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These datasets underpin the analysis presented in the agency's work. Most data may be viewed interactively on screen and downloaded in Excel format. All countries. Topics A-Z. The content in this section is aimed at anyone involved in planning, implementing or making decisions about health and social responses. Best practice. We have developed a systemic approach that brings together the human networks, processes and scientific tools necessary for collecting, analysing and reporting on the many aspects of the European drugs phenomenon. Explore our wide range of publications, videos and infographics on the drugs problem and how Europe is responding to it. All publications. More events. More news. We are your source of drug-related expertise in Europe. We prepare and share independent, scientifically validated knowledge, alerts and recommendations. About the EUDA. The content of this summary does not necessarily reflect the official opinions of the European Union, nor the official opinion of the Republic of Tajikistan, and should be seen as the product of CADAP 5. Updated: August Studies on the prevalence of drug use among the population of Tajikistan were not carried out in In total, 5 respondents were interviewed, of which 2 The study found that the female respondents had a slightly higher awareness of the existence of drugs than the males. Some Among all respondents, Some 1. The survey results showed that However, When asked about drug use, 0. The consumption of inhalants was the most prevalent. According to the responses, 1. The use of marijuana or hashish was second most popular, with 0. The first experience with drugs most often took place at the age of 16 and usually the drug was marijuana, amphetamines, or tranquillisers. In a series of educational, sports and cultural events aimed at promoting a healthy lifestyle were organised. Participants were given information about the problems of drug use in modern society and its consequences. Health bulletins were issued and health information prepared in both the Tajik and Russian languages. Articles were published in newspapers and magazines and awareness-raising programmes were broadcast on three TV channels Channel One, Safina, and Jahonnamo and on the Republican radio. Anti-drug events are also organised annually to coincide with the International Day against Drug Abuse and Illicit Trafficking 26 June. Studies to estimate the population of opiate users, including injecting drug users IDUs , were not carried out in Drug treatment is carried out in the Republic of Tajikistan in specialised drug treatment facilities. The State guarantees anonymous drug treatment. In a total of 1 people received inpatient treatment in substance abuse treatment centres. Of these, The number of drug addicts who received hospital treatment in increased by The main strategic focus of this programme included:. As of 31 December , the country had 3 officially registered HIV cases cumulative number , of which The HIV prevalence rate was HIV cases have been registered in 66 of the 68 districts of the country. The average estimated number of HIV-positive people in the country ranges between 6 —10 Moreover, in recent years, the number of newly reported HIV cases among females has increased almost 2. Thus, in the proportion of women among registered new cases was 8. In , of the total number of registered HIV cases, In the country registered new cases of HIV infection, of which Among the newly registered HIV cases, people The number of reported cases of hepatitis C virus HCV in was According to the Centre for Health Statistics of the Ministry of Health of Tajikistan, in there were cases of syphilis infection among the general population, of which were male and were female. The official data from Tajikistan provide very limited information on the number of deaths related to drug use. Drug treatment is carried out in the Republic of Tajikistan at specialised drug treatment facilities. Services provided by specialised drug treatment agencies in the country include inpatient and outpatient care, anti-relapse therapy, rehabilitation programmes, work with drug addicts and efforts to prevent substance abuse. Treatment of drug dependence in the Republic of Tajikistan is conducted mainly at public drug treatment facilities, including:. The availability of substance abuse treatment beds in the Republic of Tajikistan is 4 per inhabitants. Harm reduction programmes are implemented to minimise the consequences of drug use. Geographically, the HR programme covers almost the whole of the country. In the Government of the Republic of Tajikistan reviewed and supported the letter of the Ministry of Health of the Republic of Tajikistan asking it to consider a pilot implementation of a programme of OST. Up to patients have received OST at this centre. This is the first gender-sensitive project in the Republic of Tajikistan. The centre provided low-threshold services laundry, showers, communication, leisure, food, sanitary napkins