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You have full access to this open access chapter. Psychoactive substances take a functional role in the management of emotional and social life of humankind. However, the bond between mind-altering substances and their users or potential users is of changing nature, since the diversity and the accessibility of these substances, as well as the perception of expected benefits and related risks are constantly evolving. Science and technology have contributed to develop new or more potent drugs. The legal status of drugs has become blurrier with the emergence of new synthetic psychoactive substances, highly accessible and most attractive, especially to younger users. New information and communication technologies have changed the way information is spreading among us as well as the means and channels to procure various controlled and non-controlled substances. The increasing popularity and varieties of hemp and psychoactive cannabis products, their developing medicinal use and their potential impact on the perception and acceptance of cannabis are equally at stake when it comes to understand changing patterns in cannabis use for instance. More opportunities stand for more choices to make, especially by young people. Knowing that regular drug use bear highest risks, notably in terms of cognitive and psychosocial developments in children and adolescents, it is sound to question its impact on public health and challenges in terms of prevention, demand and harm reduction. This paper reflects the attempt to describe and to analyse evolutions in drug supply, drug demand and drug use as well as other behaviors with addictive potential in youngsters over the last two decades in Luxembourg and to address national specificities, trends and challenges in terms of response and to place the national situation in a wider international context. You have full access to this open access chapter, Download chapter PDF. However, these indicators merely provide a fragmented picture of the complex and changing bond between psychoactive substances and their users or potential users in a given era and socio-cultural environment. Moreover, national data might not be available, not representative or not comparable to previous data or to data from other countries, due for instance to divergent methodologies or data formatting. This said, data from representative general population surveys provide a sound framework to discuss patterns of drug use in the general population. Although national data from a series of selective surveys on various target groups at regional or national levels are available, the latter are either outdated or too specific to provide meaningful input to the present analysis. To date, the sole representative national data on drug use in the general population of Luxembourg stems from the wave of the European Health Interview Survey EHIS. Prevalence rates of substance use in age group 15—34 years are presented in Fig. Cocaine and ecstasy-type substances appear to be the most used controlled substances cannabis excluded in residents aged 15—34 years. Drug prevalence rates applied to age group 15—18 years are not included in Fig. Cannabis is the most used controlled psychoactive substance at the national level, and thus deserves special attention, notably because of its use prevalence in youngsters. Figure 2 provides an overall picture of national cannabis use prevalence in the general population according to age groups 15—18 years and 15—34 years, based on EHIS data. To put these results in a European perspective, a comparison with comparable prevalence data from other EU member states has been performed. Table 1 shows that first substance use most frequently occurs in age group 15—19 years, with the exceptions of heroin and cocaine, for which first use typically occurs between 20 and 24 years. Virtually, half of youngsters use cannabis for the first time while being still minor of age. A longitudinal analysis of prevalence trends in the general population cannot be performed since serial data on drug use at the national level are unavailable to date. In contrast, data from school survey allow, to a certain extent, a more in-depth analysis of the evolution of drug use in youngsters over the last decades. First representative school surveys including national data on drug use have been conducted as early as Matheis et al. However, only the first national wave of the Health Behavior in School Children HBSC survey in and subsequent serial surveys allowed to validly compare national prevalence data in a longitudinal perspective. When looking specifically into younger age groups, data from the HBSC study suggest that, among 15—16 years-old, lifetime consumption of illicit drugs has been generally decreasing since , with the notable exception of cocaine use Fig. As to the age group 13—14 years, similar trends can be observed with the exceptions of cocaine, showing a decreasing use prevalence, and cannabis use, which has been remarkably stable between and , following a marked decrease compared to data. Between and , last 12 months consumption of cannabis in 15 and 16 years old schoolchildren has been decreasing. Moreover, last 12 months cannabis use prevalence shows a discontinuous decrease for 15 years old and a fair stability for 16 years old between and Fig. As for other controlled substances, cocaine use has been showing a slight increase and ATS and LSD use have been witnessing a decrease in both 15 and 16 old students between and No serial last 12 months prevalence data for substances other than cannabis are available for Figure 5 shows trends in lifetime, last 12 months and