Metrics drug treatment drugs Abstract New psychoactive substances NPS continue to be considered as a major public health concern in many European countries. The study was implemented within the framework of a transnational project of six Drug treatment drugs countries Germany, Hungary, Ireland, Netherlands, Poland, Portugal.
Our aim here is to report on the distinct and differentiating characteristics of marginalised NPS users. Three subgroups of a total of adult NPS users socially marginalised, night life, online community were examined regarding their socio-demographic characteristics, substance use, and external motives towards NPS use.
Poland and Hungary reported higher rates of NPS use in comparison to traditional controlled drugs. The most important variables which contributed to be categorised as a marginalised NPS user were lower level education, being older, having an unfavourable labour market position and using drugs intravenously.
Contextual motives did not play a decisive role in being categorised as a marginalised user when drug diabetes and high blood pressure life expectancy pattern was controlled.
Diabetes Drugs (Oral Antihyperglycemics \u0026 Insulins)
These identified discriminative features of marginalised drug users should inform policy makers to develop and implement tailor-made interventions targeting this user group to successfully tackle the elevated public health concerns associated with NPS use. New psychoactive substances NPS are a major public health and policy concern in several parts of the world.
In general, NPS represent a multitude of synthetic and natural compounds marketed as alternatives to conventional illicit drugs i. The legislative procedures related to NPS drug treatment drugs very much varied in the different EU member states, covering, and initiating a wide range of measures to tackle the problem.
Neicun et al. General population-based prevalence estimates are rare and inconsistent with regard to trend monitoring of NPS use Korf et al. Surveys targeting special vulnerable populations of Cukor cukorbetegség ödéma kezelésére use are rare and struggle with methodological challenges; the available data suggest that these groups are alacsony cukorszint prone to NPS use, and show higher prevalence rates across all NPS types MacLeod et al.
Studies exploring the knowledge related to NPS in different countries and age groups revealed that the relevant knowledge is unevenly distributed among young respondents, with young people from rural areas showing less knowledge. These studies also suggested that there is a strong association between NPS use and the risk of binge drinking Martinotti et al.
The NPS situation has become even more challenging due to the emerging synthetic opioid crisis, which seems to be less alerting in most European countries than in the USA Schifano drug treatment drugs al. Little knowledge is available about the specific motivations for NPS use and more in-depth research is needed to better understand these reasons Moore et al.
Studies which have assessed the motivational background of NPS use have applied the four-factor motivation scale of Cooper which is used to measure alcohol consumption motivations, and was later further developed to measure cannabis Simons et al. The internal motivation of different user groups and the psychometric properties of a new motivation scale appropriate for cross ingyenes vércukormérő study of NPS motivation were also analysed based on the dataset of this research.
Apart from identifying the psychometric properties and usability of the scale in a transnational setting and in a special population, it was found that marginalised users showed a higher endorsement in coping motives. The reported results also suggest that marginalisation can be considered as a cross-cultural factor behind instrumental substance use Benschop et al. The data collection was carried out on a convenience sample of three different user groups supposed to have diverging consumption habits, motivations and socioeconomic background in both countries.
The survey was conducted between April and November The different user groups reached have an uneven representation in the sample; marginalised users proved to be hard to reach, mostly in Germany, the Netherlands and Portugal. Three inclusion criteria were set as 1 recent NPS use at least once in the past 12 months ; 2 being resident of one of the participating countries; drug treatment drugs 3 an age of 18 years or older.
To reach the most heterogeneous sample of NPS users as possible, three subgroups were aimed to examine for more details see Van Hout et al. Socially marginalised users were defined by their known and supposed drug using habits on one hand and by their availability low threshold, harm reduction services and also by the venue of substance use, on the other.
