer Heart Liver Myth Violence 70% 70% ALCOHOL HEALTH WARNINGS COMPARED WOULD IT MAKE YOU THINK ABOUT DRINKING LESS? (M+F combined)

38 ALCOHOL LABEL HEALTH WARNINGS COMPARED WOULD IT MAKE YOU THINK ABOUT DRINKING LESS? (by age and gender) 21.5% Female <25 2 days off Calories Cancer Heart Liver Myth Violence Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female 25 + Female <25 Male 25 + Male <25 Female % Male % Male < % Female % Female < % Male % Male < % Female % Female < % Male % Male <25 60% 50% % of Respondents 40% 30% 20% 23.8% 20.8% 19.9% 18.0% 29.9% 23.6% 18.3% 13.7% 37.4% 31.3% 33.2% 34.5% 25.9% 22.9% 27.7% 29.9% 27.9% 10% 0%

39 ALCOHOL LABEL HEALTH WARNINGS ON VIOLENCE WOULD IT MAKE YOU THINK ABOUT DRINKING LESS? (M+F combined) Only countries with n > 250 drinkerswere included in these graphs England Scotland Sweden Columbia Mexico Poland Brazil Russian Federation Italy Balkans Czech Republic Hungary Slovakia Belgium Portugal Republic of Ireland Finland France Israel USA Spain Australia Canada Netherlands Norway Austria Germany Denmark 10.8% New Zealand Switzerland % 18.0% 19.7% Violence % 37.6% 35.0% 16.5% 29.7% 27.1% 17.7% 21.4% 18.3% 22.5% 13.3% 18.9% 16.3% 21.6% 13.4% 18.6% 14.7% 13.8% 18.1% 17.3% 13.9% 17.3% 12.7% 15.0% 14.9% 16.2% 13.6% 19.3% 10.2% 18.3% 10.9% 18.5% 9.6% 15.9% 11.7% 14.4% 12.2% % 13.7% 13.3% 11.4% 12.2% 10.0% 10.2% 9.0% 11.5% 11.8% 11.5% 12.6% 10.6% 12.1% 11.9% 10.9% 8.4% 9.8% 8.4% Country Answer Maybe 60 Yes

40 ALCOHOL LABEL HEALTH WARNINGS ON CALORIES WOULD IT MAKE YOU THINK ABOUT DRINKING LESS? (M+F combined) Only countries with n > 250 drinkerswere included in these graphs 11.6% 17.6% USA 16.7% 11.5% Netherlands 15.3% 12.5% Poland 12.8% 14.0% Denmark 16.0% 10.2% Germany 11.6% 13.5% Israel 15.6% 9.4% Austria 13.9% 10.9% Country Mexico New Zealand Brazil Columbia Australia England Republic of Ireland Spain Canada Balkans Finland Russian Federation Italy Hungary Portugal France Czech Republic Belgium Scotland Slovakia Sweden 8.3% 14.6% Norway 14.1% 8.5% Switzerland Maybe Answer 40 Yes 35 Calories % 17.4% 18.1% 19.5% 14.8% 15.9% 19.3% 16.7% 13.8% 15.3% 16.7% 15.1% 17.4% 13.9% 15.0% 15.9% 14.7% 16.6% 14.8% 14.8% % 23.1% 21.6% 19.6% 23.1% 19.3% 14.1% 16.7% 18.6% 16.5% 14.9% 16.4% 14.0% 17.4% 15.6% 14.4% 15.2% 13.0% 14.8% 14.7% 0

41 Only countries with n > 250 drinkerswere included in these graphs Cancer Columbia Brazil Italy Spain Mexico Portugal Poland Russian Federation England Belgium France Canada New Zealand Czech Republic Australia USA Hungary Balkans Republic of Ireland Finland Netherlands Slovakia Germany Austria 34.00% 31.10% 24.40% 20.70% 24.80% 25.40% 21.40% 19.70% 22.00% 17.00% 19.40% 23.10% 22.50% 17.30% 22.10% 22.60% 21.60% 19.00% 18.60% 15.50% 12.90% 17.10% 12.30% 12.60% 26.60% 25.60% 28.00% 29.60% 25.20% 22.50% 26.40% 28.10% 24.70% 29.20% 26.50% 22.20% 22.00% 26.90% 22.00% 20.30% 20.50% 22.40% 22.50% 24.90% 26.90% 22.50% 25.80% 25.30% Sweden Israel Scotland Norway Switzerland Denmark 12.80% 17.40% 15.40% 15.70% 9.70% 12.10% 22.70% 17.50% 18.80% 16.10% 21.00% 17.70% Country 60 Yes Maybe Answer ALCOHOL LABEL HEALTH WARNINGS ON CANCER WOULD IT MAKE YOU THINK ABOUT DRINKING LESS? (M+F combined)

42 Only countries with n > 250 drinkerswere included in these graphs Israel Italy Colombia USA Balkans Russian Federation Hungary Austria Portugal Switzerland Germany Norway Canada Poland New Zealand Czech Republic Brazil Spain Sweden Slovakia France Mexico Netherlands England Ireland Australia Finland Belgium Denmark Scotland Male 16+ % of Respondents % 8.9% 10.4% 10.9% 11.2% 11.4% 12.1% 12.3% 12.3% 12.6% 12.7% 12.8% 13.4% 13.9% 14.0% 14.2% 14.6% 14.6% 15.0% 16.3% 16.7% 16.7% 17.7% 19.3% 20.0% 21.2% 21.6% 22.0% 26.8% 31.7% 0 50 Female 16+ % of Respondents % 12.0% 11.0% 10.0% 6.9% 8.4% 10.8% 7.0% 8.1% 9.9% 6.6% 12.8% 13.7% 15.5% 9.1% 13.4% 9.5% 8.0% 11.6% 12.8% 13.8% 14.5% 11.1% 17.5% 14.8% 18.9% 19.9% 9.5% 22.3% 16.7% COUNTRY COMPARISON OF RISKY ALCOHOL USE AUDIT 16+ (by gender)

