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Early results of the headline findings from Switzerland
GDS2015
Prepared exclusively for 20 Minuten
By Dr Adam R Winstock
Dr Jason Ferris, Jon Waldron, and Dr des Larissa Maier
May 22nd 2015
Global Drug Survey GDS2015©
Dr Adam Winstock
IN ALL COPY RELATED
TO THE DATA PROVIDED THE STUDY
SHOULD BE REFERRED TO AS GLOBAL
DRUG SURVEY 2015 CONDUCTED IN
PARTNERSHIP WITH GLOBAL MEDIA
PARTNERS INCLUDING 20 MINUTEN
GDS RUNS THE WORLD’S
BIGGEST DRUG SURVEY
THE DATA REPORT IS NOT TO BE
SHARED WITH ANY OTHER
ORGANISATION
GDS RUNS THE WORLD’S BIGGEST
DRUG SURVEY
A TOTAL OF 102,000* PEOPLE FROM
OVER 50 COUNTRIES PARTICIPATED IN
GDS2015
OF THESE 6.1% (6,204)
WERE FROM SWITZERLAND.
*Data analysis was conducted on out on 97,000 for these preliminary analyses
The founder and CEO of GDS is Dr 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
organisations.
No government, regulatory authority, corporate organization or
advocacy group has influenced the design of the survey or content
of report.
Adam Winstock
When reporting the results in print, on-line and on TV we ask all our media
partners to place links to our free anonymous, objective web and smart phone
apps the
Drinks Meter ( www.drinksmeter.com and free at the i-tunes and Google Play
app stores)
drugs meter (www.drugsmeter.com and free at Google Play app store)
Adam Winstock
About
Global Drug Survey (GDS) runs the world’s biggest annual drug survey. GDS is an
independent global drug use data exchange hub that conducts university ethics approved,
anonymous on-line surveys. We are a international network of experts, academics and
clinicians from diverse backgrounds and cultures. We collaborate with global media
partners who act as hubs to promote our work. Our last 3 surveys, run at the end of 2012,
2013 & 2014 received over 200,000 responses. GDS has a proven track record in being
able to track trends over time, profile new drugs and identify key issues of relevance and
importance to both people who use drugs and those who craft public health and drug
policy.
We aim to help people and communities reduce the harm associated with the use of drugs
regardless of their legal status use by sharing information in a credible and meaningful
way. Identifying new drug trends among sentinel drug using populations allows preemptive service planning and informed policy development. Over the last decade these
methods have successfully supported the widespread dissemination of essential
information both to people who use drugs through our media partners and to the medical
profession through academic papers presentation at international conferences, expert
advisory meetings and through www.drugsmeter.com and www.drinksmeter.com
Adam Winstock
Methodology
Our recruitment strategy is an example of purposive sampling. We acknowledge that this has
significant limitations, most notably with respect to response bias whereby there will be inherent
differences between those who participate and those who do not. 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. Therefore, as participants in our survey may have a
greater interest in or experience with drugs, they may not be representative of the wider population.
However, purposive sampling that seeks to include a wide cross-section of users and a large
overall sample size can result in a sample of drug users that may be considered sufficiently
representative to make reasonable inferences for the general population. Importantly our approach
accesses sections of the populations that general household surveys do not (e.g. students) and of
course we are able to explore drug related in significantly more depth. Our sample size is also
considerably bigger than most national household surveys. When judged against traditional
epidemiological criteria for monitoring public health, GDS fully acknowledges that our methods have
potentially significant limitations. These have been fully discussed in the academic publications that
the GDS Academic Network produce each year. A few of these are listed on next slide.
Adam Winstock
Recent publication derived from GDS research
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 2015
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 2015
Winstock, Adam. "Cannabis regulation: the need to develop guidelines on use. BMJ 348 (2014).
Lawn W, Borschmann R, Williams M, Winstock AR The NBOMe hallucinogenic drug series: patte4rsn of use, characteristics
of users and self reported effects from large international sample J Psychopharmacolgy2014
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 2014
Winstock AR, Kaar S, Borschmann R Dimethyltrtamine (DMT): prevalence, user characteristics and abuse liability. J
Psychopharmacolgy 2014
Barratt MJ, Ferris JA, Winstock AR The use of the Silk road, the on lien drug market place, in the UK, Australia and
the USA. Addiction 2014
Winstock AR, Barratt M Synthetic cannabis comparison of patterns of use an effect profiles with natural cannabis Drug and
Alcohol Dependence 2013
Winstock AR, Barratt M The 12 month prevalence and nature of adverse experiences resulting in emergency medical
presentations associated with the use fo synthetic cannabis products . Human Psychopharmacol 2013
Winstock AR, Mitcheson L, De Luca P, Davey Z, Schiffano F ‘mephedrone – new kid on the block’ Addiction 2011
Winstock AR, Marsden J, Mitcheson L What should be done about mephedrone BMJ 2010;340:c1605
Winstock AR , Ramsey JD. Legal highs and the challenges for policy makers. Addiction. 2010
Winstock AR, Mitcheson L Marsden J The Lancet, 2010
bal Drug Survey GDS2015©
Summary of limitations
– This is not a nationally representative sample, but it does represent one of the largest
studies of drug use ever conducted in Netherlands
– Although the findings cannot be said to be representative of the wider Netherlander
population they do provide a useful snapshot of what drugs are being used and how
they are impacting upon people’s lives in Netherlands
– The findings can inform policy, health service development and most importantly
provide women who drink and/or take drugs with practical advise on how to keep
healthy and minimize the harms associated with the use of substances.
– Results have usually provided to the nearest full or half percent
– In the time frame and resources provided only these preliminary analyses are
provided
– Stories are thus based on preliminary findings and are subject to change on further
analyses.
– Given enormous data we gathered, composite results on key issues are provided
only.
Global comparison
slides have a colored
background
Limitations with cross country comparison
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 considerable variation in the size of the country sample, its
representativeness, the precise demographics and other characteristics of respondents such
as age, gender, involvement in clubbing and drug use such comparisons have to be treated
with some caution.
The results although based on the response of 100s or even thousand of users of drug in
you country and across the world do not necessary represent the wider drug suing
community. Saying that if you ask a 100 people in a country how much a drug costs or a
group 25,000 MDMA users how often they need to seek emergency medical help you can
not dismiss the findings as way off what you’d expect with more representative samples.
The limitations in cross country comparisons will be more marked for some results than
others.
For countries with small numbers the findings need to be treated with even more caution.
Content of this report – by section
Topic
Data
Demographics
country data v Global GDS2015
Drug use prevalence
country data
Alcohol
E-Cigarettes
Global GDS2015
Cannabis
country data
Synthetic cannabis
Seeking emergency medical treatment Global GDS2015
Drugs and the internet
Dark net markets
Research chemicals
Mystery white powders
MDMA
Cocaine
Nitrous oxide
Prescription medication
country data
Cognitive enhancers
country prevalence data & Global GDS2015 overview
Why I stopped using drugs
Global GDS2015
ALL DATA RELATING TO
THIS REPORT IS
EMBARGOED UNTIL THE
WEEK COMMENCING
TH
JUNE 8 2015*
*EXCEPT COSMO UK – JUNE 2 AND MEN’S HEALTH UK
ND
JUNE 5TH (THEY HAVE A LOCAL GENDER SPECIFIC REPORT)
The report is not to be shared with any other news agencies or
organisations including health or other government departments
ACCESSING THE SURVEY
DATA ON 6,204*
PARTICIPANTS FROM
SWITZERLAND HAVE BEEN USED
FOR THIS ANALYSIS
*n
varies for each section of survey
Accessing the Survey – Switzerland (N=6,204)
Participants were asked which of our media partners
prompted them to access and complete the survey
Other
59.8%
Twenty Minutes
17.4%
Facebook
9.3%
Zeit Online
8.7%
Country Breakdown % (n)
Germany
32.2% (32,625)
Belgium
2.0% (1,998)
France
8.6% (8,696)
Austria
1.7% (1,701)
United Kingdom
6.6% (6,678)
Canada
1.3% (1,296)
Unites States
6.2% (6,254)
Portugal
1.2% (1,240)
Switzerland
6.1% (6,204)
Spain
0.9% (957)
Netherlands
5.7% (5,805)
Scotland
0.7% (686)
Brazil
5.7% (5,749)
Denmark
0.4% (451)
Hungary
4.5% (4,599)
Poland
0.4% (450)
Australia
4.0% (4,030)
Italy
0.4% (448)
New Zealand
3.6% (3,404)
Greece
0.4% (385)
Republic of Ireland
2.4% (2,393)
DEMOGRAPHICS
What this section covers
We asked about
• Who they live with
•
Gender
•
Age
• Geographical location
•
Sexual orientation
• Body Mass Index
•
Ethnicity
• Other recreational activities
•
Educational attainment
•
Employment/ studying
(clubbing and exercise)
Gender and Sexuality of global and Swiss participants
Global
38.1%
61.5%
Switzerland
38.0%
61.7%
Male
Female
Heterosexual
Bisexual
Homosexual
Prefer not to say
59,999
37,170
84.3%
7.9%
5.5%
2.3%
Male
Female
Heterosexual
Bisexual
Homosexual
Prefer not to say
3,722
2,289
88.5%
5.4%
4.2%
1.9%
Ethnicity and age of Swiss participants
Ethnicity
White
Mixed
Asian (Pakistani. Indian, Bangladeshi)
Black African/Black Caribbean
Hispanic Latino
SE Asian
Other
Aboriginal
Native American
Global
91.5%
3.4%
0.4%
0.7%
1.9%
0.5%
1.3%
0.1%
0.1%
Swiss
93.9%
2.6%
0.5%
0.5%
1.1%
0.4%
0.9%
-
Age
Mean age
29.3 years
29.82 years
<24 years
44.8%
42.3%
25-34 years
31.5%
30.2%
35+ years
23.6%
27.6%
Education and Employment of Swiss participants
Employment status
Paid Employment
Unemployed
(looking for work)
Unemployed
(not looking for work)
Highest Academic Qualification
76.8%
13.2%
Technical or trade certificate
32.6%
College certificate/diploma
16.6%
Undergraduate degree
19.6%
Postgraduate degree
6.3%
3.6%
19.6%
Studying? (N=5,959)
Yes full time
Yes, part time
No
High School/Secondary School
26.4%
10.6%
62.9%
Living Circumstances of Swiss participants
Living with (N=6,204)
Partner
38.8%
Friends
5.2%
Alone
17.6%
Parent(s)
28.7%
Housemates
7.3%
City/Urban
54.5%
Siblings
11.8%
Regional
38.1%
Other family
5.2%
Remote
7.4%
Other
0.9%
Geographical Location (N=6,124)
Leisure Activities Swiss v global participants
How often did you play sport/exercise
in 2014?
Never
Less than once/3 months
Once every 3 months
Once a month
Once every fortnight
Once or twice a week
3 to 4 times a week
More than 4 times a week
Global
6.4%
5.3%
5.9%
10.6%
13.5%
33.5%
16.6%
8.3%
Swiss
6.9%
3.8%
4.2%
9.8%
12.2%
35.8%
18.4%
8.9%
63.3% of the Swiss GDS2015 sample reported going clubbing at least
once every 3 months compared to 63.8% of the whole GDS2015 sample
How Healthy is Your Weight?
Body Mass Index is calculated by weight in kg divided by (height in metres)2.
It represents a measure of how healthy your weight is
The mean BMI for all GDS2015 participants was 24.2
The mean BMI for the Swiss sample is 24.4
BMI category (BMI score)
Swiss (%)
Global (%)
Extremely underweight (<18)
3.1
3.2
Underweight (<20)
10.8
11.9
Normal /healthy range (20-25)
52.3
53.3
Overweight (>25)
24.8
22.1
Obese (>30)
9.0
9.5
Vegetarian 5.9%
Not Vegetarian 94.1%
DRUG USE
PREVALENCE
What This Section Covers
We asked whether participants had ever used any of
the 150 drugs listed in the survey. We then asked
whether they had used each drug in the last 12
months and the last 30 days.
Drug Use Prevalence
•
•
•
We asked what drugs they had ever used, used in the year and the last
month.
NOTE: This is not a general population survey so the findings cannot be said
to reflect wider drug use patterns but they do give some insight into new drugs
trends, price and patterns of use and purchase among a large number of
current users.
GDS suggest you look your own country’s national household data and other
trend data for comparison
Lifetime and current drug use experience:
LIFETIME: 25.5% had only ever taken legal drugs, 73.6% had taken at least one
illegal drug. 1.0% had not used any drug at all.
LAST 12 MONTHS: 47.2% report only having used legal drugs, 47.1% at least
one illegal drug. 5.7% had not used any drug at all.
LAST MONTH: 56.4% report only having used legal drugs, 34.9% at least one
illegal drug. 8.8% had not used any drug at all.