and legal advice and referral to doctors. In this centre, 62 were re-adaptation clients, 40 of whom abstained during the reported period, and two patients were referred for further rehabilitation to the Tangai Republican Rehabilitation Centre. These clients received low-threshold services and advice at the drop-in centre. Five hundred motivational packages were given to the most active clients. Harm reduction programmes were first introduced in the Republic of Tajikistan in in Dushanbe, Khujand and Khorog, mainly in the form of needle exchange programmes NEPs and via the distribution of information materials. In Kulyab a hour drop-in centre for drug users was opened by the non-government organisation NGO Anis. The NGO Volunteer, which implemented a programme in the Gorno-Badakhshan Autonomous Oblast GBAO , provided services 9 times during the reporting period, including services related to: social support 1 ; prevention 2 ; healthcare 2 ; information and counselling 1 ; psychological care and support ; legal services ; and social services The Social Bureau covered 1 clients people injecting drugs, 9 sex workers, 24 people living with HIV, 89 people with tuberculosis, 52 ex-prisoners with HBV and 15 with HCV, 1 minor at risk, and vulnerable women. As part of this programme, one mobile trust point and four NSPs were established, located on the premises of the National Tuberculosis Hospital in urban health centres Nos 2, 12 and During the reporting period, RAN served 1 clients. A total of syringes were exchanged and 23 condoms were distributed. In a total of 4 The steady increase in seizures of cannabis, primarily hashish, continued in , with the result that cannabis comprised This significant change in the type of drug seized was a result of an increase in the areas sown with cannabis in Afghanistan in recent years. The impurities in the samples of heroin that were seized were found to be from the manufacturing process — 6-monoacetylmorphine and acetylcodeine — and cutting agents of extrinsic origin — caffeine, acetaminophen paracetamol and dextromethorphan. No extrinsic substances were found in the narcotic opium seized in Starch-containing substances were found in just a few samples. The physical appearance of the cannabis resin that was seized was either in the form of a rod or of material compressed into rectangular tiles. The dimensions of tiles varied within the following ranges: width 14—16 cm, length 21—23 cm, thickness 2—3 cm. Drug prices in Tajikistan increase in proportion to the distance from the state border. The legislation of the Republic of Tajikistan in the field of drug control is based on the rules and recommendations of the United Nations Drug Treaties and Conventions , , , of which Tajikistan became a signatory in and The main purpose of Law No. Law No. The main objectives of the law are the protection of the rights and legitimate interests of people suffering from substance abuse and addiction, establishing bases and procedures for the provision of substance abuse treatment, and the protection and security of professionals providing drug treatment services. Article 6 of the Constitution guarantees the following types of drug treatment and social protection:. The main objective of this law is the realisation of the national policy and international agreements of Tajikistan in the sphere of licit trafficking of narcotic substances, psychotropic substances and precursors, countermeasures of their illicit trafficking, prevention of drugs and toxicomania and rendering of narcological assistance to people suffering from drug addiction and toxicomania. The main task of the law is to protect the rights and legal interests of people suffering from narcological diseases, establish grounds and a procedure for rendering narcological assistance and to protect the rights of medical and other workers rendering narcological assistance. According to Article 6 of the Law, the Government guarantees the following kinds of narcological assistance and social protection:. Chapter 22 of the Criminal Code of the Republic of Tajikistan effective from 1 September stipulates responsibility for the following violations of the law related to drug issues:. The National Strategy of the Republic of Tajikistan in the field of the control of narcotic drugs is aimed at preventing the use of the territory of the state by transnational organised drug traffickers to smuggle narcotics, international commitments and the establishment of strict control over the licit movement of narcotic drugs, ensuring the effective fight against drug trafficking, guaranteeing the medical care of patients with drug addiction and increasing international cooperation in this area. One of the measures taken by the Government of the Republic of Tajikistan in the field of drug control is the coordination of bodies at all levels of society in order to synchronise the activities of law enforcement agencies in the fight against drug trafficking, as well as the relevant ministries and agencies in the control of drug trafficking, psychotropic