43 COUNTRY COMPARISON OF VERY RISKY ALCOHOL USE & DEPENDENCE AUDIT 20+ (by gender) Only countries with n > 250 drinkerswere included in these graphs Italy Switzerland Portugal Spain USA Australia Ireland England Canada France Hungary Netherlands Austria Slovakia Male 20+ Belgium Denmark Scotland Finland Female % 5.4% 3.2% 2.2% 3.0% 5.1% 2.4% 3.0% 2.4% 5.3% 3.8% 4.4% 5.1% 8.1% 3.6% 3.7% 3.4% 3.4% 7.6% 5.3% 7.1% 7.7% 5.6% 8.3% 7.5% 9.9% 4.0% 11.3% 9.2% 10.9% Mexico Poland % Female Male % 3.5% 4.3% 4.5% 4.6% 4.7% 4.9% 5.0% 5.1% 5.2% 5.3% 5.8% 6.2% 6.2% 6.3% 6.7% 6.7% 7.1% 7.3% 7.5% 7.7% 7.9% 8.1% 9.1% 9.5% 10.1% 10.5% 11.6% 11.9% Israel 0 2 Israel Italy Russian Federation Spain Portugal Colombia Germany Balkans Austria USA Switzerland Hungary Norway Poland Sweden Brazil New Zealand Netherlands Czech Republic France Canada Mexico Slovakia Ireland England Australia Belgium Finland Denmark Scotland

44 COUNTRY COMPARISON ALCOHOL USE LAST 12 MONTHS WHO WOULD LIKE TO DRINK LESS AND WHO WANTS TO SEEK HELP? Only countries with n > 250 drinkerswere included in these graphs Israel Denmark Switzerland Netherlands Austria Italy Balkans USA Germany Belgium Poland % wanting to drink less Sweden Norway Czech Republic Russian Federation Canada Portugal Mexico Scotland UK New Zealand France Slovakia Spain Republic of Ireland Hungary Colombia Finland Finland Russian Federation Colombia Scotland Slovakia New Zealand Spain Brazil Mexico Czech Republic UK France Australia Canada Hungary Republic of Ireland Sweden Norway Portugal Balkans Italy Poland Germany USA Austria Belgium Netherlands Switzerland Denmark Israel % Drink Less Yes 49.2% 45.9% 43.4% 41.0% 40.8% 40.5% 39.8% 39.1% 38.8% 38.5% 38.3% 37.9% 37.8% 36.7% 35.4% 34.9% 34.4% 32.8% 32.2% 31.4% 30.9% 30.8% 29.9% 29.5% 28.9% 28.3% 25.7% 25.3% 23.6% 23.0% Of yes % wanting help % 20.2% 13.8% 13.5% 9.2% 11.7% 5.5% 4.5% 17.3% 20.7% 12.6% 9.9% 12.8% 15.3% 3.3% 4.5% 11.0% 9.3% 7.2% 12.9% 7.5% 4.2% 6.7% 11.4% 10.8% 2.8% 5.6% 6.0% 13.3% 14.5% % wanting help 0

45 EMERGENCY MEDICAL TREATMENT SOUGHT FOLLOWING ALCOHOL USE LAST 12 MONTHS (M+F combined) 5% I did seek EMT 4% % of Respondents 3% 2% 1.1% 1.2% 1.4% 1.3% 1% 0% Female <25 Female 25 + Male <25 Male 25 +

46 0.9% Spain 0.8% France 0.8% Germany COUNTRY COMPARISON : EMERGENCY MEDICAL TREATMENT SOUGHT FOLLOWING ALCOHOL USE LAST 12 MONTHS (M+F combined) % % of Respondents % 2.3% 2.2% 2.2% 2.1% 2.1% 1.9% 1.8% 1.8% 1.7% 1.6% 1.5% 1.5% 1.5% 1.4% 1.3% 1.3% 1.3% 1.1% % 1.0% 1.0% 0.9% 0.9% 0.9% 0.9% Scotland Norway Australia Finland USA England Russian Federation Republic of Ireland Brazil Poland Belgium Canada Czech Republic Hungary Portugal Denmark Colombia Israel Sweden Switzerland Italy Netherlands New Zealand Austria Balkans Mexico Slovakia Only countries with n > 250 drinkerswere included in these graphs

47 DRINKS METER - GET CONTROL OVER YOUR DRINKING Please refer your readers to our free, anonymous and confidential online tool the app DRINKS METER, recently rated as the most highly praised digital app to help people to reduce alcohol consumption. More than 90% recommended the app to their friends and more than 60% said they plan to actually plan to drink less after completion. It takes 8-10 minutes and it can change a person s life. Why not translate this into Spanish?

48 CANNABIS GDS 2018 SAMPLE : COLOMBIA 66% of the COLOMBIAN GDS2018 participants reported ever having used cannabis, with 60% having used in the last 12 months Over 45,000 last year cannabis users competed the GDS2018 specialist section, of which approximately 650 were from COLOMBIA

49 BACKGROUND qcannabis remains the world s most widely used illicit drug. Regulatory change in many countries and the development of new technologies to deliver cannabis in less harmful ways are an important accompaniment to this change. These changes pave the way for a new discourse over its use as a medicine and legal intoxicant, as well as new public health approaches to reducing the public health harms associated with its use. qlast year we saw overwhelming interest among people who use cannabis in having cannabis consumption guidelines produced to help users monitor their use and use more safely (see This year we focus again on national patterns of use and purchase whilst spotting changes in source, dominant preparations and methods of use across cultures.gds2018 explored rates of problematic use in the community qin our specialist cannabis section we offer a global perspective on the motivations for people wanting to stop cannabis and how cannabis users have tried to stop using cannabis over the last 12 months. qit s the the biggest study of trying to quit cannabis ever conducted.

