Reasons for drug abuse among people all over the world

introduction

The use of illicit psychoactive substances is not a minority activity among young people in the UK. Findings from the most recent British Crime Survey show that around 50% of young people aged 16 to 24 have used an illicit drug at least once in their life (lifetime prevalence) (Ramsay and Partridge, 1999). Among 16-19 year olds and 20-24 year olds, cannabis is the most common drug used (40% of 16-19 year olds and 47% of 20-24 year olds use), followed by amphetamine sulfate (18th or 24%). two age groups), LSD (10 and 13%) and ecstasy (8 and 12%). The lifetime prevalence of cocaine hydrochloride (cocaine powder) use in the two age groups of
is 3% and 9%, respectively. Overall, these estimates are generally comparable to other European countries (European Center for Drug and Drug Addiction Surveillance, 1998) and the US (Johnston et al.)., 1997, 2000).

Widespread concern about illicit drug use is reflected in its high priority on the health, education and political agendas of many countries. The UK Government's ten-year national strategy on drug abuse identifies young people as a critical priority group for prevention and treatment (Tackling Drugs to Build a Better Britain 1998). If strategies are to be developed to reduce drug use and its associated harms in younger populations, particularly in the area of ​​health education, it is vital that we improve our understanding of the role that licit and illicit substances play in young people's lives . People. The tendency of educators, practitioners and policy makers to separate legal drugs (like alcohol) from illegal drugs may be in vain. This is partly due to the fact that young users of illicit drugs drink alcohol frequently and may have little regard for the legal distinction between illicit and legal drugs.To understand the role that drug and alcohol use play in contemporary youth culture, it is necessary to examine the group of psychoactive substances most commonly used.

It is common for young drug users to use a variety of psychoactive substances. The terms "polydrug" or "polydrug use" have been used to describe this behavior, although their precise definitions vary. The term "multidrug use" is often used to describe the use of two or more drugs over a period of time (eg.in the last month or year). This is the definition used in the current document. However, polydrug use could also characterize the use of two or more psychoactive substances such that their effects occur simultaneously. We have used the term “concomitant drug use” to denote this potentially riskier and more harmful pattern of drug use (Boys et al. 2000a).Previous studies have reported that users often take drugs at the same time to enhance the effects of another drug or to control its adverse effects [p. (Power et al., 1996; Boys et al. 2000a; Wibberley and Price, 2000)].

The most recent British Crime Survey found that 5% of 16-29 year olds had used more than one drug in the past month (Ramsay and Partridge, 1999). Given that 16% of this age group reported having used drugs in the month prior to the survey, this suggests that almost a third of these people had used more than one illicit substance during this period. When alcohol is included, the prevalence of multiple drinking is likely to be much higher.

There is a large body of literature on the reasons or motivations people give for drinking, particularly among the adult population. For example, studies of heavy drinkers suggested that alcohol consumption was related to multiple drinking functions (Edwards et al., 1972; Sadava, 1975). Similarly, research targeting young people has attempted to identify the reasons for using illicit drugs. There is evidence that, for many young people, the decision to use a drug is based on a rational evaluation process rather than a passive response to the context in which a substance is available (Boys et al. 2000a; Wibberley and Price, 2000). ). The reasons reported vary from fairly general statements (eg.grams. to feel better) to more specific features you can use (e.g. to boost your confidence). However, much of this literature focuses on “drugs” as a generic concept and makes little distinction between different types of illicit substances [p.G. (Carman, 1979; Butler et al., 1981; Newcomb et al., 1988; Cato, 1992; McKay et al., 1992)].Given the different effects of different drugs on the user, one might assume that the reasons for use would accurately reflect these differences. Thus, stimulant drugs (such as amphetamines, ecstasy or cocaine) are used for reasons related to increased nervous system excitation, and drugs with a sedative effect (such as alcohol or cannabis) for reasons related to nervous system depression. Therefore, in the present study, a number of drugs commonly used by young people with stimulant, sedative or hallucinogenic effects were selected to further investigate this problem.