0.4% had injected a drug in the last 12 months, with another 1.9% having
ever injected as drug but not in the last year (2.3% total)
Summary of ever and last year drug experience by legal
status and IV use (Swiss GDS2015)
100
93.8
Ever
90.6
Last 12 months
Last month
90
80
78.8
73.6
70
56.4
%
60
50
40
47.2
47.1
34.9
30
25.5
20
10
2.3
0
Used illegal drugs
Used legal drugs
Legal drugs only
0.4
Injected a drug
Summary of ever and last year drug experience by legal
status and IV use (global sample M+F)
Ever
120
97.3
100
80
% 60
94.3
Last 12 months
Last month
91.2
78.9
60
46.5
45.7
40
34.9
18.5
20
3.1
0.8
0
Used illegal drugs
Used legal drugs
Legal drugs only
Injected a drug
Lifetime Drug Use Prevalence Switzerland N = > 6,200
% lifetime prevalence
crack
3.18
heroin
3.19
opium
3.45
ketamine
3.69
2cb
3.74
z drug (sleeping drugs)
4.17
salvia divinorum
4.55
amphetamine - base/paste
4.84
benzo not presc
5.05
benzodiazepines
5.53
ritalin
5.56
tramadol
5.75
butane hash oil
opioid prescribed
caf f eine tablets
truf f les
poppers
6.30
7.04
7.54
10.07
% lif etime prevalence
10.54
nutmeg
12.46
lsd
13.01
nitrous
13.94
amphetamine
14.59
guarana
14.99
magic mushrooms
16.04
cocaine
20.33
tobacco - snus
20.92
electronic cigarettes
20.94
mdma all
21.05
tobacco - shisha
51.61
cannabis all preperations
71.52
caf f einated energy drinks
75.93
tobacco
79.40
alcohol
0.00
95.60
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
100.00
Last Year Drug Use Prevalence Switzerland N = > 6,200
% last year prevalence
crack
cocaine - other
vapoursc
opioid not prescribed
ketamine
2cb
viagra
butane hash oil
benzo not prescribed
tramadol
benzodiazepines
opioid prescribed
caf f eine tablets
ritalin
poppers
nitrous
magic mushrooms
lsd
guarana
truf f les
amphetamine
nutmeg
tobacco - snus
cocaine
mdma all
tobacco - shisha
Cannabis all preprations
tobacco
alcohol
0.00
0.74
0.76
0.97
1.10
1.23
1.32
1.55
1.77
1.81
1.84
1.95
2.22
2.26
2.32
2.58
2.63
2.69
3.22
3.48
3.77
5.53
6.14
6.29
8.22
8.56
8.70
11.14
15.04
% last year prevalence
24.31
43.17
56.14
57.14
87.19
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
100.00
Last Month Drug Use Prevalence Switzerland N = > 6,200
% last month prevalence
2cb
crack
ketamine
cocaine - other
opioid not prescribed
tramadol
vapoursc
opioid prescribed
magic mushrooms
butane hash oil
viagra
nitrous
benzo not prescribed
lsd
poppers
caf f eine tablets
benzodiazepines
ritalin
truf f les
guarana
amphetamine
mdma all
tobacco - snus
cocaine
nutmeg
tobacco - shisha
Cannabis all
tobacco
alcohol
0.26
0.29
0.40
0.40
0.47
0.55
0.56
0.71
0.76
0.79
0.81
0.81
0.89
0.92
1.02
1.06
1.08
1.13
1.21
1.50
2.47
2.51
3.00
4.45
4.48
4.50
5.32
5.54
8.17
0.00
% last month prevalence
31.32
42.42
50.05
81.95
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
90.00
100.00
ALCOHOL
SWITZERLAND
What This Section Covers 1
• We asked people from the Switzerland to tell us how they needed to
drink in order to feel the effects of alcohol, how much they needed to
drink to be as drunk as they would want to be and how much would
they drink before they reached the tipping point – that is being more
drunk than they wanted to be. We also asked how often each of these 3
states were reached.
• We then asked on a night out how intoxicated with drugs or alcohol
people were before they entered a club or other entertainment venue.
• Next we sought to find out how often people had been subject to
negative experiences as a result of another persons drinking
• Finally we sought to identify what issues would lead to them thinking
about drinking less.
What This Section Covers 2
• In order to understand overall what levels of harm the respondents
were placing themselves at however started the alcohol section with
Alcohol Use Disorders Identification Test (AUDIT) a World Health
Organisation questionnaire to ascertain harmful drinking levels and
dependence. This included:
• How often individuals drank alcohol and how many drinks they would
have on a typical days use.
• We also asked whether individuals had sought emergency medical
treatment due to alcohol use, for what reasons, how much they had
drunk and the impact this had on future behaviour.
AUDIT questions and scores
How often do you have drink containing alcohol?
1)
Never =0 monthly/less=1 2-4/month = 2 2-3/wk = 3 4 or more/wk=4
How many std drinks do you have on a day when you drink?
2)
1 or 2 =0 3 or 4 = 1 5 or 6 =2
How often do you have 6 (F) / 8 (M) or more drinks on one occasion?
3)
Never =1
4)
less than monthly =1 monthly =2 weekly =3 daily/almost daily =4
How often during the last year have you found that you were not able to stop drinking once you had started?
Never =1
How often during the last year have you failed to do what was normally expected of you because of your drinking?
5)
Never =1
How often during the last year have you needed a drink in the morning to get you going after a heavy drinking
session?
6)
Never =1
How often during the past year have you had a feeling of regret or guilt after drinking?
7)
Never =1
How often during the last year have you been unable to remember what appended the night before because you had
been drinking?
8)
Never =1
Have you or someone else been injured as a result of your drinking
9)
No=0
10)
7-9=3 10 or more =4
Yes , but not in the last year =2
Yes, during the last year=4
Has a friend, relative , Dr or other health worker been concerned about your drinking or suggested you cut down?
Alcohol 10 Item AUDIT
(Alcohol Use Disorder Identification Test)
The AUDIT is widely used for screening and the delivery of brief interventions for
alcohol problems.
The 4 statements taken below are from WHO 2006 document Babor et al. It lists
4 sets of scores 0-7,8-15,16-19,20 and above.
Total scores of 8 or more are recommended as indicators of hazardous and
harmful alcohol use, as well as possible alcohol dependence.
Technically speaking, higher scores simply indicate greater likelihood of hazardous and
harmful drinking. However, such scores may also reflect greater severity of alcohol
problems and dependence, as well as a greater need for more intensive treatment.
AUDIT scores in the range of 8-15 represented a medium level of alcohol problems
whereas scores of 16 and above represented a high level of alcohol problems.
AUDIT scores of 20 or above warrant further diagnostic evaluation for alcohol
dependence.
Alcohol 10 Item AUDIT scores (n= >5,000)
Switzerland
male
Switzerland
female
0-7
8-15
16-19
20+
51.5%
34.8%
5.5%
2.8%
0-7
8-15
16-19
20+
67.7%
22.4%
2.7%
1.1%
8.3% of Swiss men scored 16 or more on the AUDIT compared to 12.9% of
men globally. 3.8% of Swiss women scored 16 or more compared to 9.6% of
women globally.
Scores of 8 and over indicate harmful use
Frequency of drinking (those who had used alcohol in last year)
How often do you have an alcoholic drink?
How many drinks do you have on a
day when you consume alcohol?
50.0%
40.6%
Monthly or less
2-4 times per month
2-3 times a week
4 or more times a week
40.0%
35.1%
30.0%
20.0%
15.9%
10.0%
5.8%
2.5%
0.0%
15.0%
1-2
5-6
7-9
10+
16.8%
How often have 6/8* or
more drinks?
50.0%
40.6%
40.0%
33.4%
3-4
34.8%
30.0% 23.4%
20.0%
10.0%
22.1%
12.1%
1.7%
0.0%
Never
Less than monthly
Monthly
Weekly
Daily or almost daily
* Adapted to country units in GDS2015 (range
5-8) higher figure of the pair for males
Selected AUDIT responses (those who had used
alcohol within the last year)
• 12.7% stated that they could not stop drinking once they had
started at least monthly over the last year.
• 2.9% stated that they had not been able to do what was normally
expected of them at least monthly over the last year.
• 1.6% stated they needed a drink in the morning following a heavy
drinking session at least monthly over the last year.
• 7.8% reported feelings of guilt or regret after drinking at least
monthly over the last year.
• 5.5% had been unable to remember events of the night before at
least monthly over the last year.
• 7.4% said that they or others had been injured as a result of their
drinking over the last year. A further 13.4% reported injury to self or
others as a result of their drinking at some point not in the last year.
• 8.4% said that others had expressed concern about their drinking
over the last 12 months. A further 5.9% said others had expressed
concern, but not in the last year.
Bad things happening at least monthly after alcohol
(from AUDIT)
14
12.4
12.7
11.9
12
10.4
9.7
10
7.8
8
7.4
GLOBAL
6
% 6
Switzerland
5.5
4
2.9
2
0
Not stop drinking
Not fullfill expectations
Guilt/regret afterwards Can't remember the night
Injured in last year
Would you like to drink less over the next 12 months
(last year drinkers)
28.1% of Switzerland drinkers indicated they
would like to drink less over the next 12 months
Of these 6.5% reported they would like help to
drink less, whilst 7.4% indicated they planned to
seek help to cut down on their drinking
Which country has the greatest proportion of drinkers who would like to drink less in
the next 12 months and what % would like some help
45
Like to drink less
Of those wanting to drink less the % that would like help
40 38.7 38.5
35
38.7
36.0
35.2
34.2 34.9
34.2 33.7
33.3 33.6
31.7
31.9
31.4
30
28.1
30.4
27.5
26.3
27.5
24.8
25
23.1
20.2
20
16.1 15.5
14.8
15
11.7
10.1
10
0
10.8
6.5
6.3
5
11
12.9
12.3
4.6
5.0
7.9
7.2
10.3
7.1
8.4
6.4
7.8
8.9
5.3
SEEKING EMERGENCY MEDICAL TREATMENT
WE ASKED WHETHER OR NOT YOU HAD SOUGHT EMERGENCY MEDICAL
TREATMENT (EMT) AFTER DRINKING ALCOHOL IN THE LAST 12 MONTHS AND WHAT HAPPENED
What % of last year Switzerland drinkers sought Emergency Medical
Treatment in association with their use of alcohol
0.9% (n=47) of Swiss
respondents had sought
emergency medical
treatment following
alcohol use in the last
12 months
57.8% of these were
admitted to hospital
Most common
complaints were nausea
and vomiting, passing
out, accidents, trauma,
memory loss, and
headaches
Nausea / vomiting
Passed out / unconcious
Accident / trauma
Memory loss
Headache
Very low mood in days afterwards
Confusion
Aggression / violence
Thoughts or acts of self harm
Paranoia / suspiciousness
Difficulty breathing
Anxiety / panic
Palpitations
Chest pain
Extreme agitation
Extreme sweating
Bladder / kidney problems
Fits / seizures
Seeing / hearing things
46.8
36.2
31.9
29.8
27.7
25.5
23.4
17.0
17.0
12.8
10.6
10.6
8.5
8.5
8.5
6.4
4.3
4.3
4.3
0
10
20
30
40
% reporting the symptom (n=47)
50
GLOBAL Which country has the highest rates of drinkers seeking emergency
medical treatment after they have been drinking (last 12 months)
3
2.8
2.5
2.2
2
1.6
%
1.5
1.6
1.5
1.5
1.5
1.3
1.3
1.1
1
0.5
0
1
1
0.9
0.9
0.8
0.7
0.6
How long did it take to recover after seeking EMT and how
did it change drinking habits among participants (n=47)
11 persons felt back to normal within 12 hours
11 persons felt back to normal within 24 hours.
No one took over 4 weeks to get better.
No one reported still not having recovered.
36.2% of people cut down their drinking after the experience.
51.1% of people changed the way they drank.
23.4% of people indicated it led to no change in their
drinking behaviour
How much do you need to drink to get where you want to be? And how often do
you get where you want to be and how often do you miss the ‘stop’
How often have you got to the point in the evening when you have drunk just enough to feel as
‘happily drunk’ as you want to be, but have carried on drinking? How often have you drunk past
the ‘tipping point’ so you leave that happy place behind and end up more drunk than you wanted
and consequently the pleasure of the night diminishes?
Last year GDS reported that between 25%-40% of drinkers (depending on country) who were at
risk of developing dependence thought their drinking was average or less than average compared
to other people. We also reported that most drinkers were unaware of their country’s drinking
guidelines and of those who were only one in five paid any attention to them. One reason that
people may ignore drinking guidelines is because most recommend no more than a couple of
small glasses of wine or small bottles of beer a day.
For many people that might not quite be enough to get the effect they want and may be a way off
the amount they may require to be as ‘happily drunk’ as they can be. Now I know there will a
spectrum of responses both within people’s interpretation of what happily drunk is and of course
between people based on variables such as gender, weight and tolerance. But if you get enough
people to answer the question (and we have) then we might be able to learn something useful and
possibly game changing.
That something might be how to help people get the most from alcohol while minimizing the huge
risks associated with binge drinking which include accidents, violence, assault, and some pretty
serious health harms. We’ll also explore what experiences actually change peoples’ relationship
Where do you do most of your drinking ?
On own at home
5.6%
At home with partner /family 26.1%
At house parties
24.0%
At pubs/bars
33.8%
At clubs
10.4%
What we asked
GDS is interested in how much alcohol people drink and how it make
people feel.
We know that this depends on where you are, how quickly you drink and what
you are doing so please answer the following questions based on the how you
usually drink and the place you have done most of drinking over the last 12
months.
People then chose the type of alcohol (beer, wine, spirits) they drank most
often and what size in mls was typical drink for you.
Imagine you were drinking just this type of drink and not using any other drugs.
How many drinks would it take for you to reach the following stages of
intoxication?
– So you can just feel the effects
– You are drunk as you would want to be
– The tipping point – you are starting to feel more
drunk than you want to be
For the next few slides for ease of understanding we are
taking a drink to mean the number of ‘drinks’ people
reported: this is how many ‘drinks’ someone
orders/buys/consumes when they are drinking so anyone
can understand this compared to how they behave
regardless of whether they understand units or standard
drinks (we know the amount varies in a standard drink).
For a more accurate assessment using conversion into standard
WHO units of alcohol (10gm units) see the slides after the next 2
where we compare men and women from different countries
using standard units
How many drinks* to reach the following stages of intoxication
31.6% of respondents stated they would
need 1 drink to feel the effects, 58.5% said
they would need 2-3 drinks and 8.8% said
they would need 4-5 drinks
54.4% said that they would need 4-5 drinks
to be the most drunk they’d want to be.