Discriminative Characteristics of Marginalised Novel Psychoactive Users: a Transnational Study
They were recruited and interviewed face-to-face by trained fieldworkers or care professionals in the street, or through care and treatment facilities e. They were mainly recruited face-to-face on-site at clubs, raves and festivals. Users in night life mostly self-completed either a pen-and-paper or online questionnaire to which they were referred by a flyer containing a link and an individual code; 3.
Users in online communities are users who are very active on the internet, and actively participate in drug forums. They were recruited by posting messages on drug-related social media and internet forums i.
Users in online communities were only given access to the online questionnaire. Measures The questionnaire contained items on demographics, routes of administration of substances, motives and frequencies of NPS and other drug use, social and health problems related to it, modes of obtaining NPS, and possible perceived ways of tackling NPS problems.
Seven categories of NPS were initially included in the study based on their epidemiological and clinical relevance: i.
However, survey responses indicated that participants were generally unable to either properly categorise the NPS they had used or differentiate between certain categories i.
These NPS substance categories were used during the process of statistical analysis and throughout the presentation of the results. The questionnaire also contained motivations related items Footnote 1 to investigate what were the most important reasons to use NPS. Principal component analysis was carried out on the external motivation items to assess if these items construct a coherent scale.
Results Descriptive Statistics—Sample Characteristics The number of respondents reached in the different countries and user groups varied significantly across the participating countries see Table 1. Drug treatment drugs highest number of marginalised users was recruited in Hungary, whilst the highest number of online users was reached in the Netherlands. The most balanced sample in number of respondents belonging to the different user groups was achieved in Poland.
As there was no way to carry out a probabilistic and random sample selection drug treatment drugs these special populations none of the samples were representative of the participating countries. Table 1 Composition of the sample according to countries and user groups number and percentage of respondents Full size table The sample was very much varied as far as the socio-demographic characteristics of the respondents are concerned.
Most of them were male, and lived in larger cities, the most noticeable differences can be seen in the level of education the lowest level education was observed among marginalised users and the highest in the on-line community and in the employment conditions; most marginalised users were unemployed whilst night life and online community representatives were either students or full-time workers for further details see Korf et al.
Short Term Drug treatment drugs Month Frequency of Substance Use in Different User Groups According to last month frequency of substance use, all user groups, regardless of their country of residence, are also using controlled substances; apart from Hungary and Poland, these frequencies are the highest in all user groups.
Due to the fact that the different user groups were reached in an uneven proportion in the different drug treatment drugs, the following results would describe the short-term frequencies of substance use in different user groups. To be able to show the problematic nature of substance use, frequencies of intravenous drug use were also included into the analysis.
Marginalised Users Last month frequency of controlled substance use is lower among marginalised users than in the other two user groups The most popular substances among new drug treatment drugs substances are the NPS stimulants and drug treatment drugs synthetic cannabinoids.
The highest frequency of intravenous drug use was observed among this user group, half of them applied this route of administration in the month preceding the data collection. Users in Night Life Controlled substances are the most prevalent substances in the night life user group Synthetic cannabinoids are also popular in this user group as every 9th respondents used this substance during the month before the data collection was carried out.
Almost no intravenous drug use can be observed in this user group 1. Synthetic cannabinoids are the fourth most popular NPS substance used in this group during the month preceding the data collection.
Last month frequency of intravenous drug use is low, 1.
The last month frequencies of substance use, especially when we compare them with data stemming from general adult population surveys of the last 3 years, show that recent NPS users in the current sample are very intensive substance users. The frequencies of substance use estimates suggest that the most popular new psychoactive substances synthetic cannabinoids, NPS stimulants are 2—3 times more frequently used monthly among recent Drug treatment drugs consumers the frequencies are between For the most popular substances cannabis and MDMA the highest prevalence was Items related to the legal status and to the perceived non-detectability of NPS were given ratings lower than 2.
This item is rated highest among night life users see Table 3. The component loadings ranged between 0.
This factor was given the contextual motivation factor label. The Cronbach Alpha for these items was 0. The Netherlands was left out from this analysis as only one marginalised respondent was interviewed in this country.