The term “instrumental drug use” has been used to denote the use of drugs for reasons specifically related to the effects of a drug (WHO, 1997). Examples of instrumental use of amphetamine-type stimulants include motorists who report using them to improve concentration and relieve fatigue, and people trying to lose weight (particularly young women) who use these drugs to control appetite.However, the term 'gang use' appears to be used when exploiting a drug's specific physical effects and does not include use for more subtle social or psychological purposes that may also be invoked by users. In recent reports, we have described a 'functions of drug use' model to understand the phenomenology of multiple-drug use in adolescents and how decisions about use patterns are made (Boys et al., 1999a,b, 2000a). The term 'function' is intended to characterize the main or multiple reasons for using a particular substance or the purpose for which it serves in relation to the actual benefits perceived by the user. In the early 1970s, Sadava
proposed that functions were a useful tool for understanding how personality and environmental variables affect drug use patterns (Sadava, 1975).This work was limited to the role of cannabis and "psychedelic drugs" in a sample of college students. To date, there has been little research that has looked at the different functions of the different psychoactive substances commonly used by young polydrug users. It is not clear if all drugs with similar physical effects are used for similar purposes, or if more subtle social or psychological dimensions are at play. Work in this area will help improve understanding of the different roles that psychoactive substances play in young people's lives, thereby facilitating health, educational and policy responses to this problem.
Previous work has shown that perceived functions of drug use predict the likelihood of future use (Boys et al., 1999a). The aim of the present study is to take this work further by examining the functional profiles of six substances commonly used by young people in the UK.

Methods

patterns of cannabis, amphetamine, ecstasy, LSD, cocaine hydrochloride and alcohol use were examined in a sample of young polydrug users. Tobacco consumption was not discussed in the present study.

sampling and recruitment
Snowball sampling was used to recruit participants. Snowball sampling is an efficient method for generating a large sample from a hidden population for which no formal sampling frame is available (Van Meter, 1990). A team of peer interviewers was trained to recruit and interview participants for the study.We have described this procedure in detail elsewhere and only the essential features are described here (Boys et al. 2000b). Using current and former drug users to collect data on hidden populations of adult drug users has proven successful (Griffiths et al., 1993; Power, 1995).
 

study participants

study participants were current multiple substance users with no prior treatment for substance use disorders.We excluded people with a history of treatment because we believe that adolescents who have had substance use problems requiring treatment represent a different group from the general population of adolescent drug users. The inclusion criteria were: age 16 to 22 years and use of two or more illegal substances in the last 90 days. During data collection, participants' age, gender, and current occupation were recorded and controlled to ensure that enough individuals were enrolled in the groups to allow for subgroup analysis. If an imbalance was observed in any of these variables, the interviewers were instructed to select participants with specific characteristics (e.g.women under 18) to correct this imbalanceز
 

study measures

Data were collected using a structured interviewer-administered questionnaire specifically designed for the study. In addition to recording lifelong substance use, the questions included detailed patterns of use for six substances. Data were collected between August and November 1998. The interviews were tape-recorded with the consent of the interviewee.This allowed the research staff to verify that the questionnaire responses were recorded correctly and that the interview was conducted in accordance with the research protocol. The research staff also checked for consistency between different questions (e.g., the total number of days of drug use in the last 90 days must be equal to or greater than the number of days of cannabis use in the same period). In the few instances where inconsistencies were identified that could not be corrected using the tape, the interviewer was asked to contact the respondent again to verify the data.

measurements of lifetime use, past year use, and last 90 days use were based on methods developed by Marsden et al. were developed. (Marsden et al., 1998). Estimated usage intensity (amount used on a typical day of use) was recorded word by word and then translated into standardized units during data entry.