22.3% said 6-8 and only 1.4% said more
than 10 drinks
26% stated that they would need 4-5 drinks
to reach their tipping point (more drunk than
they want to be), 43.5% 6-8 drinks, with
10.1% indicating more than 10 drinks
Alcohol – How many drinks* to reach the following stages of
intoxication
70
how many drinks* someone
orders/buys/consumes when
they are drinking so anyone
can understand this
58.5
60
54.4
50
43.5
40
You can feel the effects
31.6
%
30
The most drunk you'd want to be
26
The tipping point
22.3
20
17.3
13.5
10
6.8
1.6
0
0-1
9.3
8.8
3
0.9
0
2-3
4-5
0.2
6-8
9-10
Number of drinks
0 1.1
11-15
0 0 0.4
0 0.30.2
0 0 0.2
16-20
21-50
51-100
GLOBAL COMPARISON
How much women around the world need to drink to get to different
units
levels of intoxication (mean number of 10gm alcohol units)
18
17
16.7
15.6
16
14.4
13.7
14
14.5
14.4
14.2
14.3
13.7
13.5
12.8
12
11.3
12.9
12.6
12.3
12.9
12.4
11.9
11.7
11.2
11
10.8
10.8
10.6
10.3
10.2
10
11.4
11.1
10
9.5
9.5
8.9
8.8
8.8
8.8
8.7
8.3
8
7.9
6.9
6
5.2
11
6.7
5.5
5
4.2
4.3
4
4.4
4.4
4
4.1
4.3
4.5
4
4.4
4
4
4.1
3.8
3.8
3.3
3.3
2
0
Feel the effects
Happiest
Tipped
Linear (Happiest)
3.2
units
GLOBAL COMPARISON
How much men around the world need to drink to get to different
levels of intoxication
25
22.3
21.9
22.3
21.3
21.3
19.7
20
19.1
19.1
18.9
17.9
18
17.6
17.4
17.6
17.4
16.4
15.3
15.1
16.2
15.2
15.1
15
14
14.4
13.7
13.7
13.5
12.9
12.8
12.6
12.5
12.1
12
11.7
11.6
11.6
10.6
10.4
10.1
9.5
10
6.6
5.9
6.2
15.3
14.9
9.5
6.6
6.3
5.3
5
5.1
5.2
5.4
5.9
4.7
4.5
4.8
4.2
4.4
4.9
4.6
4.4
4.4
4.1
0
Feel the effects
Happiest
Tipped
4.1
Alcohol – How often reached stages of intoxication
over last 12 months
41.4% of respondents stated that they drink
so much they can feel the effects at least
weekly
20.8% stated that they get the most drunk
they’d want to be at least weekly and a further
36.7% at least monthly
18.6% said they reach the tipping point at
least monthly with a further 33% saying they
reach it at least once a year
How often have people reached different stages of intoxication
over last 12 months
%45
41.4
You can feel the effects
40
35.3
36.7
The most drunk you'd want to be
35
The tipping point
33
30
24.7
24.4
25
23.7
20.8
20
15.6
15
15.2
10
5
9.7
8.5
4.6
3
3.5
0
At least weekly
At least monthly
At least once a year
Less than once a year
Never
35
GLOBAL COMPARISON
Which country get more drunk than they want to most often (% based on those
saying they drink passed the tipping point at least monthly)?
% drinking past the tipping point at…
30
29
27.5
25
23.3 23.2 23.2
21.4 21.4
20
20.7
20
19.7
18.9 18.8 18.6
17.4 17.1
%
16.4 16.2
15.8
14.3
15
13.3
11.6
10.5
10
5
0
What get you thinking about reducing the amount you drink /
change the was you drink alcohol?
We asked men to choose the top 3 experiences which would be
most likely to get the to think about reducing the amount they
drank / how they drank.
The experiences were as follow
Social embarrassment/humiliation
Being sexually assaulted /taken advantage of while drunk
Sexual regret (e.g. ending up in bed with someone)
Being injured in an accident
Being unable to remember the night before because of alcohol
Having to seek emergency medical treatment
Physical health condition related to/worsened by alcohol
Mental health condition related to/worsened by alcohol
Concerns raised by partner /friends about what you are like when you are drunk
Negative impact on education/study/work
Being involved in violent incident
Getting in trouble with the police
Financial worries
Changing drinking habits – what would be likely to get people thinking
about reducing their alcohol consumption
Physical health condition related to/worsened by alcohol
33%
Having to seek emergency medical treatment
31%
Negative impact on education/study/work
23%
Mental health condition related to/worsened by alcohol
20%
Social embarrassment/humiliation
28%
Concerns raised by partner /friends about what you…
30%
Being sexually assaulted /taken advantage of while…
23%
Being injured in an accident
30%
Getting in trouble with the police
19%
Being unable to remember the night before because…
18%
Being involved in violent incident
14%
Financial worries
14%
Sexual regret (e.g. ending up in bed with someone)
11%
0%
5%
10%
15%
20%
25%
30%
35%
Social humiliation/injury/ assault and sexual
regret are all addressed a fun little app we
developed last year
The one too many app at www.onetoomany.co is for
younger people and is fun way of getting younger
people to think about their drinking behaviour as
opposed to their alcohol consumption. Over 130,000
people have completed it so far. We think these could
make a goods story
The one too many app at
www.onetoomany.co is for
younger people and is fun
way of getting younger
people to think about their
drinking behaviour as
opposed to their alcohol
consumption. Over
130,000 people have
completed it so far.
Alcohol – Serving Drunks
When asked, 31.2% of respondents from the Switzerland thought it is
legal to serve alcohol to individuals who were drunk. 13.2% thought it
is illegal and 55.7% didn’t know
63.7% thought that if someone who was obviously drunk tried to get
served alcohol in a bar or nightclub in their country they would get
served.
GLOBAL – Which country thinks drunk people would normally get served in
pub/club (who has the most irresponsible service of alcohol ) and where do
people think its legal to serve drunk people alcohol
100.0
93.3
90.0
79.4
80.0
71.9
70.0
73.5
74.3
75.4
81.8
82.0
82.7
60.0
60.4
87.5
87.9
84.2
75.7
73.8
66.3
65.8
60.1
84.7
61.9
53.3
50.3
50.0
51.5
44.1
40.7
40.0
40.8
36.7
34.3
33.3
29.8
30.0
20.0
15.8
14.8
15.4
18.1
17.8
15.6
14.6
17.5
8.1
10.0
1.1
2.3
0.0
% who think a drunk person would usually get served
91.4
% who think serving drunk people is legal in their country
Safety on a night out
We asked
On a scale of 1 to 5 where 1 is very unsafe and 5 is very safe, when you
go on a night out in your country how safe do you generally feel
On your way to a venue
In bars and pubs
In nightclubs
Travelling home after a night out
Alcohol –
How safe people in Switzerland feel on a night out
60
54.6
On your way to a venue
In bars and pubs
50
In nightclubs
Travelling home after a night out
41.5
40
40
36
32.2
30.5
30
27.2
25.4
22.9
%
20.7
20
15.4
10.3
10
13.3
9.3
6.3
3.6
2 1.6
3.5 3.6
0
1
2
3
1= very unsafe 5= safe
4
5
Alcohol – Pre-loading
We asked when you arrive at the first bar or nightclub you are visiting on a
night out, would you usually:
be completely sober (i.e. have had no alcoholic drinks or drugs)
have already consumed a bit of alcohol (but not be drunk)
have already consumed a lot of alcohol (feeling drunk)
have already used drugs
57.0% of Swiss respondents stated they were sober when arriving on a night out
43.4% said they would have already consumed alcohol (but not feel drunk) and
5.8% said they would have already consumed a lot of alcohol and feel drunk on
arrival
8.6% of the individuals asked said they would have already used illegal drugs
when arriving on a night out
When someone else drinking becomes your problem
We asked ‘in the last 12 months, have you been negatively affected by
someone else’s drinking in any of the following ways’:
–
–
–
–
–
–
–
–
–
Harassed by someone who was drunk (clearly under the influence of alcohol)
Physically assaulted by someone who was drunk
Sexually harassed or assaulted by someone who was drunk
Injured accidentally by someone who was drunk
Called names or insulted by someone who was drunk
Afraid because of someone who was drunk
Involved in a traffic accident caused by a drunk driver or pedestrian
Kept awake by drunken noise
Had property damaged by someone who was drunk
Alcohol – negatively affected by anyone else’s drinking
32.6% of respondents had been harassed by someone who was drunk
5.8% of respondents had been physically assaulted by someone who was
drunk
3.8% of respondents had been sexually harassed or assaulted by
someone who was drunk
3.5% of respondents had been injured accidently by someone who was
drunk
30.7% of respondents had been called named or insulted by someone who
was drunk
20.6% of respondents had been afraid because of someone who was
drunk
0.6% of respondents had been involved in a traffic accident caused by a
drunk driver or pedestrian
12.9% of respondents had been kept awake by drunken noise
6.1% of respondents had property damaged by someone who was drunk
Where in the world does other people’s drinking cause serious problems
for you? (ranked based on physical assault)
Physically assaulted by a drunk person
35
Sexually harrassed/ assaulted
Afraid of a person who is drunk
30.3
29.4
30
28.1
26.8
26.6
27.8
27.4
26.6
26.3
25.9
24.7
25
25.3
23
21.6
20.6
18
%
20
19.9
19.4
20
19
18.4
17.8
15
12.7
10.9
10.8
10.1
10
10.9
10
8.7
7.1
7
9.2
8.4
9.3
8
6.6
5
3.2
0
12.5
7.9
7.2
7.1
9.5
7
6.5
6.3
7.1
6.1
6.1
5.9
5.8
5.8
3.8
5.6
5.4
6.2
5.4
5.5
5.2
3.9
2.6
3.4
2.3
2.3
1.3
1.7
1.7
Switzerland v Global - comment
The Swiss appear to have a healthy and insightful relationship to
alcohol. Their rates of harmful drinking is lower than the rest of the
GDS2015 sample, they seem to reach a point of contentedness at
level of alcohol much lower than their European neighbors
Less than 1 in 5 get more drunk than they would want to at least
monthly, and their rates of seeking emergency medical treatment are
about average for the sample
Despite this quite moderate level of drinking over 1/3 of the Swiss
respondents would like to drink less in the next 12 months.
The high proportion of respondents stating social humiliation as a
strong motivator for change is in line with similar findings from
Germany and Austria
E-CIGARETTES
In recent years there has been growing interest surrounding the impact of e-cigarettes on the smoking habits
of people with some commentators suggesting they might see the end of tobacco smoking altogether. Whilst
national and international regulatory bodies decide how to regulate these products (some seeing them best
controlled and licensed as medicines whilst others see them as another form tobacco or route into tobacco
smoking) what is clear is that profit is there to be made either by their use or promotion and this has led
many e-cigarette firms to have been snapped by existing tobacco companies.
The current component of GDS2015 was to give a broad indication of the prevalence of e-cigarette users in a
range of countries that vary in their policies on e-cigarettes from outright bans to treating them primarily as
consumer products.
The data used in this part of the report is based on those respondents who reported that they were current
tobacco users or had used tobacco in the past year in countries for whom this figure was at least 500.
Although there may be some additional use in never-smokers and long-term ex-smokers this has been found
to be extremely rare in countries where it has been studied such as the UK and US.
The data provided here offers both female and male data from around the world
Prevalence of e-cigarettes: use at least monthly. (figure 1 and table 1)
Legal
Female
Male
Total
status1
Australia
2
6.9 (35/509)
9.3 (94/1016)
8.4 (130/1544)
Austria2
3
3.8 (15/396)
6.1 (42/689)
5.2 (57/1086)
Belgium
2
6.9 (23/335)
5.7 (44/775)
6.0 (67/1111)
Brasil
1
1.1 (9/847)
2.6 (39/1480)
2.1 (48/2336)
Canada2
3
8.4 (24/285)
16.5 (41/249)
12.2 (66/540)
France
3
11.8 (323/2746)
16.2 (626/3876)
14.3 (952/6636)
Germany
3
2.9 (161/5648)
6.2 (752/12057)
5.2 (916/17772)
Hungary
2
5.2 (49/943)
6.5 (139/2127)
6.1 (189/3076)
Ireland
3
7.4 (53/712)
11.2 (92/819)
9.6 (147/1538)
Netherlands
3
4.3 (69/1619)
4.7 (98/2074)
4.5 (168/3713)
New Zealand
2
7.3 (28/386)
10.6 (65/611)
9.3 (93/1004)
Spain
3
1.9 (4/213)
4.2 (16/378)
3.4 (20/591)
Switzerland
3
5.5 (64/1157)
9.8 (191/1956)
8.1 (258/3186)
United Kingdom
3
12.4 (174/1402)
17.8 (506/2847)
16.0 (685/4284)
United States
3
14.9 (195/1312)
28.8 (401/1391)
22.1 (603/2728)
11=banned, 2=permitted only
without nicotine, 3=permitted; 2Legal status recently
changed from ban or partial ban
Figure 1: Prevalence of e-cigarette use in 14 countries among tobacco users
and recent ex-users
35
The highest prevalence was found in
the US, followed by the UK, France and
Canada. Spain and Brazil reported very
low levels of use. Prevalence in men is
30
28.8
Female
Male
Total
25
Percent (%)
22.1
20
17.8
16.5
16.2
14.9
14.3
15
12.2
10
16
11.2
10.6
9.6
9.3
8.4
9.8
9.3
8.4
6.9
6.1
5.2
5
12.4
11.8
8.1
7.4
6.9
5.7 6
6.2
5.2
6.56.1
5.2
7.3
5.5
4.34.74.5
3.8
4.2
3.4
2.9
2.6
2.1
1.1
1.9
0
Australia
Austria
Belgium
Brasil
Canada
France
Germany
Hungary
Ireland
Netherlands
New
Zealand
Spain
Switzerland
United
Kingdom
United
States
Prevalence of daily e-cigarette in 14 countries among tobacco users and
recent ex-users (the prevalence of daily e-cigarette use was less than half that of any current use)
Female
Male
Total
Australia
1.4 (7/509)
3.5 (36/1016)
2.8 (44/1544)
Austria
0.5 (2/396)
2.5 (17/689)
1.7 (19/1086)
Belgium
2.1 (7/335)
2.1 (16/775)
2.1 (23/1111)
Brasil
0.4 (3/847)
0.9 (13/1480)
0.7 (16/2336)
Canada
2.5 (7/285)
9.2 (23/249)
5.7 (31/540)
France
5.4 (147/2746)
8.9 (346/3876)
7.5 (496/6636)
Germany
1.1 (60/5648)
2.8 (333/12057)
2.2 (394/17772)
Hungary
2.4 (23/943)
3.4 (73/2127)
3.2 (97/3076)
Ireland
2.8 (20/712)
4.9 (40/819)
4.0 (61/1538)
Netherlands
1.5 (25/1619)
1.6 (34/2074)
1.6 (60/3713)
New Zealand
1.8 (7/386)
3.4 (21/611)
2.8 (28/1004)
Spain
0.9 (2/213)
1.9 (7/378)
1.5 (9/591)
Switzerland
1.8 (61/1124)
5.4 (10/562)
4.2 (73/1724)
United Kingdom
4.2 (59/1402)
9.3 (256/2847)
7.6 (326/4284)
United States
3.7 (49/1312)
11.4 (159/1391)
7.7 (211/2728)
40
Figure 2: Prevalence of daily e-cigarette use in 14 countries among tobacco users
and recent ex-users
35
The levels of daily use of
e-cigarettes is extremely
low given all the moral
panic that is going on in
many countries
30
Percent
25
20
15
11.4
10
9.2
9.3
8.9
5.7
5
3.5
2.8
1.4
2.5
1.7
0.5
2.12.12.1
Austria
Belgium
5.4
4.9
2.8
2.2
1.1
2.5
0.9
0.4 0.7
7.7
7.6
7.5
3.43.2
2.4
4.2
4
2.8
1.51.61.6
3.4
2.8
1.8
1.91.5
0.9
3.1
2.3
3.7
0.9
0
Australia
Brasil
Canada
France
Germany
Female
Hungary
Male
Total
Ireland
Netherlands
New
Zealand
Spain
Switzerland
United
Kingdom
United
States
As would be expected, countries with more restrictive policies have
lower e-cigarette prevalence (Figure 3)
12
10
Figure 3: Prevalence of e-cigarette use as a
function of legal status
Percent
8
10.3
7.5
Any
Daily
6
4.4
4
2.7
2.1
2
0.7
0
All banned
Nicotine banned
Permitted
CANNABIS
SWITZERLAND
• How often people who smoked cannabis has used in the last year.
