Identification and Assessment of Drug-User Groups Among Nightlife Attendees: Self-Reports, Breathalyzer-Tests and Oral Fluid Drug Tests

Abstract

Background and Objectives: Even though nightlife studies with potentially intoxicated participants provide the much needed information on drug use, they face additional methodological challenges. This study aimed to explore the utility of such studies by (i) classifying nightlife attendees based on their self-reported drug use and by (ii) examining whether these classifications were meaningful when assessed against other sources of data, including oral fluid drug tests. Methods: Self-reported questionnaires, oral fluid samples and blood alcohol concentration readings were collected in a sample of 1,085 nightlife patrons recruited outside 12 popular nightclubs in Oslo, Norway, in 2014. Patrons were classified using multiple approaches, including latent class analysis. Group differences were examined by logistic regression models. Results: Participants were classified into 5 mutually exclusive groups: 2 among current non-users (“Never-users”; “Previous users”), 2 among current users (“Multiple drugs”; “Cannabis mainly”) and one “Incomplete information” group. Meaningful differences across these groups were observed. For instance, positive tests for any illicit drug were more common in “Multiple drugs” group than in “Cannabis mainly” (62.7 vs. 29.1%, adjusted OR [aOR] 3.77 [2.42–5.84]) or “Incomplete information” groups (62.7 vs. 34.4%, aOR 2.46 [1.26–4.79]). Despite their self-declared non-use, illicit substances were detected in oral fluids of “Never-users” (13.1%; 95% CI 9.9–17.2) and “Previous users” (7.9%; 95% CI 5.1–12.1). Conclusions: Despite some discrepancies between self-reports and biological tests, self-reports proved both suitable and useful in identification of substantively different drug-user typologies, potentially informing targeted policy responses. Still, methodological challenges associated with onsite studies of illicit drug use should be further explored.

Illicit Drug Use and Associated Problems in the Nightlife Scene: A Potential Setting for Prevention

“…The age of onset was lowest for cannabis (median: 17; interquartile range (IQR): 16-19) and highest for ketamine (median: 23; IQR: 21-27) (Figure 3). The median age of onset was 20 for magic mushrooms (IQR: 19-23) and 21 for ecstasy (IQR: 19-23), amphetamine (IQR: 19-23), cocaine (IQR: 19-24), and LSD (IQR: [19][20][21][22][23][24]. As a comparison, the median age for first use was 15 for alcohol (IQR: 14-16) and 16 for tobacco products (IQR: 14-17), respectively.…”

“…Previous research shows that drug use is common among attendees of nightclubs, bars, pubs, and festivals and particularly at electronic dance music (EDM) events [ 4 , 11 , 12 , 13 , 14 , 15 , 16 ]. In the Nordic countries, studies on drug use in the nightlife scene show a higher drug use prevalence among nightlife attendees than among the general population [ 14 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. For example, studies at Norwegian clubs and festivals show that 43% and 21%, respectively, of the attendees had used illicit drugs during the previous year [ 20 , 23 ].…”

“…For example, studies at Norwegian clubs and festivals show that 43% and 21%, respectively, of the attendees had used illicit drugs during the previous year [ 20 , 23 ]. Furthermore, 25% of club goers in Norway tested positive for using an illicit drug [ 21 ]. In a Swedish study at an EDM event on a cruise ship, 9% of attendees reported that they usually use illicit drugs when clubbing and 10% tested positive for at least one illicit drug [ 18 ].…”

“…There are a substantial proportion of drug users who use several drugs during the same occasion or within a given window of time (polydrug use) [ 4 , 15 , 37 , 38 , 39 ]. Several studies show that many drug users drink alcohol while using illicit drugs [ 18 , 21 , 23 , 40 , 41 , 42 , 43 , 44 ] and that hazardous drinking is associated with illicit drug use [ 18 , 20 , 40 , 42 ]. Polydrug use is associated with mental health problems, sexual risk taking, and violence [ 3 , 6 , 33 , 45 ].…”

Nightlife scene involvement and patterns of prescription drug misuse

“…Research demonstrates that participation in nightlife scenes influences a variety of health behaviours [1][2][3][4]. Substance use is often a key component of participation across differing nightlife scenes [5][6][7][8][9][10]. In these settings, psychoactive drugs enhance environmental stimuli, facilitate social interaction and disinhibit participation in activities such as dancing, among other effects.…”