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Official websites use. Share sensitive information only on official, secure websites. Janicijevic kaja. This article was submitted to Pharmaceutical Medicine and Outcomes Research, a section of the journal Frontiers in Pharmacology. Keywords: psychoactive substances, adolescent, socioeconomic factors, national health survey, Serbia. The use, distribution or reproduction in other forums is permitted, provided the original author s or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Adolescence is a period of transition from childhood to adulthood, characterized by efforts to achieve the objectives related to the expectations of the culture, as well as the requirements of the physical, mental, emotional, and social development. It has its own characteristics in the biological, psychological, and social terms, with a process of identity formation, the development of social, and moral norms of behavior McCabe et al. Adolescence is a period of great settings in which experimentation with psychoactive substances is common and can, in some cases, lead to the development of long-term addictive behavior Jeannin et al. Psychoactive substances include licit, illicit, and prescribed psychoactive medications. Alcohol and cigarette are among the licit and controlled drugs, while marijuana, cocaine, heroin, lysergic diethylamide LSD , crack, and ecstasy are illicit drugs Kassa et al. The use of psychoactive substances in adolescents is often associated with a socioeconomic factors, such as gender, age, type, race, ethnicity, family, and social structures, socioeconomic status of the family Gebreslassie et al. Significant risk factors for psychoactive substances use among adolescents were poor parental involvement in the child's education, conflictual family relationships, and drug abuse by the parents, friends, and neighbors Kpozehouen et al. Also, parental alcoholism, parental divorce before age 18, and parental death before age 18 increased the odds of abuse psychoactive substances Vaughan et al. Socioeconomic environment in which young people were raised as children predicts their behavior in young adulthood. Understanding this relationship, is an important step in identifying persons at risk Tobler et al. In order to identify the risk factors and protective factors associated with psychoactive substances abuse among young people, it is very important to measure how socioeconomic factors influence the attitudes and behavior of young toward the use of psychoactive substances Carter et al. The study of health of population in Serbia conducted in was the source of used data. This was the third national population health survey conducted by the Ministry of Health of the Republic of Serbia 1. Fieldwork was conducted in the period from 7 October to 30 December , which respected the legislation relating to the European Health Research—second cycle: the collection of data in the field should take at least 3 months of which at least 1 month should be in the period from September to December, or in the fall. In order to achieve a high level of quality of the collected data, to provide a high response rate of households and in order to protect the representativeness of the sample, the election, and training of interviewers had been organized prior to the commencement of field work, and also guidelines for the monitoring and control of field work were given to them. The study used the most complete population register that includes a sampling units defined within the target population—Census of Population, Households, and Dwellings in the Republic of Serbia conducted in In accordance with the recommendations for the implementation of population health research EUROSTAT, the European Health Research—Second Wave—Methodological guide EHIS wave 2, Methodological manual the National representative probability sample was used: two-stage stratified sample with a known probability of selection of sample units at every stage sampling. The mechanisms that have been used to obtain a random sample of households and respondents represent a combination of the two sampling techniques: stratification and multi-stage sampling. Health Survey of the Serbian population was carried out through interviews, anthropometric measurements, and blood pressure measurements. Three types of questionnaires were used in the survey: Questionnaire for Household—collecting information on all household members, the characteristics of the household, as well as on the characteristics of the household residence. The questionnaire had to be completed in the course of verbal communication between the interviewers and interviewees who represented the main person in the household to answer questions of interest. Self-administered questionnaire which should be filled in by each household member aged 15 and over without the participation of the interviewer. In order to respect the privacy of the subjects of research and confidentiality of information collected, all necessary steps were taken in accordance with the Law on Personal Data Protection Off. Also, interviewers needed to obtain the signed informative consent of each of the participants for accepting to participate in the survey. In research, the collection of data that identify the respondents was avoided to the greatest possible extent necessary identifiers were removed at the earliest stage of statistical analysis and replaced with code. In the Serbian National Health Survey , a total of 6, households and 13, participants aged 15 and over were interviewed. Out of total of 10, households contacted, 6, of them agreed to participate in the survey, so that the response rate of households was Out of total of 16, registered household members aged 15 and over, 14, of them agreed to be interviewed, giving a response rate of Out of this number of people who agreed to be interviewed, 13, of them accepted to complete the self-administered questionnaire response rate For the purposes of this study, we analyzed data on respondents aged 15—24 years 1, interviewed respondents. Of the independent variables, the researchers used demographic characteristics age, gender, type of settlement, region and socioeconomic status education, employment, and well-being index. Participants' age was categorized in to two age groups 15—19 years; 20—24 years. Gender is coded as male and female, place of residence as urban and rural, regions of Belgrade, Vojvodina, Sumadija, Western, Southern, and