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Official websites use. Share sensitive information only on official, secure websites. This article was submitted to Addictive Disorders, a section of the journal Frontiers in Psychiatry. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s 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. Background and Aims: Several studies have pointed to relatively high levels of illicit drug use among students in higher education compared to the general population. The aim of the present study was to provide an updated examination of self-reported illicit drug use among Norwegian University and college students. Methods: Data stem from the SHoT study Students' Health and Well-being Study , a nationwide cross-sectional survey for higher education in Norway including Norwegian full-time students aged 18— Self-reported illicit drug use across a range of specified drugs comprised the outcome variables. Information on gender, age, and study location geographical area was also collected and used as stratification variables. Results: The proportion of students reporting having ever tried illicit drugs increased from to , for both males The most commonly used illicit drugs during the past 12 months in were cannabis Illicit drug use showed both linear increase with age, and inverted U-shaped relationships that peaked in the age span from 23 to 28 years of age. Males reported higher illicit drug use compared with females for all drugs. Proportions of illicit drug use varied across geographical areas within the country, with the highest use being reported in the Oslo area the largest city and capital of Norway. Conclusions: The present study reports an increase from to among Norwegian University and college students in the proportion of those reporting to have tried illicit drugs. Despite varying proportions of use across type of drug, age, gender, and geographical location, the overall high levels of illicit drug use past 12 months confirm the need to address illicit drug use in this population. Keywords: illicit drug use, university students, college students, gender differences, long-term trends. While alcohol use is widely studied among students in higher education, far less empirical data is available related to illicit drug use in this population 1. Several studies have also pointed to a high level of illicit drug use among students in higher education compared with the general young adult population 6 — 9 , including higher rates of cannabis, cocaine, and amphetamine use 1 , Both social and coping motives are described as important drivers of illicit drug use in a range of studies 11 — For students in particular, the motives may be recreational, related to mood-enhancing or used to increase study performance 15 , Stimulants such as Ritalin methylphenidate and amphetamine are among the most commonly used drugs in this respect Although a temporary increase in memory may be experienced, the use of these drugs is according to a literature review associated with detrimental negative health effects, while not improving learning and school grades Previous studies have found that cannabis during the past decades has been the most commonly used illicit drug among higher education students 5 , 15 , 19 , 20 , and regular use of cannabis over time is known to be related to severe consequences such as failing to attend to classes, problems with concentration 21 , and reductions in motivation 22 , Amphetamines and ecstasy were the second and third most commonly used drugs in a Swedish student population in the early s 19 and a more recent UK study reported that amphetamine and LSD were the second and third most commonly drugs used among university students Further, an Italian study reported that cocaine and psychedelic mushrooms were the second and the third most commonly used drugs among university students Drug trends can change rapidly due to factors such as availability, harm perception and attitudes toward using illicit drugs An important question in this respect is how rates of illicit drug use vary across age groups. Motives for drug use may potentially differ across the age span In a Swedish University sample, the highest illicit drug use was found among those aged 20—24 years, compared to both younger and older students In comparison, a Norwegian study on illicit drug use among young adults in a nightlife arena another group characterized by higher substance use than the general population, and which includes a large group of students , reported that the youngest age group 16—20 years had the highest prevalence of illicit drug use Illicit drug use accounts for a significant proportion of the global burden of disease Still, no research exists concerning the distribution of a wider array of illicit drug use among Norwegian University and college students, something which needs to be addressed. Moreover, prevalence rates of illicit drug use tend to vary substantially across countries in the general adolescent 29 , adult 30 , and student population 31 , and rates of drug use vary over time even within a given country \[e. In addition, illicit drug use may vary considerably across geographical areas within a country \[e. It is therefore important to provide a recent update on the status of illicit drug use among higher education students, focusing on differences across larger urban areas i. The aim of the present study is to present developments in self-reported illicit drug use across age and gender for Norwegian University students, in addition to differences in geographical areas. First, we will present the gender-specific proportion for having tried any illicit drugs between , , and Next, we will present frequency of self-reported use for different types of illicit drugs across age and gender groups, as well as age- and gender-adjusted estimates of use across major study locations in Norway using data from The SHoT study Students' Health and Well-being Study is a national survey first launched in among students enrolled in higher education in Norway, initiated by the three largest student welfare organizations in Norway \[Sammen Bergen and surrounding area , SiT Trondheim and surrounding area and SiO Oslo and Akershus \]. SHoT and previous waves have previously been described in detail 3 , 33 , In total, 50, students completed the questionnaires, yielding a response rate of Electronic informed consent was obtained after a complete description of the study to the participants. Age and gender were self-reported: gender male, female , age coded as a continuous variable \[range: 18—36 years\], and an ordinal variable: \[18—20, 21—22, 23—25, and 26—35 years\]. Information about study location was also self-reported. However, respondents from these areas were included for other analyses. The number of positive responses on this fake drug was negligibly small 0. SHoT was conducted in , in and in First, self-reported age-adjusted proportions of drug use ever across gender was calculated for , , and , along with pairwise comparisons between years using logistic regression models Figure 1. Estimates are presented as odds ratios OR. The age and gender distribution of the eligible sample was calculated. For the specific drug types, we calculated the frequency of drug use last months based on categories described above using logistic regression models Figure 2. The age- and gender-adjusted proportion for specific drugs across geographic location was estimated Figure 4. For the analysis across geographic location we used logistic regression adjusted for age and gender, and the margins function in Stata 15 to estimate the expected probability percentage of the individual drug use variables while averaging out the demographic characteristics. Last months drug use at least once across gender and age. Overall gender difference presented as odds ratios OR. For age, 1. It can be argued that it is most likely that those not answering specific drug types have not tried the specific drug during the last 12 months, yielding overall changes in the use estimates ranging from 0. For the trend analyses, Overall, there was no difference between and in the reported use of drugs ever Gender-specific pairwise comparisons indicated no differences between and among males and a slight decline among females. Among the 48, eligible participants, In the past year, The most commonly used drug type during the last 12 months was cannabis Figure 2 gives an overview of the frequency of use across drug types. For cannabis use, 4. Having ever tried drugs was associated with age OR-trend average OR across levels : 1. Having ever tried drugs was more commonly reported by males than females OR: 1. Furthermore, gender differences were observed for all age groups except among 18—20 year olds for meth amphetamine use. For GHB and benzodiazepines, gender differences were observed for ages 21—22 and 23—25 years only. No interaction between gender and age for any type of drug use was observed LR-test p -values ranging from 0. Having ever tried drugs was associated with geographic location, with the highest proportion in the Oslo area There was no statistical difference in ever having tried drugs between the Stavanger, Trondheim, and Bergen area. For specific drug use last 12 months, there was little geographic variation in the reported use of synthetic cannabinoids, heroin and meth amphetamine Figure 4. For all other drugs, we observed differences across regions. The largest geographic differences maximum vs. The Northern Norway reported the lowest frequency of any drug use in general. The present study from a large sample of Norwegian full-time higher education students aged 18—35 years suggests that illicit drug use is becoming an important public health issue in this population. While we found that the rates of having tried illicit drugs had remained stable from to , there was a significant increase during the time frame from to This increase in having ever tried illicit drugs was evident for both males and females. We also found that any past year illicit drug use was high in the SHoTdataset compared with the two earlier surveys. The rates of illicit drug use in our sample exceeds the rates in a relatively recent Norwegian general population sample aged 16—30 years, in which These findings are not surprising, and lend support to previous contributions that points to a higher illicit drug use among higher education students, compared with young adults in the general population 1 , Moreover, the rates of past year use were significantly higher for males for all types of illicit drugs, except synthetic cannabinoids and heroin where numbers were very small overall. These findings lend support to previous studies from student populations that also report higher illicit drug use among males \[e. We found geographical differences in proportions of past year drug use, in which students in the Oslo area had either the highest or as high past year use across all substances compared with other areas. Students in Northern Norway were in the lower end of the past year use for most substances. While any lifetime illicit drug use showed a linear increase by age, past year illicit drug use peaked in the age span between 23 and 28 years of age for most types of drugs, with some exceptions. In support of a range of previous publications 1 , 5 , 19 , 20 , cannabis was by far the most commonly used illicit drug across genders among the higher education students. Cannabis use showed an inverted U-curve across age, peaking in the age span from 23 to 28 years of age. The estimates of past year cannabis use fall within the higher range of prevalence rates in higher education students from other countries. The relatively high proportions of cannabis use among the Norwegian higher education students is worrying. A US study of 17—20 year old college students reported that approximately one out of four of all past-year cannabis users fulfilled criteria for a cannabis use disorder CUD In addition, Caldeira et al. In addition, a study by Lac and Luk 22 reported that cannabis use significantly and longitudinally prompted lower initiative and persistence. Hence, due to the high rates of past year cannabis use in our sample, interventions that target cannabis use in student settings are needed. An inverted U-curve by age was found for these substances, peaking between 23 and 28 years of age. The relatively common use of MDMA in our sample, particularly among male students 6. Adding to the reported MDMA use, 2. In comparison, a UK study of university students reported that Interestingly, a recent publication documented the re-emergence of MDMA as an important psychoactive substance in Norwegian nightlife scenes Cocaine use was also quite common in the student sample, particularly among male students. In comparison, we found that rates of cocaine use increased from 1. A UK study reported that 8. Similarly, cocaine was the second most commonly used illicit drug in a Norwegian nightlife setting On the other hand, a Swedish study of university students aged 16—25 years reported a lower rate of past year cocaine use 0. Thus, cocaine use is clearly prevalent in higher education students in some countries, something which was confirmed in our study, notably among males. In a recent study of UK University students, it was reported that 4. Interestingly, the past year use of LSD in the general young adult Norwegian population was deemed as negligible small Past year use for meth amphetamine 2. The total use of amphetamines in our sample was 2. A UK study on university students found a similar proportion of amphetamine use 4. Amphetamine use among higher education students has specifically received scientific attention as a potential drug used for neuro-enhancement, i. However, only 0. The present study did not explore motives for substance use, and we may therefore not conclude on the extent of which enhancement motives constitute a significant motive for illicit drug use in general, as