substances and precursors, and drug prevention. The main body that coordinates ministries, departments and organisations in the prevention of drug abuse, regardless of their form of ownership, is the Coordinating Council on the prevention of drug abuse, approved by Decree No. According to the decree, regional, city, and district councils for the coordination of drug prevention activities were established under republican subordination in the Gorno-Badakhshan Autonomous Oblast, Sughd and Khatlon regions, the city of Dushanbe, and other cities and districts. The Coordinating Council is recognised as the supervisory body of the interaction of ministries, departments and state bodies in the conduct of activities aimed at the prevention of the non-medical use of narcotic drugs and psychotropic and other drugs. Homepage Quick links Quick links. GO Results hosted on duckduckgo. Main navigation Data Open related submenu Data. Latest data Prevalence of drug use Drug-induced deaths Infectious diseases Problem drug use Treatment demand Seizures of drugs Price, purity and potency. Drug use and prison Drug law offences Health and social responses Drug checking Hospital emergencies data Syringe residues data Wastewater analysis Data catalogue. Selected topics Alternatives to coercive sanctions Cannabis Cannabis policy Cocaine Darknet markets Drug checking Drug consumption facilities Drug markets Drug-related deaths Drug-related infectious diseases. Recently published Findings from a scoping literature…. Penalties at a glance. Frequently asked questions FAQ : drug…. FAQ: therapeutic use of psychedelic…. Viral hepatitis elimination barometer…. EU Drug Market: New psychoactive…. EU Drug Market: Drivers and facilitators. Statistical Bulletin home. Quick links Search news Subscribe newsletter for recent news Subscribe to news releases. Breadcrumb Home Publications Tajikistan country overview Tajikistan country overview Contents Drug use among the general population and young people Prevention Problem drug use Treatment demand Drug-related infectious diseases Drug-related deaths Treatment responses Harm reduction responses Drug markets and drug-law offences National drug laws National drug strategy Coordination mechanism in the field of drugs References. Agency on Statistics under the President of the Republic of Tajikistan.
Socioeconomic and psychosocial determinants of substance misuse – a national perspective
Kulob where can I buy cocaine
You have full access to this open access article. Accurate estimates of population drug use and an understanding of the factors that influence substance choice are essential for the development of appropriate and targeted prevention strategies and campaigns. This review aims to provide an overview of the socioeconomic and psychosocial factors that influence substance use patterns within the Australian population through exploration of current and historical examples of substance misuse. Legislation, particularly relating to cannabis cultivation and personal use, has evolved significantly in response to increased scientific and commercial applications and changing attitudes towards medical and personal use. Despite the increased cost of cocaine over time, the profile of users appears to dictate rates of use. The prevalence of injecting drug use is driven by a lack of education, perceived risk, stigma, and other social factors. Additionally, psychosocial factors also contribute to substance misuse among specific population subgroups such as petrol sniffing among Indigenous Australians. In addition, an understanding of factors influencing local drug usage may assist forensic practitioners in evaluating the occurrence and effects of particular substances that may emerge as significant factors in drug-related deaths. Globally, drug misuse is a major contributor to disease, illness, injury, and death. An illicit drug is defined as a substance for which possession, use, production, importation, and distribution is prohibited by law \[ 4 \]. Illicit drug use contributes significantly to total drug use, including both the illegal use of prescription medications and that of prohibited substances \[ 3 \]. In terms of drug use trends among the Australian population, the National Drug Strategy Household Survey NDSHS found that cocaine use was at its highest level in the last 20 years but rates of substance use in general were decreasing among younger generations \[ 6 \]. It also appears that attitudes towards drug use are changing, with more Australians supportive of cannabis use and pill-testing than in previous reporting periods \[ 6 \]. Changes to drug scheduling e. However, there is a much more diverse range of substances, both pharmaceutical and non-pharmaceutical, that may be abused within given populations and not captured by the primary literature. These will be explored in further detail with illustrative examples. While there is extensive research on substance use and health-related outcomes in particular populations, analysis of socioeconomic and psychosocial