• Data on the key motivations for using cannabis (pleasure or self
medication or both).
• The most common methods of use adopted in your country including
what percentage of users mix with tobacco and how many joints or
bongs people usually get from a gram.
• *Prevalence of different types and cannabis and the cost per gram of
the most common type (with global price comparisons)
• Information on where people get their cannabis from and if they pay
how much they usually pay for one gram.
• Admissions to hospital for emergency medical treatment.
• The risk and experience of violence associated with getting hold of
cannabis
* We will send this data though next week
Cannabis in Switzerland: Last Year Users – 43.2% (N=2,678)
Days used in the last 12 months
Method of use
Joint
4.4
Daily use among Swiss participants:
3.6% (n=225) hydro
3.4% (n=210) herbal
1.6% (n=99) hash
Bong
21.1
Pipe
42.6
Blunt
Drink
18.7
Food
Vapouriser
13.2
Bucket bong
1
2-10
11-50
51-100
Over 100
0
20
With tobacco
40
60
80
100
Without tobacco
Cannabis in Switzerland: Last Year Users – 43.2% (N=2,678)
Reasons for use
Risk of violence
83.2% use exclusively for
recreational / pleasure
On a scale of 1 (almost none) to 10 (very high), the risk of
violence when acquiring cannabis in Switzerland was rated by
last year users:
14.8% use mostly for
pleasure, but sometimes for
medical reasons
70
1.9% use mostly for medical
reasons, but sometimes
recreationally
50
60.4
60
96.8% last year cannabis users had
never been exposed to violence when
buying cannabis.
40
2.2% had once, and 1.0% had on two or
more occasions.
%
0.1% used cannabis
exclusively for medical
reasons
30
20
20
9.3
10
2.8
3.1
4
5
1.6
1.6
0.7
0.2
0.5
6
7
8
9
10
0
1
2
3
Cannabis – Sought Emergency Medical Treatment Last 12 Months
2.5
2.0
2.0
% Last year users
Global EMT
rate was 1.0%
1.5
1.5
1.4
1.3
1.3
1.3
1.2
1.1
1.0
1.0
1.0
1.0
1.0
0.8
1.0
0.9
0.6
0.5
0.6
0.4
0.0
Cannabis – Global EMT Seekers (N=434)
Preparation of cannabis used (%)
Symptoms presented with
High-potency / hydroponic
Anxiety
Herbal
58.29
Feeling scared
Resin / hash
Butane hash oil
1.2
41.71
Paranoia
35.71
Breathing difficulties
13.4
28.11
Agitation
24.65
Chest pains
21.89
Mood problems
19.35
Extreme sweating
19.12
Nausea
50.9
34.4
17.28
Visual hallucinations
12.67
Auditory hallucinations
12.44
Accident
11.03
Inability to talk
10.37
Seizures / fits
8.99
Aggression
5.53
Bladder / kidney problems
2.53
0
20
40
%
60
80
SYNTHETIC
CANNABINOIDS/
CANNABIS
Background
Over the last 4 years GDS has conducted the largest studies in the world on synthetic
cannabis products and published some of the most highly cited paper on the topic in
the world.
•
Winstock AR et al Risk of seeking emergency medical treatment following consumption of cannabis or synthetic
cannabinoids in a large global sample. J Psychopharmacology 2015 THIS HIGHLIESGHTED THAT THE RISK OF SEEKING
EMERGENCY MEDICAL TREATMENT WAS 30 TIMES HIGHER IN USERS OF SCs THAN HIGH POTENCY CANNABIS
•
Winstock AR et al A comparison of patterns of use and effect profile with natural cannabis in a large global sample. Drug and
Alcohol Dependence. 2013 THIS HIGHLIGHTED THAT 93% OF USERS PREFERED NATURAL CANNABIS AND THAT SCs
HAD A MUCH LESS PLEASANT EFFECT PROFILE THAN NATURAL CANNABIS
•
Winstock AR et al The 12-month prevalence and nature of adverse experiences resulting in emergency medical
presentations associated with the use of synthetic cannabinoid products. Human Psychopharmacology: Clinical and
Experimental 2013 THIS HUIGHLIGHTED THAT ALMOST 1 IN 40 LAST YEARS USERS HAD SOUGHT EMERGENCY
MEDICAL TREATMENT IN THE PREVIOUS 12 MONTHS
This year we build on our earlier work and assess the public health impact of
1)
new preparation of SCs (oils and powders)
2)
banning of older SCs which are then replaced by often more potent products which
may be more risky and impact on rates of seeking emergency medical help
3)
the risk of developing dependence and withdrawal
Prevalence of synthetic cannabis use globally
Prevalence of use
Of the global sample (n=>101,000)
10
8.7
• 8.7% (n=8837) had ever used SC;
• 1.7% (n=1699) used in the last year,
and
• 0.6% (n=565) used last month
%
8
6
4
1.7
2
0.6
0
Use
Ever
Last year
Last month
Types used in last year
•
•
•
•
80
71.6
60
%
Of those that used SC in the last 12
months they had tried the following
preparations:
40
20
0
71.6% (n=1217) herbal
9.1% (n=154) powder
5.4% (n=91) resin
2.4% (n=41) oil
Tried -last year
Herbal
Powder
Resin
Oil
Missing
Country based last year prevalence of SC products
14.0%
Among our sample the prevalence of
use was low except in Poland,
Hungary and in NZ where they were
legally available until June 2014
12.0%
13.1%
Percentage
10.0%
8.0%
0.3% of the Swiss
GDS2015 sample had
used SC products in the
last year
6.0%
5.5%
4.3%
4.0%
2.0%
1.8%
1.7%
0.9%
1.1%
0.6%
0.0%
0.2%
2.3%
2.2%
2.0%
1.3%
1.9%
1.1%
0.5%
0.0%
1.3%
1.0%
0.4%
0.3%
The following slides are based on the responses from
the 1500 or so last year users of SCs from around the
world.
Where there are sufficient local users from your country
we have provided an additional slide after the global
data and shaded it green
Source and price of synthetic cannabis
(global last year users n > 1200)
We asked : Where the SC was purchased and how much they
paid per gram:
Source
Percentage
Mean Price Euro (SD)
Friend
39.4
€2.84 (6.45)
In person at a shop
27.1
€8.99 (7.84)
Online
18.2
€8.11 (9.96)
Dealer
15.2
€9.17 (41.14)
Global synthetic cannabis use: methods of use
(last year users)
Herbal was the most common preparation for all 12 month users
The usual routes of administration of all SC preparations were as follows
72.9% (n=944) it was a joint with tobacco
22% (n=285) it was a bong/water pipe
1.9% (n=25) in a vaporiser
1.6% (n=21) took it orally
80
1.2% (n=15) in a vape pen
0.3% (n=4) snorted it
60
0.1% (n=1) injected it
40
Usual method of use
72.9
%
•
•
•
•
•
•
•
22
How many joints / gram?
Mean number of joints per gram was 9.6
95% of users got between 5-10 joints
10 joints / gm was the most frequent
number
20
1.9
0
1.6
1.2
0.3
0.1
Method of use
Joint with tobacco
vapouriser
vape pen
IV
Bong/water pipe
oral
snorted
Seeking Emergency Medical Treatment on Synthetic Cannabis
In research published in 2015 GDS has already shown the risk of seeking EMT is at least 30 times greater
with SC than high potency herbal cannabis (Winstock et al J psychopharmacology 2015).
3.5% (n=43) of those reporting the use of
synthetic cannabis in the last 12 month had
sought EMT
All but one had smoked the synthetic cannabis
product, one had consumed orally
39 had used a herbal preparation and 3 had used
a powder preparation (1 did not answer)
How long before you felt back to normal?
11 people (26.8%) within 6 hours
2 (4.9%) not yet back to normal
How did this effect your use subsequently?
31 (72.1%) reduced synthetic cannabis use
4 (9.3%) cut down on other drugs
4 (9.3%) increased other drug use
Over one in 30 last year users sought emergency medical
treatment – the highest of any drug studied by GDS this year
What they presented with:
Panic
Nausea
Breathing difficulties
Agitation
Low mood
Sweating
Scared
Overheat
Paranoia
Chest pain
Unable to talk
Bladder problems
Fits
Seeing things
Accident
Aggression
Hearing things
Other
49%
47%
44%
35%
33%
33%
30%
30%
30%
26%
23%
19%
14%
14%
14%
12%
12%
23%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%
Percent
The more often used SC the more likely you were you seek EMT
(based on feedback from almost 1200 last year users)
1
2-10
11-50
Sought
EMT
No
Sought
EMT
Yes
328
8
483
185
10
2
51-100
94
9
>100
89
14
Total
1179
43
%
EMERGENCY MEDICAL TREATMENT
%
Emergency Medical Treatment
16
2.4%
2.0%
12
1.1%
8.7%
13.6%
13.6
14
% seeking EMT
Times
used in
last 12m
10
8.7
8
6
3.5%
4
There is a huge dose response
relationship – exactly the same as
we see with a drug like
methamphetamine – more drug,
more often = more risk of
running into serious problems
2.4
2
2
1.1
0
once
2-10 times
11-50 times
51-100 times
> 100 times
Comment
The findings suggest that as more potent synthetic cannabinoids products appear
on market the potential for those drug to cause serious harm will increase
That over one in 30 last yeas users ought EMT makes these the most dangerous
of all recreational drugs
The marked dose response relationship that is seen with more frequent use being
associated with much greater risk of seeking EMT is seen with other drugs – but
that one in 8 regular users might seek such help is a huge public health worry.
The experience does at least in most cases seem to result in people stopping their
use – it would good to find other way to help people avoid these class of drugs
however
Our data confirms that natural cannabis products although not
safe and free from the risk of any harm carry a significantly
lower risk of acute harm, dependence and withdrawal.
SEEKING EMERGENCY MEDICAL TREATMENT
Seeking Emergency Medical Treatment
Background to the section
•
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.
•
The UK seems to have higher rates of EMT seeking than other countries with
almost one in 30 women reported having sought treatment related to their use of
drugs or alcohol in the last 12 months. Their susceptibility to harm using unknown
RC drugs seems to be particularly high.
105
• 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 drug in the globally seeking emergency medical treatment
is followed by drug specific results for Germany
• Further date on alcohol related admissions are given under the
alcohol section.
What % of people had sought emergency medical treatment following
the use of drugs/alcohol in the last 12 months ? (global)
4
3.5
3.5
3.4
3.2
3
2.5
2.2
2.3
2
2
1.8 1.8
1.5
1.2
1.3
1.1
1
1.9
1.3
1 1
1.1
1
0.9
0.6 0.6
0.7
0.7
0.5
0.5
0.3
0
Alcohol
Cannabis
Synthetic
Cannabis
Cocaine
Global (M+F)
Research
chemical
Male
Female
MDMA /
ecstasy
Ketamine
Any drug
Comment & advice
Overall it is clear that that substances that carry the highest risk for needing
emergency medical treatment are the RCs/ NPS – one suspects this because of
their varied potency and effect profile and the fact there is little guidance on how to
minimize the risk associated with their use other than ‘ don’t take them’.
•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 90-120 minutes before redosing
•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
DRUGS AND THE INTERNET
AND DARK NET
Drugs, the Internet and the dark net
Background
•
The internet is the drug market without frontiers (or very often customs). Buying drugs online is a
natural extension of e commerce. People buy online because it’s convenient, for the range and
quality of products and in some cases because it represents value for money. Vendor rating
systems were also welcomed by dark net market buyers.
•
The internet as a source of psychoactive substances –both medicinal and illicit has grown
significantly in the last few years.