well as amphetamines in specific, in our sample. This could be of interest to further studies on students and substance use. The use of synthetic cannabinoids was very low in our sample. These substances constitute a large group of drugs that have an effect similar to cannabis, but many of these substances are considered to be more potent 46 and are related to serious psychiatric and medical conditions and can even lead to death This rate was similar across genders, with no evidence of geographical differences or association with age. As this drug is frequently marketed over the internet as legal and harmless 46 , it may be an important drug to further monitor in a student setting. Interestingly, a recent study using the same datasets highlighted that alcohol use among Norwegian students have remained relatively stable during the time frame from to 3. Also of note, according to a large national survey on Norwegian upper secondary school youth aged 16—19 years , alcohol use have remained relatively stable during the past 4 years, while cannabis use have increased As such, it appears that the increased substance use among Norwegian higher education students may be specific to illicit drug use, resonating with a tendency that is also found in the general, somewhat younger, Norwegian population. Potential mechanisms for changing trends in substance use include changes in availability, harm perception, and attitudes toward use 25 , and positive attitudes to illicit drug use is a particularly strong risk factor for high-frequency use As the present study do not have available data on potential changes in these aspects, interpretation of reasons for the increase in lifetime illicit drug use is hampered. Thus, we recommend that future studies evaluate the extent to which there has been an increase of positive attitudes as well as reduced perceptions of harm related to illicit drug use among students in higher education, and to what extent these factors may explain the observed increase in lifetime illicit drug use. Aggregate media coverage has previously found to be related to young people's illicit drug use 50 , 51 and could therefore be an important factor to be evaluated in relation to potential changes of attitudes and harm perception toward illicit drug use. Our findings add to previous results that demonstrate high levels of substance use among Norwegian students 3 and underscore the need for substance use prevention in this population. A report authored by the Norwegian Institute of Public Health 52 summarizes the national actions undertaken specifically to reduce substance use among students in higher education in the period from to A stronger coordination of this effort as well as utilization of interventions that are available for effect evaluations is recommended, for example by using other student locations as control groups when specific measures are implemented at a target student location The SHoT-survey is specifically highlighted in the report as an important source for knowledge on the development of substance use among Norwegian students in this respect. A notable strength of the present study was the combination of a very large sample size, and the inclusion of an array of different types of illicit drugs as well as frequency of past year use. The number of positive responses on the fake drug was negligible small. Although illicit drug use potentially could be underreported in studies based on self-report due to the stigmatized and undesirable behavior in question 53 , it should be noted that the convergent validity of self-reported illicit drug use and urine tests is satisfactory among university students Across the three waves of the SHOT-survey, some changes were made to the general content and sampling design. In general, the scope and themes covered expanded from to , but the questions relevant for the present study remained unchanged. With regards to sampling design, the number of welfare organizations and institutions increased between and In a recently published paper explicitly investigating comparability between the waves, however, only small differences were found between the waves. This finding suggests that the three samples are comparable despite an expanding sampling frame with time The low response rate raises questions regarding the representativeness of our sample, as well as the generalizability of the results, and we advise that interpretation of our findings is made with caution. However, the dataset used in this study comprise the largest dataset on higher education student illicit drug use in Norway, and no better data sources are available. Thus, our estimates of overall illicit drug use may be biased, while associations between illicit drug use and age, gender, and location are probably valid. In addition, all eligible students were included at each wave. Thus, it is possible and likely that some of the same students were recruited across at least two waves. We were, however, not able to discern those participating multiple times and those who have only participated once, due to anonymous participation in and Another limitation was that no questions were asked about the timing of initiation of drug use or duration of use, and our findings are thus not likely to measure trends in patterns of illicit drug use, i. Finally, the SHoT-surveys were conducted in different times of the year, something that may also be a limitation for details, see 3. The current study presents results from a large Norwegian sample of higher education students and demonstrated that use of some illicit drugs was fairly common in this population. The rates of having tried illicit drugs have increased during the period —, indicating that a substantial proportion of the students have tried illicit drugs—particularly among male students. These findings demonstrate that illicit drug use can constitute an important public health issue among students in higher education, and that information regarding the different substances should be provided to students. Publicly available datasets were analyzed in this study. OH conducted preliminary statistical analyses, literature search, and wrote the introduction and discussion sections. JS finalized the statistical analyses and wrote the methods and results sections. All authors were involved in interpreting the results, critially revised and contributed to the manuscript, and read the final 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. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Front Psychiatry. Find articles by Ove Heradstveit. Find articles by Jens Christoffer Skogen. Find articles by Marit Edland-Gryt. Find articles by Morten Hesse. Find articles by Lotte Vallentin-Holbech. Received Apr 15; Accepted Nov 16; Collection date Open in a new tab. Type of drug use last months across gender and age groups Norway N varies for rows due to missing data. 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.

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