Eastern Serbia. Variables that reflect the socioeconomic situation are education, which is designated as higher, secondary, and elementary, employment status as employed and unemployed and household. The Wealth Index is based on household assets and housing characteristics, such as the possession of color TV set, cell phone, refrigerator, dish washer, washing machine, PC, AC, car, construction material of floors, roofs and walls, the number of bedrooms per household member, type of drinking water resources, and sanitation facility as well as heating fuel and Internet access. Based on the Wealth Index, households were classified into five groups of equal size—quintiles: 1 the poorest Q1 , 2 poorer Q2 , 3 middle Q3 , 4 richer Q4 , and 5 the richest Q5. For the purposes of this paper, respondents were classified into three socio-economic categories: poor class, middle class, and rich class. As the dependent variable in this analysis were used: cigarette smoking daily and occasional , alcohol abuse, and abuse of other psychoactive substances drugs and illicit drugs. Data has been uploaded as Excel file while questionnaires are in PDF formats. Readers can retrieve and reuse publicly available information by visiting links given above. The highest percentage of respondents has completed secondary education In relation to the employment status the highest percentage belongs to the group of inactive or unemployment population More than half of the respondents live in urban areas When it comes to well-being index, the largest percentage of respondents belongs to the rich class The study depicted that in the past 12 months of the study period The prevalence of illicit psychoactive substances such as cannabis, ecstasy, LSD, cocaine, crack, heroin was 0. Binary logistic regression analysis has not shown a statistically significant impact of examined factors on the prevalence of cigarettes smoking. Results of binary logistic regression showed that alcohol consumption can be determined by age, gender, education, type of settlement, well-being index physical, and psychological violence. The prevalence of alcohol consumption in men is Respondents with higher education have Young people who live in urban areas are 1. Members of poor class for Also those who assess their health as good to make less frequently by Bivariate logistic regression analysis showing socioeconomic correlates of psychoactive substance abuse by adolescents in Serbia. Psychoactive substances abuse represents a significant problem of the individual, family, and society, leaving a lot of effects on mental and physical health Milovanovic et al. There are also significant costs borne by society due to the direct and indirect consequences of abuse and dependence on certain substances Jakovljevic et al. Drug abuse is a global problem, and methods of use and consequences of individual and socio-cultural are specific. The consequences of the abuse of substances may be various: education and unemployment, reduced work productivity, poor health, higher rates of human immunodeficiency-HIV and hepatitis B, C infections Jakovljevic et al. According to the World Health Organization, alcohol, and tobacco are the most commonly abused substances World Health Organization, , Eastern Europe and the Balkans region report the high rates of alcohol abuse Jovanovic and Jakovljevic, Alcohol abuse is a health problem that significantly contributes to the global disability liver-diseases, cardiovascular diseases, traffic accidents, fights, murders, suicides; Jakovljevic et al. Psychoactive substances present a great challenge of public health issue worldwide particularly regarding to the social vulnerable population of adolescents Jakovljevic et al. According to the results of the Serbian National Health Survey, distribution of smoking in adults population was Aforementioned dataset showed that there are significant differences in the abuse of psychoactive substances among young people in Serbia, depending on the demographic and socioeconomic characteristics of the respondents. They are consistent with the findings of other studies that show that there is no difference between the sexes for cigarette smoking and experimentation with drugs. It is more connected with young men. Young people of lower age groups and those who attend the school are negatively associated with the abuse of cigarette, alcohol, and illicit drugs Patrick et al. Other studies have shown that young people with low levels of education are regarded as high risk for consumption psychoactive substances Quek et al. Anxiety, low self-esteem, and self-control, as well as the low level of parental control also poses a risk for abuse belt Roy et al. Characteristics of mental health, such as loneliness and insomnia are positively associated with the abuse of tobacco, alcohol, and illicit drugs. The lack of a friend is a positive correlation with the abuse of tobacco, and illicit drugs, and the negative with the abuse of alcohol Malta et al. Also young people who abuse psychoactive substances, are more likely to have higher levels of psychological stress and decreased levels of self-efficacy to resist peer pressure Champion et al. Other studies have in turn shown that the lower the level of education of parents associated with a higher risk of psychoactive substances abuse Johnston et al. Heavy episodic drinking are frequent among young people who live in incomplete families Patrick et al. Some studies have shown that there is no significant difference in substance abuse between urban and rural areas, but there is the presence of higher levels of knowledge about the psychoactive substances in urban areas Martinotti et al. Many studies that have investigated the correlation of demographic and socioeconomic variables with the abuse of psychoactive substances have shown that high degree of religiosity, higher parent's education living with one or both parents reduces the chance to abuse, while high the socioeconomic status of the family increases the likelihood of psychoactive substances use Goodman and Huang, ; Hanson and Chen, ; Schoenborn and Adams, Children who come from wealthier families with higher socioeconomic status may be at increased risk for the abuse psychoactive substances which can be explained by the fact that their experience more pressure achievement combined with isolation of parents who have careers more demanding. In addition, parents with higher socioeconomic status in comparison with those in