Health risks |
Concern about groups at risk |
Local market |
Polydrug use interventions |
The broad definition of 'polydrug' used by many Member States is the use of more than one drug or type of drug by an individual — consumed at the same time or sequentially (as defined in the WHO lexicon). In Europe, the concept of polydrug use dates back to the 1970s. In its broadest terms, polydrug use is defined as the use of an illegal drug plus another legal or illegal drug. However, considerable differences exist in the substances included and in the time frames employed by different Member States. Differences appear to depend on the survey data available and on the perceptions of risk associated with particular substances or combinations. The substances included are usually the main illegal drugs, alcohol and medicines. Energy drinks are sometimes included and France includes tobacco. Time frames for consumption range from a six-hour period to ever experienced during an individual's lifetime.
According to the broad definition, all illegal drug users would be defined as polydrug users as they almost always use alcohol and/or tobacco at some time in their life. Even when polydrug use is defined according to the more narrow range of 'illegal drugs', the combinations and patterns of use vary so much that there is little value in adopting a standard definition. For the purposes of addressing general concerns about polydrug use in the EU, we take acute risks for health as a main focus.
There is general consensus that polydrug use has four main functions: it maximises effects, balances or controls negative effects and substitutes sought after effects. Information about the functions of combining particular drugs is based on descriptions by users of attempts to have, and prolong, pleasurable experiences (Seppälä, 1999; Strang et al.,). The substances that are used depend on local availability, fashion and local prescribing practices where they include medical drugs prescribed to drug users in treatment (in Germany, France, Ireland and the United Kingdom).