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The prevalence of cocaine use has been increasing since the mid-1990s in many European countries, Italy included. There is a large variety of patterns of cocaine use in natural settings, but on the whole, the existence of different patterns of cocaine use remains widely unknown to drug professionals, as well as to public opinion. The purpose of this paper is to investigate patterns and trajectories of use, the meaning of use within the context of users’ life styles, the perception of controlled/uncontrolled use, personal strategies to keep drug use “under control”.

This paper illustrates findings from a qualitative study among 115 cocaine users. Participants were recruited using the snow ball sampling (a minimum lifetime experience of 20 instances of cocaine use was required).

The findings confirm the variability of cocaine use trajectories and the prevalent tendency towards more moderate patterns of use. Such variability is in patent contrast to the disease model of addiction and its assumed predetermined linear trajectories. Set, and particularly setting and all the environmental factors, such as life events, appear to be the variables that can better explain the dynamic course of patterns of use.

The main limit concerns the non-randomisation in the selection of the nominees. Participants were recruited in the night entertainment scene of the main Tuscan cities through personal contacts of staff from risk reduction facilities: in spite of the personal and confidential approach, the number of “non institutionalized” users willing to collaborate was too low, therefore the authors decided to omit the randomisation.

The findings bear social implications as they can contribute to a change in the social representation of users so as to reduce the stigma. They can also prompt innovation in the operational models of drug services.

It is the first qualitative research from the “control” perspective ever led in Italy.

The purpose of this paper is to suggest that the emergence of substituted cathinones or M-cat drugs (notably mephedrone and methylone) and their rapid proliferation of use, amongst drug users in the UK from 2009 onwards, signals changes in the habits, preferences and lifestyle choices made by certain drug users, whilst also indicating a pronounced increase in the levels of co-morbid mental health conditions experienced by another, yet often distinct, group of users.

This latter group of users, it is suggested, tend to initiate use of psychoactive substances (including tobacco and alcohol) at a younger age. In addition, it is suggested, they often present to treatment and criminal justice services with a history of chronic childhood relational trauma, as a background against which severe patterns of drug abuse has evolved. In this light the lack of significant supplies of social capital, as a protective factor against the development of chronic drug use, is further considered in the paper that follows though a brief literature review and qualitative clinical case reports.

Novel psychoactive substances ( Newcombe, 2013) appear so seductive, for a certain group of users, because they seem to provide a temporary form of cognitive and emotional anaesthesia, enabling users to self-medicate, often against experiences of profound psychological trauma and contemporary lives that are typically experienced as boring, hopeless and pointless. The euphoric effects of psycho-stimulants such as mephedrone are particularly appealing to individuals attempting to escape a subjective sense of daily dysphoria and may on this basis lead to, rather than recreational use, more persistent patterns of drug use. However, in contradistinction to this group of users, another recreational – mainly weekend leisure – group of users continues to evidence a voracious appetite for psycho-stimulant substances.

It is suggested that this second group of users has been particularly influential in substitute displacement towards the emergence of legal highs, due to the poor quality and illegal status of street drugs such as cocaine, amphetamine sulphate and MDMA (ecstasy).

The purpose of this study was to investigate the relationship between parenting styles, family psychological vulnerability environment (FPVE) and drug use among adolescents.

The quantitative survey using paper and pencil was administered to collect data from 284 parents registered with a paediatric clinic in the city of São Paulo (Brazil), most of whom claimed that their children used drugs. FPVE was measured by eight scales: family relationship patterns and drug use habits; hereditary predisposition to drug use; transmission of moral values to children (reverse); parents’ hereditary predisposition; parental drug use; depression; impulsiveness; and anxiety.

Dimensions of FPVE that had effect on drug use by adolescents were: the family relationship and drug use patterns of the family of procreation, drug use by the parents and heredity in relation to drug use. Conversely, the family relationship and drug use patterns of the family of origin and the parents’ anxiety, symptoms of depression and impulsiveness did not affect their children’s drug use.

One limit of this study is the sample of parents. These parents were parents of adolescents that were at psychological treatment. The authors do not know if part of parents who declared that their children are not drug users, because the treatment effect. Another limit is that this study did not compare the effect of parents’ drugs misuse with parents that do not use drugs on adolescent drug use. One other limit is that the parents were treated regardless of whether they were mothers or fathers.

This study expands the study of the antecedents of drug use by adolescents, considering FPVE as a construct. Regarding this construct when facing resources limitation, the practitioners can prioritize strategies to prevent adolescent drug use.