•
While the focus amongst law enforcement, the media and public health has been upon ‘legal
highs’ little work has been conducted to look at the prevalence of using the internet to access
drugs amongst the general population nor exploration into what substances were being accessed.
•
With street dealing remaining a key target for drug squads, doctors being increasing wary of
prescribing irresponsibly and the purity and many illicit drugs being comprised through
adulteration, the appeal of obtaining drugs online is obvious.
•
In the following section we investigated both the timing and prevalence of using the internet to
purchase drugs and then specifically the use of dark net markets – Silk Road and those that came
after it.
When Did You First Buy Drugs Online*? (%)
30.0
25.3
25.0
Year on year
buying drugs on
line is increasing
20.0
16.4
15.0
13.0
10.0
7.9
5.0
4.1
1.3
0.1
0.3
0.3
0.5
0.6
0.4
0.6
0.7
0.9
1.6
0.8
1.4
1.5
2.2
2.2
2.4
7.5
4.9
3.1
0.0
1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Base sample: all respondents excluding those who reported use of only alcohol/tobacco/caffeine who reported buying drugs
online.
Global N = 11,757.
DARK NET MARKETS
Background
From February 2011 to October 2013, the online illicit marketplace Silk Road (SR) enabled the international
trade of illegal drugs and other goods and services . Online illicit marketplaces or ‘cryptomarkets’ are located
in the ‘deep web’ and accessed via Tor. In the deep web, site owners, vendors and buyers are able to remain
relatively anonymous as their IP addresses are masked. Purchases are made using the decentralised virtual
currency Bitcoin, which can also be used relatively anonymously.
GDS2015 occurred 1 year after the demise of the original Silk Road and just after Operation Onymous which
brought down a number of dark net markets that had arisen as replacements. Despite the disruptions to the
dark net markets through law enforcement efforts and scams by market operators, we obtained the largest
sample of drug buyers from the dark net during this period (n=5,432).
Have you ever bought drugs off the dark net*? (%)
Base sample: All respondents excluding those who reported use of only alcohol/tobacco/caffeine.
* Includes those who report personally purchasing drugs, arranging for others to purchase drugs OR purchasing on behalf of others from dark net markets.
30.0
Note the small N for
these countries <600
N
25.0
20.0
18.0
15.0
13.9 11.7
10.0
11.6
12.2
11.1
8.0
6.9
5.0
5.5
4.5
7.2
4.7
5.4
4.6
0.0
3.3
3.4
3.2
2.6
1.9
2.4
4.6
1.5
3.8
1.7
Yes (not within last 12 months)
3.4
1.9
3.2
2.2
3.3
2.0
3.0
1.8
4.5
3.1
1.3
1.6
1.3
1.2
1.4
1.1
1.4
1.5
1.0
1.3
0.7
0.4
0.8
1.9
Germany
France
United Kingdom
United States
Netherlands
Switzerland
Brazil
Hungary
Australia
New Zealand
Ireland
Belgium
Austria
Canada
Portugal
Spain
Scotland
Sweden
Poland
Denmark
Italy
Greece
Norway
Wales
All
Yes (in last 12 months)
>27K
>8K
>5K
>5K
>5K
>5K
>4K
>3K
>3K
>2K
>2K
>1K
>1K
>1K
>1K
>900
>600
>500
>400
>400
>400
>200
>200
>200
>86K
The next set of slides reflect
an overview of global dark net
use not Switzerland in
particular
Prevalence of dark net market use
1.8%
0.6%
2.8%
The most commonly reported
involvement was to consume drugs
bought on dark net markets by
others but not purchase oneself
(2.8%), or to purchase from dark
net markets for oneself but not
provide to others or have others
buy for you (1.8%). 1.8% bought
for themselves and for others.
0.7%
1.1%
92.9%
0.1%
0.1%
Bought for self
Others bought for them
Of those who reported ever use of
illicit drugs or NPS (n=72,573),
7.1% or 5,152 respondents
reported involvement in dark net
markets, either buying drugs for
themselves (4.2%), consuming
drugs others bought for them
(4.2%), or buying drugs on behalf
of or to provide to others (2.0%).
Bought for others
Base: Respondents who report ever use of
any illicit drug or novel/new psychoactive
substance (excludes alcohol, tobacco,
caffeine, inhalants, prescription medication).
Ever used the dark net stats
The median number of times they had purchased drugs from the
dark net was 4 (interquartile range 2 – 8).
20% reported only doing so once.
9% reported doing so 20 or more times.
The median number of different dark net markets they had
purchased drugs from was 2 (interquartile range 1 – 2).
43% reported using only 1 market.
6% reported using 5 or more markets.
Which drugs were bought through dark net? (%)
40.0
37.2
Given access to any drug the most popular
drugs bought are the traditional illicit – tried,
tested. Desirable, familiar and probably safer.
35.0
30.3
30.0
26.5
25.0
24.9
20.0
NPS/RC
17.8
14.9
15.0
14.8
13.9
13.5
11.5
9.8
10.0
9.1
8.0
7.1
6.6
4.5
5.0
4.0
3.9
3.4
0.0
Of 5,432 who reported ever use of dark net markets to obtain drugs, 4,718 provided at least one response to this question.
Only the most prevalent 20 drug types are shown.
3.1
How has accessing drugs through darknet markets affected the range
of drugs you have consumed?
People extend their drug
experiences on line and some
people experiment for the very
first time. Same as other ecommerce market-places.
4
6
15
I have consumed a smaller range
of drugs than previously
45
30
I have consumed the same
range of drugs as previously
I have consumed a wider range
of drugs than previously
I have consumed a different
class of drugs than previously
I did not consume drugs prior to
accessing them through dark net
markets
Who is using dark net markets?
These results are looking at the demographics and drug use
characteristics of people who report accessing drugs through DNMs in
the last 12 months. The BASE group for this analysis is people reporting
use of illicit drugs or NPS in the last 12 months.
• Dark net market users were younger than other recent drug users
(median age 22 vs 24, mean age 24 vs 27).
• Dark net market users were more often male than other recent drug
users (83% vs 65%)
• Dark net market users were less likely to be employed than other
recent drug users (55% vs 59%), but this is expected given their
younger age
• Dark net market users were no more likely to live in a city or urban
area than other recent drug users (77% vs 77%).
• Dark net market users were no more likely to report going clubbing
monthly+ than other recent drug users (60% vs 59%).
RESEARCH CHEMICALS
Background
•
GDS has been tracking the use of ‘legal highs’, ‘research chemicals’ for the last 5
years. We report here what proportion of our participants are using so called
Novel psychoactive Substance (NPS) legal highs / research chemicals RCs) .
•
While there may be many new substances identified each week just because
drugs are available on line or in ‘head shops’ it does mean they are being used. In
fact GDS thinks where people have good access to good quality traditional drugs
the interest in NPS is generally low
•
Over the last 5 years GDS has highlighted that the use of these chemicals are still
quite limited compared to the more traditional drugs and few appear to be
anything other than a transient phenomenon.
• Which countries had the highest rates of last year purchase of
drugs marketed as ‘Research Chemicals’ (RC) or ‘Legal Highs
• Where last year users sourced these drugs from (on-line, shop
etc) and if so what sort of drugs in terms of preparation e.g. herbal
smoking mixtures, powders/crystals, tablets/pills or liquids
TOP 5: Poland, Sweden,
Netherlands, UK, & USA
Last 12 month
RC use by
country
35
31
30
Switzerland had the
lowest rate of RC use of
25
20
15
10
9
9
8.6
8
6.1
5
4.7
4.5
4.2
4.2
4.2
4.1
4
3.5
3.3
3.1
3
2.9
2.8
1.1
0
% last 12 months
GLOBAL Have you purchased any drug promoted as ‘legal highs’ or ‘research chemicals’ or
‘bath salts’ in the last 12 months? (%)
4.2% of the global GDS2015 reported the use of RC in the last 12 months
What was the appearance / form of the NPS
used
Where did you get them from?
Switzerland (n= <100)Have you purchased any drug promoted as ‘legal highs’ or ‘research
chemicals’ or ‘bath salts’ in the last 12 months? (%)
1.1% of the Swiss GDS2015 sample reported the use of RC in the last 12 months
What was the appearance/ form of the NPS
used
Where did you get them from?
RESEARCH CHEMICAL –
MOTIVATIONS FOR USE
GLOBAL
Research Chemicals – Motivations for Use – Global Last Year
Users (N=4,099)
2.39
Unlikely to be detected by drug screening
1.82
Unlikely to be detected by sniffer dogs
1.37
Don't know how to get illegal drugs
Last year users of research
chemicals were asked to rank
each motivation for use on a scale
of 0 to 10 (0=completely disagree,
10=totally agree). Mean scores for
each motivation are presented.
1.52
Safer than illegal drugs
Prefer effects to illegal drugs
2.71
Believe they are legal
2.76
Better than illegal drugs
2.41
Poor quality of other drugs
2.36
5.15
Value for money
3.72
Unavailability of other drugs
3.07
Able to buy from a shop
4.29
Able to buy online
0
1
2
3
4
5
6
7
8
9
10
Mean score
Research Chemicals – Motivations for Use – Global Last Year
Users (N=4,099)
Strongly agree
Unlikely to be detected by drug screening
Unlikely to be detected by sniffer dogs
Don't know how to get illegal drugs
Safer than illegal drugs
Last year users who
ranked a motivation
for use as 9 or 10
were considered to
strongly agree, while
those who ranked 0
or 1 were considered
to strongly disagree.
Prefer effects to illegal drugs
Believe they are legal
Better than illegal drugs
Poor quality of other drugs
Value for money
Unavailability of other drugs
Able to buy from a shop
Able to buy online
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
% of last year users
MYSTERY WHITE
POWDERS
GLOBAL PATTERNS OF
USE & COUNTRY
PREVALENCE
Mystery White Powders
Background
• With the rise in myriad novel psychoactive substances many of them
crystalline white powders whose composition gives little or no clue as to their
composition, the possibility that people will be ingesting a substance what is
totally unknown to them is reality.
• The risks consequent upon taking unknown drugs, with widely varying effect
profiles, potencies and time to onset are potentially serious.
• Over the last 2 years has spotted that between 5-15% of GDS respondents
admit to having taken a mystery white powder in the preceding 12 months.
• This year we repeated that question and present comparison and the global
picture of what state people are in when they take a mystery white powder
and what happens.
• The important message is don’t take unknown pills/powders when you are
intoxicated and be aware of the risk of taking drugs from strangers – the
issues of sexual assault whilst under the influence is something GDS
highlighted 2 years ago.
143
What we asked and what is presented here.
• We asked “In the last twelve months, have you snorted or
ingested any powder without knowing what it was, or what
it was originally sold as?”
• We compare the percentage of respondents who had consumed
a powder without knowing what it was or what it was sold as in
the last year from GDS2015 countries
• We report on the use of drugs / alcohol prior to consumption of
the MWP and what the effect was among the 5000+ GDS2015
respondents who took a MWP.
Mystery White Powders – Global Last Year Users (N=5,368)
Intoxicated at time of use?
Of all respondents to the survey,
5.5% (N=5,368) stated that they had
used a mystery white powder
within the last 12 months.
No; 18.70%
Overall effect:
70
64.1
60
Yes;
81.30%
50
40
%
22.5
30
23.1
31.5
20
Those intoxicated
had used:
12.2
10
0.5
Other drugs
0
Good buzz
Alcohol
Other drugs and
alcohol
46.0
Felt sick
No effect
Sought
emergency
medical
treatment
Last year prevalence of mystery white powder use across GDS2105 countries
25
20
15
%
Perhaps there are few
mystery white powders
on offer in Switzerland.
Drug testing facilities
and low rates of RC use
mean most people
probably know hat they
are using.
19.1
13.7
11.9
11.1
10
8.4
7.9
6.6
6.5
6.2
6
5.3
5
5.3
5.2
5.2
5
4.3
4
2.9
2.4
2.1
1.8
0
*Poland n = 450)
%
MDMA
Background 1
GDS has been tracking the use of MDMA (ecstasy. Molly, Mandy, E) for over a decade. While patterns
of use, typical consumption patterns and cost vary widely across the world, it is clear that over the last
30 years MDMA has sustained its mass appeal by consistently remaining a staple in most illicit drug
markets. Significant changes since its first appearance in the 1980s include a rise in its use in
combination with other drugs especially alcohol, which increase the risks of unwanted effects (as well
as diminishing the desirable effects of the drug) and an expansion in its use beyond the dance music /
rave scene.
After a 3-year period of dissatisfaction in MDMA (from 2007/8) and restricted access to precursors led
to a decline in use due to poor quality and uncertain composition, MDMA is confidently back thanks to
new precursors and synthetic pathways for production. The current dominance of MDMA crystal over
pills represents smart remarketing and is yet another example of an old drug finding new life with a new
preparation. That users prefer powder to pills because of the ease of titration and flexibility over route of
use may also have other benefits including supporting’ test dosing’ a small amount of new batch to
avoid inadvertent overdose or ingestion of a large amount of a dangerous contaminant such as PMMA.
It also may open the way for injecting which of course would not be so good.
.
Background 2
While data from GDS2012 however showed that almost 1 in 3 users of MDMA could be experiencing
significant problems their use, GDS2013 showed MDMA as the highest ranked drug using the Net Pleasure
Index. Thus it would seem that the overall the pleasure and positive experiences associated with the use of
the drug lead few to seek treatment for their use. In line with other expert review that tend to suggest that
historical fears over long-term use may not be as robust as once thought. Those long term consequences
that may exist for many users at least, seem to be outweighed by short and medium term benefits.
But MDMA is not risk free by any means. GDS2014 reported a 3 fold variation in the percentage of users
seeking emergency medical treatment (from 0.3% in Switzerland to 0.9% in the USA). This year that trend
continues. While many users adopt sensible harm reduction strategies – others do not and the recent spate
of deaths across Europe due ecstasy pills containing PMMA show we need to be vigilant and continue our
efforts to educate users about how to minimize the risk of harms related to this common and popular drug.