50 KEY RESULTS IN THIS SECTION qnumber of days used in the last 12 months qthe most common and preferred preparations used around the world qhow much cannabis is used per day qcommon sources for obtaining cannabis qthe % of cannabis used that is paid for, vs the % shared with others qhow often people have cannabis at home just in case they feel like using it qthe % who reported having sought emergency medical treatment in the last 12 months as a result of cannabis use qthe % who should have sought emergency medical treatment in the last 12 months as a result of cannabis use but chose not to & the reasons for not having sought help qwhat % want to use less cannabis in the next 12 months qlifetime and last year experience of ever having tried to stop using cannabis Only countries with n > 100 users were included in these graphs

51 NO. OF DAYS OF CANNABIS USE DAYS PER YEAR LAST 12 MONTHS (by gender) NO. OF DAYS OF CANNABIS USE DAYS PER MONTH LAST 12 MONTHS (by gender) Female % % 23.0% 15.5% 4.7% 11.5% 10.1% 33.8% Male % % 19.6% 18.6% 7.7% 10.4% 11.1% 28.2% Mean no. of days Total % % 17.8% 29.8% % 10.8% 7.0% 3.7% 1 2 to to Female Male All

52 WHICH PREPARATIONS HAVE YOU USED? LAST 12 MONTHS M + F combined % 63.2% % of Respondents % % high potency/herbal normal weed/bush/pressed resin/hash kief edibles concentrates 27.5% 18.3%

53 MOST COMMONLY USED METHODS OF CONSUMPTION(+/- TOBACCO) M + F combined 100 Smoked in a joint 93.3% Smoked in a bong / wate.. Bucket bong Smoked in a pipe Eaten in food Smoked in a blunt Vapouriser % of Respondents % % % % 1.3% 5.6% 1.3% 0.2% 4.0% 0.2% 5.6% 0.2% With Tobacco Without Tobacco With Tobacco Without Tobacco With Tobacco Without Tobacco With Tobacco Without Tobacco With Tobacco Without Tobacco With Tobacco Without Tobacco With Tobacco Without Tobacco 8.1%

54 WHO MIXES USUALLY CANABIS WITH TOBACCO AROUND THE WORLD (% of cannabis users from each country who report usually mixing their cannabis with tobacco) M + F combined 22.7% 11.9% 100% 90% 80% 93.5% 91.6% 89.3% 88.9% 87.9% 87.7% 87.6% 86.8% 83.4% 81.5% 81.1% 79.4% 79.1% 70% 60% 50% 40% 30% 20% 10% 0% Portugal Italy Hungary France Denmark Switzerland Belgium Israel Balkans Netherlands Austria Scotland Germany Uk Ireland Spain Global Sweden Norway Czech Republic Poland Australia Slovakia South Africa Russia Ukraine New Zealand Brazil Canada US Mexico Columbia % of Respondents 70.4% 70.2% 67.0% 66.9% 66.2% 63.8% 58.1% 53.9% 49.0% 47.9% 42.1% 40.4% 30.1% 15.8% 15.8% 8.6% 8.3%

55 WHICH COUNTRY VAPES THE MOST (% of cannabis users from each country who cite vaping as their common method of use) M + F combined 2.7% France 1.9% US Canada Norway Australia UK Sweden Germany New Zealand Austria Ireland Global Spain Columbia Mexico Switzerland Czech Republic Israel Netherlands Belgium Brazil Russia 1.9% Slovakia 1.8% Scotland 1.8% South Africa 1.7% Balkans 1.6% Ukraine 1.5% Hungary 1.4% Portugal 1.1% Italy 1.0% Poland 0.7% Denmark 20% 18% 16% 14.8% 14% 12.6% % of Respondents 12% 10% 8% 6% 4% 10.2% 7.4% 6.6% 6.5% 6.2% 6.2% 5.6% 5.5% 5.0% 4.5% 4.1% 3.9% 3.5% 3.4% 3.1% 2.9% 2.7% 2.7% 2% 0%

56 USUAL AMOUNT OF CANNABIS CONSUMED ON A DAY OF USE (grams) ALL FORMS COMBINED M + F combined 1.1% 3 1.0% % 4 0.5% 5 0.2% % 7 0.2% % % Dont know % of Respondents % 8.1% 10.0% 15.2% 17.1% 10.6% 5 4.5% 4.4% 0 1.5% 2.4% 1.9% 0.8% 0.6% 0.6% 0.2% 0.5% 0.6% 1.3% 0.2% 1.6%

57 Dealers that you know Friends Friends of friends Darknet markets Dealers/friends selling vi.. Another source Shopfronts (e g adult sto.. Dealers/friends selling via WhatsApp Manufactured or grew my own On the street / festival / cl % 1.2% 1.0% 0.8% 0.2% 0.2% 3.9% % 20 % of Respondents % % 60 MOST COMMON SOURCE FOR CANNABIS PURCHASE IN LAST 12 MONTHS

58 HAVE YOU SOUGHT EMERGENCY MEDICAL TREATMENT (EMT) IN THE LAST 12 MONTHS FOLLOWING THE USE OF CANNABIS HAVE YOU THOUGHT THAT YOU SHOULD HAVE SOUGHT EMERGENCY MEDICAL TREATMENT IN THE LAST 12 MONTHS FOLLOWING THE USE OF CANNABIS BUT DID NOT Yes 0.2% Yes 0.2% No 99.8% No 99.8%

59 Only countries with n > 100 users were included in these graphs Of those, like help to use less Columbia 28.5% Portugal 12.2% Denmark 12.3% Scotland 27.2% Australia 17.8% Turkey 8.7% Czech Republic 13.7% Balkans 17.9% Belgium 17.6% Italy 12.4% Switzerland 6.5% Canada 19.1% Mexico 20.8% Brazil 28.0% Slovakia 2.2% Spain 16.1% Hungary 7.3% Global 12.2% UK 19.7% Israel 14.9% Netherlands 9.0% Austria 6.9% Germany 7.5% Ireland 19.0% New Zealand 10.7% USA 16.1% Poland 8.5% Like to use less % 38.8% 37.3% 35.9% 34.8% 34.6% 34.2% 33.4% 33.1% 32.7% 32.3% 32.2% 31.8% 30.3% 30.3% 30.1% 29.9% 29.3% 29.3% 29.1% 28.5% 28.3% 27.5% 26.4% 25.4% 24.3% 19.6% 60 WHO WOULD LIKE TO USE LESS CANNABIS & WHO WANTS TO SEEK HELP?