Functions for the Substance Use Scale

The questionnaire included a 17-point scale measuring perceived functions for substance use. This scale consisted of elements developed in previous work (Boys et al., 1999a) as well as features derived from qualitative interviews , recent literature and informal interviews with young drug users. Elements were extracted from five domains (Table I).

participants were asked if they had ever used a particular drug to perform that specific function. Those who endorsed the article were then asked to rate how often they had used it for that purpose in the past year, using a five-point Likert scale (from never to always; coded 0–4). One point differed between the functional scales for stimulants and for alcohol and cannabis. For stimulant drugs (amphetamines, cocaine and ecstasy) the item was replaced by 'Have you ever used [named drug] to help you lose weight?', for cannabis and alcohol this item was replaced by 'Have you ever used [named drug] to help you lose weight?” replaces sleeping?'.(The fully written items as they appeared in the questionnaire are listed in Table III, along with the abbreviations used in this document.)(Boys et al., 1999b)
 

Statistical Procedures

The internal reliability of the substance use function scales for each of the six substances was assessed using the Chronbach α coefficient. Chronbach's α is a statistic that reflects the degree to which each item on a measurement scale is related to other items. Technically, it is the average of the correlations between all possible comparisons of the items on the scale that are split in half. A coefficient α for a scale can range from 0 (no internal reliability) to 1 (full reliability).Analyzes of categorical variables were performed using the χ2 statistic. Differences in the means of the scales were assessed using t-tests.
 

results

The sample consisted of 364 young polydrug users (205 males; 56.3%) with a mean age of 19.3 years; 698% worked full-time and the rest part-time. Estimates of disposable monthly income (any money left over after paying rent, utility bills and groceries) ranged from £0 to over £1,000 (median = £250).
 

substance use history

The drug with the highest lifetime prevalence was cannabis (96.2%). This was followed by amphetamine sulfate (51).6%), cocaine hydrochloride (50.5%) (hereafter cocaine) and ecstasy (48.6%). Twenty-five percent of the sample had used LSD, and this was more common among male participants (χ2[1] = 9.68, P<0).01). Other drugs used were crack (25.5%), heroin (12.6%), tranquilizers (21.7%) and hallucinogenic mushrooms (8).0%). On average, participants had used a total of 5.2 different psychoactive substances (out of a possible 14) in their lifetime (median=4.0, mode=3.0, range 2–14).There was no gender difference in the number of different drugs ever used.

Table II describes the use of the six target drugs in the past year as well as the frequency and intensity of use in the 90 days prior to the interview.

With the exception of amphetamines, there were no gender differences in drug use in the past year and in the past 90 days. For this substance, women who had ever used this drug were more likely than men to have done so in the past 90 days (χ2[1] = 4.14, P<0.05). The mean number of target drugs used in the last 90 days was 3.2 (median = 3.0, mode = 3.0, range 2 to 6).No gender differences were observed. Hardly any differences were observed in the frequency and intensity of use either. Men reported drinking alcohol more frequently in the three months prior to the interview (t[307] = 2.48, P < 0.05) and consuming cannabis more intensively on a "typical consumption day" (t[337] = 3 ).56, P < 0,001).

Perceived functions for substance use

There were few differences between the features approved for use of each drug 'ever' and those approved for use 'in the year prior to interview'. Therefore, this section focuses on data from the year before the interview. We believe that in order to use a drug for a specific function, the user must know firsthand the effects of the drug before making that decision. Consequently, the functions reported by people who had used a particular substance only once in their lifetime (i.e.People who had no experience with the drug at the time they decided to take it were excluded from the analyses. Table III summarizes the proportion of the sample that confirmed each function of the medicines used in the last year. Roman numerals were used to indicate the characteristics with the five highest mean values. Table III also shows the mean values ​​for the total number of different items recommended by individual users and the internal reliability of the performance scales for each substance using Chronbach's α-coefficients. There were no significant gender differences in the total number of permitted functions for any of the six substances.

The following sections summarize the five most popular characteristics for each drug along with any observed age or gender differences in approved products.
 

cannabis use (n=345)

Overall, the most popular functions for cannabis use were “RELAX” (supported by 96.8% of people who had used the drug in the past year), “CHEAT YOURSELF” (90.7%), and “IMPROVE ACTIVITY” (72 ,8th %).Cannabis was also commonly used to relieve boredom (70.1%) and sleep (69.6%). Nine of the 17 items were endorsed by more than half of those who had used cannabis more than once in the past year.No significant gender differences were observed, with the exception of “KEEP GOING” use, where male participants reported significantly more often that they had used cannabis for this role in the past year (χ2[1] = 6.10, P<0, 05).