last 30 days prevalence of cannabis use in students aged 13 to 18 years between and Last 30 days cannabis use prevalence rates in schoolchildren aged 15 to 18 years, provided by serial HBSC data, have been witnessing an overall increase between and see Fig. A more in-depth analysis has revealed that the increase is statistically significant overall and for girls and that according to specific age groups, cannabis use appears to have been decreasing in younger adolescents i. In summary, data from general population and school surveys suggest that national drug use prevalence in younger residents i. More detailed national data are available for cannabis use in youngsters between and Whereas lifetime and last 12 months use of cannabis in students aged 13—18 years have been stable as a whole during the referred period, recent cannabis use last 30 days has been witnessing an overall increase between and Problem drug use PDU or high-risk drug use HRDU Footnote 1 are further indicators to measure drug use prevalence and drug use patterns in a given population or target group. The number of high-risk drug users has been estimated at persons based on national data Origer et al. A more recent study on data, Berndt et al. After a closer look at age distributions over time, it appears that the obvious aging of the national HRDU population is primarily due to a marked increase in the proportion of users aged 40 years and more and to a decreasing proportion of users aged 20 to 29 years and not to any genuine trend in younger users aged 15—19 years. This observation contrasts with markedly higher average ages of first dug use in the general population see Table 1. On the supply side, special attention is due to cannabis when it comes to drug use in youngsters. Maximum concentrations of THC in national samples of cannabis show the same trend as can be seen in Fig. In other words, cannabis users tend to getting more THC for less money over recent years Fig. Source LNS Moreover, new varieties of cannabis have been appearing on the illicit market with high levels of THC and low levels of cannabidiol CBD Footnote 2. These emerging cannabis products as well as the average increase of THC concentrations in cannabis not only bear greater risks in terms of immediate psychological and behavioral effects but also in terms of cerebral maturation and the development of cognitive functions such as working memory, decision-making, impulsivity control, motivation and of mental health in general, according to the frequency of use. Purity is one aspect of quality; impurity is another one. Drugs sold on the illicit market are knowingly of diverse and changing quality. They may contain cutting agents Footnote 3 and other adulterants Solomini et al. As far as cannabis is concerned, a considerable variety of impurities has been found in samples worldwide over recent years, including sand, soil, shoe wax, hairspray, henna, glass beads, lead, talcum, etc. Moreover, street cannabis and its derivatives may be contaminated for instance with pesticides, heavy metals, bacteria, fungi and mycotoxins Buchicchio et al. A more recent emerging trend that is bearing increased risks appears to be the adulteration of cannabis products with synthetic cannabinoid receptor agonists Oomen et al. Research on the nature and components of cannabis and its potential applications for health related matters, and the fact that an increasing number of countries or jurisdictions throughout the world have put or plan to put legislations in place allowing the use of cannabis and its derivatives for medical and non-medical purposes, supposedly had an impact on how people perceive cannabis and its potential risks and benefits. Moreover, in recent years, new markets have been developing. One of these relates to cannabidiol CBD products, reaching from dried flowering tops of hemp containing less than 0. Although these products do fall under various legal and regulatory frameworks, the market has been developing nervously and selling points have been proliferating, commending a wide range of beneficial proprieties of hemp and CBD. Notably via CBD, hemp-based products may have created confusion and more importantly curiosity, interest, visibility and supposedly increased acceptance in the general population. This having been said, cannabis and related products sold on the illicit market bear increasing risks, while cannabis as such tends to be perceived as more beneficial, useful and potentially less harmful than half a century ago when cannabis was put in the very same and most restrictive schedules of relevant UN conventions as heroin or desormorphine for instance. These evolutions in somehow opposite directions need to be addressed also because of their likely impact on the perceptions, risk assessment, choices and behaviors of young people, users and potential users. As a matter of fact, the risk perception of cannabis use seems to have changed in EU youngsters aged 15 to 24 years between and The same downward trend has been observed regarding risk assessment of occasional use. Knowing that numerous studies have found an inverse relationship between risk perception related to cannabis and the prevalence of its use Bachman et al. As addressed earlier, drug supply and accessibility are relevant factors in the analysis of drug use patterns. Nonetheless, they do evolve according to an equally dynamic demand for psychoactive substances in the course of time. Why do people start or do not start using drugs and what kind of psychoactive substances do they use for which reasons in a given era, in a given environment, during a given time of their life? These questions should be asked when