The latest edition of the European Web Survey on Drugs confirms that despite rampant prohibition, people use a lot of different drugs—including, critically, drug combinations. And most do it primarily to have a great time.
Among respondents who used drugs of all kinds, 70 percent said they used to have fun or get high. That was particularly pronounced among MDMA consumers, with 88 percent reporting that they use it for fun. Some different motivations were apparent depending on the drug, however. About 60 percent of people using heroin, for example, mainly used it to reduce stress or relax. Meanwhile around a third of people using amphetamines, powder cocaine or MDMA did so to socialize.
Delivered across May and June 2024 by the European Drugs Agency, a European Union monitoring body, the survey gathered insights about drug use in the past year from over 67,000 people in 35 countries, including most EU members and nearby places like the Western Balkans, Ukraine, Lebanon and Palestine. Its results were published in late February.
The multi-national coverage paints a hugely valuable picture, though with some limitations. The self-selecting nature of respondents and variability of countries’ implementation mean the survey is not necessarily representative of national drug prevalence rates. This edition, for example, had a disproportionate number of responses from Sweden and Spain. However, the results have been aggregated with other national measures of drug prevalence to provide more accurate insights.
Almost three-quarters of respondents used drugs at home. This finding is particularly informative for future harm reduction work.
The web-based, time-consuming nature of the survey also means that certain groups of people who use drugs, especially the most marginalized, may be underrepresented.
The last edition was in 2021, and depicted Europe’s post-COVID drug landscape. The latest edition offers more granular insights into people’s habits, and reflects wider recognition of the normality of drug use.
Many of the results uncovered are not groundbreaking: Alcohol and tobacco/nicotine—an aggregation of tobacco with non-tobacco products like vapes and pouches—were consistently the most used drugs across all nations (the survey did not include caffeine). Among the “illegals,” cannabis was by far the most popular, with almost 60 percent of respondents reporting its use. Second came MDMA, with 30 percent of respondents using it, followed by powder or crack cocaine (29 percent).
For many, home is where the drugs are: Almost three-quarters (73 percent) of respondents used drugs at home. This tracked with the 2021 survey, although it was then unclear whether this preference was due to ongoing pandemic restrictions.
This finding is particularly informative for future harm reduction work. With so many resources and interventions focused on social settings, developing projects or techniques to keep people safe when using in private settings, potentially alone, is increasingly important.
There were some predictable exceptions to the general preference for the home setting. MDMA was primarily used (79 percent) at music festivals or parties, with 45 percent of users opting for clubs or bars. Powder cocaine was primarily used (68 percent) in clubs or bars. Cannabis, crack cocaine and heroin were the drugs most likely to be used in nature or in public spaces like streets and parks.
The most likely combinations of criminalized substances were methamphetamine and cannabis, and heroin and benzodiazepines.
This edition of the survey also drilled down on the reality of polysubstance use. This should be a given: If you ask people who use drugs whether they use more than one substance, “mono use” is likely to be the exception.
The results clearly reflected this, with 96 percent of respondents reporting that they used more than two drugs on the same occasion in the past year.
Alcohol and tobacco/nicotine were consistently the substances most often mixed with other drug groups. The most likely combinations of criminalized substances were methamphetamine and cannabis (mixed by 31 percent of respondents) and heroin and benzodiazepines (30 percent). But powder cocaine was overall the criminalized substance most likely to be mixed with other drugs. Notably, 30 percent of people using cannabis said they would not mix it with other drugs.
While polysubstance use has long been known as typical, capturing it in the survey represented a big methodological challenge, according to the researchers.
“I can say that defining [polysubstance use] was one of the things that took the longest and generated the most discussions,” João Matias, scientific analyst at the EUDA and the survey’s lead designer, told Filter. The survey’s format—from what to ask, to which drugs to include or group together—had to be agreed across all 35 participating countries.
As for what “polysubstance use” should be taken to mean, “These are substances you take at the same time, or in a row, or with a few hours in between,” Matias said. “It’s complicated. What’s really a ‘use session’? Methodologically, it’s a challenge.”
The survey decided to define polysubstance use as “the use of two or more substances on the same occasion,” leaving respondents to interpret that for themselves.
Alexei Lakhov, the executive director of the European Network of People who Use Drugs (EuroNPUD), was not surprised by the findings—or the researchers’ difficulties.
“I think that poly-drug use accurately reflects real-world trends,” he told Filter. “In addition, some people just don’t perceive certain substances, such as alcohol, benzos or tobacco, as ‘drugs’ per se, and can use them even without wanting to ‘get high.’”
“In a fatal overdose, it’s rare for just one drug to be in someone’s system. So we need to integrate the concept [of polysubstance use] into all our work.”
Despite the challenges, Matias underscored that it was essential to capture this finding. “We have data for the first time confirming what people have said, that it’s rare for people to just use one drug.”
“We need to work on definitions, as it’s a field with little consensus,” he continued. “We need to apply a poly-use perspective not only in data collection but also in how we interpret drug use and interventions. In a fatal overdose, it’s rare for just one drug to be in someone’s system. So we need to integrate the concept into all our work.”
Studies on polysubstance use are relatively rare, and much of the research that exists has a narrower focus on just two drugs. Only a handful of examples—like a 2006 study looking at alcohol and prescription stimulants, painkillers and sedatives, or a 2022 study examining motivations for poly-drug use—have made broader attempts to widen our understanding.
As British researchers stated almost 20 years ago, polysubstance use is “poorly defined” and “frequently overlooked”—and this partly still holds true. But the benefits of engaging in this work have the potential to be felt across all drug-using communities.
“Recognizing that people who use drugs may seek specific combinations to achieve desired effects, cope with personal issues, or enhance social experiences can inform more empathetic and tailored harm reduction strategies,” Lakhov said.
The survey’s reflection of people’s pleasure in using drugs is also important. It’s another area that research largely ignores—contributing to harmful policies, when drugs are often viewed purely through a pathologizing or negative lens.
Drug use is as messy, complex and diverse as life itself. It is crucial to have a body of research that reflects this reality, so that we can develop more pragmatic and effective support for people who need and want it.
Image (cropped) by Pixabay via Stockvault/Public Domain
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