There were statistically significant age differences on four of the functional variables: cannabis users who reported having used the drug in the past year to feel CHECKY/euphoric or to help "SLEEP" were significantly older than those who did not had used cannabis for these purposes (19.6 versus 19.0; t[343] = 3.32, P < 0.001; 19.4 front to 19.0; t[343] = 2.01, P < 0.05). In contrast, those who used cannabis to “boost confidence” and “stop worrying” tended to be younger than those who did not (19.0 vs. 19.4; t[343 ] = -2).26, P < 0.05; 19.1 front to 19.5; t[343] = -1.99, P < 005).
 

amphetamines (n=160)

Common functions for amphetamine use were “CONTINUE” (95.6%), “STAY AWAKE” (91.3%), or “IMPROVE ACTIVITY” (66.2%).Using it to feel “HAPPY/EUPORIC” (60.6%) and “ENJOYING THE SOCIETY” (58.1%) were also frequently mentioned. Seven of the 17 functioning points were endorsed by more than half of the participants who had used amphetamines in the past year. As with cannabis, gender differences were rare: women were more likely to use amphetamines to aid in "weight loss" than male participants (χ2[1] = 21.67, P < 0.001).

Significant age differences were found in four functional variables. People who reported having used amphetamines in the past year to feel CHECK/EUPORIC were significantly older than those who did not (19.9 vs. 19).0; t[158] = 2.87, P < 0.01). In contrast, participants who used amphetamines were more likely to “STOP WORRYING” (18.8 vs. 19.8th; t[158] = -2.77, P < 0.01), for "LEARLY DECREASE" (19.2 vs. 19.9; t[158] = -2.39, P < 0.05) or "IMPROVE ACTIVITY" (19.3 vs. 20.1; t[158] = -2.88, P<0.01) were younger than those who weren't.

Ecstasy (n=157)

The five most popular modes of action of ecstasy use were similar to those of amphetamines. The drug was used to “STAY WALK” (91.1%), to “IMPROVE ACTIVITY” (79.6%), to feel “high/euphoric” (77.7%), to “WALK TO STAY” (72).0%) and “INTOXICATE” (68.2%). Seven of the 17 functional elements were endorsed by more than half of those who had used ecstasy in the past year. Female users were more likely to have used ecstasy for weight loss than male participants (Fisher's exact test, P<0.001).

As with the other drugs discussed above, participants who reported using ecstasy to feel HIGH/EUPORIC were significantly older than those who did not (19.8 versus 18.9; t[155 ] = 2.61, P<0.01).In contrast, those who had used ecstasy felt "BETTER" (19.3 vs. 20.0; t[155] = -2.29, P<0.05) and "INCREASE CONFIDENCE" (19) .2 vs 19.9; t[155] = -2.22, P < 0.05) and "stop worrying" (19.0 vs. 19.9; t[155] = -2.96, P < 0.01) tends to be younger.
 

LSD (n=58)

Of the six target substances examined in this study, LSD was associated with the least diverse functional functions. All but two of the feature claims were supported by at least some users, but only five were reported by more than 50%.The most common reason for LSD use was “intoxication” (77.6%). Other popular characteristics included feeling “ELEGANT/EUPORIC” and “IMPROVE ACTIVITY” (both endorsed by 72.4%), as well as “Keep going” and “enjoying the company” (both endorsed by 58.6% supports).In contrast to the other substances examined, no gender or age differences were observed.
 

cocaine (n=168)

Similar to ecstasy and amphetamines, the most commonly supported roles in cocaine use were helping to “keep going” (84.5%) and helping to “stay awake” (69.0%). Using cocaine to “boost self-confidence” and “to get high” (both supported by 66).1%) were also popular. However, unlike the other stimulants, 61.9% of cocaine users reported using cocaine to “FEEL BETTER”. Ten of the 17 articles were endorsed by more than half of those who had used cocaine in the past year.