60 % OF CANNABIS USERS WHO HAVE EVER TRIED TO STOP HAVE YOU TRIED TO STOP USING CANNABIS IN THE LAST 12 MONTHS (% of those who ve ever tried to stop)

61

62 COLOMBIAN GDS 2018 SAMPLE : COCAINE Ø 25% of global GDS2018 participants reported ever having used cocaine with 17% reporting use in last 12 months. Ø 36.7% of the COLOMBIAN GDS2018 participants reported ever having used cocaine, with 26.8% having used in the last year. Data from >15,000+ people who had used cocaine in the last 12 months was used in the preparation of this report, of which about 200 came from Colombia

63 BACKGROUND Gram for gram cocaine remains the most expensive commonly used drug in the world. Prices vary widely across the world from less than 10/gram in South America, to an average of 60-80/gram in parts of Europe to over 200/gram in Australia. In recent years, the purity of cocaine in Europe has increased, with 60-70% purity commonly seen in street level deals. Higher purity cocaine can lead to an increase in the risk of acute medical harms and possibly higher rates of dependence in the community. GDS2017 identified a significant increase in the percentage of recent user seeking emergency medical treatmentin many parts of the world. Increased purity is in part due to greater amount of cocaine entering the supply chain, consequent upon diversification and sophistication of dealing networks, including the dark net. At a local level dealers will be competing for customers not only through the quality of their product but also on the convenience and speed of delivery. To explore the workings of sophisticated delivery networks in our major cities GDS2018 asked consumers about access to same day delivery of cocaine and where available asked participants to compare the speed of delivery of cocaine with takeaway pizza. Given the recent changes in global drug markets, GDS2018 contained a wider exploration of the circumstances around people s first ever use of cocaine,lsd and MDMA amongst those who had used these substances in the previous 12 months. Two thirds of the GDS2018 subsample who reported ever having used cocaine had also used the substance in the past year.

64 KEY RESULTS IN THIS SECTION þ þ þ þ þ þ þ þ þ Number of days used in the last year How much cocaine is used per day How much a single gram purchase costs Common sources for cocaine purchase Delivery times of cocaine The % of cocaine paid and used alone vs. the % shared with others How often people have cocaine at home just in case they feel like using it The % who reported having sought emergency medical treatment in the last 12 months as a result of cocaine use The % who should have sought emergency medical treatment in the last 12 months as a result of cocaine use but chose not to & the reasons for not having sought help

65 NO. OF DAYS COCAINE USED LAST 12 MONTHS M VS F AND M+F COMBINED MEAN NUMBER OF DAYS USED IN THE LAST 12 MONTHS

66 USUAL AMOUNT OF COCAINE CONSUMED ON A DAY USED

67 USUAL AMOUNT OF COCAINE CONSUMED ON A DAY USED BY COUNTRY Only countries with last year users are included in these graphs Finland 0.4 Hungary Austria Germany Grams Scotland England Canada Ireland United States Brazil Balkans Australia France Global Denmark Israel New Zealand Poland Netherlands Switzerland Colombia Belgium Slovakia Czech Republic Italy

68 AVERAGE PRICE (IN EROS) PAID FOR SINGLE GRAM PURCHASE OF COCAINE Only countries with n > 100 users were included in these graphs United States Belgium Netherlands Brazil Colombia Euros New Zealand Australia Finland Israel Denmark Slovakia Austria Czech Republic Switzerland England Italy Ireland Global Scotland Balkans Germany Hungary Poland France Canada

69 MOST COMMON SOURCE FOR PURCHASE OF COCAINE LAST 12 MONTHS

70 HAVE YOU HAD PIZZA/COCAINE DELIVERED IN THE LAST 12 MONTHS? CAN YOU GET PIZZA/COCAINE DELIVERED WITHIN 30 MINUTES? No 14.0% 30 mins or less 37.4% Had cocaine delivered: last 12m Delivery time of cocaine More than 30 mins 62.6% Yes 86.0% No 9.2% 30 mins or less 19.8% Had pizza delivered: last 12m Delivery time of pizza Yes 90.8% More than 30 mins 80.2%

71 HAVE YOU HAD PIZZA/COCAINE DELIVERED IN THE LAST 12 MONTHS? CAN YOU GET PIZZA/COCAINE DELIVERED WITHIN 30 MINUTES? 30 mins or less 30.3% Had cocaine delivered: last 12m No 41.3% Yes 58.7% Delivery time of cocaine More than 30 mins 69.7% No 14.3% 30 mins or less 16.7% Had pizza delivered: last 12m Delivery time of pizza Yes 85.7% More than 30 mins 83.3%

72 BUYING YOUR OWN DRUGS SHARING YOUR DRUGS WITH OTHERS USING OTHER PEOPLE S DRUGS All 15.2% Of cocaine personally purchased: how much did you share Dont know 2.0% Around three quarters 26.2% Around half 24.2% Around a quarter 15.2% Of the total amount of cocaine you have personally consumed over the last 12 months, what proportion of it did you pay for? None 13.8% All 1.3% Of cocaine used: how much did you pay for Dont know 8.4% Around three quarters 6.8% Around half 28.6% Around a quarter 41.2% Of the total amount of cocaine you have purchased for your personal use overthe last 12 months, what proportion do you think was consumed by others?