.
•
•
•
•
•
•
The price paid per pill and per gram.
The most common route of use.
The mean dose consumed on a day of use.
Its value for money, changes in quality and ease of access.
The frequency of use combined with alcohol and cocaine.
The risk of violence when you get MDMA and the exposure
to violence over the last year.
• Finally, the percentage of last year users who sought
emergency medical treatment after using MDMA.
MDMA in Switzerland (last year users n>690)
Last year use of MDMA types
11.1% (n=691) of the sample had used
MDMA last year
8.4% (n=523) of sample had used MDMA
pills last year
8.5% (n=529) of sample had used MDMA
powder last year
Price
66.5% buy their own Ecstasy
Mean price was €15.6 per pill
Mean dose 1.7 pills
61.8% buy own MDMA powder
81.2% buy 1 gram or less
Mean price €76.2 per gram
Average number of doses/gram was 8.5
Mean dose /session 0.25gm
Route of use
95.1% oral
3.8% snort
0% rectally
0.2% smoke
0.9% other
0% stated they had ever injected MDMA
Alcohol
34.2% always drink alcohol,
20.9% drink 50% or 75% of the time,
26.2% never drink alcohol
MDMA - Amount Used Per Session – Global Comparison
2.50
Global mean number of ecstasy pills used
per session was 1.60
2.25
Ecstasy - pills per session
MDMA - grams per session
Global mean grams of MDMA powder
used per session was 0.28
2.00
2.10
1.89
1.75
1.98
1.72
Mean
1.50
1.57
1.72
1.61
1.59
1.74
1.53
1.44
1.51
1.43
1.41
1.25
1.33
1.30
1.00
0.88
0.75
0.50
0.25
0.82
0.42
0.20
0.26
0.37
0.25
0.25
0.24
0.26
0.21
0.26
0.25
0.17
0.31
0.19
0.21
0.38
0.27
0.00
0.35
Global Ecstasy and MDMA Powder Prices
300.00
257.28
250.00
Global average ecstasy
price was €9.00 per pill
200.00
Ecstasy - per pill
166.33
MDMA - per gram
Global average powder
price was €45.01 per gram
€ 150.00
100.00
76.18
64.85
54.32
50.00
41.38
59.51
46.42
44.51
40.67
7.61
9.94
10.27
11.74
13.32
4.33
12.41
18.38
5.15
36.61
32.14
28.84
24.46
56.35
7.97
5.27
10.72
6.65
44.67
49.04
52.80
33.17
7.00
7.76
11.52
8.39
0.00
MDMA in Switzerland (last year users n>690)
Over the last 12 months do you think the
quality of MDMA has:
Ease of access (1=very easy, 10=almost
impossible)
25
45
38.8
36.6
40
19.6
18.7
20
17.1
15.2
35
15
%
30
27.9
%
23.8
22.4
9.1
7.9
10.1
9.9
8.8
5.9
20.9
20.1
20
10.5
9.5 9.7
10
25
14.5
13.8
14.3
5
2.7
1.6
15
0.8
0.4
0
1
9.4
10
2
3
4
MDMA pills
5
0
Gone up
Gone down
MDMA pills
Stayed the
same
MDMA powder
Don't know
5
6
7
8
9
10
MDMA powder
Risk of Violence
3.9% stated that they had been exposed
to violence in the last year when
attempting to buy MDMA.
2.7% on one occasion and 1.2% more
than twice
Seeking Emergency Medical Treatment (EMT) on
MDMA (Last Year Users n>690)
Prevalence 0.8% (n=5) of those
reporting the use of MDMA in the last
12 month had sought EMT
20.0% had taken pills
60.0% had taken powder
20.0% had taken both
What they presented with:
Memory loss
Extreme sweating
Nausea
Confusion
80.0% had also taken alcohol
20.0% had only taken MDMA
Mood problems
Over heating
How did this effect your use
Accident
subsequently?
Passed out/unconscious
20.0% reduced MDMA use
None decreased other drug and alcohol
Other
use
None increased use of other drugs
Visual hallucinations
Compare your use of
MDMA to the people who
completed this survey and
thousands of others from
across the world using the
drugs meter MDMA app at
www.drugsmeter.com
0
10
20
30
40
50
60
70
%
MDMA – Sought Emergency Medical Treatment in Last 12 Months
(min number of users is 100/country)
3
% Last year users
2.5
2
1.5
1.8
Global EMT
rate was 0.9%
1.2
1.2
0.9
1
1.3
0.8
0.6
0.5
1.4
1.4
0.8
0.9
0.6
0.4
0.6
0.4
0
0
0
0
MDMA Emergency Medical Treatment – Type Used
100%
90%
5.7
15.4
12.9
15.4
20.0
11.4
22.2
23.0
25.0
33.3
80%
40.0
25.8
% Seeking EMT
70%
25.0
40.0
50.0
7.7
33.8
66.7
25.0
60%
57.7
50%
100.0 60.0
100.0
20.0
41.0
82.9
40%
77.8
69.2
61.3
30%
60.0
50.7
50.0
50.0
20%
10%
75.0
25.6
26.9
33.3
40.0
20.0
0%
Ecstasy pills
MDMA powder
Both
MDMA Emergency Medical Treatment – Other Drug Use
100%
90%
4.0
25.0
27.5
80%
41.9
40.0
50.0
% Seeking EMT
70%
60.0
68.0
60%
50%
30.8
35.9
62.5
20.0
51.5
25.0
48.4 59.0
30%
60.0
41.7
28.0
21.0
9.7
20.0 20.0
5.1
Only taken MDMA
69.2
20.0
20%
0%
50.0
66.7
75.0
80.0 33.3
40%
10%
50.0
40.0
25.0
50.0
25.0 25.0
50.0
33.3
40.0
12.5
Taken with alcohol
Taken with other drugs
ALREADY DOWNLOADED OVER 50,000 TIMES
Adam Winstock
Safer drug use
appears to be
more enjoyable
drug use
Adam Winstock
Adam Winstock
Adam Winstock
Adam Winstock
Adam Winstock
Adam Winstock
Adam Winstock
Adam Winstock
COCAINE
Background
Cocaine remains popular as stimulant drug of choice for those with money.
Available in widely different purities, it also varies widely in price across the work
form €40/gram in parts of Europe to over €400/gram in Australia. Crack cocaine
although less commonly used causes significantly more harm both related to its
modes of administration (smoked or injected) and its overwhelming association with
deprivation, criminality and with heroin use especially in the UK and Europe. In
GDS2013 and GDS2014 cocaine was voted the worst value drug for money in the
world with an average score of 2.5/10. The Belgians were the most satisfied
consumer ranking their cocaine at almost 6/10 on value for money. This year GDS
continues to track the use of cocaine and its impact on users health and bank
balance and see if the widespread appearance of a 2 and even 3 tier market is
leading users to once again invest in a white powder than for many years has been
delivering little and costing lots.
•
•
•
•
•
•
•
•
The price paid per gram.
The most common routes of use.
The mean dose consumed on a day of use.
Its value for money, changes in quality over the last year and ease of access.
The frequency of use combined with MDMA and cocaine.
Whether or not there is a premium and economy market and whether paying more for
your cocaine is worth it.
The risk of violence when you get cocaine and the exposure to violence over the last
year.
Finally the % of last year users who have sought emergency medical treatment after
using cocaine.
Cocaine in Switzerland (last year users =>540)
Use
8.70% (n=6,204) had used cocaine last year
Mean amount used on typical days use was 0.76
grams
65% used 10 or less times in the last year
10.5% used 50 or more times
Mean of 9 lines /gram
72% always /nearly always drink alcohol when they
use cocaine
Price
55.2% purchase their own cocaine
Mean price €83.12 per gram when buying one
gram at a time
Usual route of use
96% snort it
0.2% inject
2.2% swallow it
1.2% smoke it
0.2% rectally
Compare your use of
cocaine to the people who
completed this survey and
thousands of others from
across the world using the
drugs meter cocaine app
at www.drugsmeter.com
Global Cocaine Price Per Gram
300.00
250.00
Global average price per
gram for normal cocaine
was €74.47
251.73
222.14
Normal cocaine - per gram
207.15
200.00
€
150.00
Global average price per
gram for luxury cocaine was
€96.26
190.83
Luxury cocaine - per gram
117.56
112.74
108.32
100.00
94.36
71.32
100.95
90.55
70.59
88.41
86.58
74.90
111.22 109.76
71.15
54.51
50.00
83.05
81.99
69.29
60.43
59.46
47.31
51.80
71.03
61.90
53.14
47.93
74.53
66.18
52.68
64.13
14.78
9.21
0.00
Cocaine in Switzerland (last year users)
Ease of Availability (1=very easy, 10=almost impossible)
30
What has happened to the quality of
cocaine?
26.3
25
20
16.8
% 15
13.9
13
9.6
10
28
8
6
6.6
7.2
5
3.4
3.2
9
10
0
1
2
3
4
5
6
7
8
Risk of Violence (1=none, 10=very high)
30
26.8
25
38.7
20
19.4
%
14.3
15
16.4
9.2
10
6.8% reported experiencing
personal violence at least
once when buying cocaine
in last year
11.2
7.4
6.1
5.7
5
1.4
1.4
9
10
0
Gone up
Gone down
Stayed the same
Don't know
1
2
3
4
5
6
7
8
How much and how good? (last year users) and
seeking Emergency Medical Treatment
How much in a typical session?
Luxury cocaine?
62% use half a gram or less in a
session
21.4% use 1 gram
11.2% use 2gm or more in a
session
Of those who bought their own
cocaine, 46.4% offered cocaine
at higher price with promise that
it is better quality in the last 12
months
Most used in a session
Mean price €117.56 per gram
66.2% have used 1 gram or more
42.8% have used 2 grams or more
17.8% have used 4 grams or more
1.4% (n=7) of those reporting the use
of cocaine in the last 12 month had
sought EMT. 71.4% reduced cocaine
use following this episode
NITROUS OXIDE
Nitrous Oxide: background
Nitrous oxide is a colourless, non-flammable gas with a slightly sweet odour. 40
years after its discovery in 1800, it was being bellowed out by the gallon to
entertain Victorian gentlemen and the masses in ‘laughing tents’. In 1845 at one
event an observant dentist noticed a fellow visitor with a gashed leg but who
appeared oblivious to the pain. A few years later such serendipity led to the
adoption of nitrous as the world’s first anaesthetic agent. While it’s still commonly
used in medical practice – most commonly when pulling teeth and pushing
babies out, the last decade has seen a gradual increase its popularity among
young people who use drugs. Widely available in supermarkets and kitchens
where it is used to help make cream light and whippy in recent years it use at
festivals and parties has increased . GDS2014 started its investigation into the
possible risks associated with its use and this year we follow up on our work to
determine just what the risks are if any of having a balloon.
What This Section Covers the results of the biggest study of
current nitrous oxide users ever conducted.
• The prevalence of nitrous oxide use in your country compared to other
GDS2015 countries
• The most common methods of consumption around the world
• Adverse experiences as a result of use including symptoms suggestive of
peripheral neuropathy (past research usually of health care professionals
suggests long term heavy use of nitrous oxide can lead to a nerve
condition called a peripheral neuropathy with tingling, numbness and
weakness in the arms and legs due to inactivation of vitamin B12 (which
can also cause anaemia – not enough red blood cells). This year we asked
people if they Whether users were concerned about longer term impacts on
physical and mental health
The questions we asked about neurological symptoms are
given below
Have you ever experienced any of the following?
Numbness / tingling in hands or
feet that has persisted for at
least 2 weeks following your last
use of nitrous and that you had
not experienced before you
started using nitrous
Numbness / tingling around the
face or mouth that has persisted
for at least 2 weeks following
your last use of nitrous and that
you had not experienced before
you started using nitrous
Yes
Yes
No
If yes within the last 12 months?
No
If yes within the last 12 months?
Yes
No
Yes
No
Yes
Painful sensations eg burning /
shooting pain in arms or legs
that has persisted for at least 2
weeks following your last use
of nitrous and that you had not
experienced before you started
using nitrous
Yes
No
If yes within the last 12
months?
Yes
No
Nitrous Oxide : global overview from > 6800 last year users
16% of the sample ever reported using nitrous oxide with over 6.5% (6800
people) reporting use in the last 12 months
Inhaling from a balloon was the most common method (>85%). 0.9%
inhaled from a plastic bag and another 0.9% directly from the gas bulbs –
both a very risky – the first due the risk of asphyxiation the later due to the
possibility of cryo-burns since the gas is ejected at super cold
temperatures.
Most people source nitrous from whipped cream bulbs but 7% reported
sourcing from bigger tanks
The most common place last year users got nitrous from was from
supermarkets (37.5%), followed by friends (35%) and the internet (24%)
and festivals (24%).
The most common place of use was at house parties (70%), festivals
(48%), at home (43%) and clubs (28%).
Nitrous oxide prevalence of use and worries
Lifetime, last 12 months prevalence use and current worries about use
Last year
Worried about use
24.4
Very small numbers of users in these countries
7.5
0.6
0.2
5.1
1
0.3
0.05
2
0.1
1.75
0.45
0.4
4.3
7.1
9
10.9
11.8
12.7
1
0.7
20.7
20.8
23.7
21.6
3
0.4
1
3.4
0.17
8.7
10.2
13.7
17.5
5.6
2.7
0.26
2.6
0.17
3.2
0.15
1.5
0.3
7.3
5.9
7
2.8
1
0.1
3
6.2
10.3
13.9
14.4
19.5
22.7
14.3
21.1
23.7
33
36.3
38
48.3
Ever use
Short term effects following the use of nitrous
oxide
% reporting in last year
30
27
26
25
20
15
10
10
4.5
5
1.6
0
Hallucinations
Confusion
Nausea
Fainting
Accidents
Signs of nerve damage – symptoms persisting for more
than 2 weeks after last use
3.5
3
2.5
Overall 7.7% of users said
they worried about the effect
of nitrous on their mental
health and 9.3% on their
physical health and 2.0%
were worried their use had
got out of control
3
2.9
2
1.5
1
0.5
0.4
0
Painful sensations
numbness hands/feet
numbness face/moutth
Interpretation
Our previous work has suggested that a small minority of heavy are at risk of
developing neurological problems.