the lower socioeconomic status families can have positions that are tolerant of the substance abuse Luthar and Goldstein, The higher income families may be related to the use of psychoactive substances because of increased access to, or to buy the substance and have a social association with others who also have financial resources. On the other hand, a lower revenue may be associated with the abuse of psychoactive substances such mechanism of survival due to increased stress and less access to alternative actions that can be a focal point for preventive strategies Goodman and Huang, Despite worldwide concern and education about psychoactive substances, many adolescents have limited awareness of their adverse consequences Oshodi et al. Preventive activities should be carried out through the development of specific programs to promote healthy lifestyles, strengthening the implementation of existing programs, and the promotion of prevention through various forms of educational activities, including peer education, supporting youth initiatives for the implementation of actions aimed at the affirmation of healthy lifestyles, develop social skills, informing young people, and parents about the risks of consuming psychoactive substances through school programs and workshops in schools, identification, and reduction of risk factors in the school environment. In perceiving the frequency of using illegal drugs, it should take in mind specific limited researches of health in national population, because the drugs abuse, as social non acceptable behavior endanger sincerity of patients during answering these questions. All authors listed, have made substantial, direct and intellectual contribution to the work and approved it for publication. KJ and SMR drafted the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. As a library, NLM provides access to scientific literature. Front Pharmacol. Find articles by Katarina M Janicijevic. Find articles by Sanja S Kocic. Find articles by Svetlana R Radevic. Find articles by Mirjana R Jovanovic. Find articles by Snezana M Radovanovic. Sherif, University of Tripoli, Libya. Received Apr 27; Accepted May 26; Collection date Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel. Gender a. Education b. Emplyment status c. Type of settlement d. Well-being index e. Self-assessed health f. Exposure to physical violence in the family, in school, on the street. Exposure to psychological violence in the family, in school, on the street.

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The Western Balkans is often labelled as a transit region for the trafficking of drugs like cannabis, cocaine and heroin. But there are signs that the region is also a producer of synthetic drugs, as well as a growing consumer market. The main synthetic drugs being smuggled into the Western Balkans are amphetamines, methamphetamine and ecstasy MDMA , as well as new synthetic versions of cannabis and opioids like heroin. In addition, local production appears to be increasing, particularly in North Macedonia and Serbia. Between and , police in Serbia uncovered over illicit drug laboratories, mostly on residential premises. Nevertheless, only people were convicted — an average of less than two people per illegal laboratory uncovered. In , most seizures of synthetic drugs in Serbia were made either in Belgrade and Novi Sad or close to the border with Hungary, for example at the Horgos border crossing point. Seizures were also made in Kragujevac and Bor. The problem is not limited to Serbia. In December , police discovered illegal drug labs in the village of Batinci and in a home near Tetovo in North Macedonia. The main suspect, Milan Zarubica, had previously been convicted in relation to a lab in Stara Pazova, Serbia. A few months later, Macedonian police found yet another laboratory used to illegally manufacture synthetic drugs. In addition to trafficking and production, there seems to be a growing local market for synthetic drugs. In Serbia and North Macedonia, prices for synthetic drugs are relatively low, which is a major factor in their increasing market share compared to plant-based drugs. The drug is usually sold on the black market in the form of pills or capsules, but can also be mixed with ecstasy. Synthetic drugs are easily accessible, particularly in large cities. Methamphetamine is less present in Serbia. It is unclear how COVID has affected the synthetic drug market in the Western Balkans, but there is a sense that the market is relatively resilient, with some synthetic drugs being used as a substitute for heroin. Although heroin remains the main cause of the approximately 50 drug-related deaths in Serbia every year, 19 increased access to and use of synthetic drugs have heightened health concerns in the country and led to the tragic drug-related deaths of young people. After a year-old girl died in November in the small town of Arandjelovac after taking ecstasy for the first time at a party, locals organized a series of protests calling for better prevention measures. In , four young people aged 17 to 21 died after taking ecstasy, while between and more than fifty people died in the country from different synthetic drugs. While the focus on drugs in the Western Balkans has usually been on the transit of plant-based substances like cocaine, heroin and cannabis, it is also important to keep an eye on the production and use of synthetic drugs. Interview with a former police officer from the Belgrade anti-drug unit, Belgrade, November Interview with a police officer, Belgrade, December Interview with a professor of criminology, Belgrade, December Interview with a civil society activist, Belgrade, November Interview with a former police officer, Belgrade, December Based on an analysis of various interior ministry press statements, mup. See also: Siracusa Institute, op. Interviews with civil society activists in Belgrade, November , and Podgorica, December Synthetic drugs in the Western Balkans The Western Balkans is often labelled as a transit region for the trafficking of drugs like cannabis, cocaine and heroin. Troubled waters: smuggling migrants across the Adriatic. Risk Bulletins. Tap or select text, and then tap the bookmark icon to save a bookmark. Bookmarks are saved in your browser cache. Clearing your cache will remove them. Your last visit. The last time you visited, you stopped reading here. Acknowledgements About Risk Bulletins.

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