Gender differences were more common in all roles for cocaine use than for the other substances studied.More men reported using cocaine to potentiate the effects of other drugs (χ2[1] = 4.00, P<0.05); more women used the drug to “STAY AWAKE” (χ2[1] = 12.21, P<0.001) and “LOSE INHIBITIONS” (χ2[1] = 9).01, P < 0.01), "STOP WORRYING" (χ2[1] = 8.11, P < 0.01), or "enjoying the company of friends" (χ2[1] = 4.34, P < 0).05). All of the participants who advocated using cocaine to lose weight were women.

Those who had used cocaine felt “BETTER” (18.9 vs. 19.8; t[166] = –3.06, P < 0.01) to "stop worrying" (18.6 vs. 19.7; t[166] = -3.86, P<0.001) or “REDUCING BOREDOM” (18.9 vs. 19.6; t[166] = −2.52, P<0.05) were significantly younger than those who did not support these roles.As with the other drugs, participants who had used cocaine in the past year to feel CHECK/EUPORIC tended to be older than those who had not (19.6 vs. 18.7; t[166 ] = 3.16, P<0.01).

Alcohol (n=312)

The functions of alcohol consumption were the most diverse of the six substances studied. As with LSD, the most commonly reported purpose of drinking was "intoxication" (89.1%). Many consumed alcohol to relax (82.7%), to “enjoy the company” (74).0%), on “INCREASE CONFIDENCE” (70.2%) and on “FEEL BETTER” (69.9%). Overall, 11 of the 17 feature articles were endorsed by more than 50% of those who had drunk alcohol in the past year. Male participants reported using alcohol in combination with other drugs more frequently in order to "BOOST" the effects of other drugs (χ2[1] = 4).56, P < 0.05) or to alleviate the "POSTERS" of other substances (χ2[1] = 7.07, P<0.01). More women than men reported drinking alcohol to “reduce boredom” (χ2[1] = 4).42, P < 0.05).
T-tests of
showed significant age differences in four of the functional variables: those who drank to feel CHECK/EUPORIC were significantly older (19.7 vs. 19.0; t[310] = 3.67, P < 0.001) and those who drank to "lose inhibitions" (19.6 vs. 19.0; t[310] = 2.36, P<0.05). Conversely, participants who reported drinking alcohol only to "get intoxicated" reported (19.2 vs. 20.3; t[310] = -3.31, P<0).001) or "REDUCED BOREDOM" (19.2 vs. 19.6; t[310] = -2.25, P<0.05) were significantly younger than those who did not.
 

Combined use of functional drugs

The substances used by most participants to “ENHANCE THE EFFECTS” of other drugs were cannabis (44.3%), alcohol (41.0%) and amphetamines (37.5%). Cannabis use was also common (64.6%) and to a lesser extent alcohol (35.9%) in combination with other medications to manage “AFTER EFFECTS”. Amphetamines, ecstasy, LSD and cocaine were also used for these purposes, albeit to a lesser extent. Participants who advocated concomitant drug use were asked to list the three drugs with which they had most frequently combined the target substance for these purposes. Table IV summarizes these responses.
 

General features for drug use

To examine which functions were most popular overall, a dummy variable was created for each item that indicates whether one or more of the six target substances had been used for this purpose in the year prior to the survey. For example, if a person reports using cannabis for relaxation, but using ecstasy, amphetamines, and alcohol has not served this function, the variable “RELAX” is scored “1”. If they had used all four relaxation substances in the last year, the variable would also be rated “1” again. A score of “0” means that none of the target substances were used to perform a specific
function. Table V summarizes the data for these new variables.

More than three quarters of the sample had used at least one target substance for 11 of the 18 functions listed in the past year. The five most common functions for substance use in general were “RELAXATION” (96.7%); "INDOXIC" (96.4%); "KEEP AHEAD" (95.9%); "INCREASE ACTIVITY" (88.5%) and “FEEL BETTER” (86.8%). Although "SLEEP" was only relevant for two substances (alcohol and cannabis), more than 70% of the total sample voted in favour. Use for “WEIGHT LOSS” was only relevant for stimulants (amphetamines, ecstasy and cocaine), but was supported by 17.3% of the overall sample (nearly a third of all female participants).Overall, this was the least popular role for recent substance use, followed by WORK (32.1%). All other articles were approved by more than 60% of all participants.