73 HOW OFTEN DO PEOPLE HAVE COCAINE AT HOME JUST IN CASE THEY FEEL LIKE USING IT?

74 COLOMBIAN GDS 2018 SAMPLE : MDMA >40% of GLOBAL GDS2018 participants reported ever having used MDMA 28.5% reporting use in the last 12 months 32.2% of COLOMBIAN GDS2018 participants reported ever having used MDMA,with 22.5%reporting use in the last 12 months Data from 22,000+ people from around the world who reported the use of MDMA in the last 12 months was used in the preparation of this report., including approximately 300who came from Colombia

75 BACKGROUND MDMA remains one of the most popular illicit drugs in the world. The use of MDMA crystals and powder in many parts of the the world has increased in recent years and in conjunction with the appearance of high dose MDMA pills has led to changes in consumption habits and risk profile of users. In response to the apparent increase in the risks associated with higher potency pills and reports of novel drugs making their way into ecstasy tablets/powders we have seen growth in the appearance of drug checking services across many countries. GDS2018 in addition to asking about the patterns of use and purchase of MDMA use, explored the use of drug checking services and the utility of the information provided by such services and also gave users the opportunity to design the perfect MDMA pill. GDS2018 also chose MDMA as one of 3 drugs that we focused on as part of a wider exploration of the circumstances around peoples first ever use of drugs (the others were cocaine and LSD). For MDMA this represented one third of the GDS2018 sample who reported ever having used MDMA.

76 KEY RESULTS IN THIS SECTION þ Number of days used in the last year þ How much MDMA is used per day þ Common routes of use and use of test dosing for new batches þ How much a single gram and single MDMA pill costs to purchase þ Common sources for MDMA purchase þ The % of MDMA used that is paid for vs the % shared with others þ How often users have MDMA at home just in case they feel like using it þ Circumstances of people s first ever use of MDMA þ The % who reported having sought emergency medical treatment in the last 12 months as a result of MDMA use þ The % who reported thinking they needed emergency medical treatment in the last 12 months as a result of MDMA use but chose not to seek it and why they did not.

77

78 NUMBER OF DAYS MDMA USED LAST 12 MONTHS M+F COMBINED AND BY GENDER (RANGE AND MEAN DAYS)

79 AVERAGE NUMBER OF DAYS MDMA USED LAST 12 MONTHS ON A DAY OF USE BY COUNTRY Only countries with n > 100 users were included in these graphs 5.9 Norway Brazil France Australia Hungary Scotland Colombia Ireland Slovakia Poland Balkans England Czech Republic Belgium Denmark Global Israel Germany Netherlands Austria New Zealand Switzerland Spain Canada Italy Russian Federation Finland 5.3 United States 5.2 Sweden Mean No. of Days

80 USE OF PILLS, POWDERS & CAPSULES: PREPARATIONS USED IN LAST YEAR PILLS POWDER /CRYSTAL CAPSULES How often have you used MDMA from more than one batch / source over a session in the last 12 months?

81 Only countries with n > 100 users were included in these graphs 1.2 Belgium 1.2 Russian Federation MEAN NUMBER OF MDMA PILLS USED ON A DAY OF USE BY COUNTRY Australia Scotland Ireland Canada Brazil Denmark Norway England Netherlands Finland Switzerland United States Global Poland Sweden Hungary Balkans France New Zealand 1.2 Germany 1.1 Czech Republic 1.1 Slovakia Israel Austria Colombia Italy Spain Average Pills

82 MEAN AMOUNT OF MDMA POWDER USED LAST 12 MONTHS ON A DAY OF USE BY COUNTRY Only countries with n > 100 users were included in these graphs 0.3 Scotland Denmark Colombia Australia Ireland England Brazil Czech Republic France Global Canada Italy Switzerland Balkans Israel Poland Hungary Russian Federation Slovakia United States 0.3 New Zealand 0.3 Norway 0.3 Austria 0.3 Germany 0.3 Sweden 0.3 Netherlands 0.3 Spain 0.3 Finland 0.2 Belgium Median Amount (Power Form)

83 MAIN METHOD OF CONSUMPTION MDMA PILLS/TABLETS VS CRYSTAL/POWDER MEDIAN USE PILLS/POWDER PER DAY

84 HOW OFTEN DID YOU START WITH A SMALL TEST DOSE OF MDMA WHEN TRYING A NEW BATCH/SOURCE?

85 Only countries with n > 100 users were included in these graphs 22.9% Colombia COUNTRY DOSING: ALWAYS/OFTEN TESTS A DOSE WHEN TRYING A NEW BATCH/SOURCE Hungary France Germany England Scotland Spain Austria Belgium Poland Ireland Global Israel Switzerland Balkans Canada Sweden Czech Republic United States Norway 21.9% Denmark 19.5% Australia 19.0% Italy 19.0% Netherlands 18.2% Finland 18.0% Slovakia 16.8% Brazil 16.7% New Zealand 16.0% Russian Federation % % of Respondents % 40.2% 39.5% 37.8% 36.0% 35.8% 33.7% 32.6% 32.5% 31.9% 31.7% 31.2% 30.5% 30.1% 29.6% 26.7% 26.5% 23.2%

86 MEAN PRICE FOR A SINGLE MDMA TABLET OR PILL (EUROS) Only countries with n > 100 users were included in these graphs New Zealand Norway Australia Finland Israel Brazil Sweden Switzerland Russian Federation Italy United States Scotland Austria Denmark England Colombia Balkans France Slovakia Canada Global Spain Ireland Germany Czech Republic Hungary Poland Belgium Netherlands Mean Price for Pills (Euros)

87 MEAN PRICE FOR A SINGLE GRAM OF MDMA (EUROS) Only countries with n > 100 users were included in these graphs 37.1 Finland Israel Norway Australia Sweden Switzerland United States New Zealand Italy Ireland France Denmark Balkans Austria Hungary Scotland Canada Global Spain Russian Federation Brazil England Slovakia Czech Republic 34.6 Germany 31.5 Poland 31.3 Colombia 27.8 Belgium 22.5 Netherlands Mean Price Per Gram (Euros)

88 MOST COMMON SOURCE FOR PURCHASE OF MDMA LAST 12 MONTHS

89 BUYING YOUR OWN DRUGS SHARING YOUR DRUGS WITH OTHERS USING OTHER PEOPLE S DRUGS Of MDMA personally purchased: how much did you share? Of the total amount of MDMAyou have purchased for your personal use over thelast 12 months, what proportion do you think was consumed by others? Of MDMA used: how much did you pay for? arter Of the total amount of MDMA you have personally consumed over the last 12 months, what proportion of it did you pay for?

