Using life course charts to assess and compare trajectories of amphetamine type stimulant consumption in different user groups: a cross-sectional study

Abstract

Background Amphetamine-type stimulants (ATS) are the second most commonly used illicit drugs in Europe and globally. However, there is limited understanding of what shapes patterns of ATS use over the life course. The ATTUNE project “Understanding Pathways to Stimulant Use: a mixed methods examination of the individual, social and cultural factors shaping illicit stimulant use across Europe” aims to fill this gap. Here we report initial findings from the life course chart exercise conducted as part of qualitative interviews with ATS users and nonusers. Methods Two hundred seventy-nine in-depth qualitative interviews were conducted with five ATS user groups (current and former dependent users;current and former frequent users;non-frequent users) and one group of exposed non-ATS users in five European countries (Germany, UK, Poland, Netherlands and Czech Republic). As part of the interviews, we used life course charts to capture key life events and substance use histories. Life events were categorised as either positive, neutral or negative, and associated data were analysed systematically to identify differences between user groups. We applied statistical analysis of variance (ANOVA) and analysis of covariance (ANCOVA) to test for group differences. Results Out of 3547 life events documented, 1523 life events were categorised as neutral, 1005 life events as positive and 1019 life events as negative. Current and formerly dependent ATS users showed more negative life events for the entire life course after age adjustment. Although some group differences could be attributed to the individuals’ life course prior to first ATS use, most negative life events were associated with periods of ATS usage. A detailed analysis of the specific life domains reveals that dominantly, the social environment was affected by negative life events. Conclusions For non-dependent, frequent and non-frequent ATS users, negative life events from the period of ATS use do not become obvious in our analysed data. Besides preventing a pathway into ATS dependency, the aim of an intervention should be to reduce the harm by for example drug testing which offers also the opportunity for interventions to prevent developing a substance use dependency. For the group of dependent ATS users, our study suggests holistic, tailored interventions and specialist treatment services are needed, as a single, simple intervention is unlikely to cover all the life domains affected.

Analyse biografischer Ereignisse bei unterschiedlichen Gruppen von Konsumierenden amphetaminartiger Substanzen in Deutschland: Eine qualitative Studie

“…Die Auswertung der Lebensereignisse nach Konsumgruppen zeigt, dass sich bei den aktuell und ehemals ATS Abhängigen die höchste Anzahl an negativen Lebensereignissen im Lebenslauf findet. Die Analyse der Lebensereignisse von den gesamten 279 Interviews der ATTUNE Studie kam bei den ATS Abhängigen zu gleichen Ergebnissen [28]. Aus dem Geschlechtervergleich ging hervor, dass die befragten Frauen in ihren Leben signifikant stärker durch negative Lebensereignisse belastet waren als die be-▶tab.…”

Relapse risk factors for patients with comorbid affective disorders and substance abuse disorders from an intensive treatment unit

“…Variables selected for the exploratory analysis were obtained via a compilation of literature reviews of risk factors associated with substance abuse, which can be summarized to several broad categories of risk factors associated with relapse and higher resource utilization, including social determinants like marital status and prior incarceration, specific substances used (namely heroin, benzodiazepines, prescription opioids, alcohol, marijuana, cocaine, crack, MDMA/ecstasy, PCP, methamphetamine, amphetamine; individually and in combination), physiological comorbidities, such as HIV/AIDS, frequent prior ED, and rehabilitation admissions, as well as psychiatric comorbidities like anxiety and posttraumatic stress disorder. 6,[8][9][10]16,17 Together, 47 prospective variables were subject to an exploratory univariate log-rank test and all variables demonstrating p < .1 were included in the initial Cox model. This data was considered right-censored for the Cox variable hazards model and only relapsed patients were considered for the log-rank test of equivalency.…”

Different Phases of ATS Use Call for Different Interventions: a Large Qualitative Study in Europe

“…It included questions about participants' ATS use career (i.e., changes in use trajectories and occurrence of life events in various domains). Interviewees were asked to recall changes in different life domains and their ATS use patterns in their entire life, using individual time charts (Liebregts, 2018;Martens et al, 2020). The time chart referred to the frequency of substances used and to experiences in life domains (including social life, health, work/study, leisure).…”