factors that influence drug choice and impact upon drug prevalence within specific communities is comparatively limited. Significant factors which influence substance choice include availability, geographic affluence, substance policies, law enforcement activity, targeting, product formulations and quality, cost, demographics, drug-related stigma, perceived risk of harm, and traditional use \[ 7 , 8 , 9 , 10 \]. There are many examples of idiosyncratic substance use in countries and demographic groups which can be attributed to the intersectional relationship between and among many of these factors \[ 7 , 11 , 12 , 13 \]. An understanding of these complex and inter-related issues is essential for the development of targeted prevention strategies and may assist in predicting trends in future substance use with reduced associated morbidity and mortality. This review provides an overview of these factors in the context of the Australian population and explore current and historical examples of substance misuse that are particularly prevalent within specific demographic groups or geographic areas. A literature search was undertaken for reports of substance misuse both from the internet in general and from specific search engines such as PubMed and Google Scholar. In addition, relevant media articles and national reports from various health and government bodies were also evaluated. As the availability of drugs fluctuates, trends in drug use vary accordingly. For example, someone whose main drug of preference is heroin may substitute this for morphine if it is deemed to be more widely available or cheaper by comparison. Availability of drugs may be influenced by several other factors including means of access, social dynamics, geography, legislation, and large-scale supply interventions \[ 8 , 15 , 16 \]. Relative geographic isolation, both national and regional, may also influence the ability to obtain certain drugs, as is demonstrated by significant regional and sub-regional differences in drug use prevalence for specific substances. For example, in the Oceanic region, the number of past-year cannabis, cocaine, amphetamine, and ecstasy users are amongst the highest in the world, while the number of opioid users is comparatively low \[ 17 \]. Before the advent of the internet, buying and selling illicit drugs was a more intensive undertaking often associated with significant personal risk. The dark net is a network within the internet that is only accessible with specific software or authorization and may be used for both illegal e. The website served as a marketplace for a variety of illicit substances for thousands of users in 34 different countries \[ 21 \]. In Australia, online drug markets have rapidly grown in popularity, as new iterations of previous websites emerge. In the most recent month reporting period, there was a considerably rapid turnover of crypto market platforms \[ 22 \]. While the online Australian drug market is largely comprised of Australian sellers and Australian buyers which is largely attributed to the reduced risk of border seizures and legal penalties in addition to better-quality products \[ 23 \], individuals may also buy drugs online from overseas. Importation methods can include international mail, sea or air cargo, and air passengers or crew \[ 24 \]. However, opioids showed the highest rate of growth concomitant to a decrease in LSD listings in comparison to other substances \[ 22 \]. Use of online resources often depends on social network dynamics and the drug use habits of acquaintances, friends, and family. However, the digital age has also introduced other newer, more popular platforms in high socioeconomic countries including Australia , which are used to facilitate the purchase of drugs; these have included Snapchat, Instagram, and WhatsApp \[ 19 , 25 \]. These platforms provide quick, easy, and convenient means of facilitating buyer—seller interactions and as they are perceived to be more secure than traditional methods, they are rapidly growing in popularity \[ 19 , 25 \]. Legislation i. At a global level, drug legislation has needed to evolve to target not only traditional plant-based drugs e. One of the current difficulties in regulating illicit drugs, particularly NPS, is in keeping drug policy abreast of rapidly changing drug use patterns. Over the last 20 years, integration of national drug policies underpinned by harm reduction strategies has become increasingly popular, supporting larger-scale interventions to reduce supply and demand \[ 16 \]. However, legislation varies widely between and within countries. Responses from the Global Drug Survey indicate that residents from countries with prohibition-based drug policies such as Australia, would feel more confident in utilizing harm-minimization programs if drug policies were to be liberalized, due to reduced fear of criminal charges \[ 27 \]; i. There is also growing evidence to support decriminalization of drug use such as low rates of drug use in European countries where this has occurred