Background/Aims: Polydrug use is a complicated phenomenon that is measured in a wide variety of different ways. Using Finland as an example, we aimed to demonstrate how the prevalence and prevalence trends of concurrent polydrug use (CPU) varied in the general population based on the different measurements used. Methods: Population-based Drug Surveys conducted every 4 years during 1998-2014 were used. CPU was measured with different measurements: strict, medial and loose definition of CPU, which were based on different combinations of alcohol, illicit drugs, pharmaceutical drugs and cigarettes used during the last 12 months/30 days. Logistic regression was used to estimate the p values for assessing trends. Results: Depending on the measurements used, the prevalence of CPU in 2014 varied between 2.0 and 18.7%. Different definitions also produced contradictory trends of CPU: there was a modest increase in prevalence if it was measured with a medial (p < 0.001) or strict (p = 0.054) definition, but when measured with the loose definition (only measure that included smoking), there was a decrease in prevalence (p < 0.001). Conclusions: The prevalence of CPU varies greatly depending on the measurement used, as does the course of the prevalence trends. The concept of simultaneous polydrug use may capture the phenomenon better compared to the concept of CPU.

Keywords:
Polydrug use, Prevalence, Trends, General population, Finland
1.
Douglass FM, Khavari KA: The drug use index: a measure of the extent of polydrug usage. Int J Addict 1978;13:981-993.
2.
Kaufman E: Polydrug abuse or multidrug misuse: it's here to stay. Br J Addict Alcohol Other Drugs 1977;72:339-347.
3.
Hakkarainen P: Polydrug use - a challenge to research and policy. Conference paper presented in 10th Annual ISDDP (The International Society for the Study of Drug Policy) Conference. Sidney, Australia, 2016.
4.
EMCDDA: Annual Report 2011: The State of Drug Problem in Europe. Luxembourg, Publications Office of the European Union, 2011.
5.
Council of the European Union: EU Drugs Strategy (2013-2020). C 402/1, 2012.
6.
Babor T, Caulkins J, Edwards G, Fischer B, Foxcroft D, Humphreys K, Obot I, Rehm J, Reuter P, Room R, Rossow I, Strang J: Drug Policy and the Public Good. Oxford, Oxford University Press, 2010.
7.
Byqvist S: Patterns of drug use among drug misusers in Sweden. Gender differences. Subst Use Misuse 2006;41:1817-1835.
8.
Midanik LT, Tam TW, Weisner C: Concurrent and simultaneous drug and alcohol use: results of the 2000 National Alcohol Survey. Drug Alcohol Depend 2007;90:72-80.
9.
Coffin PO, Galea S, Ahern J, Leon AC, Vlahov D, Tardiff K: Opiates, cocaine and alcohol combinations in accidental drug overdose deaths in New York City, 1990-98. Addiction 2003;98:739-747.
10.
Connor JP, Gullo MJ, White A, Kelly AB: Polysubstance use: diagnostic challenges, patterns of use and health. Curr Opin Psychiatry 2014;27:269-275.
11.
Martin CS: Timing of alcohol and other drug use. Alcohol Res Health 2008;31:96-99.
12.
Mammone A, Fabi F, Colasante E, Siciliano V, Molinaro S, Kraus L, Rossi C: New indicators to compare and evaluate harmful drug use among adolescents in 38 European countries. Nordic Stud Alcohol Drug 2014;31:343-358.
13.
Höhne B, Pabst A, Hannemann T, Kraus L: Patterns of concurrent alcohol, tobacco, and cannabis use in Germany: prevalence and correlates. Drugs (Abingdon Engl) 2014;21:102-109.
14.
Choquet M, Morin D, Hassler C, Ledoux S: Is alcohol, tobacco, and cannabis use as well as polydrug use increasing in France? Addict Behav 2004;29:607-614.
15.
Kelly AB, Chan GC, White A, Saunders JB, Baker PJ, Connor JP: Is there any evidence of changes in patterns of concurrent drug use among young Australians 18-29 years between 2007 and 2010? Addict Behav 2014;39:1249-1252.
16.
Kokkevi A: Polydrug use by European adolescents; in Hibell B, Guttormsson U, Ahlström S, Balakireva O, Bjarnason T, Kokkevi A, Kraus L (eds): The 2011 ESPAD Report - Substance Use Among Students in 35 European Countries. Stockholm, The Swedish Council for Information on Alcohol and Other Drugs (CAN), 2012, pp 166-170.
17.
Schensul JJ, Convey M, Burkholder G: Challenges in measuring concurrency, agency and intentionality in polydrug research. Addict Behav 2005;30:571-574.
18.
Quintero G: Controlled release: a cultural analysis of collegiate polydrug use. J Psychoactive Drugs 2009;41:39-47.
19.
Stinson FS, Grant BF, Dawson DA, Ruan WJ, Huang B, Saha T: Comorbidity between DSM-IV alcohol and specific drug use disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Drug Alcohol Depend 2005;80:105-116.
20.
