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Elena Gomes de Matos, Tessa-Virginia Hannemann,

New drug use trends in Germany? The use of new psychoactive substances and methamphetamine in six federal states. Elena Gomes de Matos, Tessa-Virginia Hannemann, Josefine Atzendorf, Ludwig Kraus, Daniela Piontek II Lisbon Addicitions Conference 24-26 October 2017, Lisbon. Background.

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Elena Gomes de Matos, Tessa-Virginia Hannemann,

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  1. New drug use trends in Germany? The use of new psychoactive substances and methamphetamine in six federal states Elena Gomes de Matos, Tessa-Virginia Hannemann, Josefine Atzendorf, Ludwig Kraus, Daniela Piontek II Lisbon Addicitions Conference 24-26 October 2017, Lisbon

  2. Background • Trends in drug use subject to changes and trends • Lately discussed: New psychoactive substances (NPS), methamphetamine • Lack of epidemiological studies covering a broad geographical range • Regional variation in prevalence? 2

  3. Background Aim: Assess distribution of NPS and methamphetamines in 6 German federal states 3

  4. Methods Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 4

  5. Methods • Epidemiological Survey of Substance Abuse (ESA) • Adults aged 18-64 years • Sample sizes: Bavaria (n = 1,916), Hamburg (n = 1,125), Hesse (n = 1,151), North Rhine-Westphalia (n = 2,008), Saxony (n = 1,897), Thuringia (n = 1,543) • Self-administered paper-and-pencil and online questionnaires, telephone interviews 5

  6. Methods • Prevalence rates by federal states • Factors associated with lifetime use (logistic regression analyses) • Predictors: federal state, sex, age, education, consumption of alcohol, tobacco and cannabis 6

  7. Results: NPS prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 7

  8. Results: NPS prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 8

  9. Results: NPS prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 9

  10. Results: NPS prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 10

  11. Results: Forms of NPS consumption 11

  12. Results: Methamphetamine prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 12

  13. Results: Methamphetamine prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 13

  14. Results: Methamphetamine prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 14

  15. Results: Methamphetamine prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 15

  16. Results 16

  17. Results: Methamphetamine prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 17

  18. Discussion: NPS Constant update of medical staff (e.g. emergency department, GP) regarding new NPS trends and symptoms on a national basis • More prevalent than any illicit drug except cannabis • In international comparison rather low consumption prevalence • “Risk factors” similar to other illicit drugs (younger age, low education, use of tobacco and cannabis) • No indications for differences between federal states 18

  19. Discussion • Rarely used in adult general population • Agglomeration in Saxony and Thuringia • Proximity to Czech border (production sites) 19

  20. Results: Methamphetamine prevalence rates Hamburg Northrhine- Westphalia Saxony Thuringia Hesse Bavaria 20

  21. Discussion • Training for medical institutions on symptoms and challenges of methamphetamine in affected regions • Selective and indicative prevention and intervention; nationwide prevention campaigns not recommended • Rarely used in adult general population • Agglomeration in Saxony and Thuringia • Proximity to Czech border (production sites) • Known from clinical populations (treatment data) • Not an “everyday drug” throughout population • Serious health risks 21

  22. Thank you for your attention!

  23. Background and aims Background & aims Methods Results Discussion • Methamphetamine (Crystal Meth) • Globally most widespread illicit drug except cannabis (yet less common than e.g. in USA) • Higher potency and longer half-life period than amphetamine • Long-term effects (e.g. cardiovascular diseases, mental problems) • Indications of higher consumption in federal states close to Czech Republic Background 23

  24. Methods Background & aimsMethodsResultsDiscussion • NPS & methamphetamine • Prevalence (lifetime, 12-months, 30-days) • Consumption frequency last 12 months (methamphetamine) • Consumption forms last 12 months (NPS) • Clinical relevant consumption using the Severity of Dependence Scale (SDS) • Alcohol, tobacco, cannabis (last 12 months) • Sociodemographic variables (sex, age, education) Variables & instruments 24

  25. Results Figure 2. Consumption of methamphetamine based on lifetime (LT), 12 months (12 M) and 30 days (30 T). n unweighted number. % weighted percent. Background & aimsMethodsResultsDiscussion Figure 1. Consumption of new psychoacitve substances based on lifetime (LT), 12 months (12 M) and 30 days (30 T). n unweighted number. % weighted percent. 25

  26. Results HH Nordrhein-Westfalen Sachsen Thüringen Hessen Bayern 26

  27. Results NPS • Lifetime prevalence between 2.2 % (Bavaria) and 3.9 % (Hamburg) • Maximum 12-month prevalence 1.4 % (Hamburg, Saxony); consumption in last 30-days only in Saxony and Thuringia (0.1 %) • Equal lifetime prevalence across federal states • Lower consumption with higher age and education • Higher consumption associated with alcohol and cannabis use Background & aimsMethodsResultsDiscussion 27

  28. Results Methamphetamine • Lifetime prevalence highest in Saxony (2.0 %) and Thuringia (1.7 %) and Bavaria (1.1 %) • 12-month prevalence between 0.8 % (Thuringia) and 0.4 % (Bavaria, Hamburg); consumption in last 30-days only in Hamburg (0.3 %) and Thuringia (0.2 %) • Higher consumption risk in Saxony and Thuringia • Lower consumption with higher age and education • Higher consumption with tobacco and cannabis use Background & aimsMethodsResultsDiscussion 28

  29. Results Background & aimsMethodsResultsDiscussion Note. Controlled for interview type (written, telephone, online). OR: Odds Ratio. 95 % CI: 95 % Confidence interval. Reference of variable federal states was average of all included federal states. a. Continuous variables. b. Reference category: „low education“. * p < .05. 29

  30. Results NPS – consumption forms • Herbal mixtures most widespread and highest in Bavaria (90.9 %) and Saxony (89.6 %) • Crystals/pills most common only in North Rhein-Westphalia (84.3 %) • Liquids least popular in all states except Saxony Table 2. NPS consumption forms in six federal states. Note. NRW North Rhein-Westphalia. n unweighted number. % weighted percent. Multiple responses allowed. Background & aimsMethodsResultsDiscussion 30

  31. Results Methamphetamine – frequency Table 3. NPS consumption forms in six federal states. 31

  32. Results Methamphetamine – frequency and clinical relevant consumption Frequency • Frequency varied across federal states • At least 10 times consumption highest in Thuringia (7 out of 15) and Saxony (3 out of 4) Clinical relevant consumption • In total nine persons with clinical relevant consumption across federal states • Most prevalent in Thuringia (5 persons) Background & aimsMethodsResultsDiscussion 32

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