Measuring substance use in the club setting: a feasibility study using biochemical markers

Abstract

BackgroundDuring the last few decades the use of club drugs (e.g., cocaine, amphetamines) has been of increased concern in nightlife settings. Traditionally, surveys have been used to estimate the use of club drugs, however, they mostly rely on self-reports which may not be accurate. Recent advances have allowed for readily accessible drug testing methods such as oral fluid drug testing. Nevertheless, research using oral fluid sampling to measure the frequency of drug use in the club environment is scarce. The objective of this study is to evaluate the feasibility of measuring the frequency of alcohol and drug use among Swedish clubbers using breath alcohol and oral fluid drug testing.MethodThe setting was a 40 hour electronic music dance event (EMDE) on a cruise ship on the Baltic Sea, departing from Sweden, with 875 passengers. Groups of participants at the EMDE were randomly invited to participate. Data were collected with face-to-face and self-administered questionnaires. Further, oral fluid samples were collected to determine illicit drug use, and blood alcohol concentration (BAC) levels were measured using a breath analyzer.ResultsA total of 422 passengers were asked to participate in the study whereof 21 declined (5.0% refusal rate). Of the 401 study participants (accounting for 45.8% of all attendees), 5 declined oral fluid drug testing. Results show that there was a discrepancy between self-reported and actual drug use as 10.1% of the participants were positive on illicit drug use (amphetamines, ecstasy/MDMA, cannabis, cocaine), while only 3.7% of the participants reported drug use during the last 48 hours. The average BAC level was 0.10% and 23.7% had BAC levels ≥ 0.15%, while 5.9% had levels below the detection limit. The mean BAC levels for the illicit drug users were significantly higher (p = 0.004) than for non-drug users (0.13% vs. 0.10%). Self-reported AUDIT-C scores (using a threshold of ≥ 5 for men and ≥ 4 for women) revealed that 76.0% of the men and 80.7% of the women had risky alcohol consumption patterns.ConclusionThis study indicates that it is feasible to conduct breath alcohol and oral fluid drug testing in a Swedish club setting.

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

“…Some have observed poor agreement between oral fluid tests and self-reported drug use [5,[28][29][30][31], while others reported relatively good validity when examined self-reports against blood, urine, hair or saliva drug tests [32][33][34][35]. Even though we did not have direct validation hypotheses, our results suggest that questionnaires still provided information useful for both research and policy purposes.…”

Risky substance use among young adults in the nightlife arena: An underused setting for risk-reducing interventions?

“…In an EMDE in Sweden, 10% tested positive on oral fluid drug testing for illicit drugs, and 94% tested positive on alcohol with an average BAC level of 1.00‰ (Gripenberg-Abdon et al, 2012). Further, in a Swiss study where EMDE attendees were surveyed about their alcohol and drug use in the previous 30 days, the figures were high: alcohol (87%), cannabis (54%), ecstasy (23%) and cocaine (21%) (Chinet et al, 2007).…”

“…Short-term consequences include factors such as increased risk of aberrant driving, violence, injuries and sexual risk taking (Bellis et al, 2003;Gripenberg-Abdon et al, 2012;Schnitzer et al, 2010). Long-term consequences may be manifested by somatic and psychiatric illnesses; drop out from -or reduced productivity in -educational or employment activities; and ultimately possible development of substance addiction (Degenhardt and Hall, 2012).…”

Indicators of Club Management Practices and Biological Measurements of Patrons’ Drug and Alcohol Use

“…Biological assessments typically identify higher rates of recent drug use than self-reports (Gripenberg-Abdon et al, 2012; Johnson, Voas, Miller, & Holder, 2009). Studies using biological measurements show frequent drug and heavy alcohol use among club patrons (Miller, Byrnes, Branner, Johnson, et al, 2013; Miller, Byrnes, Branner, Voas, et al, 2013; Miller et al, 2005; Miller et al, 2009).…”