for personal drug use \[ 29 \]. There is disagreement concerning the measurable impact of drug policy and legislation on the prevalence of drug use, as quite similar drug trends have been observed between counties with markedly different drug policies and vice versa. For example, the United States US , United Kingdom UK , Netherlands, Switzerland, and Australia all have very different drug policies but present similar trends in certain, but not all, drug categories \[ 16 \]. While the issue of drug policy is multifaceted, it is evident that policy reform has the capacity to influence drug use patterns, and subsequently reduce morbidity and mortality. Conversely, it has been argued that changes in drug policy may not directly correlate to reduced drug use or positive outcomes for drug users. In , cannabis use among adults in Australia and New Zealand was found to be significantly higher than the global average \[ 30 \]. The popularity of cannabis use in Australia may be attributed to stability in the cost, purity, and accessibility of cannabis compared to other illicit drugs. While drug policies related to personal cannabis use in Australia have historically followed a strict, no-tolerance approach, recent developments have seen the legalization of commercial cannabis growing for medical and scientific purposes. Furthermore, states and territories including the Australian Capital Territory have also legalized small amounts of cannabis for personal use without penalty, in line with changing national attitudes. More recent studies using survey data indicate, however, that the legalization of cannabis has been associated with increased prevalence of use and substance use disorders, allowing for the lag time between the passage of laws and the development of trends \[ 31 , 32 , 33 , 34 \]. Furthermore, these studies have highlighted that increased cannabis use has occurred not only among frequent users, but also among previously non-using adolescents and young adults \[ 6 , 31 , 32 \]. Another important issue following increased availability due to legalization has been a decrease in the perceived risk of harm \[ 34 , 35 , 36 , 37 \]. Evolution and optimization of drug manufacturing processes has resulted in a rapid increase in the number and variety of drugs available on the market, particularly involving NPS. Population drug use trends often reflect a desire to obtain these newer, more popular drugs as higher quality formulations of traditional drugs enter the market. Australia also criminalized the possession and use of ecstasy \[ 40 \]. However, ecstasy use has recently re-emerged, partly in response to increased availability of higher quality products with newly available formulations powder and crystal \[ 2 \]. A study of illicit drug substitution among high-risk drug users found a preference for substituting traditional drugs with either newer drugs, including NPS \[ 41 \]. The most common substitutions were those within the same drug class, where the substituted drug elicits similar physiological effects e. However, synthetic cannabinoids are complex structures, allowing for a potentially endless number of chemical modifications to create new products with unknown potency and physiological effects \[ 42 \]. These substitutions may also involve more complex factors than the desire for new product formulations with improved quality, but also relationships between availability, cost, drug policy and desired effects. Enhanced domestic drug manufacturing processes have also increased the local availability of specific drugs such as cannabis and methamphetamine. The wastewater study involved daily sampling of wastewater over a period of one week between and and analysis for the presence of popular drugs of abuse e. It is unclear whether increasing use among adults over the age of 40 is due to the aging of long-term methylamphetamine users or an increasing appreciation by younger people of the risks associated with the drug. Other factors that may have contributed to reduced rates of use among young people include availability or popularity of other drugs and their associated effects, changes to social landscapes, and group dynamics. However, since — when ATS border detections were the highest on record, the number of methylamphetamine detections have consistently decreased \[ 48 \]. The reduction in numbers of detections may be partially due to the significant increase in domestic production of methylamphetamine. Compared to other countries, Australia has a comparatively high number of clandestine laboratories and thus, a large domestic market for methylamphetamine \[ 23 \]. In terms of geographic variability, both recent and lifetime methamphetamine use has been found to be higher in rural areas compared to urban regions \[ 49 \]. The appeal of methylamphetamine and ATS in Australia appears to involve a relationship between geographic location, availability through local manufacturing, and a steady cost despite increased product quality. Median methylamphetamine price and purity in