90 HOW OFTEN DO PEOPLE HAVE MDMA AT HOME JUST IN CASE THEY FEEL LIKE USING IT?

91 5.1% 3.3% 2.0% PERSONAL STASHES COMPARED HOW OFTEN DO PEOPLE HAVE COCAINE, LSD OR MDMA AT HOME IN CASE THEY FEEL LIKE USING THEM? (M vs F) last 12 months 80 COCAINE LSD MDMA Cocaine LSD MDMA % % % of Respondents % % 20.3% 19.4% 10 0 Never Rarely Sometimes Often Always Never Rarely Sometimes Often Always Never Rarely Sometimes Often Always 15.0% 9.8% 8.6% 8.6% 7.3% 8.5%

92 MDMA USE VIRGINITY CIRCUMSTANCES SURROUNDING FIRST TIME USE People and especially governments don t talk much about first time drug use. The idea of universal primary prevention like drug education in schools is to stop people from using drugs. And that is, of course, is the best way to avoid drug related harm. Failing that (or choosing not to use any drugs at all-the safest option), delaying peoples first use until their brain has stopped developing (in your early 20s) is not a bad second aim. Grow your brain before you expand it. The first drug experience might be particularly risky if you are on your own, take the wrong dose, are in the wrong place or time, or are already under the influence of something else usually and probably most dangerously alcohol. If people knew more about what they were taking, how to take it and what to watch out for we believe they would be safer, especially on that very first occasion. GDS2018 sought to explore the first experiences of people who used cocaine for the first time in the last 12 months. We ask people whether this first use was planned, about who they were with and how they were feeling, what they knew about the drug, how important peer influences were, and whether their expectations (both positive and negative) were met. Using drugs can be risky. We hope this information can be used to increase the awareness about potential risks of first time use to reduce negative outcomes people completed our special section on first time MDMA use. Have you used MDMA for the first time in the last 12 months? Yes 30.2% No 69.8% How long ago did you you use use MDMA for the first time (within the last 12 months)? 30 days or less 14.5% 6-12 months ago 47.0% 1-5 months ago 38.6%

93 HOW OLD WERE YOU WHEN YOU USED MDMA FOR THE FIRST TIME? 0.0% % 14 % of Respondents % 11.2% 11.2% 9.6% 8.0% % 5.7% 4.9% 3.7% 3.9% % 0.5% 1.7% 1.8% 1.8% 1.5% 0.8% 1.3% 0.5% 0.4% 0.3% 0.2% 0.5% 0.2% 0.1% 0.1% 0.1% 0.1% 0.1% 0.1% 0.1% 0.0% 0.2% 0.1% 0.1% 0.1% 0.0% 0.1% 0.0% 0.0% 0.0% 0.0% 0.0% AGE

94 40.9% 43.3% 39.8% I always knew Id take it one day 14.7% 15.4% 14.3% I have never considered using it before the day I took it for the first time THINKING ABOUT THE FIRST TIME YOU USED MDMA, WAS IT ACTUALLY PLANNED? BEFORE YOUR FIRST TIME HOW CERTAIN WERE YOU THAT YOU D TRY MDMA? Gender % 50.1% Average % of Respondents % % Female % of Respondents Spontaneous (MDMA happened to be available on that day) Planned (you ensured you had access to MDMA on that day) I thought I might take it at some point 46.0% 41.3% % 52.0% 45.9% Male % of Respondents

95 4.7% Dont know / unsure baby sitter 3.7% On my own 3.1% Other public space 2.5% DID YOU HAVE A TRIP/BABYSITTER? FIRST TIME USE OF MDMA WHERE WERE YOU? FIRST TIME USE OF COCAINE WHO WERE YOU WITH? Close friend/group of friends No baby sitter Yes baby sitter Large group of people i.. At a private party At an entertainment venue (club, pub, concert) At a festival At a friends house At home With a partner/lover Outdoors / place of beauty 1.3% Other place not described above % 56.8% 50 % of Respondents % 29.2% 28.8% % 18.8% 16.3% % 6.2% 0

96 FIRST TIME USE OF MDMA ADVICE FORM TEST DOSE KNOWLEDGE mdma: advice about use mdma: first time form Yes - from a drug checking / testing service 10.0% Yes - by the person I got it from 38.3% Yes - by the people I was with 51.8% I used multiple forms the first time I took MDMA 1.3% Ecstasy/MDMA powder/crystal 34.2% No 15.2% Yes 84.8% Ecstasy/MDMA caps/capsule 6.1% Ecstasy/MDMA pills/tablets 58.4% Answer A lot Ecstasy/MDMA caps/capsule Ecstasy/MDMA pills/tablets Ecstasy/MDMA powder/crystal I used multiple forms the first time I took MDMA Little or nothing No Quite a bit Yes Yes - by the people I was with Yes - by the person I got it from Yes - from a drug checking / testing service mdma: first time knowledge Quite a bit 39.9% A lot 31.6% Little or nothing 28.5% DID YOU SEEK EMERGENCY MEDICAL TREATMEMT AFTER YOUR FIRST TIME USE OF MDMA Yes 0.5% mdma: first time test dose Yes 48.9% No 51.1% No 99.5%

97 THE FIRST TIME YOU USED MDMA HOW EXCITED WERE YOU? HOW SCARED WERE YOU? Before you used Ecstasy/MDMA/Molly on this first occasion how scared did you fee / Gender A little excited A little scared Not at all excited Not at all scared Very excited Very scared 38.4% Male % Male < % Average 29.6% Female 25 + Female < % Average Female 25 + Female <25 Male 25+ Male <25 Average Female 25 + Female <25 Male 25+ Male <25 Average Female 25 + Female <25 Male 25+ Male <25 Average Female 25 + Female <25 Male 25+ Male <25 7.1% Average 9.8% Female % Female <25 4.7% Male % Male < % 59.2% 57.5% 59.6% 57.0% 59.8% % 49.3% 51.2% % 45.2% 43.3% % of Respondents % 32.7% 30.2% % 11.7% % 5.5% 5.4% 0