To the best of the authors’ knowledge, no study has previously examined the use of psychoactive substances (PASs) at electronic dance music (EDM) events in Ukraine. Addressing this gap in the research literature, this study aims to: describe the recreational drug scene associated with Ukrainian EDM culture; identify clusters of EDM participants who use PAS, based on their drug use patterns; and assess the uptake of drug checking and investigate associations between drug checking and subsequent drug-related behaviour.

A series of cross-sectional surveys were conducted in 2021 (N = 1,307) among EDM festival participants in Ukraine. The authors performed cluster analysis to identify distinct profiles of PAS users. Trends in drug checking were analysed based on cross-sectional surveys conducted at one recurring festival in 2018 (N = 99), 2019 (N = 195) and 2021 (N = 237).

The substances most often used at EDM events were 3,4-Methylenedioxymethamphetamine (37%), amphetamine (16%), lysergic acid diethylamide (11%) and cocaine (9%). Between 2018 and 2021, the proportion of participants who reported to have ever tested their drugs has increased from 2% to 26% (p < 0.001). Unexpected or inconclusive test results led to a significantly lower chances of drug consumption (p = 0.003). The authors identified three distinct clusters of PAS users among the EDM festival attendees in Ukraine.

This study will inform the development of harm reduction interventions tailored to various subgroups of recreational PAS users taking into account gender-specific patterns of use suggested by the authors’ cluster analysis. Increased availability of drug checking is crucial to reduce the risks of drug-related harm associated with the consumption of mis-sold, mislabeled and/or adulterated substances.

Recent studies have shown that people who attend electronic dance music events and use drug checking services (DCS) are a predominantly white male, highly educated middle-class population. However, there is still a lack of data beyond sociodemographic characteristics that must be addressed. This paper aims to describe the drug use patterns and protective behavior strategies (PBS) used by testers and nontesters at Boom Festival 2018 and analyze the relationship between these behaviors and the decision to use the DCS.

This is an exploratory research based on a cross-sectional design using baseline data collected at the Boom Festival from testers (N = 343) and nontesters (N = 115).

Nontesters presented, in general, slightly higher frequencies of use for most drugs, whereas testers tended to adopt PBS more frequently. Moreover, testers planned their drug use more often than nontesters and set more limits on the amount of drugs they used in one session. Both of these behaviors work as predictors for using the DCS.

Our data suggest that DCS might not be easily accessible to all people who use drugs, reaching almost exclusively highly educated people that already apply several harm reduction strategies. Actions should be taken to promote service accessibility.

To the best of the authors’ knowledge, this paper is the first to compare the demographics, drug use and PBS adoption of DCS users with nonusers who attended the same festival.

The challenge for drug and health promotion services is to keep up‐to‐date with the dynamics of drug use patterns and trends both nationally and within certain groups (Kilpatrick, 2000). The traveller community present with lower but similar levels and patterns of drug use than the general population, but are particularly vulnerable to early onset of drug use and problematic substance use relating to their life circumstances. Drug use in the traveller community is facilitated and mediated by a combination of risk and resilience factors, which include lack of education, unemployment, comprised health and poor housing conditions.The research aimed to provide an explorative account of the issue of drug use in the traveller community and consisted of focus groups (N=12) of travellers (N=57) with a gender balance (47/53%) based on self‐selection and volunteerism. The focus groups (4‐5 individuals) were predominantly peer‐accompanied where a traveller guided the facilitation of the traveller focus groups and were also gender based. The focus groups incorporated the following key themes relating to the travellers and drug use; traveller culture and drug use, drug availability and dealing, gender differences in drug use, types of drugs used, reasons for drug use, levels of drug related knowledge, attitude to drug use, drug taking contexts and patterns, problematic drug use in the traveller community, drug awareness, perceptions of risk and experiences of drug treatment and community services.The travellers indicated increased drug availability in recent years. Some members of their community were dealing in and using drugs, as a result of unemployment, lack of education, depression, and increasing contact with the settled community. This has lead to a fragmentation of traveller culture. Traveller men are at heightened risk of substance dependency in terms of increased contact with drugs such as cocaine, speed, hash and ecstasy. In contrast, traveller women reported prescription medication abuse. The travellers described a fear of problematic drug use within their communities coupled with concern in terms of discriminatory experiences with health and drug services, lack of awareness of current service provision and the lack of culturally appropriate drug education material and addiction counseling.

The purpose of this paper is to assess the relevance of cryptomarkets, characteristics of purchasers and possibilities for survey research by approaching users directly on cryptomarkets.

Cross-country comparison of the results from the European Web Survey on Drugs (EWSD) and summarizing lessons learned during the data collection was carried out.