As the figure below Fig. These comparisons show that contextual motivations presumed to be NPS specific play a different role depending on the country of residence of the respondents.
Note: F value drug treatment drugs countries, 5. For this purpose, two binary logistic regression models were created; in each case, the dependent variable was if the 1 es tipusu cukorbetegseg tunetei was categorised as marginalised vs.
The Netherlands was left out from this analysis as the total number of marginalised users reached during the interview was only one person.
The total number of respondents included into this analysis was In the first model, we included only socio-demographic characteristics education, current status of employment, gender, age, size of the settlement and living conditions. The low level of accomplished education, living on benefits, being unemployed, being older, living with friends, using homeless-type accommodation drug treatment drugs and living in bigger settlements significantly increased the probability of being a marginalised user see Table 4.
Table 4 Binary logistic regression analysis of socio-demographic factors for being categorised as a marginalised user Full size table Country of residence seems to be associated with significant and high odds ratios for being categorised as a marginalised user, though these findings might just be the consequence of sample attainment. As the number of marginalised users reached during the data collection was very much varied we carried out a country based binary logistic regression analysis as well drug treatment drugs which the same set of variables were used to find out the country specific characteristics of the marginalised user group.
Level of education played a role in being categorised as a marginalised user in the case of Hungary and Germany. In Hungary, less education elevated the risk of being part of the marginalised user group whilst in Germany any accomplished education increased this risk very probably due to the high number of participants with higher education attainment in the sample. The employment status proved to be an active ingredient of being categorised as a marginalised user in Poland.
Living on benefits or being unemployed elevated this risk 32—9. Age also had a different role depending on the country of residence of the respondent.
In case of Hungary and Poland, being older than 24 highly elevates the risk of being part of drug treatment drugs marginalised group. Living with friends just in Germany, residential care in Germany and Poland and homeless accommodation in Germany, Hungary and Poland contributed to the marginalised categorisation.
Size of the settlement where the respondent was living did not add to this categorisation. In the case of Portugal and Ireland, drug treatment drugs of the variables revealed any patterns see detailed result in Appendix Table 6.
Chemsex – the Drugs and Sex Subculture in the Gay Community
Another binary logistic regression model was developed on substance use—related behaviour Table 5. We included NPS and controlled substance use frequencies life time, last year, last monthvenue of substance use, problems physical, social and mental health experienced after using NPS, parallel usage of different substances, and contextual motivation factor.
But what help is there to stop for people who get addicted to chemsex? What Is Chemsex? The term chemsex also refers to the parties, often hosted by dealers of chemsex drugs, where men meet up to take drugs and have sex. Chemsex is distinct to sex that takes place after gay men have used recreational drugs coincidentally. Instead, chemsex is the intentional use of drugs to fuel, enhance or prolong sexual activity.
The model shows that characteristics of problem drug use EMCDDA, are clearly associated with being a marginalised respondent. Those who used heroin or methamphetamine during their life time or in the last year have a 2. In case of those who had ever or during the last year injected any kind of substances, the odds ratios are considerably elevated. Frequencies of current substance use reveal that using synthetic cannabinoids or crack also highly increases the odds ratios for being categorised as marginalised user, whilst using cannabis or amphetamine during the last month decreased the chance for belonging to this category.
If someone is using substances in residential drug treatment drugs, the chance for being categorised as a marginalised user is 5. Table 5 Binary logistic regression analysis of substance use related factors for being categorised as a marginalised user Full size table As we found considerable differences in the sociodemographic variables according to countries of residence, we analysed the country-specific contributing factors of substance use the same set of variables as described above in being categorised as a marginalised user.
The analysis revealed that last year and last month use of heroin and intravenous drug use in Germany and Polandamphetamine, methamphetamine use in Poland and synthetic drug treatment drugs and crack use in Hungaryhighly elevated the risk of being categorised as a marginalised user.