98 FIRST TIME USE OF MDMA EXPECTATION VS EXPERIENCE PLEASURABLE HIGH SIDE EFFECTS 50 negative expectation negative experience positive expectation positive experience How pleasurable were you expecting your MDMA before you took it vs. how pleasurable it actually was. (Scale of 1-10 with 10 being the most pleasurable and 1 being the least pleasurable) % of Respondents % More positive and less negative than expected 22.1% 23.9% 39.2% How unpleasant were you expecting the negative effects of MDMA to be before you took it vs. how negative it actually was. (Scale of 1-10 with 10 being the most pleasurable and 1 being the least pleasurable) % 11.9% 18.5% 14.9% 16.8% 8.4% 6.5% 6.0% 1.7% 2.9% 17.2% 14.0% 9.0% 8.6% 5.4% 5.2% 4.4% 2.0% 2.5% 0.8% 0.3% 1.2% 2.0% 9.0% 10.9% 12.0% 17.9% 1.7% 1.2% 1.9% 1.9% 5.5% 5.2% 9.3% 14.8% 19.1%

99 FIRST TIME USE OF MDMA MEAN SCORES EXPECTATION VS EXPERIENCE PLEASURABLE HIGH SIDE EFFECTS How pleasurable were you expecting your MDMA experience before you took it vs. how pleasurable it actually was. (Scale of 1-10 with 10 being the most pleasurable and 1 being the least pleasurable) How unpleasant were you expecting the negative effects of MDMA to be before you took it vs. how negative it actually was. (Scale of 1-10 with 10 being the most pleasurable and 1 being the least pleasurable) Average Rating More positive and less negative than expected 4.2 People s first MDMA experience tended to be slightly more pleasurable than they expected whilst the expected negative effects were not as significant as expected. positive experience positive expectati.. negative expectation negative experience 3.3

100 HAVE YOU TAKEN MDMA AGAIN/DO YOU PLAN TO? % % % of Respondents % % 5 0 Yes (already have) Yes (plan to) Unsure / dont know No

101 Russian Federation 3.70 Slovakia 5.30 Czech Republic 7.89 Italy 1.75 Denmark 5.59 France 7.50 Scotland 5.97 Hungary 0.00 Balkans Sweden 0.00 Australia 6.34 United Kingdom 5.91 Brazil 6.78 Global 5.45 Norway 0.00 Poland 4.37 Finland 4.26 Austria 4.76 Germany 2.58 New Zealand 9.09 Switzerland 3.17 Belgium 0.00 Israel 2.38 Canada 0.00 United States 1.05 Would you like help to use less? Would you like to use less? MDMA USE WHO WOULD LIKE TO USE LESS ANSD WHO WANTS TO SEEK HELP? Netherlands

102 Scotland Russian Federation Australia United Kingdom Belgium Canada Colombia Denmark France Brazil Hungary Sweden Finland Czech Republic Global Switzerland Italy Poland Austria Netherlands New Zealand Ireland Slovakia Germany Israel Balkans 0.0 % of Respondents % 1.8% 1.8% 1.8% 1.5% 1.5% 1.4% 1.4% 1.2% 1.2% 1.2% 1.2% 1.1% 1.1% 0.9% 0.9% 0.8% 0.8% 0.8% 0.7% 0.7% 0.7% 0.7% 0.6% 0.6% 0.6% SEEKING EMERGENCY MEDICAL TREATMENT FOLLOWING THE USE OF MDMA (LAST 12 MONTHS) United States 0.3% Norway 0.0% Spain 0.0%

103 GLOBAL GDS 2018 SAMPLE : THE PERFECT MDMA PILL Last year over 15,000 users of MDMA gave their opinion on what would constitute the perfect MDMA pill This section is based on their responses.

104 THE PERFECT MDMA PILL DOSE, SHAPE, BREAKS & COLOUR We guess that if your pill has MDMA in it (and nothing else) and you know how much MDMA (in mg) it contains there s probably not much else you really need or want to know? But of course there is no such thing as the perfect MDMA pill. A perfect MDMA pill would be safe for everyone, guarantee a good time with no comedown or risks at all. And we know that even if you follow every harm reduction tip in the book and know what s in your pill, you still can t guarantee safety or fun for everyone. That is why taking drugs, like so many activities is risky. This issue is more relevant today than it has been for years. High dose MDMA (common place since 2014 ) has surfaced as way of cementing a new supplier s product credentials and raising brand awareness often through adopting diverse and innovative logo branding (including random shapes, fluorescent pills and multi-coloured tablets). While escalating price and sales are good for profit, the consequent rise in MDMA related harm and possibly deaths is not good. Understanding the chemical content and its dose is fundamental to influencing your drug experience. Since most people don t know the composition of an MDMA pill, GDS thought it might worth asking people who use MDMA what sort of pills they would they like to see on the market. In this section we report on the shape, dose and colour (assuming the dose/mg would be the same) -that constitutes the perfect MDMA pill users would like to take to optimise their drug use experience and to minimise risks.

105 KEY RESULTS IN THIS SECTION BASED ON GLOBAL SAMPLE OF MDMA USERS þ What dose of MDMA (in mg) you would like to see in an MDMA pill? þ What would be your preferred tablet shape? þ Do you have a preference for bigger pills with bigger doses you can split or smaller pills with lower doses? þ Would you like score lines (grooves ) that allow easy breaking into quarters or halves? þ Do you have a preference for crumbly pills that might mean the effect comes on quickly or hard pressed pills that might come onmore slowly? þ Would you like the dose in mg, printed on the pill? þ How important is the look and feel of a pill in your decision to take it?