gender differences were found in six items. Women were significantly more likely to endorse: Use to “INCREASE TRUST” (χ2[1] = 4.41, P < 0.05); "STAY AWAKE" (χ2[1] = 5.36, P<0.05), "LOSE INHIBITIONS" (χ2[1] = 4.48, P<0.05), "IMPROVE SEX" (χ2[1] = 5.17, P<0.05) and "LOSE WEIGHT" (χ2[1] = 29.6, P<0.001).Conversely, men were more likely to use one substance to "potentiate the effect of another drug" (χ2[1] = 11.18, P<0.001)

Statistically significant age differences were found for three of the items. Those who had used at least one of the six target substances in the past year to feel high/high (19.5 vs. 18.6; t[362] = 4.07, P<0.001) or "SLEEP" (19.4 vs. 18.9; t[362] = 2.19, P<0.05) were significantly higher than those who had not used this function.In contrast, participants who were used to "LISTEN TO CONCERN" tended to be younger (19.1 vs. 19.7; t[362] = -2.88, P<0.01).

discussion

This article examined the use of psychoactive substances in a sample of young people and focused on the perceived functions of use using a 17-point scale. In terms of sample characteristics, reported lifetime and recent substance use were directly comparable to other samples of polydrug users recruited from the UK [p. (Publication, 1997)].

Previous studies that asked users to provide reasons for their overall “drug use” rather than by drug type [p.Gramm. (Carman, 1979; Butler et al., 1981; Newcomb et al., 1988; Cato, 1992; McKay et al., 1992)] may have overlooked the dynamic nature of drug-related decision-making.A key finding of the study is that with the exception of two of the function-related scale items (use to aid sleep or weight loss), all six drugs were used to perform all measured functions, despite differences in their potent pharmacological effects. The total number of features endorsed by individuals for use of a particular drug ranged from 0 to 15 for LSD and up to 17 for cannabis, alcohol, and cocaine. The average number ranged from 5.9 (for LSD) to 9.0 (for cannabis).This indicates that substance use served multiple purposes in this sample, but the functional profiles of the six target drugs were different.

We have previously reported (Boys et al. 2000b) that high scores on a cocaine functioning scale are a strong predictor of high scores on a cocaine-related problems scale. Current evidence supports the use of similar functional scales for cannabis, amphetamines, LSD and ecstasy. Whether there are similar connections with problem scores remains to be seen.Future development work in this area should ensure that respondents have the opportunity to cite in addition to the characteristics listed here, so that the scales can be expanded and refined.

Recent campaigns targeting young people have tended to assume that use of hallucinogens and stimulants is mainly associated with dance events, so the reasons for use will relate to this context. Our results support the notion that these drugs are used to enhance social interactions, but other functions are also evident. For example, about a third of the women surveyed had taken a stimulant medication to help with weight loss. Future education and prevention efforts must take this diversity into account when planning interventions for different target groups.

The finding that the use of different drugs performs the same functions suggests that at least some may be interchangeable. Other studies have found evidence that alternative drugs can be used to fill a role when a preferred drug is not available [e.g. (Boys et al. 2000a)].Prevention efforts should perhaps focus on the general motivations for use, rather than trying to eliminate use of specific types of drugs in isolation. For example, the focus on ecstasy prevention over the past decade may have inadvertently contributed to the increase in cocaine use among young people in the UK (Boys et al., 1999c). It is important that health educators consider this possibility when developing awareness and prevention initiatives. Considering the role that substance use can play for young people could help us understand which drugs may be interchangeable.If prevention programs were designed to target a range of substances that generally perform similar functions, this could potentially reduce the likelihood that some young people will switch to other drugs if they are discouraged from their preferred substance.

