The 2014 Global Drug Survey (GDS2014) conducted during November / December 2013 was the biggest survey of current drug use ever conducted. Published in 8 languages and promoted through media partners in 17 countries, it received almost 80,000 responses…countries included USA, UK, Australia, Germany, France, Republic of Ireland, Scotland, Belgium, The Netherlands, Denmark, New Zealand, Hungary, Spain, Portugal, Switzerland, Mexico, Slovenia and Brazil.

The self-nominating sample were typically in their in 20s and 30s, well-educated, and about 50% went clubbing at least 4 times a year.

They tended to have higher lifetime prevalence of illicit drug use (over 85%) than the general population and one suspects a greater interest in the topic, but only about 60% had used an illicit drug in the last year, most typically cannabis.

Whilst alcohol, tobacco and cannabis remained the most common drugs used within the last year, with cocaine, amphetamine in its various forms and MDMA frequently just behind them, countries showed marked variation in the use of other drugs. The increasing uptake of other preparations nicotine containing products namely shishas tobacco and electronic cigarettes demonstrate the pervasive presence of diverse nicotine based products in our culture.

The high rates of caffeine energy drinks, caffeine tablets (and in some countries like Germany even intranasal caffeine) demonstrate the market for this legal stimulant is as strong as ever. Prescribed and non-prescribed psychoactive medication particular opioid painkillers and benzodiazepines were frequently in the top 10 drugs used by GDS populations in the last year, with their use, non-medical and problematic use being particularly high in the USA and New Zealand being dominant forces. Other medications that crossed over into the recreational drug scene such as GHB, methyphenidate (Ritalin) and ketamine were more sporadically distributed.

Drugs prices varied widely – the average price of gram of high potency cannabis being 12 euros but varied almost fourfold from 6 euros in Spain to over 20 in Ireland. Cocaine remained the most expensive drug at mean global single gram purchase price of 100 euros / gram (ranging in price from 50 in parts of Europe to over 250 in NZ, which also had the most expensive MDMA as well).

Regardless of price, cocaine was voted the worst value for money drug in the world, with a mean score of 3.4/10. MDMA was voted the best value for money drug in the world. The Belgians were the most satisfied with their cocaine with a mean rating of 5.5/10 and the Australians the least with rating of 2.2.

The use of ‘research chemicals and legal highs (including substances sold as bath salts, and synthetic cannabis products) varied widely between countries. The biggest users were those in USA with over one in 5 having used one of these compounds in the last year.

The worst drug of them all is still the most readily available one: alcohol.

Alcohol remained the biggest cause of concern among friends and the biggest culprit in sending people to Emergency Department. The percentage of last year drinkers who had sought emergency again varied widely from an average of just 1%, to 0.7% in France to over 2% in Ireland. Awareness of national drinking guidelines was universally poor with over 40% of drinkers being unsure of their countries drinking guidelines. The Germans were most clueless with 65% being unsure of them, the Danes the best informed with only 8% reporting they did not know them (that did not stop 1.5% of last year’s Danish drinker seeking emergency medical treatment following drinking last year).

The rates of seeking emergency medical treatment for other drugs other than alcohol varied widely. Further research is required to determine the factors that underlie the 3 fold difference in seeking emergency medical treatment (EMT) following the use of MDMA between Switzerland with the lowest rate of seeking EMT (03% of last year users) and the USA, The Republic of Ireland and France (09.1-1%).

MDMA in Switzerland leads to far fewer hospitalizations than in the US. Just because it’s called “Molly“, doesn’t mean you know what’s in it kiddies – be careful.

2013 saw more press coverage about ecstasy related deaths in the UK than there had been for years. Was it PMA? Was it bad ventilation and dehydration? Was it deaths to weird and wonderful novel psychoactive drugs (aka legal highs)? …rarely was PMA the only thing taken, with MDMA and alcohol usually being present…almost 3 fold increase in those seeking EMT following the use of MDMA in the UK (from 0.3% in GDS2013 to 0.8% in GDS2014)…Twice as many people reported taking powder than pills, over half has also used alcohol. 

They likes their medicine green in the good ‘ole US of A:

Our huge study of over 38,000 cannabis users showed that the USA was home to safest smokers – with only 7% choosing to smoke cannabis with tobacco followed by NZ (25%) , compared to over 80% of smokers in most other countries. Although the most sensible cannabis smokers, the USA was the worst place to get caught with cannabis with over 17% reporting that it impacted on their education, employment, and travel…among all illegal drugs, cannabis was the drug that most people wanted to use less of and help with in reducing their use. This confirms that for some users (perhaps 10-20%) cannabis can be associated with problems. For many dependent users, withdrawal on stopping will also be an issue with sleep disturbance, weird dreams, irritability, restlessness and craving being the major problems.

A third of respondents had been to work with a hangover, and a sixth had been there while coming down from drugs. Ireland was “worst” (or best, depending on your perspective), with 50% going to work with hangovers.

Turning up to work hung over or coming down from the effects of drugs was common among the GDS2014 sample, with over one third of those in work reporting going to work hung-over – but less than half of that number reporting going work coming down from drugs.

The highest rates of turning up to work hung-over in the last 12 months was the Republic of Ireland (50%) followed by the UK and Hungary (46%). The lowest rates were reported in the USA and Portugal (both less than 25%). The highest rates of turning up to work coming down from the effects of drugs was in the Netherlands (25%), the UK and the Republic of Ireland (both over 20%). The lowest rates were reported in New Zealand (less than 8%)

People reported a neutral to positive effect from pursuing harm reduction strategies.

Safer drug use is more enjoyable drug use. Adopting safer drug using practices can reduce drug related risk. The full list of strategies adopted and rated by almost 80,000 drugs users from across the world on 8 of the most commonly use drugs have been published as a collection of guides known as the High-way Code. Such a guide – with strategies put forward but drug users and other drug experts has the potential to save lives, reduce emergency medical service utilization and promote healthier less harmful drug use.

So there you go – read the High-way Code and be a more responsible drug user, even especially if your drug of choice is alcohol or tobacco.

The report makes a strong case for governments to treat addiction as a medical issue:

The overwhelming finding across countries was not that a reduction in criminal penalties would encourage [hordes] of non-drug users to try drugs or for current drug users to increase their use. Instead it was that people who use drugs would be more open with their family and friends about their use and more likely to seek help or advice about the use and associated health harms.