Our findings here support this . Although only preliminary analyses have been
conducted the findings that 3% report persistent numbness or tingling in their
hands or feet / around their face or mouth is worrying and suggest recreational
users may be at risk of developing a peripheral neuropathy if they use heavily for
extended periods of time. We are confident we have excluded the possibility that
people were reporting short lived rugs effect through our questions that asked
about symptoms ‘that have persisted for at least 2 weeks following your last use
of nitrous and that you had not experienced before you started using nitrous’
That almost in 1 in 10 report being worried about the use of nitrous oxide of their
mental / physical health is also rather high and the 2% who are concerned about
loss of control suggest that this short lived easy to access drug may for some
people become a cause of harm.
We stress however that low level infrequent use is unlikely to be
associated with any serious risk of harm and that our findings are relevant
to a small proportion of users – typically using 25 or more balloons in a
session and continuing heavy use over an extended period of harm.
Safer use tips from GDS to reduce the risks of using
nitrous oxide.
Don’t inhale directly from the charger
Avoid mixing in nitrous when you are off your face on other drugs especially alcohol
Try not to use more than 5 balloons in a session and leave time between them
Make sure any space you are using is well ventilated
Don’t use near roads, canals or other bodies of water
Make sure you got mates around you in case you fall over and hurt yourself.
Leave several minutes between rounds of hits and give yourself breaks between
periods of use to refill those vitamin stores. Animal protein (beef and fish in particular),
eggs, cheese are good sources of B12. Fortified soy products and supplements can
be used by vegetarians. And Marmite !!
If you experience persistent numbness, tingling or weakness in your fingers, hands or
feet, or notice you’re having difficulty typing or losing your balance or coordination
strop using and go see your doctor. weakness in your arms of legs
Finally there are reports that cheap whipped cream bulbs imported for China leave an
oily residue when the gas evaporates – probably making them unfit to dispense cream
let alone to inhale. So if you are going to inhale try accessing your gas from a quality
supplier.
PRESCRIPTION MEDICATION
Background 1
Until the 1990s, opioids were used sparingly for chronic pain, in part due to historic
fears that their long term use was disguised maintenance of opioid addiction, but also
due to the concern that with longer term use, the development of tolerance would
render them ineffective analgesics. But research has shown that opioids can be used
safely in chronic non-cancer pain. In the last 2 decades there has been a rapid rise in
opioid prescribing for chronic, non-cancer pain. As prescription of opioids increased for
pain in the USA, non-medical use of prescribed opioids rose in proportion. Overdose is
a marker of the prevalence of opioid misuse, and in the years 1999-2006, fatal
poisoning involving prescription opioids in the USA more than tripled. By 2002 opioid
analgesics had overtaken heroin and cocaine as being the most frequently mentioned
drugs in the Drug Abuse Warning Network system of notification of drug problem, and
by 2004 had surpassed heroin and cocaine as a cause of fatal overdose. More people
die in the USA today from prescription medication than heroin! The problem is starting
to appear in Europe and Australia but data is scant..
Background 2
GDS has been tracking the use and misuse of prescription medications for the last 4
years. The aims of GDS2014 was to build on past work and better define the
prevalence, source and function of the major prescription medication groups.
Specifically we sought information on the frequency of non-medical use (including
use to get high) and behaviours suggestive of ‘problematic use’ including overdose.
We also asked just about any information about addiction that had been provided to
the patients by their doctors and just how easy it would be for them to get a
prescription in the next 7 days. Finally we were interested in just how many people
wanted help with their prescription drug use.
We offer some composite findings from France and compare them to the findings from
all respondents to GDS2015
• The numbers and percentages of people from Netherlands compared to other
countries with >2000 respondents and the full GDS2015 sample using different
groups of prescription medications.
• Where individuals source their prescription drugs in the Netherlands.
• The reasons for their use: specifically use to relieve unpleasant states as opposed
to achieve desirable ones and the percentage of those using to get high and
whether individuals had injected the drugs.
• The proportion of individuals who had been advised by their doctor about the
medications addictive potential and what proportion indicated that it would be easy
/ very to get a prescription f these drugs in the next 7 days.
• The proportion of people endorsing 2 or more problem behaviours suggestive of
‘misuse’ of the medication
• The proportions of last year users ho would like to use less of these medication in
the following 12 months
Caveat when interpreting country comparison slides
• The numbers and percentages of people from the Switzerland compared to other countries with
>2000 respondents and the full GDS2015 sample using different groups of prescription medications
is provided in the next few slides
• Caution needs to be used when comparing these countries that differ widely in prescribing
regulation and overall prevalence of use.
• Our grindings broadly reflect the international data that highlights the greatest problems in English
speaking countries.
• Perhaps the most surprising finding is that despite the USA having the highest rates of prescription
opioid medication misuse in the world, ease of access to such medications is among the most
restrictive in the world. This may be function of the far greater number of users overall from the US
answering this question but it might also reflect a gradual change in practice among doctors in the
US – who will be the cornerstone of any solution to the prescription medication problem.
• The other findings that is perhaps surprising in the relatively low rates of people accessing this
medication on line – a finding that is in stark contrast to the escalation in in on-line drug sopping
GDS has noted over the last 3 years.
Prescription opioid use is higher among participants from Switzerland
compared to the global sample of GDS2015
Globally, around 14% of participants reported use of any prescription opioid in
the past 12 months; in Switzerland less than 7% reported use and this was
overwhelmingly due to the provision of codeine.
Codeine is most commonly used, with Swiss participants reporting pretty low
rates of other opioid analgesics.
Codeine
Hydrocodone
Oxycontin
Morphine-based
Tramadol
All opioids
Global
Switzerland
10.2
1.5%
1.4
1.4
2.1
13.8
4.0
0.1
0.3
1.3
1.4
6.6
Last 12 months prevalence of opioid prescription medications among GDS2015
countries with n > 2000
Hydrocodone
Oxycontin
Morphine-based
Tramadol
ALL OPIOIDS
33.8
27.4
0.1
0.2
1
0.8
0.1
0.3
0.5
0.9
1.3
0.1
0.1
0.4
0.5
2.1
2.9
4.3
5.7
6.6
4
0.1
0.3
1.3
1.4
France Global AverageNetherlands Switzerland
4.3
10.3
0.1
0.6
1.6
1.7
1.5
1.3
1.3
2.1
UK
2.6
3.2
Ireland
0.1
0.2
0.4
0.5
2.1
USA
4.5
0.5
1
2
2.7
Australia
0.5
1.6
2.8
New Zealand
2.5
3.8
0.5
1.5
3.2
5.9
7.4
10
10.8
10.8
9.4
13.5
18.2
21.4
24.7
22.3
26.3
29
30.1
34
33.2
38.1
Codeine
Brazil
Germany
Hungary
Note very small Ns among these countries when looking at next few
slides
% of last year users reporting misuse (2 or more problem behaviours in last 12 month) of
different prescription opioid medications among GDS2015 countries with n > 2000
Codeine
Hydrocodone
Oxycontin
Morphine-based
Tramadol
ALL OPIOIDS
New
Zealand
Global
average
Ireland
50
Netherlands
16.7
21.4
14.5
30.7
6.5
11.5
12.7
18.2
18.8
12.2
13.2
0
4.4
7
3.3
Australia
0
0
USA
20
16.7
17.7
18
27.7
25
22.2
27
26
23.7
15.6
13.8
7.7
8.2
6
9.2
12.5
14.5
10.2
22.2
22.3
27
8.3
7.7
8.1
9.6
14.7
8.2
11.7
12.4
16.5
22.3
20.3
21.9
23.8
5.9
11.5
9.1
13
9.5
6.9
10.8
19.4
17.1
21.6
19.6
22.6
22.8
26.5
35.4
33.2
44.4
50
Abuse liability appears in the order oxycontin & hydrocodone >
morphine > tramadol > codeine
UK
Germany
Switzerland
Brazil
France
Hungary
Prevalence: Amongst Switzerland participants, prescription opioid use
was lower than in other countries
Source: Most people have obtained opioid medication on
prescription
Obtaining drugs via a friend was the next most common way
participants accessed these drugs.
Advice and access: About 50% of Switzerland participants recalled
discussing the risk of addiction to these drugs with their doctor
Around 40% said it would be “very easy” or “easy” to obtain a
prescription for one of these drugs in the next 7 days.
Motivations for using prescription opioids
•
•
•
Unpleasant states include: withdrawal, boredom, pain, sleeplessness
Desirable outcomes include: relaxation, having sex, getting high, and
socializing
Switzerland respondents report slightly lower rates of using prescription
opioids to achieve desirable states than global participants, with the
same being true for negative states
Non-medical use: About 10% of participants reported misusing
opioids obtained on prescription
Misuse includes: taking more than prescribed, seeking extra medication, mixing with
alcohol or other drugs to enhance drug effects, overdosing, or sharing with others
(misuse here = endorsing 2 or more problems behaviours). NOTE: the figure given for
‘misuse’ is the percentage of prescription users (those who obtained their medication on
prescription), whereas getting ‘high’ and’ injecting’ are the percentage of past-year users
(regardless of source) who reported getting high / injected at least once in the 12
months
Wanting to use less
Comment
Overall rates of highly abusable opioid pain killers was low, with very few
reporting use of the most abusable types – hydrocodone and oxycontin.
That access was not perceived as difficult may reflect the low levels of
concerns that Swiss doctors may have in prescribing these medications or
that the participants have legitimate medical conditions and feel supported
by a good healthcare system. The relatively low rates of access of via
‘friends’ suggest the practice of medication sharing seen elsewhere is
uncommon in our Swiss sample.
COGNITIVE ENHANCERS
Cognitive Enhancers – Background 1
The growth in the market for so called human enhancement agents such as
neuroenhancers and anabolic steroids has been driven by a perfect marriage of
manufacturers (big pharma), distributors (doctors and pharmacists) and a new
generation obsessed with vanity and the defiance of age. As in other areas of
substance use we are witnessing the migration of prescription medications with tight
therapeutic indications to high school kids and office executives keen to be on top of
their game to get that grade or bonus. And if you can find the right doctor with a
prescription pad and a flexible diagnostic mindset or a website and a credit card,
accessing many of these drugs is not hard.
Methylphenidate, used for the treatment of ADD/ADHD, and Modafinil, used for the
treatment of the chronic sleep disorder (narcolepsy), are the most researched active
agents used for cognitive enhancement in healthy individuals. But there are others,
developed to treat the cognitive decline associated with dementia or developed on the
basis of a theoretical understanding of the complex cognitive processes that underlie
learning and memory.
Cognitive Enhancers – Background 2
So can drugs make you smarter? Probably not. Can drugs improve your attention,
concentration, some aspects of memory and reduce your need for sleep? Yes. And that
can mean being able to study for longer without the need for sleep. Which might for
some translate into improved performance at work or during exam preparation. Saying
that amphetamines can also seriously impair your exam performance promoting chaotic
thinking, repetitive writing, and catastrophic implosions. From headache, anxiety and
insomnia to aggression and cardiovascular problems, trying to be extra smart may
come at a cost.
To find out exactly what is going on and look at the global picture GDS teamed up with
some of Europe’s leading experts including Dr Larissa Maier to undertake the biggest
survey of cognitive enhancers ever conducted to define exactly who is taking what and
why. This year we did not just look at core issues such as source and function but also
at health worries and complications. We also placed the use of these drugs within the
broader context of other lifestyle behaviours and asked if they were being used for
reason beyond enhancing work performance (sex and socializing for example).
This section focuses on answers of 93,723 study participants who answered the
questions about prescription and illegal drug use for cognitive enhancement (CE)
at work or while studying.
11,246 study participants (12.0%) had already used prescription drugs or illegal
drugs to improve their performance at work or while studying. Of these 2,590
participants reported being diagnosed with ADD/ADHD what means that one in
10 “healthy” study participants (9.8%) had used CE drugs.
No gender differences were found globally.
No age differences were found globally.
Differences exist between “healthy” CE users and CE users with a history of
ADD/ADHD diagnosis.
In the next few slides we will present data of the type of drug used for cognitive
enhancement globally before providing more detail on their function, utility,
source, and impact on overall health and well being.
A word about ADD/ADHD & caution when comparing countries
Attention Deficit Hyperactivity Disorder (ADHD) / Attention Deficit Disorder(ADD) is a common
childhood psychiatric childhood disorder that has its neurobiological basis in a deficit of dopamine in
the frontal lobes of the brain. It is much more common in males than females ( 5:1). Common
restlessness and inattentiveness moves beyond trouble sitting still and reading a book and can involve
extreme mal-adaptive impulsivity, hyperactivity, and inattention that disrupts ability to interact with
others, creates huge difficulties at home, at school and at work. Children with ADHD have higher rates
of conduct disorder and drug use.
Treatment is often with stimulant type medications such a methylphenidate & dexamphetamine. People
with ADHD have a paradoxical response to these drugs so instead of becoming more hyper and
distractible people find themselves feeling settled, calm and are able to focus and be more appropriate.
In adults general population studies estimate the prevalence of ADHD to be between 2-4%. In our
sample the self reported prevalence ( based on positive response the question ‘have you ever been
diagnosed with ADHD by a doctor) is higher at 5.8% and the rate of 5.7% in female GDS2015 is much
higher than in the general population. Given the higher rates of substance use in our sample this not a
surprise.
Because adults with ADHD may be prescribed stimulant medication for their condition where it
‘corrects’ deficits in cognitive abilities such as attention we present the results separately for those with
and without ADHD.
Note: the prevalence of ADHD varied significantly between countries (for example 9% in NZ). This may
reflect the different stories that different media partners ran to promote GDS2015.