There is considerable concern about the perceived increase in the number of young people using cocaine in the UK (Tackling Drugs to Build a Better Britain 1998; Ramsay and Partridge, 1999; Boys et al. 2000b). It has been suggested that cocaine may, for a variety of reasons, replace ecstasy and amphetamines as the stimulant of choice for some young people (Boys et al., 1999c). The results of this study suggest that the reasons for cocaine use are similar to those for ecstasy and amphetamine use, e.g. B.Grams. Use it to “keep going” when going out with friends, “enhance an activity,” “to induce an exhilaration or exhilaration,” or to “stay awake.” However, in addition to these features shared by the three stimulants, more than 60% of cocaine users said they used the drug to "feel safer" in a social situation and to "feel better when they were depressed." or are depressed”. ". . Another finding that distinguished cocaine from ecstasy and amphetamines was the relatively high incidence of sex differences in licensed functional items ', 'enjoying the company of friends' or 'losing weight'.This could indicate that women are more likely to take on certain roles than their male counterparts. However, the fact that no similar gender differences were observed for the other five substances on the same items suggests that this interpretation is unlikely. Likewise, the absence of gender differences in cocaine use patterns (both frequency and intensity) suggests that these differences are not due to higher levels of cocaine use among women. If these results are later confirmed, it could indicate that young women tend to use cocaine for social support, specifically to help them feel less inhibited in social situations. If so, young cocaine users may be more vulnerable to longer-term cocaine-related problems.

Many respondents reported using alcohol or cannabis to control the effects of another drug. This has implications for the choice of health messages conveyed to young people about the simultaneous use of two or more different substances. Much of the literature directed at young people warns against mixing drugs as the interactions can be dangerous [p. (HIT, 1996)].This kind of "just say no" approach doesn't take into account the motives behind the drug mix. In most areas, drug education and prevention has moved away from this form of communication. A more nuanced approach is needed that takes into account the role that drug sharing is likely to have for young people and seeks to modify the messages to make them more relevant and acceptable to this population. Further research is needed to examine the rationale for mixing different drug combinations.

More than three quarters of the sample reported using at least one of the six target substances to perform 11 of the 18 functions.These results provide strong evidence that young people use psychoactive drugs for different purposes that do not solely depend on the specific effects of the drug. Overall, the top five functions were “helping you relax”, “getting high”, “moving on”, “improving activity” and “feeling better”. Each of these was supported by more than 85% of the sample. While all six substances were more or less strongly associated with each of these elements, there were certain drugs that were more commonly associated with each of these elements. For example, cannabis and alcohol were popular choices for relaxation or intoxication.In contrast, more than 90% of amphetamine and ecstasy users reported using these drugs in the past year to 'make ends meet'. Use to increase activity was a common feature among users of all six substances and was endorsed by more than 70% of ecstasy, cannabis and LSD users. Finally, alcohol and cannabis (and to a lesser extent cocaine) were mainly used to “feel better”.

Several gender differences were observed in the combined roles for recent substance use. These results suggest that young women use drugs other than cocaine for social support. Also in younger women, use for certain physical effects (weight loss, sex, or wakefulness) was more common. In contrast, male users stated significantly more frequently that they used at least one of the target substances in order to enhance the effect of another substance. This suggests that the young males in this sample are more likely to mix drugs than their female counterparts.Age differences were also observed on several functional elements: participants who had used a drug to "feel high or high" or "to help them fall asleep" tended to be older, and those who had used a drug earlier to "quit to take care of a problem”, were older. teenagers. If future studies confirm these differences, educational programs and interventions could benefit from tailoring their strategies to specific age groups and genders. For example, it might be appropriate to focus on stress management strategies and coping skills with a younger target group.

It is necessary to acknowledge some limitations of the study. The sample for this study was recruited using a snowball sampling method.Although this method does not create a random sample of research participants, this method has been used successfully to access hidden samples of drug users [p. (Biernacki, 1986; Lenton et al., 1997)]. Among the various advantages of this approach is that it allows theories and models to be tested quantitatively on a significant number of subjects who have engaged in relatively rare behaviors.

Further research is now needed to determine whether our observations can be extrapolated to other populations (e.g. addicted drug users) and drug types (e.g. heroin, tranquilizers or tobacco) or whether additional functional elements need to be developed. Future studies should also examine whether functions can be classified into primary and secondary causes and how they relate to changes in drug use and addiction patterns. Recognizing the role that substance use plays could help inform education and prevention strategies and make them more relevant and acceptable to target groups.