Measuring Concurrent Polydrug Use in General Populations: A Critical Assessment

Abstract

Background/Aims: Polydrug use is a complicated phenomenon that is measured in a wide variety of different ways. Using Finland as an example, we aimed to demonstrate how the prevalence and prevalence trends of concurrent polydrug use (CPU) varied in the general population based on the different measurements used. Methods: Population-based Drug Surveys conducted every 4 years during 1998-2014 were used. CPU was measured with different measurements: strict, medial and loose definition of CPU, which were based on different combinations of alcohol, illicit drugs, pharmaceutical drugs and cigarettes used during the last 12 months/30 days. Logistic regression was used to estimate the p values for assessing trends. Results: Depending on the measurements used, the prevalence of CPU in 2014 varied between 2.0 and 18.7%. Different definitions also produced contradictory trends of CPU: there was a modest increase in prevalence if it was measured with a medial (p < 0.001) or strict (p = 0.054) definition, but when measured with the loose definition (only measure that included smoking), there was a decrease in prevalence (p < 0.001). Conclusions: The prevalence of CPU varies greatly depending on the measurement used, as does the course of the prevalence trends. The concept of simultaneous polydrug use may capture the phenomenon better compared to the concept of CPU.

More social research into polydrug use

“…Although the increase in polydrug use has appeared challenging to study due to the lack of stable measurements ( Karjalainen, Kuussaari, Kataja, Tigerstedt, & Hakkarainen, 2017 ), the volume of publications dealing with the theme has certainly increased to a significant degree. This is shown in Figure 1 , which displays the number of publications retrieved in a search in the Web of Science from the 1970s up until 2017.…”

Alcohol Interaction with Cocaine, Methamphetamine, Opioids, Nicotine, Cannabis, and γ-Hydroxybutyric Acid

“…People abusing alcohol or suffering from alcoholism tend to use multiple illegal and addictive drugs either sequentially or simultaneously [4,5]. Alcohol interacts with the co-abused drug and, additively or synergistically, modulate their effects via common pharmacokinetic (interference with the drug’s metabolism) and pharmacodynamic (modulation of the drug mechanisms) mechanisms detailed in the following sub-sections.…”

“…However, drug abusers have historically tended to use more than one drug, a condition known as poly-drug abuse (defined as the concurrent or sequential abuse of more than one drug or type of drug, with dependence upon at least one [3]). Over the past several years, there has been an increasing tendency to combine narcotics, alcohol, sedatives, and/or stimulants [4,5].…”

Poly and Tricky Dick: The drug war origins of the term “polydrug use”

“…It is this underlying reality that lends stability to the term and credibility to the rising number of studies and publications on drug combinations ( Karjalainen, 2017 ). Yet, its rise, popularity, and implicit suggestion of particularity are suggestive of a process of social construction driven by vested interests and connected networks.…”