To study the prevalence of cannabis use and drug-related problems among European adolescents and the utility of the prevention paradox.
Methods
Survey data from the European School Survey Project on Alcohol and Other Drugs (ESPAD) in 2007 in the 27 countries with information about drug use and drug-related problems was used. We analysed the proportion of all drug-related problems that occurred in a high risk group and among others who had used cannabis in the previous 12 months. The cut-off for the high risk group was chosen to include 10-15 % of the most frequent cannabis users.
Results
The high risk groups accounted for a substantial, but a minority, of drug-related problems among boys as well as girls. A minority of those who had used cannabis reported any drug-related problem. The proportion of adolescents with drug-related problems and the average number of problems increased with frequency of cannabis use.
Conclusions
We find support for policy measures of more general character, supported by the prevention paradox. However, this does not exclude a policy supporting frequent drug users if they can be identified
AndreassonS. (2011). Is there an epidemiological paradox for illicit drugs?Addiction106(2), 248–249.
2.
BrookJ. S., LeeJ. Y., RubenstoneE., FinchS.J., SeltzerN., & BrookD. W. (2013). Longitudinal Determinants of Substance Use Disorders.Journal of Urban Health. (E-publication 6 December).
3.
Cox,R G., ZhangL., Johnson,W H., & BenderD R. (2007). Academic performance and substance use: findings from a state survey of public high school students.Journal of School Health, 77, 109–115.
4.
Danielsson,A K., WennbergP., HibellB., & RomelsjöA. (2012). Alcohol use, heavy episodic drinking and subsequent problems among adolescents in 23 European countries: does the prevention paradox apply?Addiction, 107, 71–80.
5.
EMCDDA (2013). European Drug Report 2013.Lisbon: EMCDDA.
6.
EMCDDA (2014). European Drug Report 2014.Lisbon: EMCDDA.
7.
FergussonD. M., HorwoodL. J., & Swain-CampbellN. (2002). Cannabis use and psychosocial adjustment in adolescence and young adulthood.Addiction, 97, 1123–1135.
8.
GmelG., KuntscheE., WickiM., & LabhartF. (2010). Measuring alcohol-related consequences in school surveys: alcohol-attributable consequences or consequences with students' alcohol attribution.American Journal of Epidemiology, 171, 93–104.
9.
HallW., & SokowijN. (1998). Adverse effects of cannabis.Lancet, 353, 1611–1616.
10.
Harvey,M A., Sellman,J D., PorterR., & FramtonC. (2007). The relationship between non-acute use of cannabis and cognition.Drug and Alcohol Review, 26, 309–319.
11.
HibellB., GuttormssonU., AhlströmS., BalakirevaO., BjarnasonT., KokkeviA., & KrausL. (2009). The 2007 ESPAD Report. Substance Use Among Students in 35 European Countries.Stockholm: The Swedish Council for Information on Alcohol and other Drugs (CAN).
12.
HibellB., GuttormssonU., AhlströmS., BalakirevaO., BjarnasonT., KokkeviA., & KrausL. (2012). The 2011 ESPAD Report. Substance Use Among Students in 36 European Countries.Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN).
13.
HuasC., HasslerC., & ChoquetM. (2008). Has occasional cannabis use among adolescents also to be considered as a risk marker?European Journal of Public Health, 18, 626–629.
14.
JessorR., & JessorS. L. (1977). Problem behaviour and psychosocial development: A longitudinal study of youth.New York: Academic Press.
15.
KuendigH., PlantM., PlantM., MillerP., KuntscheS., & GmelG. (2008). Alcohol-related adverse consequences: cross-cultural variations in attribution process among young adults.European Journal of Health, 18, 386–391.
16.
KreitmanN. (1986). Alcohol consumption and the preventive paradox.Addiction, 81, 353–363.
17.
LegleyeS., Obradovic,I, JanssenE., SpilkaS., Le NézetO., & BeckF. (2010). The mediation role of licit drugs in the influence of socializing on cannabis use among adolescents: A quantitative approach.European Journal of Public Health, 20, 157–163.
18.
LynskeyM., HeathA., BucholzK., SlutskeW., MaddenP., Nelson,E (2003). Escalation of Drug Use in Early-Onset Cannabis Users vs. Co-twin Controls.Journal of the American Medical Association. (JAMA),289, 427–433.
19.
Molero-SamuelsonY. (2011). Antisocial behaviour over the life course among females and males treated for substance misuse.Stockholm: Karolinska Institutet. (Thesis).
20.
PapstA., KrausL., PiontekD.in HibellB., GuttormssonU., AhlströmS., BalakirevaO., BjarnasonT., KokkeviA., & KrausL. (2012). The 2011 ESPAD Report. Substance Use Among Students in 36 European Countries.Stockholm: The Swedish Council for Information on Alcohol and Other Drugs (CAN).
21.
RoseG. (1981). Strategy of prevention: lessons from cardiovascular disease.British Medical Journal, 282, 1847–1851.
22.
RossowI., & RomelsjöA. (2006). The extent of the ‘prevention paradox’ in alcohol problems as a function of population drinking patterns.Addiction, 101, 84–90.
23.
StenbackaM., AllebeckP., & RomelsjöA. (1992). Do cannabis drug abusers differ from intravenous drug abusers? The role of social and behavioural risk factors.British Journal of Addiction, 87, 259–66.
24.
SteppanM., KrausL., PiontekD., & SicilianoV. (2012). Are cannabis prevalence estimates comparable across countries and regions? A cross-cultural validation using search engine query data.International Journal of Drug Policy, 24, 23–29.
25.
StockwellT., ToumbourouJ., LetcherP., SmartD., SansonA., & LyndalB. (2004). Risk and protection factors for different intensities of adolescent substance use: when does the Prevention Paradox apply?Drug and Alcohol Review, 23, 67–77.
26.
StockwellT., HawksD., LangE., RydonP. (1996). Unravelling the preventive paradox for acute alcohol problems.Drug and Alcohol Review, 15, 7–15.
27.
TempleE., BrownR., & HineD. (2011). The ‘grass ceiling’: limitations in the literature hinder our understanding of cannabis use and its consequences.Addiction, 106, 238–244.
28.
WindleM. (1990). A longitudinal study of antisocial behaviors in early adolescence as predictors of late adolescent use: Gender and ethnic group differences.Journal of abnormal psychology, 99, 86–91.