Caution therefore needs to be used when comparing these countries that also differ widely in the
assessment, diagnosis and treatment of ADHD.
Lifetime (ever used) “prevalence” of prescription or
illegal drug use to help work or study
60%
50%
47.7%
47.9%
Global female
(n=1,997)
Global male (n=3,391)
40%
30%
20%
12.0%
10%
9.6%
9.9%
Global female
(n=33,001)
Global male
(n=53,339)
0%
Global total (N=93,723)
No ADD/ADHD
ADD/ADHD
12-month-“prevalence” of prescription or illegal
drug use to help work or study
35%
31.7%
30.5%
30%
25%
20%
15%
10%
6.5%
5%
4.7%
5.2%
Global female
(n=33,001)
0%
Global total (N=93,723)
No ADD/ADHD
Global female
(n=1,997)
ADD/ADHD
Comparison of cognitive enhancement rates
across countries (ever used)
New Zealand (n=3,233)
18.2%
Netherlands (n=5,437)
15.6%
Hungary (n=4,323)
15.2%
Australia (n=3,738)
14.3%
Germany (n=30,703)
13.4%
France (n=8,276)
12.8%
Ireland (n=2,266)
12.0%
USA (n=5,734)
11.7%
Switzerland (n=5,869)
7.9%
Brazil (n=5,531)
7.8%
UK (n=6,986)
6.8%
Belgium (n=1,923)
5.7%
Austria (n=1,582)
5.1%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
Psychoactive substances used to improve
performance at work/ while studying (ever used)
Global female (n=34,998)
Global male (n=56630)
5.8%
5.4%
3.7% 3.8%
3.4% 3.5%
2.3% 2.4%
1.5% 1.4%
1.0% 1.1%
Methylphenidate
Illegal amphetamine Dexamphetamine
Cocaine
Modafinil
Illegal
methamphetamine
Psychoactive substances used to improve
performance at work/ while studying (ever used)
Global "healthy" (n=88,301)
Global ADD/ADHD (n=5,422)
32.1%
17.1%
10.5%
7.6%
4.0%
Methylphenidate
3.3%
4.0%
2.6%
2.0%
Cocaine
1.3%
Modafinil
3.9%
0.9%
Illegal
methamphetamine
Switzerland (ever used)
Cognitive enhancement at work/ while studying
"Healthy" Swiss (n=5,635)
Swiss with ADD/ADHD (n=234)
23.5%
11.5%
6.4%
2.6%
3.4%
2.3%
.9%
Methylphenidate
Not approved
1.1%
Cocaine
1.7%
.7%
.4%
Modafinil
.3%
Illegal
methamphetamine
GLOBAL The drug most often used to improve
performance at work/ while studying (12 months)
Global “healthy” CE users (n=4,126)
Global CE users with ADD/ADHD (n=1,565)
Dexamphetamine
Dexamphetamine
3.9%
2.6% 2.6%
9.6%
23.5%
9.3%
30.7%
Cocaine
Illegal
amphetamine
Illegal
methamphetamine
Methylphenidate
Cocaine
31.8%
49.8%
Illegal
amphetamine
Illegal
methamphetamine
Methylphenidate
3.6%
Modafinil
2.3%
20.7%
Other drugs
Modafinil
8.6%
1.1%
Other drugs
Switzerland
The drug most often used for CE (12 months)
Swiss“healthy” CE users (n=170)
Swiss CE users with ADD/ADHD (n=44)
Dexamphetamine
6.5%
2.3%
2.3%
12.4%
Cocaine
9.4%
5.9%
25.3%
Dexamphetamine
22.7%
Cocaine
Illegal
amphetamine
Illegal
methamphetamine
Methylphenidate
4.5%
Illegal
amphetamine
Methylphenidate
52.3%
Modafinil
38.8%
Modafinil
15.9%
Other drugs
1.8%
Other drugs
GLOBAL: How many times used to improve performance at
work/ while studying in the past 12 months? (main drug)
CE with prescription drugs (n=4,102)
CE with illegal stimulants (n=1,498)
CE with other drugs (n=339)
41.1%
36.5%
35.7%
28.9%
26.3%
22.3%
17.4%
13.7%
12.3%
12.1%
7.7%
15.3%
13.6%
10.1%
7.1%
Once
2-10x
11-50x
51-100x
>100x
Switzerland
Cognitive enhancement (CE) in the past 12 months
CE with prescription drugs (n=147)
CE with illegal drugs (n=62)
50.0%
43.5%
26.5%
24.2%
16.7%
15.6%
14.5%
16.7%
16.7%
11.3%
10.9%
6.5%
3.4%
Once
2-10x
11-50x
51-100x
>100x
How many times used to improve performance at work/
while studying in the past 12 months? (main drug)
Global „healthy“ CE users (n=4,303)
5.0%
6.7%
6.1%
17.1%
21.0%
Once
2-10x
11-50x
51-100x
>100x
24.5%
37.3%
Once
2-10x
11-50x
51-100x
>100x
21.3%
46.7%
14.2%
Frequency of drug use for cognitive enhancement
in the past 12 months
Global "healthy" CE user (n=4,238)
41.2%
23.7%
21.1%
12.6%
5.0%
6.6%
11.9%
8.8%
Daily/almost 3-4 days per 1-2 days per
daily
week
week
11.8%
5.2%
Once a
month
9.4%
10.9%
8.9%
6.1%
4.6% 3.0%
4.4% 4.8%
For a period For a period For a period For a period Less than
of 1-2 weeks of 1-2 weeks of 3-4 weeks of 3-4 weeks once a month
before and before and before and before and
during exams during exams during exams during exams
or a very
or a very
or a very
or a very
busy period busy period busy period busy period
at work once at work 3 or at work once at work 3 or
or twice / year more times or twice / year more times
/year
/year
Reflecting the patterns of
cognitive enhancement (CE) use
The previous slide showed that „healthy“ CE users reported CE drug
use most commonly during exam periods or stressful periods at work
(43.6%) for less than a month (21.1%).
However, CE users with a self-reported ADD/ADHD diagnosis
reported most commonly daily (41.2%) or multiple weekly use
(21.4%) of drugs to improve their performance at work/ while
studying. Although non-medical use was asked, some might have
referred to their prescribed medication (over) use as well.
While the previous slide let us assume that only few people use CE
drugs regularly, we find a different picture on the next slide when
examining the different CE drug categories...
Frequency of drug use for cognitive enhancement
in the past 12 months
CE with prescription drugs (n=4,062)
CE with illegal stimulants (n=1,471)
24.3%
22.2%
19.4%
19.4%
17.8%
17.7%
17.2%
16.8%
16.0%
13.1%
10.5%
7.2%
7.5%
7.4% 8.1%
8.9%
Daily/almost 3-4 days per 1-2 days per
daily
week
week
More than 1/3 of people who use illegal
stimulants for CE are regular users!
10.4%
7.7%
6.8%
Once a
month
8.3%
7.4%
4.7%
4.6% 4.3%
4.4% 4.6%
3.2%
For a period For a period For a period For a period Less than
of 1-2 weeks of 1-2 weeks of 3-4 weeks of 3-4 weeks once a month
before and before and before and before and
during exams during exams during exams during exams
or a very
or a very
or a very
or a very
busy period busy period busy period busy period
at work once at work 3 or at work once at work 3 or
or twice / year more times or twice / year more times
/year
/year
Main motives for use (most used substances)
To improve your performance at work
To improve your ability to study
For socialising / intoxication purposes
74.4%
60.2%
59.3%
48.6%
35.4%
30.1%
26.2%
21.3%
16.6%
14.5%
9.0%
4.4%
Methylphenidate (n=1,991)
Modafinil (n=427)
Dexamphetamine (n=1,442)
CE with illegal stimulants
(n=1,461)
Perceived effectiveness of the drug most often
used for CE in the past 12 months
More than I had expected
Much less than expected
What I expected
Hardly any benefit/ none
Less than I expected
58.7%
53.8%
47.3%
44.9%
35.5%
28.2%
26.5%
18.5%
21.7%
19.0%
12.3%
7.6%
4.1% 4.2%
4.6%
2.6%
Modafinil (n=431)
1.3% 1.7%
2.8%
4.4%
CE with illegal stimulants
(n=1,466)
Perceived effectiveness of the drug most often
used for CE in the past 12 months
Global "healthy" CE user (n=4,251)
53.1%
50.1%
28.0% 26.8%
14.2% 13.9%
3.4%
More than I had
expected
What I expected
Less than I expected
3.0%
4.3%
3.2%
Much less than expected Hardly any benefit/ none
Main source of supply of prescription drugs used for
cognitive enhancement at work or while studying
Given by a friend
Prescribed by a doctor
Family member
Bought from a dealer
Bought from a friend
65.0%
51.4%
51.2%
35.8%
35.2%
29.4%
25.0%
13.8%
8.9% 7.7%
8.7%
3.3%
4.6%
2.1%
Modafinil (n=436)
1.8%
Abuse potential of prescription drugs used for CE
80.0%
70.0%
23.9%
60.0%
50.0%
40.0%
28.9%
Getting high
Socializing
Losing weight
30.0%
13.1%
20.0%
10.0%
4.8%
10.5%
11.5%
7.0%
5.5%
Modafinil (n=436)
0.0%
20.9%
Worries about potential adverse effects of drug
use for cognitive enhancement (CE)
100% with those who do
not worry about potential
consequences at all.
Little worries about prescription drug (PD) use for CE
Big worries about prescription drug (PD) use for CE
Little worries about illegal drug (ID) use for CE
Big worries about illegal drug (ID) use for CE
70.0%
18.4%
60.0%
17.8%
13.5%
13.4%
50.0%
11.0%
47.6%
47.5%
10.2%
10.1%
13.3%
45.0%
40.0%
8.9%
12.6%
8.3%
37.9%
35.2%
30.0%
40.6%
6.7%
37.1%
33.2%
7.6%
32.6%
33.4%
31.8%
30.3%
27.3%
5.8%
20.0%
5.3%
18.8%
17.1%
2.8%
18.3%
10.0%
0.0%
CE with CE with CE with CE with CE with CE with CE with CE with CE with CE with CE with CE with CE with CE with CE with CE with
PD
ID
PD
ID
PD
ID
PD
ID
PD
ID
PD
ID
PD
ID
PD
ID
Restlessness
Heart function
Depression
Nervouseness
Rapid mood
fluctuation
Loss of interest
in other things
Relationship
quality
Aggression
Intention to change CE drug use behaviour
in the future
Want to use less
Like help to use less
Plan to seek help to use less
33.7%
28.5%
25.8%
4.7%
3.9%
4.1%
4.0%
2.3%
Modafinil (n=426)
2.7%
WHY I STOPPED USING
DRUGS
GLOBAL MALE V FEMALE
Background
Most people stop their use of drug or alcohol on their own. This sits well
with the idea that most people don’t develop significant problems with
their use of drugs. While most research has been conducted looking at
motivations to stop among those seeking treatment (either because they
have developed addiction or other problems associated with their use)
there has been little work on how the wider community of people who
drink or take drugs decide to stop and how. So this year GDS thought
we would ask former users of the world’s most common drugs –why
they had stopped.
Given the relatively small numbers of participants who responded to
this section we have chosen to provide all media partners with the global
results which are more meaningful.
People who reported ever use of alcohol, tobacco, cannabis, MDMA and
cocaine but reported no use in the last 12 months were asked to select
from list of 20 possible options the most important factors (if any) in
getting them to stop using.
Will I ever drink again and how did I stop ( global M v F)
Do you think you will ever drink again?
Women 17.3% yes; 52.1% no; 30.6% maybe
Men 13.7% yes; 58.4% no; 27.8% maybe
Did you make a conscious decision to stop drinking?
Women 74.0% yes; 21.9% no; 4.1% cannot remember
Men 80.8% yes; 16.3% no; 2.9% cannot remember
If yes, did you cut down gradually or stop suddenly?
Stop suddenly – women 94.8% / men 93.6%
If yes, did you stop on your own or seek help
Stopped on own – women 89.4% sought help from others 10.6%
Stopped on own – men 82.4%; sought help from others 17.6%
Will I ever smoke again and how did I stop ( global M v F)
Do you think you will ever smoke again?
Men 5.3% yes; 77.4% no; 17.4% maybe
Did you make a conscious decision to stop smoking?
Stop suddenly – women 89.6% / men 91%
Stopped on own – men 94%; sought help from others 6%
Will I ever use cannabis again and how did I stop
(global M v F)
Do you think you will ever use cannabis again?
Men 27.8% yes; 31.8% no; 40.4% maybe
Did you make a conscious decision to stop using cannabis?
Stopped on own – men 96.0%; sought help from others 4%
Will I ever use cocaine again and how did I stop
Do you think you will ever use cocaine again?
Men 16.3% yes; 39.2% no; 44.5% maybe
Did you make a conscious decision to stop using cocaine?
Women 41.3% yes; 56% no; 2.7% cannot remember
Will I ever use MDMA again and how did I stop
Do you think you will ever use MDMA again?
Women 18.5% yes; 45.5% no; 36% maybe
Men 20.6% yes; 30.4% no; 49% maybe
Did you make a conscious decision to stop using MDMA?
Men 30.7% yes; 67% no; 2.3% cannot remember
Comment
In general terms, the similarities between males and females are more
striking than the differences. The one difference that caught my eye and
seems to be fairly consistent across the illicit drugs is that proportionately
more females say they stopped using because they split with their
partner and/or because they no longer see the people they used to use
with – this suggests a tendency for women’s drug use to be more
contingent and/or relational than men’s (this fits with the findings from
other studies) .
It’s worth noting that proportionately more women than men cited
pregnancy or having children as a reason for giving up though the
differences in this regard were not as striking as we might expect.
My impression is that there seems to be a tendency for women to cite
‘bad experiences’ and ‘concerns about health’ more than men which may
indicate that they tend to be a bit more risk-averse. I haven’t had a
chance to check these patterns, but you might want to consider them.

Not to be reproduced without authors permission

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