investigating the bond between individuals and psychoactive substances. Notwithstanding the potential impact of the interactions between individual genetics and life and social environments on human behaviour, one may categorise the motivation to use psychoactive substances overall in terms of pleasure, relief, and individual functions. Allen ; Boys et al. Reasons to start using or to using psychoactive substances commonly cited in literature Brunelle et al. Moreover, as new drugs have been developed and already existing psychoactive substances have found their ways to recreational drug use over the last decades, their use has been going along with innovation in drug development and societal changes. Data were analysed according to 10 different classes of substances throughout several generations of Americans: the Baby Boomers — , Generation X — , and Millennials — Detailed data analysis has been performed, but in the present context, the mere general conclusion of the surveys is at stake; namely: every generation has its trends in psychoactive substance use. Summarily, according to the authors of the analysis, alcohol is the most commonly used substance by all generations, although Baby Boomers show a higher prevalence and have started drinking earlier than other generations. Cannabis is the second most used substance in all generations, with the Baby Boomers, having lived through the 60s, once again showing highest prevalence rates. What characterises Baby Boomers most, however, is their highest use of stimulants and sedatives, which might be linked to the fact that they have lived through a post-World War II period when amphetamines were frequently prescribed as a treatment for depression before they were eventually regulated more strictly due to their widespread abuse. Moreover, in the 60s, new barbiturates were frequently prescribed for insomnia and anxiety but these drugs were progressively replaced by a broader class of medications known as benzodiazepines. Alcohol and cannabis use of Generation X is lower than the one of the Baby Boomers but higher than the prevalence in Millennials. This said, psychotropic medications commonly prescribed in case of mental disorders use is highest in Generation X. After alcohol and cannabis use, Millennials, for their part, seem to be more attracted to painkillers than any previous generation. In the 70s, the prescription of opioid painkillers expanded in the US and by , more than million prescriptions of these medications were registered, compared to 76 million in Footnote 5 Facing the growing problem of opioid painkiller addiction and the increase of accidental opioid overdose deaths between and , the US government has been undertaking a series of measures to reduce opiate painkiller use and abuse as for instance abuse-deterrent formulation of these medications. This contributed to reduce supply at street level, increase their price and lead numerous users to heroin, a less expensive and more accessible alternative to opioid prescription drugs. Slevin and Ashburn As it stands, this is another sound example of how regulations, pharmacological developments and economic aspects may affect drug supply and demand as well as drug use and abuse patterns. In a commercial perspective, NPS are drugs, which were designed or recovered to replicate or mimic the effects of illegal substances while not being controlled by international drug conventions by the time of their appearance on the market. They may, however, pose a public health threat comparable to that posed by substances listed in these conventions Footnote 6. Most of these substances have appeared in Europe in the s and in the beginning of the s. From onwards, synthetic cannabinoids became available on the market, followed by synthetic cathinones and others. UNODC Precursors and additives used in the manufacturing of NPS are often easily available because they serve other, commercial or industrial legitimate purposes and the production process generally requests reasonable means in terms of investments and knowhow. In addition, the genuine, praised or supposed legality of these substances and the multitude of expected or hoped for effects make them remarkably attractive especially to young users who may consider that if a substance is not or said to be not illegal, it should not be that dangerous. Unfortunately, the contrary is mostly the case. Indeed, the legal status of NPS are often blurry and rapidly changing and many of these man-made substances are potentially more dangerous than plant based drugs or long known psychoactive substances; some of which have been used and studied for decades. Availability of and access to an increasing variety of psychoactive substances have become greater. Online selling sites offer a vast range of psychoactive products, providing home delivery and customer reviews, fora and quality ratings. A large variety of psychoactive substances are accessible on the street or online. Access to drugs has probably never been that easy for younger and older regular or first users. Notably NPS and cannabis are increasingly accessible to youngsters, while potentially more harmful on the one hand, whereas various factors, addressed previously, may contribute to lower their risk assessment, on the other hand. It thus appears essential that information and prevention strategies take into account the dynamic nature of the relationship between drugs, demand and supply, markets and end users. Drugs are only one of many temptations young people are exposed to. New information and communication technologies, smart communication devices, social media, gaming and online gaming Footnote 7 , etc. Information and prevention