Australia between — and — adapted from \[ 4 , 47 , 48 , 54 , 55 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 \]. Cost is a significant factor influencing drug prevalence and preference \[ 7 \]. Cost has also been cited as a significant factor driving growth within the illicit fentanyl market, as it is cheaper to produce than heroin \[ 52 \]. However, this is highly variable between socioeconomic and geographic areas. In two cities in Tajikistan, heroin was cheaper than a bottle of vodka and so it subsequently became a popular drug of choice among people who injected drugs PWID \[ 12 \]. High drug costs can also promote risky behaviors to obtain drugs or the necessary purchasing funds. For example, a Canadian cohort of female sex workers had a preference for heroin, despite it costing twice as much as cocaine, and were prepared to actively participate in high-risk activities to support their drug preference \[ 53 \]. As discussed above, the price of methylamphetamine has increased in parallel with a significant increase in purity Fig. The higher price of methylamphetamine may also be contributing to decreasing use among younger people, where rates of use among those over 30 years of age has more or less plateaued \[ 6 \]. Significant increases in the price of cocaine and heroin were also seen over the four reporting periods. Despite the large increase in price for cocaine, the frequency of use and socioeconomic profile of cocaine users may account for unchanged rates of use i. While heroin has a price comparable to methylamphetamine, rates of use among the Australian population are significantly lower \[ 6 \]. As discussed, there may be significant stigma attached to injecting drugs, which may discourage uptake in a new, younger cohort of users, in addition to the high monetary cost. The price of hydroponic cannabis i. Interestingly, the purity of phenethylamines mostly MDMA has markedly increased, yet the price dropped significantly across the four reporting periods. Age, sex, and the lifestyle associated with particular demographic groups may influence which drugs are favored. There are also certain age groups that demonstrate higher overall levels of drug taking, in particular youth and adolescents \[ 9 \], with studies of high school and university students showing higher drug use rates compared to the general population. Wastewater studies have provided evidence of significant regional differences in drug use; for example, cocaine and methylenedioxymethamphetamine MDMA use in Australia is approximately twice as high in urban areas, whereas methamphetamine use is higher in rural areas \[ 49 , 58 \]. Overall, however, drug use is generally higher in urban areas compared to rural areas; a trend observed in many countries \[ 26 , 58 , 59 \]. This can be largely attributed to the relationship between urbanization and geographic affluence. An additional consideration may be increased accessibility to drugs in urban areas compared to more remote regions which may also have restricted access through online purchasing i. Studies suggest that cocaine users demonstrate a consistent and specific socioeconomic, educational, and employment profile. The dominant group of cocaine users in Australia appear to be employed, well-educated individuals from high socioeconomic areas with the financial resources to support cocaine use \[ 6 , 60 \]. Between and , the median age of cocaine users increased from 25 to 28 years of age, suggesting that this was due to the aging of a group of users rather than increased uptake among older persons \[ 6 \]. However, in , cocaine use was found to be at its highest level in the last 18 years among adults \[ 6 \]. According to a recent survey, the two most significant factors which discourage drug use among young people are the perceived risk of harm and personal disapproval \[ 10 \]. However, although a majority of young people are aware of the risks associated with illicit drug use, this does not prevent use. Alternatively, perceived risk of harm may not be impactful enough to combat peer pressure within social groups. Conversely, addiction disorders are the most commonly encountered explanation for continuation of drug use among regular drug users despite recognition of the risks, particularly in the setting of injecting drug use. There are also distinct differences in perceived harm between non-users and users. Compared to users, individuals who do not engage in the non-medical use of prescription stimulants NMUPS perceived them to be less safe and more harmful; they would expect guilt, dependence, and anxiety and would be less likely to divert their medication if it were prescribed to them \[ 62 \]. In general, it appears that those who do not use drugs perceive a higher risk of harm compared to those who do \[ 61 , 63 \]. For those who already use drugs, the opportunity to discourage drug use may be limited if risk perception is already lowered by familiarity with a particular drug s \[ 63 \]. This may be further compounded by additional factors such