14-9-2018 Health consequences of substance use in nightlife settings in the Netherlands Dr. Karin Monshouwer, senior researcher Department of Epidemiology & Research Support I will show you some results on the health consequences of substance use in nightlife settings.

Conflict of interest: NONE 14-9-2018 Funding: Ministry of Health Welfare and Sports. Dr. K. Monshouwer Dr. P. van der Pol Dr. Y. Drost Dr. M. van Laar

Nightlife study 2016 14-9-2018 Target group: 15-35 year olds who visited a party, festival, club or discotheque ≥ 1 in the past year. Recruitment via social media Online data collection 6866 completed questionnaires 4905 met inclusion criteria No sampling frame-> representative? The results I will present are based on the Nightlife study 2016. It is the same dataset which Peggy used for her presentation. Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

14-9-2018 As you all know, nightlife and substance use are closely linked

Last year prevalence Cannabis XTC Speed Cocaine GHB 14-9-2018 Cannabis XTC Speed Cocaine GHB Nightlife study 2016 (15-35) 53 46 25 8 General population 2015 (15-34)1 16 7 3 4 1 -This slide shows you a comparison of the drug prevalence rates that we found in our nightlife population and the prevalence rates in the general population. -As you can see, there are large differences, prevalences of the party drugs are 7 to 8 times higher in the nightlife population. But also cannabis use prevalence, which is not considered to be a party drug, is more than 3 times higher among the nightlife population. 1Gezondheidsenquête/Leefstijlmonitor CBS i.s.m. RIVM en Trimbos-instituut, 2015

14-9-2018 -This slide shows you the frequency of occurrence for 5 different type of substance use related health incidences. It is important to note that this is based on self-report. -As you can see, Having had a blackout is by far the most reported health incident by nightlifers in our study, 58% has experienced a blackout at least once in the past year due to alcohol and/or drug use. -13% reports to have lost consciousness due to substance use and 1 in 5 has experienced a anxiety or panic attack. -Only a small percentage has ended up at an accident and emergency department or first aid post of an event (respectively 2 and 3%). Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

Substances used at the night of the incident 14-9-2018 Substances used at the night of the incident It is of course interesting to know which substances caused these health incidences. To get more insight in that question, we asked the respondents which substances they used the last time the particular incident occurred. Based on these results we cannot draw conclusions on the causality because respondents may have used more than 1 substance so we can’t tell which substance or which combination of substances caused the incident. Furthermore substances like alcohol have a very high prevalence so, the chances that it was used at the night of the incidence are higher than for a less popular substance. But, by comparing the substances we can see some interesting patterns. As you can see, most of those who had a blackout (blue bars) had used alcohol. Which is not unexpected given the effects of alcohol and the high prevalence of alcohol use. – With respect to loosing consciousness, GHB and nitrous oxide score relatively high. This can also be explained by the effects of these substances. Furthermore, GHB is difficult to dose, and therefore users easily overdose resulting in adverse effects like passing out. - With respect to anxiety and panic attacks, ecstasy stands out, but also speed and cannabis have been used relatively often. Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

Polysubstance use at night of incident (1) 14-9-2018 We made 5 groups. - As you can see, for blackout the majority only used alcohol. Most nightlifers who passed out used only alcohol, or only 1 drug. The majority who had a panic attack reported to have used 1 drug. These findings do not imply that polysubtance use is more safe than the use of a single drug because the prevalence of polysubstance use is lower. But it does show that these incidences can also easily occur when people use only alcohol or one drug. Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

Alcohol or drug related effects on functioning (last year) 14-9-2018 Alcohol or drug related effects on functioning (last year) -Respondents were also asked for the effects of their alcohol and/or drug use on day-to-day functioning. -For each of the three consequences, approximately half reports to have never experienced consequences on their functioning in the past year. The other half has experienced consequences, for most of them it was only once or a few times. Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

Experienced sense of health 14-9-2018 We asked respondents to rate their general health Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

Experienced general health 14-9-2018 Comparable with the general population (CBS-GE, 2014): 88% (very) good. 1% bad 0,1% very bad The nightlifers experienced their health as quite good, comparable with the age group from the general population. Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

Experienced mental health 14-9-2018 Average score MHI-5 (71) well above cut-off (60) But % ‘unhealthy’ higher compared to the general population (MHI-5) 16% versus ~10% in general population 2 groups at risk? Frequent blackouts (MHI-5 score: 56) Several incidences of anxiety/panic (58) -Mental health appears to be good as well. The average score on the Mental Health Inventory is above the cut-off score for unhealthy. -Nevertheless, compared to the general population the percentage who score in the range of ‘unhealthy’ is higher among the nightlifers. - If we look at this group in more detail, we see that those who have frequent blackouts or several incidences of anxiety/panic have an average score below the cut-off. -Perhaps vulnerable users, who already suffer from mental health problems are more susceptible to the adverse effects of alcohol and drugs. We can’t tell from survey, the relationship could also be explained by the fact that there is a connection between the items of the screener and the health incident. One of the items of the MIH-5 is for example: how often did you feel nervous. Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

Visual complaints 14-9-2018 - The use of party drugs has been linked to persistent visual disorders (like ….). An addiction doctor in the Netherlands Gerard Alderliefste did some research on it based on the clients who came to his ‘party drugs’ consultation hours with these type of complaints. Since we didn’t have any national data we included some question on this issue in our survey. - As you can see there is quite a large group who reports this type of effects. However when respondents are asked to what extents it has an effect on their daily lives, only one percent reports that it has serious effects. High prevalence but only 1% experiences (serious) impediments in their daily lives Monshouwer, K, van der Pol, P, Drost, Y, van Laar, M. Het Grote Uitgaansonderzoek 2016

Thank you kmonshouwer@trimbos.nl www.trimbos.nl 14-9-2018 Free download with English summary (google: Trimbos AF1494) https://www.trimbos.nl/producten-en-diensten/webwinkel/product/?prod=af1494 kmonshouwer@trimbos.nl www.trimbos.nl