Salasuo M, Vuori E, Piispa M, Hakkarainen P: Suomalainen Huumekuolema 2007. Poikkitieteellinen Tutkimus Oikeuslääketieteellisistä Kuolinsyyasiakirjoista [Drug-Related Deaths in Finland in 2007. A Multidisciplinary Study on Forensic Causes-of-Death Data]. Helsinki, Yliopistopaino, Nuorisotutkimusseura, 2009.
21.
Smith GW, Farrell M, Bunting BP, Houston JE, Shevlin M: Patterns of polydrug use in Great Britain: findings from a national household population survey. Drug Alcohol Depend 2011;113:222-228.
22.
Carter JL, Strang J, Frissa S, Hayes RD; SELCoH Study Team, Hatch SL, Hotopf M: Comparisons of polydrug use at national and inner city levels in England: associations with demographic and socioeconomic factors. Ann Epidemiol 2013;23:636-645.
23.
Olszewski D, Matias J, Monshouwer K, Kokkevi A: Polydrug use among 15- to 16-year olds: similarities and differences in Europe. Drugs (Abingdon Engl) 2010;17:287-302.
24.
McCabe SE, Cranford JA, Morales M, Young A: Simultaneous and concurrent polydrug use of alcohol and prescription drugs: prevalence, correlates, and consequences. J Stud Alcohol 2006;67:529-537.
25.
Ives R, Ghelani P: Polydrug use (the use of drugs in combination): a brief review. Drugs (Abingdon Engl) 2006;13:225-232.
26.
Hakkarainen P, Metso L: Joint use of drugs and alcohol. Eur Addict Res 2009;15:113-120.
27.
Karjalainen K, Savonen J, Hakkarainen P: Suomalaisten Huumeiden Käyttö ja Huumeasenteet - Huumeaiheiset Väestökyselyt Suomessa 1992-2014 [Drug Use and Drug Attitudes among Finns - Drug-Related Population Surveys in Finland 1992-2014]. Helsinki, National Institute for Health and Welfare, 2016.
28.
Tomczyk S, Isensee B, Hanewinkel R: Latent classes of polysubstance use among adolescents - a systematic review. Drug Alcohol Depend 2016;160:12-29.
29.
Reyes J, Perez C, Colon H, Dowell M, Cumsille F: Prevalence and patterns of polydrug use in Latin America: analysis of population-based surveys in six countries. Rev Eur Stud 2013;5:10-18.
30.
Oliveira LG, Alberghini DG, Santos Bd, Andrade AG: Polydrug use among college students in Brazil: a nationwide survey. Rev Bras Psiquiatr 2013;35:221-230.
31.
Varis T, Virtanen S: Tupakkatilasto 2014 [Tobacco Statistics 2014]. Statistical Report 18/2015. Helsinki, National Institute for Health and Welfare, 2015.
32.
Jääskeläinen M, Virtanen S and Räikkönen O: Päihdetilastollinen Vuosikirja 2016: Alkoholi ja Huumeet [Yearbook of Alcohol and Drug Statistics 2016]. Helsinki, Juvenes Print - Suomen Yliopistopaino Oy, National Institute for Health and Welfare, 2017.
33.
Hakkarainen P, Karjalainen K, Ojajärvi A, Salasuo M: Huumausaineiden ja kuntodopingin käyttö ja niitä koskevat mielipiteet Suomessa vuonna 2014 [Drug use, doping and public opinion in Finland: results from the 2014 Drug Survey]. Yhteiskuntapolitiikka 2015;80:319-333.
34.
Baggio S, Studer J, Mohler-Kuo M, Daeppen JB, Gmel G: Concurrent and simultaneous polydrug use among young Swiss males: use patterns and associations of number of substances used with health issues. Int J Adolesc Med Health 2014;26:217-224.
35.
Karjalainen K, Lintonen T, Impinen A, Mäkelä P, Rahkonen O, Lillsunde P, Ostamo A: Mortality and causes of death among drugged drivers. J Epidemiol Community Health 2010;64:506-512.
36.
Subbaraman MS, Kerr WC: Simultaneous versus concurrent use of alcohol and cannabis in the national alcohol survey. Alcohol Clin Exp Res 2015;39:872-879.
37.
Leri F, Bruneau J, Stewart J: Understanding polydrug use: review of heroin and cocaine co-use. Addiction 2003;98:7-22.
38.
Martin CS, Clifford PR, Clapper RL: Patterns and predictors of simultaneous and concurrent use of alcohol, tobacco, marijuana, and hallucinogens in first-year college students. J Subst Abuse 1992;4:319-326.
39.
Quek LH, Chan GC, White A, Connor JP, Baker PJ, Saunders JB, Kelly AB: Concurrent and simultaneous polydrug use: latent class analysis of an Australian nationally representative sample of young adults. Front Public Health 2013;1:61.
40.
Earleywine M, Newcomb MD: Concurrent versus simultaneous polydrug use: prevalence, correlates, discriminant validity, and prospective effects on health outcomes. Exp Clin Psychopharmacol 1997;5:353-364.
41.
EMCDDA: Polydrug Use: Patterns and Responses. EMCDDA Selected Issue 2009. Luxembourg, Office for Official Publications of the European Communities, 2009.
© 2017 S. Karger AG, Basel
2017
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.