Purchasers of drugs on cryptomarkets are still a rather small segment of all drug purchasers, and most people who use cryptomarkets also use other sources of supply to buy drugs. The percentage of people using cryptomarkets is unevenly distributed across countries and substances. Purchasers on cryptomarkets in most countries are more likely to be men and more likely, on average, to use more substances. Other characteristics such as age or place of residence do not show a consistent pattern across countries. Recruitment of respondents on cryptomarkets calls for specific techniques and procedures. Specific attention should be paid to build trust and guarantee credibility and anonymity.

Interpretation of the quantitative results is limited by nonprobabilistic sampling and different recruitment strategies in different countries.

Users of cryptomarkets show some specific characteristics, providing a challenge for research and prevention agencies to keep up with digital technology. Increasing knowledge about characteristics of users of cryptomarkets may help to create adequate responses for harm reduction measures in different supply settings. However, collecting self-reported data from users on cryptomarkets is limited owing to significant privacy concerns and requires specific skills and strategies.

The EWSD provides a rare opportunity for detailed analyses of consumption patterns and characteristics of active drug users across several European countries. Furthermore, experiences of a new recruitment strategy are discussed.

This paper aims to research the prevalence of a new drug which appeared at the era of economic crisis in Greece, called “shisha.” Shisha, a rather cheap form of crystal meth, has spread fast among drug users in Greece with the deepening of the economic crisis. The present paper is concerned with the socio-demographic characteristics of drug users who choose this type of drug and reveals the conditions under which this drug is used. In addition, perceptions of drug users about the specific drug are also explored.

In total, 148 drug users took part in this study. Of these 73 percent were men and 27 percent women. The average age of participants was approximately 37 years. All participants in the study were interviewed face-to-face on the basis of a structured brief questionnaire with closed and open-ended questions.

The data suggests that the majority of drug users who use “shisha” are mainly heroin users (63.2 percent) and they use this new drug as a second choice to heroin. Shisha can be found in the center of Athens and it is usually smoked through a glass pipe. The cost for buying the drug is relatively low (two to three euros) and the drug is produced in small illegal labs. Most participants argued that shisha is linked to violent and aggressive behavior, loss of weight, insomnia, sexual arousal and a psychotic state that may cause death. The drug is made out of a form of crystal meth produced by amphetamines and liquid acids found in batteries liquids.

This drug is mainly used by homeless drug users in the center of Athens. Its exact synthesis cannot be identified given the fact that drug users use various recipes to produce it. Taking the drug is extremely dangerous for the health of the users.

Research of the use of a new drug linked to the economic crisis in Greece. Researchers in this paper approached street drug users who are highly unlikely to seek help from health or other types of treatment providers.

The reasons why some people use illicit drugs recreationally and in a dependent, harmful, way are not clearly understood. Various factors have been put forward, each of which may play some part in affecting individual drug using outcomes. Rounsaville (1982), for example, analysed the life records of approximately 400 opiate users and identified two antecedents to drug use, childhood trauma and early antisocial or delinquent behaviour. Social background and deprivation have also been noted as possible preceding factors. Parker et al (1987) found correlations between heroin use and unemployment, overcrowding and other indices of deprivation. Other perspectives on use, cited by Johns (1990), include availability and peer influence. Sub‐culture has also been suggested as an important context to use (Becker, 1963; Williams, 1989). The Third Triennial Report to Congress (Department of Health and Public Service, 1991) focused on individual ‘risks’, which were categorised as biological (genetic), psychological, behavioural (anti‐social and delinquent activies), demographic (such as gender or ethnic factors), and environmental (arising from family or peer group influence). However, despite these and many other perspectives on pathways to illicit drug use and drug‐related harm, a comprehensive account which seeks to ground such practices in the complex interplay between the individual, their community and elements of social structure has yet to be achieved.

There has been increasing concern about inappropriate or excessive medication of people with learning disabilities. Audits of prescribing practice may guide clinicians towards a more rational use of psychotropic drugs. Most previous studies have come from North America or Europe. This paper reports on a survey of prescribing patterns in an institution that cares for adults with severe to profound learning disabilities in Hong Kong. The survey found that 27% of the 294 hospital patients were receiving psychotropic drugs, but this rate was significantly higher (90%) in the ward for people with challenging behaviours. Most patients (67%) received a single psychotropic drug, 26% received two and 7%, three. Around half the patients (151) had epilepsy, of whom 90% received anticonvulsants. Of these, 52% received a single anticonvulsant, 37% received two and 11% received three or more. Dosages were generally within the recommended ranges. This survey revealed several good aspects of prescribing practice at Siu Lam Hospital, but also areas that need improvement. The latter include a drug‐reduction programme for the people with challenging behaviours, trials of drug‐free periods for seizure‐free patients receiving anticonvulsants and replacement of phenytoin and phenobarbitone with safer alternatives.