as peer pressure, normalization, situational stress, and physical addiction. Between and , heroin and methamphetamine remained the two most prevalent drugs among a sample of people who inject drugs PWID from all Australian states and territories \[ 50 \]. Over this period, rates of heroin use have remained stable, while methamphetamine use has consistently increased in popularity to overtake heroin within the last 2 years \[ 50 \]. Heroin use is highly stigmatized and widely perceived as a drug associated with significant health and social risks, by users and non-users alike \[ 61 , 64 , 65 , 66 \]. Unfortunately, a large proportion of people who inject drugs PWID also experience significant stigma when engaging with healthcare providers \[ 67 \]. Not only does this behavior discourage PWID from engaging with healthcare services while perpetuating negative attitudes within society, but also has detrimental economic implications for healthcare expenditure. For example, more than 5. Reluctance to engage with health care services also contributes significantly to a lack of knowledge of blood-borne diseases among PWID. Inadequate knowledge of the health risks may also contribute to the initiation of drug injection \[ 68 \]. Several studies have highlighted inadequate knowledge about sterilization practices required to prevent the transmission of blood-borne diseases among PWID \[ 69 , 70 \]. In a cohort of homeless individuals injecting drugs, limited awareness of the health risks was evident, as well as steps taken to mitigate risk given their limited circumstances \[ 69 \]. It has also been shown that a small proportion of heroin users may combine heroin with other drugs which may also increase risks \[ 68 \]. Awareness of the health risks and physiological effects associated with injecting drug use may prevent transitioning from smoking to injecting. A significant proportion of people who smoke heroin expressed a dislike for the intense physiological effects of injecting compared to smoking \[ 66 \]. Alternatively, risk awareness may motivate some injecting heroin users to substitute heroin with a different drug \[ 66 \]. Injecting heroin users cited awareness of health risks as a motivating factor to substitute heroin with cocaine, illicit methadone or other prescription opioids \[ 71 \]. However, the latter substitution is particularly problematic as heroin users may overdose on these \[ 72 , 73 \]. There are also perceived risks related to factors external to injecting drug use, such as the risk of being arrested for possession, lack of affordability, and social isolation \[ 68 \]. Among a cohort of people who smoked heroin, with some occasionally injecting, significant concerns were highlighted as to the social implications of injecting versus smoking as injecting was deemed to pose risks of unemployment, relationship problems, and social isolation \[ 66 \]. Prolonged exposure to drug use has been highlighted as a potential risk factor in the escalation of drug use practices, from smoking to injecting heroin for example \[ 70 \]. It has also been shown that PWID may also engage in other high-risk behaviors, either before or subsequent to initiating injecting drug use, with sex work being the main source of income for a significant proportion of PWID in Vietnam \[ 70 \]. Some drugs have persisted for thousands of years and continue to be used among communities and cultural groups as traditional herbs and remedies. For example, substances such as kratom, khat, kava, coca, ayahuasca, kambo, and peyote mescaline have been part of traditional cultural and religious practices for centuries in various parts of the world \[ 75 , 76 , 77 \], but modern use in Western society is becoming increasingly popular. In Iran, there is a long history of opium use with a supportive culture that persists even today \[ 11 \]. However, there are also examples of psychoactive plant-derived substances that have their origins in traditional use among local populations, where they have now been banned and diverted to the illicit trade within Western society. Contrastingly, peyote mescaline is classified as a Schedule I controlled substance in the US, with associated legal penalties for possession and sale \[ 77 \]. However, members of the Native Americans Church are excepted because they ingest peyote legally during religious ceremony \[ 77 \]. The cultural and traditional importance of these substances among some population groups introduces significant complexities in consideration and implementation of legal regulations relating to possession and use. Volatile substance sniffing is a form of recreational drug use which involves the inhalation of certain chemical substances \[ 78 \]. Petrol sniffing, an example of volatile substance misuse, is a persistent problem particularly among Indigenous communities in Australia \[ 79 \]. The appeal of petrol sniffing may lie in the rapid action of inhalants, the low cost, and the lack of access to other drugs \[ 81 \]. Other reasons provided by individuals from an