strategies should consider these evolutions and constantly adapt to emerging facts and evidence; but ideally in a holistic perspective in which drug use is only one element among others to consider. Consume behavior and wellbeing in general are at stake here. Especially young people should be supported in acquiring overall life competences and resilience based on objective and sound information as well as on skill and capacity building, notably in terms of risk and benefits assessments allowing them to make informed and responsible individual choices, regardless of the object of desire or choice. Drugs and drug use patterns are of changing nature. There is thus no reason why responses to risks, damage and other problems related to drug use should be set in stone. The very nature of drugs are changing as are their access, their attractiveness and the perceptions of their benefits and harm potential. Numerous underlying factors such as market rules, technological innovations and societal changes are difficult to influence. Drug demand, and drug supply in the long term, may, however, be reduced if the underlying mechanisms are understood and duly taken into account. Moreover, country specific parameters need to be addressed. Social and economic factors are potential determinants of drug use and misuse Galea ; Patrick Evidence has emerged suggesting that drug abuse tends to be highest in wealthier nations Degenhardt and Hall Knowing that Luxembourg ranks among the countries with the highest GDP per capita worldwide, these findings are of particular relevance in a national perspective. More research is needed in this regard, especially on the possible relationship between the power of purchase of youngsters, money at their disposal and drug use patterns and prevalence Johnston et al. One should also bear in mind that, more recently, the Covid crises will show how drug use prevalence and patterns might have changed in youngsters also in the aftermath of a pandemic unprecedented for the current generation. Young people start and continue to use drugs for different reasons and individual factors are clearly at stake as well when it comes to better understand why and how a behavior has become excessive and dysfunctional or addictive whether substance use is involved or any other behaviors with addictive potential. Additionally, although sound and objective information is needed, the means and channels by which to reach youngsters, to trigger their curiosity and to maintain their attention are equally important and require a great deal of insight in and understanding of youth culture, values, and communication forms. Combining these transient knowledge and skills in the interaction and communication with young people may be a valuable means to impact beneficially on their perceptions and reflections on their way to self-determination and informed decision making in a world of increasing possibilities, temptations, incertainty and challenges. Origer et al. Allen, D. 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Trends, motivations and settings of recreational cocaine use by adolescents and young adults in the Netherlands. International Journal of Drug Policy , 20, — Volkow, N. Adverse health effects of marijuana use. The New England journal of medicine , 23 , — Wall, M. Journal of Psychopharmacology. Wibberley, C. Drugs: Education, Prevention and Policy, 7 2 , — Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Alain Origer. Die in diesem Kapitel enthaltenen Bilder und sonstiges Drittmaterial unterliegen ebenfalls der genannten Creative Commons Lizenz, sofern sich aus der Abbildungslegende nichts anderes ergibt. Reprints and permissions. In: Heinen, A. Springer VS, Wiesbaden. Published : 07 July Print ISBN : Online ISBN : Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Policies and ethics. Skip to main content. Download book EPUB. Wohlbefinden und Gesundheit im Jugendalter. Download book PDF. Abstract Psychoactive substances take a functional role in the management of emotional and social life of humankind. Patterns of cannabis use, perception of harm, and perceived impact of legislative change in an online sample of young adults from Lebanon: insight on recreational users versus dual motive users Article Open access 15 February Predictors of onset of cannabis and other drug use in male young adults: results from a longitudinal study Article Open access 22 November Full size image. Table 1 Age distribution of first substance use. Cannabis price and potency in Europe — Notes 1. CBD is a non-intoxicating cannabinoid found in cannabis. References Allen, D. Article Google Scholar Bachman, J. Article Google Scholar Berndt, N. Google Scholar Berndt, N. Google Scholar Boys, A. Article Google Scholar Boys, A. Article Google Scholar Brunelle, N. Google Scholar Buchicchio, L. Article Google Scholar Degenhardt, L. Google Scholar European Commission. Google Scholar Inchley, J. Google Scholar Johnston, L. Book Google Scholar Kreek et al. Google Scholar Lynskey, M. Article Google Scholar Matheis,J. Google Scholar McCrystal, P. Google Scholar McInstosh, J. Article Google Scholar Miech, R. Google Scholar Oomen, P. Google Scholar Palmqvist, R. Article Google Scholar Parker, M. Article Google Scholar Parks, K. Article Google Scholar Patrick, M. Google Scholar Solimini, R. Google Scholar Van der Poel, A. Article Google Scholar Volkow, N. Google Scholar Download references. About this chapter. Cite this chapter Origer, A. Copy to clipboard. Publish with us Policies and ethics. Search Search by keyword or author Search. Navigation Find a journal Publish with us Track your research.

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