106 HOW MUCH MDMA WOULD YOU LIKE IN YOUR MDMA TABLET/PILL? WHAT IS YOUR PREFERRED SHAPE FOR YOUR MDMA TABLET/PILL? % 17.5% 16.9% % % 35 % of Respondents % 7.7% % of Respondents % 6 4.4% 5.3% % 4 2.9% 3.4% % mg 50mg 75mg 100mg 125mg 150mg 175mg 200mg 250mg 300mg >300mg Dont kno.. 1.7% 1.0% % 3.6% 2.9% 1.4% No prefer Characte.. Round Square Oval Thin Fat ence / n.. rectangle rectangle Triangle

107 BIG PILLS WITH BIG DOSES OR SMALLER PILLS WITH SMALLER DOSES? SCORE LINES TO SPLIT INTO HALVES OR QUARTERS? % % % % of Respondents % 23.2% % of Respondents % Bigger pills to split Dont care Smaller pills not to split 0 Yes - to split into halves Yes - to split into quarters No

108 CRUMBLY (SOFT PRESS) PILLS THAT MAY COME ON MORE QUICKLY OR HARD PILLS THAT MAY COME ON SLOWER? DOSE IN MG TO BE IMPRINTED ON THE PILL? % % % 70 % of Respondents % % of Respondents % 3.5% 0 No preference / unsure Soft press Hard press 0 No prefer ence / un.. Yes No

109 ANY COLOUR PREFERENCE? HOW IMPORTANT IS THE LOOK AND FEEL IN YOUR DECISION TO TAKE IT? % % 60 % of Respondents % of Respondents % % 6.8% 6.2% 4.8% 4.5% 3.3% 2.8% 2.6% 1.9% 0.4% 20 No prefer ence / un.. Purple Blue Red Violet Green White Orange Yellow Black Brown % 0 Not important at all Somewhat important Very important

110 COLOMBIA GDS2018 SAMPLE LSD 19.4% of the global GDS2018 sample reported ever having used LSD, with 11% reporting use in the last 12 months 40.9% of the Colombian GDS2018 participants reported ever having used LSD, with 26.95% reporting use in the last 12 months 10,000 people completed this specialist section on LSD, including about 300 from Colombia

111 BACKGROUND Last year GDS2017 highlighted that the practice of micro-dosing (taking very small doses of LSD or magic mushrooms to increase performance and creativity) is in fact a rather common practice with between % of users to GDS2017 reporting such use across their lifetime. Although most indicated that they had only experimented like this on a few occasions, about 2% of those reporting micro-dosing indicated they adopted such a strategy on a regular basis. For the 500 of so respondents who described micro-dosing to help manage a medical/ psychiatric condition, over 90% reported the experience as positive. While we strongly echo the importance of not self-medicating serious health conditions and always seeking professional help, the fact remains that drugs like LSD (and its many analogues such as (1P-LSD) are experiencing a renaissance in so many ways. One question that remains however is just how much LSD people are using that is what is a micro-dose and how do people judge their dose? This is what GDS2018 sought to find out. Given the changes we have seen in recent years in global drug markets, GDS also chose LSD as one of 3 drugs (in addition to MDMA and cocaine) that we focused on as part of a wider exploration the circumstances around peoples first ever use of a drug (when it occurred over the previous 12 months). Over 40% of LSD users reported using LSD for the first time in the last 12 months and 3250 completed our specialist section about the circumstances surrounding their first ever use. Only countries with more than 100 last year users are included in country comparisons

112 KEY RESULTS PRESENTED IN THIS SECTION þ Number of days people had used LSD in the last 12 months þ Typical dose in tabs per day of use þ How much a single tab purchase cost þ Route of use þ Common sources for LSD purchase þ The % of cocaine used that is paid for vs. shared with others þ How often users have cocaine at home just in case they feel like using it þ Circumstances of peoples first ever use of LSD þ How your psychedelic experience rates in your life / spiritual experience þ Micro/dosing methods and dose þ Seeking EMT þ Not seeking EMT when you thought you should have and top 3 reasons why you did not seek help

113 NO. OF DAYS LSD USED LAST 12 MONTHS M VS F AND M+F COMBINED MEAN NUMBER OF DAYS USED IN THE LAST 12 MONTHS % 60.3% 63.4% % of Respondents % Mean No. of Days % % 14.4% 15.6% % % 0.0% 1.3% 1 Average Female Male Average Female Male Average Female Male Average Female Male 0 Average Female Male

114 HOW MUCH LSD (IN FRACTIONS OF AN LSD TAB) DO YOU USE ON A TYPICAL DAY OF USE % % of Respondents % % 5 3.8% 0 0.8% 2.9% 2.1% % 0.2% 0.6%

115 AVERAGE PRICE (IN EUROS) PAID FOR SINGLE GRAM TAB OF LSD Only countries with n > 100 users were included in these graphs 7.97 Poland 7.86 Austria 7.74 United Kingdom 7.72 Germany 7.61 Hungary Australia Finland Israel New Zealand Sweden Balkans Switzerland Denmark Slovakia Scotland Brazil Colombia Mexico Global 6.73 Czech Republic 6.63 United States 6.08 Canada 5.63 Netherlands Mean Price (Euros)

116 HOW DO YOU MOST COMMONLY USE LSD? % % of Respondents % 0 1.9% 0.6% 0.2% Oral - suck a tab / microdot Oral - dissolved on sugar cube Oral - spray and dilute solution Other Snort

117 MOST COMMON SOURCE FOR PURCHASE OF LSD LAST 12 MONTHS % % % of Respondents % 16.3% % 1.8% 0 0.7% 0.5% 0.2% Friends Dealers that you know Darknet markets Friends of friends On the street Other social / festival / cl.. media apps (.. Another source Open Shopfronts (e Websites (n.. g adult stor..

118 BUYING YOUR OWN DRUGS SHARING YOUR DRUGS WITH OTHERS USING OTHER PEOPLE S DRUGS Dont know 0.8% None 12.0% Of the total amount of LSD you have personally consumed over the last 12 months Around three quarters 12.8% Around half 10.1% Around a quarter 2.2% All 62.1% Of the total amount of LSD you have personally consumed over the last 12 months, what proportion of it did you pay for? Of the total amount of LSD you have purchased for your personal use over the las None 50.8% All 0.6% Around a quarter 24.1% Around half 15.5% Around three quarters Dont know 4.6% 4.3% Of the total amount of LSD you have purchased for your personal use over thelast 12 months, what proportion do you think was consumed by others?