Aboriginal community cite rebellion, lack of parental control, and peer pressure \[ 80 \]. Petrol sniffing among these communities has commenced at increasingly younger ages and appeared to be driven by psycho-social factors related to changes in social dynamics and even seasonal changes \[ 82 \]. The most well-documented and successful intervention has been the introduction of low aromatic fuel which, while still harmful, does not produce the desired psychoactive effects due to reduced amounts of intoxicating solvents \[ 79 , 83 \]. The reasons why volatile substance misuse seems to be particularly prevalent among isolated indigenous communities, not only in Australia but in several other countries \[ 84 , 85 , 86 \], is not yet completely understood. Accurate estimates of population drug use and an understanding of the factors that influence drug choice may assist in the development of appropriate and targeted prevention strategies. This review has highlighted several psychosocial and socioeconomic factors that influence drug use patterns for consideration in the development of future drug use interventions. Given the increasing popularity and availability of NPS, there is much uncertainty about how drug use patterns will evolve over the coming decades. 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Inhalant use by Canadian Aboriginal youth. J Child Adolesc Subst Abuse. Am J Drug Alcohol Abuse. Inhalant use patterns among Eskimo school children in western Alaska. J Addict Dis. Download references. You can also search for this author in PubMed Google Scholar. Correspondence to Lilli Stephenson. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions. Stephenson, L. Socioeconomic and psychosocial determinants of substance misuse — a national perspective. Forensic Sci Med Pathol Download citation. Accepted : 21 August Published : 08 September 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. Download PDF. Abstract Accurate estimates of population drug use and an understanding of the factors that influence substance choice are essential for the development of appropriate and targeted prevention strategies and campaigns. Use our pre-submission checklist Avoid common mistakes on your manuscript. Introduction Globally, drug misuse is a major contributor to disease, illness, injury, and death. Availability As the availability of drugs fluctuates, trends in drug use vary accordingly. Online drug purchasing in Australia In Australia, online drug markets have rapidly grown in popularity, as new iterations of previous websites emerge. Legislation Legislation i. Cannabis legislation In , cannabis use among adults in Australia and New Zealand was found to be significantly higher than the global average \[ 30 \]. Product formulations and quality Evolution and optimization of drug manufacturing processes has resulted in a rapid increase in the number and variety of drugs available on the market, particularly involving NPS. Full size image. Cost Cost is a significant factor influencing drug prevalence and preference \[ 7 \]. Table 1 Median prices of methylamphetamine, MDMA, cannabis, cocaine and heroin in Australia between — and — adapted from \[ 24 , 48 , 54 , 55 \] Full size table. Demographics and geographic affluence Age, sex, and the lifestyle associated with particular demographic groups may influence which drugs are favored. Use of cocaine Studies suggest that cocaine users demonstrate a consistent and specific socioeconomic, educational, and employment profile. Stigma and perceived risk According to a recent survey, the two most significant factors which discourage drug use among young people are the perceived risk of harm and personal disapproval \[ 10 \]. Risk perception and stigma among people who inject heroin Between and , heroin and methamphetamine remained the two most prevalent drugs among a sample of people who inject drugs PWID from all Australian states and territories \[ 50 \]. Culture and tradition Some drugs have persisted for thousands of years and continue to be used among communities and cultural groups as traditional herbs and remedies. Conclusion Accurate estimates of population drug use and an understanding of the factors that influence drug choice may assist in the development of appropriate and targeted prevention strategies. Key points This paper: Provides a narrative review of socioeconomic and psychosocial determinants of substance misuse. Explores current and historical examples of substance misuse in Australia. Article Google Scholar Goldberg T. Google Scholar Schwartz MJ. Google Scholar Australian Government. Byard Authors Lilli Stephenson View author publications. View author publications. Ethics declarations Competing interests The authors declare no competing interests. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. About this article. Cite this article Stephenson, L. Copy to clipboard. Search Search by keyword or author Search. Navigation Find a journal Publish with us Track your research.
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